Allocations

NHS England is responsible for determining allocations of financial resources to Clinical Commissioning Groups (CCGs). Total annual budgets given to CCGs cover the majority of NHS spending. The allocations process uses a statistical formula to make geographic distribution fair and objective, so that it more clearly reflects local healthcare need and helps to reduce health inequalities.

This page contains the allocations and associated documents for the 2019/20 to 2023/24 allocations round. Information on previous allocations rounds can be found at the following links:

• Revised Allocations for 2018/19
• Non-Recurrent Adjustments for 2017/18 and 2018/19
• Allocations for 2016/17 to 2020/21
• Revised Allocations for 2015/16
• Allocations for 2014/15 and 2015/16
• Allocations for 2013/14

Allocation of resources 2019/20 to 2023/24 (summaries)

• Note on CCG allocations 2019/20 to 2023/24
• CCG allocations 2019/20 to 2023/24 (core services)
• CCG allocations 2019/20 to 2023/24 (primary care medical)
• CCG allocations 2019/20 to 2023/24 (specialised services)
• CCG allocations 2019/20 to 2023/24 (total place based)
• CCG Running cost allowance 2019/20 to 2020/21
• NHS Operational Planning and Contracting Guidance 2019/20

• CCG allocations 2019/20 to 2023/24 (all funding streams, spreadsheet)
• CCG Running cost allowance 2019/20 to 2020/21 (spreadsheet)
• Change to CCG core services target allocation (waterfalls)

• GMS Contract Settlement and Allocation Changes 2019/20 to 2023/24

Technical guide to CCG allocations 2019/20 to 2023/24 (Apr 2019)

• Technical Guide to Allocation Formulae and Pace of Change for 2019/20 to 2023/24 revenue allocations.

Spreadsheet files for allocations 2019/20 to 2023/24

• A – Registrations by GP practice and CCG – Nov 17 to Oct 18
• B1 – Population Projections by CCG 2019/20 to 2023/24
• B2 – Population Projections by GP practice 2019/20 to 2023/24
• C1 – General and Acute Need 2019/20 to 2023/24
• C2 – Community Services Need 2019/20 to 2023/24
• D – Mental Health Need 2019/20 to 2023/24
• E – Maternity Need 2019/20 to 2023/24
• F – Prescribing Need 2019/20 to 2023/24
• G – SMR weighted populations 2019/20 to 2023/24
• H – Market Forces Factor (MFF) 2019/20 to 2023/24
• I – Emergency Ambulance Cost Adjustment (EACA)
• J – Overall weighted populations by CCG 2019/20 to 2023/24
• K1 – Primary care (medical)
• K2 – Primary care (other)
• L – Specialised services
• M – Supporting information for pace of change
• N – Min growth primary medical care
• O – Min growth CCG core services
• P – Min growth specialised services
• Q – Total place based pace of change
• S – Running cost allowance
• X – Changes to CCG-DCO-STP mappings over time

Equality analysis

Equality and Health Inequality Analysis for 2019/20 to 2023/24 revenue allocations to Clinical Commissioning Groups was presented at the NHS England Board on the 31 Jan 2019.

Background materials

Cost recovery for overseas visitors

• Improving Systems for Cost Recovery for Overseas Visitors – Updated guidance (Jan 2018)
• Improving Systems for Cost Recovery for Overseas Visitors – Interim guidance (May 2015)
• Who pays? Determining responsibility for payments to providers (Aug 2013)

Research reports on the allocations formulae

• Refreshing the Formulae for CCG Allocations for allocations to Clinical Commissioning Groups from 2016/17 – Report on the methods and modelling – NHS England Analytical Services (Finance)
• Primary medical care – new workload formula for allocations to CCG areas
• Specialised services formula

ACRA recommendation letters and papers

The Advisory Committee on Resource Allocation (ACRA) provides recommendations and advice on the target, relative geographical distribution of funding for health services in England, given the objectives of the funding formula. It is supported by a Technical Advisory Group (TAG).  ACRA membership is set out in the terms of reference.

ACRA recommendation letters

• Letter of 10 Mar 2016 from the Chair of ACRA on specialised services formula
• Letter of 15 Dec 2015 from the Chair of ACRA setting out the committee’s latest recommendations for the formulae for NHS allocations
• Letter of 16 Dec 2013 from the Chair of the ACRA setting out the committee’s latest recommendations for the formulae for NHS allocations

ACRA papers

This section contains papers from ACRA discussions.  Some aspects of these papers have been redacted in line with FOI principles.

• ACRA(2015)36 – Costs of unavoidable smallness due to remoteness
• ACRA(2015)35 – Health inequalities adjustment (based on Ben Barr paper)
• ACRA(2015)28R – Refreshing the CCG formula
• ACRA(2015)24B – Unavoidable smallness due to remoteness: Identifying remote hospitals
• ACRA(2015)18A – Unavoidable smallness due to remoteness: Identifying remote hospitals
• ACRA (2013/14)13 – Interim adjustments for unmet need and health inequalities
• ACRA (2013/14)19 – Primary Care Allocations

Further reading

• Unmet need in healthcare funding allocations (Academy of Medical Sciences Roundtable Jul 2017)
• Unmet need literature review (University of York) research paper (Jan 2017)
• Public health formula for local authorities from April 2016 (Consultation Oct 2015)
• Fundamental Review of Allocations Policy (NHS England Aug 2013)
• Person-based Resource Allocation (PBRA) (Nuffield Trust Dec 2011)
• Weighted Capitation Formula 7th Edition (Department of Health Mar 2011)