Public Expenditure On Health and Personal Social Services 2006

House of Commons Health Committee
Public Expenditure on Health and Personal Social Services 2006

Memorandum received from the Department of Health containing Replies to a Written Questionnaire from the Committee
Written evidence
Ordered by The House of Commons to be printed 26 October 2006
HC 1692-i
Published on 21 November 2006 by authority of the House of Commons London: The Stationery Office Limited 0.00
The Health Committee

The Health Committee is appointed by the House of Commons to examine the expenditure, administration, and policy of the Department of Health and its associated bodies. Current membership Rt Hon Kevin Barron MP (Labour, Rother Valley) (Chairman) Mr David Amess MP (Conservative, Southend West) Charlotte Atkins MP (Labour, Staffordshire Moorlands) Mr Ronnie Campbell MP (Labour, Blyth Valley) Jim Dowd MP (Labour, Lewisham West) Sandra Gidley MP (Liberal Democrat, Romsey) Anne Milton MP (Conservative, Guildford) Dr Doug Naysmith MP (Labour, Bristol North West) Mike Penning MP (Conservative, Hemel Hempstead) Dr Howard Stoate MP (Labour, Dartford) Dr Richard Taylor MP (Independent, Wyre Forest) Powers The Committee is one of the departmental select committees, the powers of which are set out in House of Commons Standing Orders, principally in SO No 152. These are available on the Internet via www.parliament.uk. Publications The Reports and evidence of the Committee are published by The Stationery Office by Order of the House. All publications of the Committee (including press notices) are on the Internet at www.parliament.uk/healthcom Committee staff The current staff of the Committee are Dr David Harrison (Clerk), Emma Graham (Second Clerk), Christine Kirkpatrick (Committee Specialist), Ralph Coulbeck (Committee Specialist), Duma Langton (Committee Assistant), Julie Storey (Secretary), Jim Hudson (Senior Office Clerk) and Luke Robinson (Media Officer). Contacts All correspondence should be addressed to the Clerk of the Health Committee, House of Commons, 7 Millbank, London SW1P 3JA. The telephone number for general enquiries is 020 7219 6182. The Committees email address is healthcom@parliament.uk.
Public Expenditure 2006
Contents
Page
Expenditure
1.1 1.2 1.3 1.4 Total Expenditure By Area of Expenditure Programme Budgeting Income from Charges Ev 1 Ev 4 Ev 10 Ev 22
Investment
2.1 2.2 2.3 2.4 2.5 Total Investment Publicly Funded Private Finance Initiative (PFI) Primary Care Personal Social Services (PSS) Investment Ev 23 Ev 25 Ev 29 Ev 53 Ev 56
NHS Plan and Reform

3.1 3.2 3.3 3.4 3.5 Staff Pay and Contracts Treatment Outside the NHS Other Reforms National Institute for Health and Clinical Excellence (NICE) Ev 59 Ev 85 Ev 94 Ev 101 Ev 107
Breakdown of Spending Programme

4.1 4.2 4.3 4.4 4.5 4.6 General Breakdown Primary Care Trust (PCT) Allocations Pharmaceutical Expenditure National Specialist Services (NSCAG) Community Care Personal Social Services (PSS) Ev 115 Ev 117 Ev 136 Ev 138 Ev 143 Ev 147
Activity, Performance and Efficiency

5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 In-Patient Activity and Waiting Out-Patient Activity and Waiting Primary Care Activity Action on Waiting Lists Beds Delayed Discharge Mental Health Performance Ratings Management Costs Financial Balance NHS Inflation Efficiency Managing the Department of Health Ev 169 Ev 178 Ev 186 Ev 187 Ev 190 Ev 193 Ev 197 Ev 219 Ev 222 Ev 225 Ev 249 Ev 252 Ev 253
Public Expenditure 2006
Departmental Report
6.1 6.2 6.3 6.4 6.5 Public Service Agreement (PSA) Targets Capital Investment Reforms to the Management of the NHS Expenditure Activity, Performance and Efficiency Ev 256 Ev 259 Ev 262 Ev 269 Ev 277
Full List of Questions
Ev 283
Public Expenditure Committee: Evidence Ev 1
Written evidence
Memorandum received from the Department of Health 1. Expenditure 1.1 Total Expenditure 1.1.1 What has net NHS expenditure and annual change in net NHS expenditure been (a) in current prices (b) in real terms and (c) adjusted for NHS-specic ination in each year and planned year since 199394? What has net NHS expenditure been as a proportion of GDP in each year since 199394? (Q1) Answer 1. The information requested is given in Table 1a and Table 1b. 2. Between 199394 and 200304, the latest year for which NHS specic indices are available, net NHS expenditure has increased by: 103.0% in cash terms; 58.3% in real terms adjusted by the GDP deator; and, 37.6% after accounting for NHS specic ination. 3. Between 200304 and 200708, net NHS resources increase by: 43.6% in cash terms; and, 30.2% in real terms adjusted by the GDP deator. 4. GDP is provided by HM Treasury and is only available for the UK as a whole, so we cannot provide NHS Expenditure in England as a proportion of GDP. Table 1a CHANGE IN NET NHS EXPENDITURE 199394 TO 200708 Change after adjusting for NHS specic ination(2) % 3.0 0.8 0.3 2.9 1.6 4.1 5.0 6.5 6.5 10.0
Net NHS expenditure(3) millions Cash 199394 199495 199596 199697 199798 199899 19992000 Outturn Outturn Outturn Outturn Outturn Outturn Outturn 28.942 30.590 31.985 32.997 34.664 36.608 39.881 40.201 43.932 49.021 54.042 55.724 64.181 69.306 77.847 84.387 92.173
Percentage change % 5.7 4.6 3.2 5.1 5.6 8.9 9.3 11.6 10.2 15.2 8.0 12.3 8.4 9.2
Real terms change(1) % 4.1 1.5 "0.2 2.1 3.0 6.8 7.8 9.0 6.9 11.9 5.1 10.0 5.8 6.4
Stage 1 Resource Basis 19992000 Outturn 200001 Outturn 200102 Outturn 200203 Outturn Stage 2 Resource Basis 200203 Outturn 200304(4) Outturn 200405 Outturn 200506 Estimated outturn 200607 Plan 200708 Plan
Footnotes: 1. Change after adjusting for the GDP deator (30 June 2006). 2. NHS specic ination index is available of the period up to 200304. 3. NHS Expenditure Figures for the period 19992000 to 200708 are consistent with Table 3. 4. NHS expenditure gures for 200203 to 200708 have been adjusted for classication changes by HMT. As a result, growth in NHS expenditure in 200304 is distorted. Once these are adjusted for, real terms growth in NHS expenditure in 200304 is 7.3%.
