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.
- CCG allocations announcements
- Allocations infographics
- Technical details of allocations formula
- Advisory Committee on Resource Allocation (ACRA)
- Further reading
CCG allocations announcements
Allocation of resources 2019/20 to 2023/24
- Note on CCG allocations 2019/20 – 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)
Revised allocations for 2018/19
Non-recurrent adjustments for 2017/18 and 2018/19
Allocation of resources 2016/17 to 2020/21
- Allocations 2016/17 – 2020/21 Policy Statement (Jan 2016)
- Total Place-based allocations
- CCG core allocations
- Primary care (medical) allocations
- Running cost allowances
- Specialised allocations
- CCG summary statements
- Frequently asked questions – Technical briefing
Allocations for 2015/16
- Allocations 2015/16 policy statement (Dec 2014)
- Guidance Notes – Annex A: Summary of allocations
- Guidance Notes – Annex B: CCG allocations
- Guidance Notes – Annex C: Primary care allocations by team
- Guidance Notes – Annex D: Specialised services mapped to CCG
Allocations for 2014/15 and 2015/16
- Clinical Commissioning Group Allocations 2014/15 and 2015/16 (Dec 2013)
- CCG funding Allocations for next two years following adoption of new formula
Allocations for 2013/14
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)
Allocations infographics
We have produced an illustrated summary of the allocations process (see also detailed technical guides below), which explain the calculations behind financial allocations to CCGs. We hope that using images and metaphors make the ideas and models more accessible.
Technical Details of Allocations Formulae
Technical Guide to CCG Allocations 2018-19 (Apr 2018)
These spreadsheet files set out the underlying components of the revised 2018-19 allocations for core CCG services. For detailed technical guidance, and allocations for primary care and specialised services, please see the guidance published in April 2016 below.
Spreadsheet files for CCG allocations 2018-19
- A – GP practice registrations October 2017
- B – Population projections by CCG
- C – General and acute need estimates
- D – Mental health need estimates
- E – Maternity need estimates
- F – Prescribing need estimates
- G – SMR weighted populations
- H – Market Forces Factor (MFF)
- I – Emergency Ambulance Cost Adjustment (EACA)
- J – CCG combined weighted populations
- X – Changes to CCG-DCO-STP mappings over time
Technical guide to CCG allocations 2016-17 to 2020-21 (Apr 2016)
The Technical Guide to Allocation Formulae and Pace of Change for 2016-17 to 2020-21 revenue allocations to Clinical Commissioning Groups and commissioning areas has now been published. The technical guide sets out the methodology and actual calculation of the allocations which were agreed at the 17 December 2015 NHS England Board meeting and published on 8 January 2016. This documentation covers both the target allocations (determined by the formulae for core CCG, specialised and primary medical care services) and pace of change policy. Supporting analysis for setting CCG running cost allowances and Better Care Fund contributions are also included. The accompanying Advisory Committee on Resource Allocation (ACRA) documents, research reports and spreadsheets are below:
ACRA documents
- Letter of 15 December 2015 from the Chair of the Advisory Committee on Resource Allocation (ACRA) setting out the committee’s latest recommendations for the formulae for NHS allocations
- Letter of 10 March 2016 from the Chair of the Advisory Committee on Resource Allocation (ACRA) on specialised services formula
- ACRA(2015)36 – Costs of unavoidable smallness due to remoteness
- ACRA(2015)18A – Unavoidable smallness due to remoteness: Identifying remote hospitals
- ACRA(2015)24B – Unavoidable smallness due to remoteness: Identifying remote hospitals
- ACRA(2015)28R – Refreshing the CCG formula
- ACRA(2015)35 – Health inequalities adjustment (based on Ben Barr paper)
Research Reports on the allocation 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
Spreadsheet files for allocations 2016-17 to 2020-21
- A – Registrations by GP practice and CCG – October 2015
- B – Calculation of CCG estimated registrations 2016-2020
- C – General and Acute need per head 2016-17
- D – Mental Health need per head 2016-17
- E – Maternity need 2016-17
- F – Prescribing need 2016-17
- G – SMR weighted populations
- H – Market Forces Factor
- I – Emergency Ambulance Cost Adjustment
- J – Overall weighted populations CCGs 2016-17
- 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
- P – Min growth specialised
- Q – Total place based pace of change
- R – Better Care Fund
- S – Running cost allowances
Equality Analysis
Technical guide to CCG allocations 2014-15 to 2015-16 (Mar 2014)
The Technical Guide to 2014-15 and 2015-16 CCG allocations and primary care allocations to Area Teams has now been published. The technical guide sets out the methodology and actual calculation of the allocations which were agreed at the 17 December 2013 NHS England Board meeting. This documentation covers both the target allocations determined by the formulae and pace of change policy.
- Equality Analysis for 2014-15 and 2015-16 revenue allocations
- ACRA 2013 recommendations letter
- ACRA 2013-14 – Interim adjustments for unmet need and health inequalities
- ACRA 2013-14 – Primary Care Allocations
- A – Registrations by GP Practice and CCG October 2013
- B – Calculation of CCG population growth rates
- C – Need per head (General & Acute)
- D – Need per head (Mental Health)
- E – Need (Maternity)
- F – Market Forces Factor
- G – Need (Prescribing)
- H – SMR75 weighted populations
- I – CCG weighted populations
- J – CCG pace of change options
- K – Primary care
- L – Better Care Fund 2015/16
Advisory Committee on Resource Allocation (ACRA)
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.
Further reading
- Unmet need in healthcare funding allocations (Academy of Medical Sciences Roundtable July 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 – March 2011)