Overall, NHS England has a budget of £95.6 billion to deliver the mandate. Within this overall funding, it has allocated £65.6 billion to local health economy commissioners: that is, CCGs and local authorities. This represents 2.6% growth compared to equivalent 2012/13 baselines – a real term increase of 0.6% at a time of limited resources.
The baseline calculations used were generated by the detailed exercise to analyse PCTs’ expenditure plans for 2012/13 undertaken earlier this year. They incorporate an adjustment to take account of the revised national definition set for specialised services.
The resources for local commissioners are comprised of three key elements:
- An allocation to CCGs to cover the local services they will commission on behalf of their populations (£63.4 billion, representing 2.3% nominal growth or 0.3% real terms growth). Current assumptions suggest that an average CCG successfully delivering its Quality, Innovation, Productivity and Prevention (QIPP) schemes should in fact require less than 1% to cover expected cost pressures;
- The running costs allocated to CCGs, as published on 8 November 2012 (£1.3 billion); and
- An allocation to local authorities to fund services that benefit both health and social care, which will increase by 38% to £0.9 billion in 2013/14, as previously announced.
£25.4 billion has been allocated for NHS England’s commissioning of specialised healthcare, primary care and military and offender services. These are being commissioned nationally for the first time to ensure improved quality of care for patients through increased consistency of provision. These budgets have also been increased by 2.6% compared to the equivalent 2012/13 baseline expenditure.
Excluding a specific allowance for the cost of convergence towards new national commissioning criteria for specialised services, underlying commissioning expenditure will grow by 2%. This will require the achievement of a substantial programme of efficiencies to contain the trend of significantly higher expenditure growth in specialised services.
The remainder of the national budget will provide:
- £1.8 billion for NHS England’s public health responsibilities on behalf of Public Health England, which broadly comprise immunisation, screening and health visiting
- £1.2 billion surplus carry forward from PCTs and SHAs, to be allocated to CCGs and NHS England for future investment (see section 3.20 onwards of Everyone Counts: Planning for Patients 2013/14 )
- £1 billion for central health programmes to be administered by NHS England, such as clinical excellence awards and support for PFI schemes and
- £0.7 billion for technical accounting adjustments.
Download the table of 2013/14 revenue allocations to CCGs
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Somehting has gone wrong with pages 5 and 6 of the table of allocations: South East is shown as having some CGs that are in South Central, and there are none shown for Southwest.
Hi John
Thank you for your comment, this document is based on local authority groupings rather than old strategic health authorities.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
Simon
I think you have been misinformed. On pages 1 to 4 of the document, CCGs are listed under headings that correspond to former SHAs. On pages 5 and 6, all of the CCGs in the former South Central SHA, as well as those in the former South East Coast SHA, have been listed under South East. All the CCGs in the former South West SHA have been listed under South Central. There is no heading for South West.
The NHS CB has seemingly moved eg Kernow CCG, which covers Cornwall and the Isles of Scilly, from the South West to South Central, and has moved eg Oxfordshire CCG from South Central to South East.
There are no local authority groupings on which to base these listings. This is a simple error, which should be acknowledged and corrected.
John
Hi John
Thank you for your comments and for bringing this to our attention. Please accept my apologies for the error, the document is being revised by our finance team and I’ll upload the updated version with revised groupings (the specific clinical commissioning group allocations will stay the same) once complete.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
Many thanks for acknowledging the error, and for undertaking to correct the headings/groupings.
Is there or will there be a document available that reconciles the baseline collection exercise to the notified 2013/14 baseline allocations?
Hi Matthew
Thank you for your comment. The document you’ve requested has been sent to all clinical commissioning group chief financial officers, so is available locally from them or your finance team.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
Could you tell me if there will be further documentation sent out that reconciles what CCG’s originally included in their baseline allocation returns to what CCG’s have been notified as their 13/14 Revenue Allocations which will clearly identifiy the change in service responsibilty since this intial baseline return was completed.
And secondly within the baseline return it asked PCT’s to include certain Enhanced Service LES’s within the return as DES’s for example Minor Surgery and Extended Access therefore the funding would reside with NHS CB. However how would this now work going forward into the future organisations? Would NHS CB commission the LES or would they devolve funding over and above the 13/14 revenue allocation identified in the recent pdf document that has been disseminated?
Many thanks
Hi James
Thank you for your comment. The document you’ve requested has been sent to all clinical commissioning group chief financial officers, so is available locally from them or your finance team. Local Enhanced Services’ are a CCG responsibility so the funding would sit with individual CCGs.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
If the allocations are based on PCT spending plans, does this mean that any differences in funding/planned spend per head of weighted population will be preserved into the future?
(DOI from Bedfordshire – historically below fair shares funding)
Is there an easily available source of capitation and weighted capitation?
And will CCGs, where the PCT has left overspends, be expected to make these up and if so, over what timespan? (we already know that surpluses and assetts go to NHSCB)
Hi Mary
Thank you for your questions, please find the answers below:
Q: If the allocations are based on PCT spending plans, does this mean that any differences in funding/planned spend per head of weighted population will be preserved into the future?