Ev 2 Public Expenditure Committee: Evidence
Table 1b UK HEALTH SPENDING AS A PERCENTAGE OF GDP 199798 TO 200708 UK Public Spending (bn) Cash 199798 Accruals 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 Outturn Outturn Outturn Outturn Outturn Outturn Outturn Outturn estimated outturn plan plan 44.7 47.1 49.6 54.3 59.9 66.3 74.9 82.6 88.6 97.4 107.2 Public Spending as a % of GDP 5.4% 5.4 5.4 5.6 6.0 6.3 6.7 7.0 7.3 7.4 7.8 Private Spending as a % of GDP 1.3% 1.4 1.4 1.4 1.3 1.4 1.4 1.4 1.4 1.4 1.4 Total Health Spending as a % of GDP 6.7% 6.8 6.8 7.0 7.3 7.6 8.1 8.4 8.7 8.9 9.2
Source: HM Treasury Footnotes: 1. For any further informaton regarding UK Health Expenditure, please contact the HM Treasury General Enquiry oYce on 0207 270 4558 or email at public.enquirieswhm-treasury.gov.uk 2. This is a statistic supplied by HM Treasury. It is not appropriate to construct a statistic showing NHS Expenditure as a proportion of GDP as the numerator is on an England basis, and the denominator is on a UK basis. 1.1.2 What has net NHS expenditure, net NHS expenditure per head and net NHS expenditure as a proportion of GDP been in (a) England (b) Wales (c) Scotland (d) Northern Ireland and (e) the United Kingdom in each year since 199798? (Q2) Answer 1. Table 2 shows Net NHS Expenditure in England, Scotland and Northern Ireland for 200506. Wales expenditure is not currently available for 200506, so 200405 data has been used. The table also shows Net NHS expenditure per head of population for each of these countries. The information based on UK expenditure and GDP has not been included as this is calculated, and provided by HM Treasury.
Table 2 TOTAL NET NHS EXPENDITURE PER HEAD FOR ENGLAND, WALES, SCOTLAND AND NORTHERN IRELAND 199798 to 200506 s
199798 England Wales Scotland Net NHS Expenditure Net NHS spend per head Net NHS Expenditure Net NHS spend per head Net NHS Expenditure Net NHS spend per head 34,663,992,000 710 2,256,100,000 770 4,353,695 860 1,139,500,000 680 199899 36,608,266,000 750 2,423,000,000 830 4,589,002 900 1,231,800,000 730 19992000 39,933,308,000 810 2,649,300,000 900 4,940,950 970 1,339,500,000 800 200001 200102 200203 200304 200405 200506
43,951,247,000 49,278,589,000 56,727,900,000 63,314,406,000 69,382,043,000 77,561,299,000 890 1,000 1,140 1,270 1,390 1,540 2,880,200,000 980 5,379,811 1,060 1,517,500,000 900 3,143,900,000 1,070 6,233,984 1,230 1,762,300,000 1,040 3,450,100,000 1,180 6,667,426 1,320 2,042,600,000 1,200 3,590,716,000 1,220 7,175,988 1,429 2,209,300,000 1,300 3,961,555,000 1,340 8,191,236 1,610 2,471,500,000 1,450 4,204,392,000 1,420 8,902,401 1.750 2,712,500,000 1,570
N Ireland Net NHS Expenditure Net NHS spend per head
Source: Expenditure gures for Wales have been provided by NHS Finance, The Welsh Assembly Government Expenditure gures for Scotland have been provided by The Scottish Executive Health Department Expenditure gures for Northern Ireland have been provided by DHSSPSNI Footnotes: 1. Expenditure pre 19992000 is on a cash basis 2. Expenditure gures from 19992000 to 200203 are on a Stage 1 Resource Budgeting basis 3. Expenditure gures from 200304 to 200708 are on a Stage 2 Resource Budgeting basis 4. Figures are not consistent over the period (199798 to 200506), therefore it is diYcult to make comparisons across diVerent periods 5. Figures exclude expenditure on departmental administration, for England prior to 2000, this adjustment has not been made 6. Figures are rounded to the nearest 10
1.2 By Area of Expenditure 1.2.1 Could table 2.2.1, detailing trends in actual and planned expenditure on health and personal social services by area of expenditure, be updated, together with the commentary on it? (Q3) Answer 1. The information requested is given in Table 3a and Table 3b. 2. Expenditure in Table 3a is shown on a Stage Two Resource Budgeting basis. Table 3a is consistent with the presentation of the data in Figure 3.4 of the 2006 Departmental Report. Table 3a TRENDS IN ACTUAL AND PLANNED EXPENDITURE ON THE HEALTH AND PERSONAL SOCIAL SERVICES 200304 TO 200708 BY AREA OF EXPENDITURE(1)(2)(3)(4) (STAGE TWO RESOURCE BUDGETING) 200304 Outturn Central Government Expenditure National Health Service Hospitals, community health, family health (discretionary) and related services Current Net spending(13) Charges and receipts(5) Total spending Change over previous year in cash (%) Change over previous years in real terms (%) (total) Change over previous years in real terms (%) (net) Capital Net spending Charges and receipts(5) Total spending Changes over previous year in cash (%) Changes over previous years in real terms (%) (total) National Health Service family health services (non-discretionary)(7) Current A. Net spending B. Charges and receipts C. Total spending D. Change over previous year in cash (%) E. Change over previous years in real terms (%) (total) Departmental administration(8) (14) Current A. Net spending B. Charges and receipts C. Total spending D. Change over previous year in cash (%) 2,141 912 3,052 2,129 850 2,980 "2.4 "5.0 2,011 769 2,781 "6.7 "8.6 1,099 466 1,565 "43.7 "45.1 1,162 454 1,616 3.2 0.6 200405 200506 Estimated Outturn outturn 200607 Plan 200708 Plan
