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Independents' Day

Board rejects 'fair shares' allocation for CCG funds

The NHS Commissioning Board has rejected a ‘fair shares’ allocation for individual CCG funding based on disease burden and instead awarded a 2.3% uplift across the board for CCGs on their share of PCT allocations from the previous year.

The decision means that two CCGs in southern England have the highest funding allocation this year, although the Board said that it will be cinducting an ‘urgent review’ into the way CCG allocations work.

North, East, West Devon CCG and Dorset CCG have been awarded the highest allocations for 2013/14 with £1,060,184 and £896,682 respectively. Overall, CCGs were collectively awarded £63,355,299 budget for their first year.

Click here to read the full list of CCG allocations

The NHS Commissioning Board rejected the ‘fair shares’ recommendation by the Advisory Committee on Resource Allocation, which it had tasked to look into the number of patients registered at each practice and used diagnosed conditions to assess overall needs of the population.

Instead, the Board decided to award 2.3% uplift across the board for CCGs on their share of PCT allocations from the previous year.

The Board said ACRA’s formula accurately predicted the future spending requirements of CCGs ‘based on the pattern of need’, but that it would redistribute funding to areas that have the best health outcomes, compared with the worst.

However, it added: ‘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.’

Dr David Jenner, a senior policy adviser at the NHS Alliance and a GP in Cullompton, Devon, said the Board was mistaken for rejecting ACRA’s recommendations.

He said: ‘I don’t understand why they dropped the formula. They applied a 2.3% uplift without using a funding formula. Which strikes me as a very different approach to the one regarding GMS and PMS contracts. I don’t quite follow the logic of doing that while deciding on moving GP contracts to “fair share”.

‘My initial analysis is that this is political, to avoid there being obvious losers in the first year of CCGs.’

Readers' comments (4)

  • Bornjovial

    Accurate coding of diseases helps to a point. Its unconceivable how the disease registry and public health data is basis for "fair share" when at least 5% of the population are migratory (and hence less accurate data) and also this is much higher in certain cities and university towns. The "fair share" assumes an extremely good database of health conditions but we all know how good the data is! See Audit commission report of quality of SUS data.(Aug 2012)
    Although this means status quo for the time being which may leave CCG`s to have fixed envelope to plan services from.
    If cost of disease is based on QOF registers rather than cross section survey by Public health the data can be worse or better eg. Depression prevalence is higher in GP QOF data and Obesity and smoking data is much higher in public health data.

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  • Does this mean CCGs will then have to rethink how they distribute money to locality consortiums and individual practice budgets?

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  • No it means they should wait awhile and consider uplifting these by 2.3% to follow same methodology for commissioing budgets

    But mote the different approach to GP provider contracts, that is the amiguity this year

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  • The NHS Commissioning Board made this decision in the private part of the 14th December Board - there was no published agenda - no minutes are publicly available. Where is the transparency and accountability. Nine people meet in private session to decide on how to allocate £95bn! London PCTs get the largest "unfair share" allocation AGAIN for the 3rd year running. Why ask ACRA to develop a fair shares allocation formula and invite the NHS Commissioning Assembly to vote on whether to reinstigate Pace of Change (71% voted yes) and then ignore both?!! A vote of no confidence in The Commissioning Board - its accountability and transparency could surely follow?

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