A: Yes it does. This is a policy choice for 2013-14, not one that we plan to continue with.
Q: Is there an easily available source of capitation and weighted capitation?
A: Capitation is available on the Nuffield Institute web-site and HfMA Introductory Guide to NHS finance.
Q: And will CCGs, where the PCT has left overspends, be expected to make these up and if so, over what timespan?
A: No PCT overspends will be inherited by CCGs unless incurred in 2012-13. We’re carrying forward surplus’ to CCGs into 2013-14. If the PCT has a recurrent overspend – this spending position, if unchecked, would be carried forward.
Hope that helps, kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
In addition/instead of pdfs of tables of numbers (eg the ccg allocations) can you provide ssheets; usually more useful.
Thanks
When will the Distance From Target as assessesed by the new ACRA funding formula be published please? This is the THIRD year with no Pace Of Change. Has this decision not moved those PCTs/CCGs already distant from fair shares target even further away from fair shares? I was at the National Assembly and we voted (I thought) to correct this – why was this ignored?
Where are the minutes supporting this decision – I cant find the issue in any of the agendas for the Commissioning Board and no discussion occurs in any of the videos. There has been a decision made about how to allocate £63bn – who made the decision please and where is it documented what the rationale was to award everyone exactly the same % amount. Do the Standing Financial Instructions of the Commissioning Board allow for decisions about £63bn to be made in secret?
Hi Andrew
Thank you for your comment. The NHS Commissioning Board has concluded that the formula proposed by the Advisory Committee on Resource Allocation (ACRA) accurately predicts the future spending requirements of clinical commissioning groups (CCGs) based on the pattern of need as it is being met from that particular budget.
However, it is concerned that use of the formula on its own to redistribute funding would predominantly have resulted in higher growth for areas that already have the best health outcomes compared to those with the worst. On the face of it, this appears inconsistent with the NHS Commissioning Board’s public purpose to improve health outcomes for all patients and citizens and reduce health inequalities.
It will therefore conduct an urgent, fundamental review of the approach to allocations, drawing on the expert advice of ACRA and involving all partners whose functions impact on outcomes and inequalities. It will be completed in time for initial conclusions to inform 2014/15 allocations. In the meantime, it has opted for an above real terms uniform increase in funding to all CCGs that will give these new organisations stability in their first year.
This item was discussed in the private meeting of the Board on 14 December 2012. Regarding the private meeting of the Board, our standing order states that “representatives of the press, and other Members of the public, be excluded from the whole or part (as relevant) of this meeting, having regard to the confidential nature of the business to be transacted, publicity on which would be prejudicial to the public interest, in accordance with section 1(2) Public Bodies (Admission to Meetings) Act 1960”.
The Board was able to consider the impact of potential allocation scenarios at a level of detail that was not available at the time of the NHS Commissioning Assembly meeting. CCGs will be fully involved in the planned review of allocation approaches, which will recommend the best way to differentiate future allocations to reflect need while also supporting the reduction of inequalities and the improvement of outcomes.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
Dear Simon,
Is it possible for you to let me have the total number of patients currently registered at each CCG listed.
I do not need it by sex or age grouping simply the total number registered.
Kind regards Joe McKenna
Hi Joe
Thank you for your comment. On the CCG directory page you can find a list of proposed CCGs with proposed known constituent member practices which contains list sizes for every GP practice. This data file can be sorted into CCGs to give the total for each.
Hope that helps, kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
I expected the CCG allocation information to include details of revenue and capital funding for GP IT (as suggested by the finance slide in “Securing excellence in GP IT Services”), Are there any more details? It’s not explicitly mentioned in the table of allocations nor in the information that went to CCG CFOs.
Hi Tad
Thank you for your comment. We will be publishing more details on this shortly so please follow us on Twitter or subscribe to our RSS feed so that we can let you know when it’s available.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
Dear Simon,
Would it be possible for you to clarify the situation around LES’s please, i feel my original question has been misinterpreted.
I understand that LES’s will be a CCG responsibility however I am struggling to understand who will commission those LES’s which we had to treat as DES’s in the original baseline return i.e. Minor Surgery and Access. The funding for these will not be sitting in the CCG allocation. Can u confirm whether the CCG will commission the LES and receive funding above the notified baseline allocation or whether the NHS CB will commission these as a DES, as you can appreciate we will have to notify the practices of the change if the latter.
Many thanks
James
Hi James
Thank you for your comment. There are no plans to devolve funding or management of current DESs to CCGs. PCTs need to plan for these to be carried over to the Board for 2013/14 and that includes DESs which have been locally specified such as minor surgery. It’s the existing agreement that will be carried over to the Board, there would only be a need to consider splitting if the funding had been reported seperately as DES and LES in the finance workstreams and then only if it was substantial amount.
You can find more information on DESs in the enhanced service commissioning factsheet.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board