A. B. C. D. E. F.
58,157 2,146 60,303
63,001 2,665 65,666 8.9 6.0 5.5
70,112 3,184 73,297 11.6 9.3 9.0
76,620 3,325 79,945 9.1 6.5 6.7
83,239 3,345 86,584 8.3 5.5 5.8
A. B. C. D. E.
2,566 289 2,854
2,804 353 3,157 10.6 7.7
4,381 393 4,774 51.2 48.1
5,180 205 5,385 12.8 10.1
6,167 130 6,297 16.9 13.9
307 22 329
295 20 315 "4.2
286 27 312 "0.8
261 10 271 "13.2
259 10 269 "0.8
200304 Outturn E. Change over previous years in real terms (%) (total) Cost of Collecting NHS element of NI contributions Central health and miscellaneous services(15) Current Net spending Charges and receipts Total spending Change over previous year in cash (%) Change over previous years in real terms (%) (total) Other NHS Capital Net spending Charges and receipts Total spending Change over previous year in cash (%) Change over previous years in real terms (%) (total)
200405
200506 Estimated Outturn outturn "6.8 "2.8 14
200607 Plan "15.3 14
200708 Plan "3.3 14
14
14
A. B. C. D. E.
975 93 1,068
1,046 103 1,149 7.6 4.7
1,026 140 1,166 1.5 "0.6
1,180 141 1,321 13.3 10.6
1,315 132 1,448 9.6 6.8
A. B. C. D. E.
36 0 36
32 0 32 "11.2 "13.5
30 0 30 "4.4 "6.4
47 0 47 53.5 49.9
32 0 32 "32.4 "34.2
A. B. C. D.
NHS Total Net spending Charges and receipts(5) Total spending Change over previous year in cash (%) E. Change over previous years in real terms (%) (total) F. Change over previous years in real terms (%) (net) Central Government Personal Social Services(16) Net spending Charges Total spending Change over previous year in cash (%) Change over previous year in real terms (%) (total) Central Government (specic and special) grants to local authorities Net spending Charges Total spending Change over previous year in cash (%) Change over previous year in real terms (%)
64,181 3,461 67,643
69,306 3,992 73,298 8.4 5.5 5.1
77,847 4,513 82,361 12.4 10.0 10.0
84,387 4,147 88,534 7.5 4.9 5.8
92,173 4,073 96,246 8.7 5.9 6.4
A. B. C. D. E.
195 52 247
251 50 300 21.4 18.2
245 46 291 "3.1 "5.1
251 46 297 2.1 "0.4
273 46 319 7.5 4.7
A. B. C. D. E.
1,450 0 1,450
1,896 0 1,896 30.8 27.3
1,912 0 1,912 0.9 "1.2
1,628 0 1,628 "14.9 "16.9
1,666 0 1,666 2.3 "0.3
200304 Outturn Credit Approvals (LA capital) Net spending Charges Total spending Change over previous year in cash (%) E. Change over previous year in real terms (%) A. B. C. D. Health and Personal Social Services Total Net spending Charges and receipts(5) Total spending Change over previous year in cash (%) G. Change over previous years in real terms (%) (total) H. Change over previous years in real terms (%) (net) 49 0 49
