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New CCG funding formula ‘will exacerbate north-south divide’



A CCG funding formula being reviewed by NHS England would widen the north-south health divide, benefiting the more affluent, healthier south east of England more than the poorer, less healthy north, researchers have warned.

Research reveals that the weighted capitation, or fair shares, formula would increase funding by £164 per person in south-east Hampshire for example at the expense of areas such as Sunderland where funding will decrease by £146 per person compared to current levels.

The researchers from Durham University also warned that more deprived parts of London would also lose out – with Camden receiving £273 less per head.

Last year, NHS England rejected the ‘fair shares’ allocation for individual CCG funding based on disease burden, awarded a 2.3% uplift across the board for CCGs on their share of PCT allocations from the previous year and ordered an urgent fundamental review of the approach to allocations. This review is currently ongoing.

The fair shares recommendation came from the Advisory Committee on Resource Allocation, which had been tasked to look into the number of patients registered at each practice and used diagnosed conditions to assess overall needs of the population.

Using data provided by NHS England, the researchers mapped the differences in funding per person between the current formula – which incorporates a deprivation-related measure, the ‘health inequality weighting’ – and the weighted capitation formula which removes that in favour of a person-based allocation model of previous health utilisation.

In a letter to the BMJ, Professor Clare Bambra and Dr Alison Copeland, from Durham’s Wolfson Research Institute for Health and Wellbeing urged ‘worried readers’ to contact NHS England about the formula saying the changes were ‘potentially a first step towards an age-only allocation and could widen the north-south health divide by reducing NHS services in the north’.

Pointing out that NHS England’s aim with any new formula is to provide ‘equal opportunity of access for equal need’, they concluded: ‘Although these changes are not on the scale that a purely age-only allocation formula would produce, they are still sufficient to undermine the principle of equal opportunity of access for equal need.

A spokesperson for NHS England said: ‘It is quite right that during this review process funding allocations are publically debated and scrutinised.

‘Discussions around what the proposals for funding allocations might be are ongoing. No decisions have been or will be made until the NHS England Board meeting in December.’