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.
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