200405
200506 Estimated Outturn outturn 53 0 53 7.2 4.4 53 0 53 0.9 "1.1
200607 Plan 53 0 53 0.0 "2.4
200708 Plan 53 0 53 0.0 "2.6
A. B. C. D.
65,876 3,513 69,389
71,505 4,042 75,547 8.9 6.0 5.7
80,058 4,559 84,617 12.0 9.7 9.6
86,319 4,193 90,512 7.0 4.4 5.2
94,165 4,119 98,284 8.6 5.8 6.3
Local Authority Personal Social Services Current(9) (10) (11) A. Net spending B. Charges and receipts C. Total spending Local Authority Personal Social Services Capital(9) (10) (11) A. Net spending B. Charges and receipts C. Total spending Local Authority Personal Social Services Total A. Net spending B. Charges and receipts C. Total spending Local Authority, Health and Personal Social Services Total(12) A. Net spending B. Charges and receipts(5) C. Total spending GDP deator w 30 June 2006
14,763 2,077 16,839
15,586 2,800 18,386
n/a n/a n/a
n/a n/a n/a
n/a n/a n/a
186 75 261
222 77 299
n/a n/a n/a
n/a n/a n/a
n/a n/a n/a
14,949 2,152 17,100
15,808 2,877 18,685
n/a n/a n/a
n/a n/a n/a
n/a n/a n/a
80,825 5,665 86,490 95.3
87,313 6,919 94,232 97.9
n/a n/a n/a 100.0
n/a n/a n/a 102.4
n/a n/a n/a 105.2
Footnotes: 1. Figures may not sum due to rounding. 2. Percentages are rounded to one decimal place. 3. Real terms growth gures diVer from those given last year because of subsequent changes in GDP deators. Where not otherwise specied, the gures are calculated on total expenditure gures and therefore diVer from the Departmental Report, where increases are calculated on net expenditure. 4. The measures in changes in expenditure shown in lines D to F are as follows: Line D shows the percentage change in total expenditure; Line E shows the percentage change in total expenditure after accounting for ination in the overall economy as measured by the GDP deator; Line F shows the percentage change in net expenditure after accounting for ination in the overall economy as measured by the GDP deator.
5. Includes NHS trust charges and receipts. 6. Input Cost Data is not available for years where outturn data is not available. 7. With the introduction of PMEds allocation in 200405, there is no longer any GMS non-discretionary funding. All GMS funding is now discretionary. 8. Include Trading FundsMedicines Control Agency (MCA) and NHS Estates Agency. 9. Net budget gures are taken from Local Authority Revenue Accounts returns. 10. Net budget gures are taken from Local Authority Revenue Account returns. Current gures are for Adult services only. Capital gures show spend on Adult and Children services (as this cannot be broken down further). 11. Local Authorities do not forecast expenditure for future years. Figures for 200304 are available, but expenditure on Adults services cannot be seperately identied. 12. Local Authority, Health and Personal Social Services total excludes Central Government (Specic and Special) grants to Local Authorities and Credit Approvals (LA Capital) to avoid double counting. The total still does include an element of double counting (unquantiable) with regard to joint working between hospitals and local authorities. 13. Less HCFHS depreciation of: 354 443 614 802 1,052 14. Less Dept Admin depreciation of: 12 13 13 17 16 15. Less CHMS depreciation of: 18 16 19 18 19 16. Less PSS depreciation of: 8 12 16 15 16 Table 3b gives a brief explanation of the main areas of expenditure in Table 3a. Table 3b EXPLANATION OF MAIN AREAS OF EXPENDITURE IN TABLE 3a Area of expenditure NHS Hospital and Community health Services and discretionary family health services (HCHS) Description This covers hospital and community health services, prescribing costs for drugs and appliances and General Medical Services (which include reimbursements of GMS GPs practice staV, premises, out of hours and IM&T expenses). It also includes other centrally funded initiatives, services and special allocations managed centrally by the Department of Health (such as service specic levies which fund activities in the areas of education and training and research and development). HCFHS includes all GMS funding. This is becasue of the introduction of the GP contract in April 2004, which means that there is no longer any GMS non discretionary funding. Capital expenditure is that used on the acquisition of land and premises, individual works for the provision, adaptation, renewal, replacement or demolition of buildings, items or groups of equipment and vehicles etc.
Capital
NHS Family Health Services This covers demand-led family health services, such as the cost of general (FHS) (non-cash limited) dental and ophthalmic services, dispensing remuneration and income from dental and prescription charges. Departmental administration The administrative costs of running the Department of Health. Central health and miscellaneous services (CHMS) These are a wide range of activities funded from the Department of Healths spending programmes whose only common feature is that they receive funding direct from the Department and not via health authorities. Some of the services are managed directly by Departmental staV; some by non-departmental public bodies, or other separate executive organisations. Includes the capital elements of Departmental administration and CHMS. The sum of HCHS current and capital expenditure, FHS, Departmental administration, CHMS current expenditure and other NHS capital.
Other NHS capital NHS total
Personal social services (PSS) Personal care services for vulnerable people, including those with special needs because of old age or physical or mental disability. Examples are residential care homes for the elderly, home help and home care services, and social workers that provide help and support for a wide range of people.
Area of expenditure
Description
Central Government (specic Cash grants targeted at services which require a higher priority, where and special) grants to local pump priming is appropriate or where the service is needed in only some authorities authorities. Credit approvals (LA capital) Local Authority Personal Social Services Central government permission for individual local authorities to borrow or raise other forms of credit for capital purposes. Personal care services for vulnerable people, including those with special needs because of old age or physical or mental disability. Examples are residential care homes for the elderly, home help and home care services, and social workers that provide help and support for a wide range of people. The sum of NHS total, central Government personal social services, central Government (specic and special) grants to local authorities, credit approvals (LA capital), and civil defence. The sum of Health and Personal Social Services Total and Local Authority Personal Social Services Total.
Health and Personal Social Services Total Local Authority, Health and Personal Social Services Total
1.2.2 What is the Departments assessment of expenditure on each programme in 200405 against plans for that year, and anticipated expenditure by programme in 200506 against plans for that year and outturn in 200405? (Q4) Answer 1. Table 4 outlines the signicant changes (ie over 10 million) between estimated outturn reported in last years evidence and outturn expenditure in Table 3 of this years evidence for 200405. 2. Table 4 also shows the signicant changes (ie over 10 million) between planned expenditure in last years evidence and estimated outturn expenditure in Table 3 of this years evidence for 200506. Table 4 COMPARISON OF NET EXPENDITURE PLANS FOR 200405 AND 200506 WITH THOSE IN LAST YEARS HEALTH COMMITTEE WRITTEN EVIDENCE (HC 736) The main areas of change (10 million or over) to the spending plans for various parts of the programme other than LAPSS are as follows. The grant to local authorities for central government is unhypothecated. Local authorities determine their own expenditure.
million DiVerence HCFHS current 233 1,385 "1,497 "155 68 "34 HCFHS capital "563 72 "49 "587 FHS Current Departmental Administration CHUMS current 34 "33 31 "20 "11 "77 "26 "26 10 "34 200405 Reclassiction of trust depreciation previously outside DEL. Change in the methodology for calculating clinical negligence provisions. Reduced budgets following reclassication of capital grants to the private sector to capital. Depreciation adjustment. Underspends by NHS bodies and DH central budgets. Additional expenditure on capital grants to the private sector following a reclassication of the budget for capital grants to the private sector as capital. Lower spending on capital grants to local authorities by PCTs from their unied budgets. Slippage on capital programmes of NHS bodies and by DH central budgets. Higher than planned expenditure on the demand led General Dental Services. Timing adjustments to the Departments Change Management Programme. Changes in the attribution of receipts for secondees. Underspend on demand led EEA medical costs. Underspend and slippage on central health and miscellaneous services. Higher than forecast expenditure on demand led welfare foods budget. Lower than forecast outturn on non-departmental public bodies.
Central Government PSS
29
10 19
Higher outturn recorded against central personal social services budgets. Higher outturn for non-departmental public bodies. Preserved Rights grant expenditure lower than forecast.
PSS Grants to Local Authorities PSS Credit Approvals
"29
"29
"3 DiVerence
No changes of 10 million. 200506 "200 "352 200 "192 1,538 65 "68 192 196 "200 "12 352 Reduction in provisions. Transfer to FHS Non Discretionary. Transfer from HCFHS Capital. Third party grants transferred to HCFHS capital. Trust depreciation move into DEL (Technical adjustment). Revised recording of EEA medical cost provision. Transfer to/from other Government Departments. Third Party Grants from HCFHS Current. Take up of EYF. Transfer to HCFHS current. Transfer to other Government Departments. Transfer from HCFHS current. No changes of 10 million.
HCFHS current
995
HCFHS capital
175
FHS current Departmental Admin Current CHUMS current Central Government PSS PSS Grants to Local Authorities PSS Credit Approvals Notes:
352 3
"65 "1 "5 0
"65
Revised recording of EEA medical cost provisions. No changes of 10 million. No changes of 10 million. No changes of 10 million.
1. Changes less than 10 million are not listed and may slightly aVect totals.
1.2.3 What has additional NHS expenditure in 200506 compared with 200405 been spent on? Is it possible to provide a more detailed breakdown than last year? (Q5) Answer 1. Total NHS revenue expenditure in 200506 is 73.4 billion. This compares to 66.5 billion in 200405. However, the 200405 gure includes a 1.5 billion reduction due to a one-oV adjustment in the method of calculating NHS provisions. Therefore, the actual increase in available revenue expenditure in 200506 was 5.5 billion. 2. The additional 5.5 billion revenue expenditure in 200506see Table 5was accounted for in the following proportions: Pay, including additional staV 56% Supplies and Services including drugs expenditure accounted for 33% Debt Repayment 5% Other accounted for 6% 3. More detail on the actual disposition of resources in 200506 will be available when nal 200506 accounts are published in the autumn. 4. The Supplies and Services category used above can be broken down further: Supplies and Services Clinical includesdrugs, gases, dressings, medical and surgical equipment, x-ray equipment, appliances, laboratory equipment. Supplies and Services general includesbedding and linen, uniforms, kitchen and provisions, contract hotel services, laundry and cleaning equipment.
Table 5 NHS TRUST REPORTED USE OF ADDITIONAL RESOURCES IN 200506 Expenditure Component % of Additional Expenditure Consumed 47% 9% 16% 16% 5% 6%
PayPrice(1) PayVolume(1) Supply & ServicesPrice(2) Supply & ServicesVolume(2) Debt Repayment Other
Source: FIMs Month 12 Returns. Footnotes: 1. Trusts report that 56% of the additional resources have been accounted for by payboth recruitment of new staV and pay increases to existing staV. 2. Trusts report that 33% has been spent on supplies and services which includes the cost of drugs. 3. The breakdown shown is at the most detailed possible using this data source. This data has previously been published in more aggregate form (ie without price/volume split) in the report NHS Financial Performance 200506. 1.3 Programme Budgeting 1.3.1 Can the Department detail improvements in the scope and quality of programme budgeting? What changes are planned over the next year? (Q6) Answer 1. To date, the Programme Budgeting project has had two key objectives: To track total NHS expenditure, for each of the 23 Programme Budgeting categories, for use in DH Resource Accounts; and To allow PCTs to benchmark their spend per head of population on each of the Programme Budgeting categories, with other PCTs locally, nationally and with similar characteristics. 2. By working with the National Centre for Health Outcomes Development (NCHOD) at the London School of Hygiene and Tropical Medicine, we are currently expanding the scope of Programme Budgeting projects bringing together for each of the Programme Budgeting categories expenditure and health outcomes data. 3. This approach, will for the rst time, enable PCTs to investigate the relationship between their expenditure on a particular healthcare programme with linked outcomes data. Data for the top six programme categories in expenditure terms were published on the NHS web on 31 July 2006 (www.dh.gov.uk/PolicyAndGuidance/organisationPolicy/FinanceAndPlanning/ProgrammeBudgeting/fs/ en). Work is in progress to provide linked data for the remaining 23 categories by the end of the year. 4. We are improving the presentation of the Programme Budgeting data. As well as publishing the data using an interactive Excel spreadsheet, we are also using software (Interactive Atlas) that presents data is a more user-friendly way using England and sub England level maps. 5. We have also been working with the National Audit OYce (NAO) to further our objective of improving the quality of the Programme Budgeting expenditure data. Over the last six months, we have organised and accompanied the NAO on a series of NHS visits to enable to NAO to improve their knowledge of how the expenditure data are collected. 6. Following these visits, we are expecting NAO to produce a report with recommendations on how to improve further the collection of Programme Budgeting data and if or when PCT Programme Budgeting data returns should be subject to audit. 1.3.2 What was expenditure on cancer (a) in (b) as a proportion of total expenditure and (c) per head of population by Primary Care Trust in 200304 and 200405? Could the Department comment on these data and the quality of them? (Q7) Answer 1. Data showing expenditure on cancer (a) in (b) as a proportion of total expenditure and (c) per head of population by Primary Care Trust in 200304 and 200405 is given in Table 7a and Table 7b. 2. Programme Budgeting is a relatively new data collection exercisedata being collected for the rst time in the 200304 nancial yearit is inevitable it will take some time for the data to settle down. At England level comparing data for 200304 and 200405 suggest that the data are relatively stable. As expected, between 200304 and 200405, the data are subject to more variation PCT level.
3. We have been working with the National Audit OYce (NAO) to further our objective of improving the quality of the Programme Budgeting expenditure data. Over the last six months we have organised and accompanied the NAO on a series of NHS visits to enable to NAO to improve their knowledge of how the expenditure data are collected. 4. Following these visits, we are expecting NAO to produce a report with recommendations on how to improve further the collection of Programme Budgeting data and if or when PCT Programme Budgeting data returns should be subject to audit. 5. The best way to improve the quality of the Programme Budgeting expenditure data is to ensure the data are used by the NHS. To facilitate this we have: Published on the NHS web linked Programme Budgeting expenditure and outcome data, which made the data signicantly more useful to the NHS: Improved our presentation of the data through use of interactive Excel spreadsheets and new software presenting the data using England level maps; and, Been running a series of workshops at SHA level bringing together NHS professionals from Finance, Public Health and Commissioning to provide the NHS locals more information about Programme Budgeting.
Table 7a
NET NHS EXPENDITURE ON CANCER 200304 AND 200405

200304 200405 200304 per head 200405 per head 200304 % of Total of PCT 200405 % of Total of PCT thousands expenditure population thousands expenditure population 9,068 9,517 6,243 8,732 8,252 7,464 9,875 7,856 6,024 8,473 10,251 5,041 14,423 6,678 13,476 9,751 10,770 7,737 10,682 10,825 5,294 5,420 10,585 3,772 8,505 9,309 10,939 4,485 5,784 7,479 12,354 7.9% 7.5% 7.3% 6.6% 8.5% 5.8% 6.8% 7.5% 5.3% 6.3% 10.2% 6.2% 7.6% 7.2% 6.6% 7.6% 7.6% 5.5% 5.1% 8.3% 5.9% 3.1% 6.2% 5.6% 5.7% 8.2% 6.4% 4.6% 5.8% 5.9% 8.6% 79.1 76.5 64.4 61.4 90.9 50.6 69.6 80.3 58.0 65.5 101.5 56.5 71.1 69.0 58.4 79.8 75.3 53.4 44.1 75.2 60.4 30.0 58.1 49.4 48.6 73.7 64.6 46.9 55.8 54.7 75.0 9,513 10,868 6,831 11,324 9,813 9,374 11,146 8,944 5,782 10,287 6,658 5,825 18,610 7,292 15,826 11,149 11,626 9,073 13,371 11,534 6,965 8,983 10,417 4,420 9,930 11,471 17,528 5,972 7,353 9,157 11,622 8.0% 10.9% 4.8% 8.9% 5.1% 8.6% 10.4% 6.8% 4.7% 6.3% 4.0% 6.2% 18.6% 7.4% 8.1% 4.7% 5.5% 3.8% 8.7% 9.0% 6.5% 5.6% 6.2% 5.8% 13.4% 4.9% 11.8% 3.1% 6.6% 6.1% 7.0% 83.0 87.3 70.5 79.6 108.0 63.5 78.5 91.4 55.6 79.5 65.9 65.3 91.7 75.4 68.6 91.3 81.3 62.7 55.2 80.1 79.5 49.7 57.1 57.9 56.7 90.8 103.6 62.4 70.9 67.0 70.6
Code Primary Care Trust 5JL 5JH 5JT 5JK 5GT 5GF 5JQ 5JM 5AF 5A2 5JJ 5AG 5G1 5JR 5JW 5JV 5CY 5GD 5GE 5GW 5CP 5GC 5GH 5GK 5GJ 5GX 5GV 5GG 5GR 5GP 5JP Broadland PCT Cambridge City PCT Central SuVolk PCT East Cambridgeshire and Fenland PCT Great Yarmouth PCT Huntingdonshire PCT Ipswich PCT North Norfolk PCT North Peterborough PCT Norwich PCT South Cambridgeshire PCT South Peterborough PCT Southern Norfolk PCT SuVolk Coastal PCT SuVolk West PCT Waveney PCT West Norfolk PCT Bedford PCT Bedfordshire Heartlands PCT Dacorum PCT Hertsmere PCT Luton PCT North Hertfordshire and Stevenage PCT Royston, Buntingford and Bishops Stortford PCT South East Hertfordshire PCT St Albans and Harpenden PCT Watford and Three Rivers PCT Welwyn Hateld PCT Basildon PCT Billericay, Brentwood and Wickford PCT Castle Point and Rochford PCT
Code Primary Care Trust 5JN 5GM 5AJ 5DC 5GL 5AK 5AH 5GQ 5GN TAG 5K5 5HX 5H1 5K6 5AT 5HY 5LA 5LC 5A9 5K7 5C1 5C9 5K8 5C2 5C3 5A4 5NA 5C5 5C4 5NC TAK 5A7 5A8 5LD 5LF 5LE 5K9 5A5 5M6 5M7 5LG 5KF 5D7 5D8 TAC 5KG 5KL 5J9 5KA 5KC 5J8 5KD 5D9 5KN 5KM 5E1 5JL 5KE 5KJ 5E3 5E5 Chelmsford PCT Colchester PCT Epping Forest PCT Harlow PCT Maldon and South Chelmsford PCT Southend on Sea PCT Tendring PCT Thurrock PCT Uttlesford PCT Witham, Braintree and Halstead Care Trust Brent PCT Ealing PCT Hammersmith and Fulham PCT Harrow PCT Hillingdon PCT Hounslow PCT Kensington and Chelsea PCT Westminster PCT Barnet PCT Camden PCT Eneld PCT Haringey Teaching PCT Islington PCT Barking and Dagenham PCT City and Hackney PCT Havering PCT Redbridge PCT Newham PCT Tower Hamlets PCT Waltham Forest PCT Bexley Care Trust Bromley PCT Greenwich PCT Lambeth PCT Lewisham PCT Southwark PCT Croydon PCT Kingston PCT Richmond and Twickenham PCT Sutton and Merton PCT Wandsworth PCT Gateshead PCT Newcastle PCT North Tyneside PCT Northumberland Care Trust South Tyneside PCT Sunderland Teaching PCT Darlington PCT Derwentside PCT Durham and Chester-Le-Street PCT Durham Dales PCT Easington PCT Hartlepool PCT Langbaurgh PCT Middlesbrough PCT North Tees PCT Broadland PCT Sedgeeld PCT Craven, Harrogate and Rural District PCT East Yorkshire PCT Eastern Hull PCT
200304 200405 200304 per head 200405 per head 200304 % of Total of PCT 200405 % of Total of PCT thousands expenditure population thousands expenditure population 8,142 12,168 6,631 5,905 4,835 13,588 10,479 6,706 4,074 7,515 13,372 17,856 16,705 8,607 11,526 16,758 8,486 32,071 18,701 22,544 15,669 17,321 15,969 11,754 9,947 17,832 14,202 15,988 18,645 13,537 9,677 20,965 13,230 20,179 11,724 11,485 19,989 10,436 9,420 34,395 15,819 12,354 20,449 12,806 19,532 9,930 14,918 6,959 5,898 9,116 5,063 5,998 6,617 8,354 14,378 8,818 9,068 6,516 12,457 8,994 8,186 7.1% 8.4% 6.5% 6.4% 7.2% 7.8% 7.4% 5.1% 6.1% 6.5% 4.0% 5.0% 7.5% 4.2% 4.7% 6.6% 3.5% 10.2% 5.2% 7.2% 5.6% 6.2% 6.1% 6.9% 3.4% 7.1% 6.2% 5.1% 6.8% 5.2% 4.6% 6.6% 4.7% 5.0% 3.8% 3.6% 6.0% 6.5% 5.1% 8.9% 4.8% 5.4% 6.3% 5.9% 6.0% 5.8% 4.7% 6.4% 6.4% 6.1% 5.3% 5.5% 6.4% 7.9% 6.8% 5.0% 7.9% 6.6% 6.6% 6.6% 6.4% 67.6 74.3 63.2 71.9 60.1 84.3 78.6 46.8 58.1 56.2 48.6 56.7 104.0 44.8 49.0 76.0 50.0 170.7 59.7 112.3 61.3 75.4 91.1 72.1 45.1 76.1 64.9 63.7 95.7 59.6 47.1 69.8 60.0 72.4 46.8 49.3 61.0 63.8 54.4 97.1 61.5 63.0 80.4 64.8 63.6 65.1 54.0 72.0 73.2 62.6 60.5 62.4 74.7 86.9 81.2 49.6 79.1 72.2 61.0 62.3 70.6 9,267 15,167 7,711 7,200 5,058 14,705 13,982 7,952 4,988 9,523 15,874 23,588 16,583 10,586 14,888 17,783 15,137 16,573 20,087 32,394 19,423 17,598 16,241 13,432 12,385 19,656 18,643 15,839 28,308 15,949 15,978 23,664 18,097 25,496 21,877 15,592 19,570 15,626 12,212 29,562 19,275 18,250 26,951 15,345 28,247 12,755 19,507 6,389 7,323 11,288 5,558 7,301 5,532 7,852 16,227 10,754 9,513 5,854 16,477 9,944 9,520 5.7% 20.0% 6.7% 2.0% 2.9% 7.6% 8.6% 7.3% 3.4% 4.0% 6.9% 8.0% 5.6% 2.9% 5.3% 10.4% 4.4% 3.5% 5.0% 10.3% 6.3% 5.5% 4.3% 6.7% 3.7% 7.0% 6.5% 4.4% 8.9% 4.4% 9.7% 6.9% 5.9% 7.0% 6.0% 4.4% 18.6% 8.3% 2.9% 14.5% 7.3% 9.1% 11.2% 13.6% 21.0% 10.8% 8.4% 6.9% 4.4% 9.0% 4.5% 6.5% 5.4% 2.6% 13.7% 3.8% 8.0% 2.3% 9.3% 6.2% 5.1% 76.9 92.6 73.4 87.7 62.8 91.2 104.8 55.5 71.1 71.2 57.6 74.8 103.2 55.0 63.3 80.6 89.2 88.2 64.2 161.3 75.9 76.6 92.6 82.4 56.2 83.8 85.1 63.1 145.3 70.2 77.8 78.8 82.1 91.5 87.4 67.0 59.8 95.6 70.5 83.4 74.9 93.1 105.9 77.6 91.9 83.6 70.7 66.1 90.9 77.5 66.4 75.9 62.4 81.6 91.6 60.4 83.0 64.9 80.6 68.9 82.1
Code Primary Care Trust 5KH Hambleton and Richmondshire PCT 5AN North East Lincolnshire PCT 5EF North Lincolnshire PCT 5KK Scarborough, Whitby and Ryedale PCT 5E2 Selby and York PCT 5E6 West Hull PCT 5E4 Yorkshire Wolds and Coast PCT 5AW Airedale PCT 5CF Bradford City PCT 5CG Bradford South and West PCT 5J6 Calderdale PCT 5HK East Leeds PCT 5E7 Eastern Wakeeld PCT 5LJ Hudderseld Central PCT 5HJ Leeds North East PCT 5HM Leeds North West PCT 5HH Leeds West PCT 5CH North Bradford PCT 5J7 North Kirklees PCT 5LK South Hudderseld PCT 5HL South Leeds PCT 5E8 Wakeeld West PCT 5CC Blackburn with Darwen PCT 5HP Blackpool PCT 5G8 Burnley, Pendle and Rossendale PCT 5D4 Carlisle and District PCT 5F2 Chorley and South Ribble PCT 5D5 Eden Valley PCT 5HE Fylde PCT 5G7 Hyndburn and Ribble Valley PCT 5DD Morecambe Bay PCT 5HD Preston PCT 5D6 West Cumbria PCT 5F3 West Lancashire PCT 5HF Wyre PCT 5HG Ashton, Leigh and Wigan PCT 5HQ Bolton PCT 5JX Bury PCT 5CL Central Manchester PCT 5F4 Heywood and Middleton PCT 5CR North Manchester PCT 5J5 Oldham PCT 5JY Rochdale PCT 5F5 Salford PCT 5AA South Manchester PCT 5F7 Stockport PCT 5LH Tameside and Glossop PCT 5F6 TraVord North PCT 5CX TraVord South PCT 5F8 Bebington and West Wirral PCT 5H2 Birkenhead and Wallasey PCT 5H4 Central Cheshire PCT 5HA Central Liverpool PCT 5H3 Cheshire West PCT 5H5 Eastern Cheshire PCT 5H6 Ellesmere Port and Neston PCT 5J1 Halton PCT 5J4 Knowsley PCT 5G9 North Liverpool PCT
200304 200405 200304 per head 200405 per head 200304 % of Total of PCT 200405 % of Total of PCT thousands expenditure population thousands expenditure population 7,681 10,920 10,830 7,393 11,138 10,805 8,759 8,097 5,587 10,206 17,067 13,342 12,660 10,621 10,066 10,488 9,300 7,645 9,818 6,477 9,475 8,296 8,861 14,138 14,540 7,564 13,256 4,087 5,304 8,299 20,480 11,160 8,571 5,647 9,468 20,101 14,589 10,376 12,718 3,486 13,517 13,153 5,365 16,333 13,466 18,628 14,339 4,445 5,016 7,861 14,033 14,207 2,619 11,045 8,977 3,462 4,546 10,444 9,503 7.4% 6.7% 7.3% 4.6% 4.5% 6.5% 6.1% 6.8% 3.8% 6.9% 8.3% 8.1% 6.2% 7.7% 6.5% 6.4% 7.3% 6.9% 5.9% 8.5% 6.4% 5.6% 5.5% 8.3% 5.6% 6.3% 6.9% 5.9% 7.9% 7.5% 6.3% 7.1% 6.1% 4.4% 7.7% 6.1% 5.3% 5.9% 5.2% 4.5% 6.7% 5.6% 3.7% 5.6% 8.1% 6.7% 6.0% 4.5% 4.2% 6.7% 5.6% 6.3% 0.8% 7.1% 4.9% 3.9% 3.2% 5.8% 7.3% 67.0 66.9 71.3 47.6 41.4 70.7 61.5 73.7 40.8 75.3 88.6 92.8 70.8 82.6 68.3 57.8 87.3 88.0 58.9 76.3 66.1 56.2 60.5 100.2 59.3 66.9 63.6 58.2 79.5 75.7 66.7 82.3 66.0 53.2 81.2 68.3 55.7 58.3 80.7 47.6 96.6 59.8 41.5 74.3 105.3 65.7 64.3 49.5 42.5 77.5 66.6 57.7 10.3 69.7 48.2 41.5 39.3 67.4 89.7 8,365 12,048 11,778 11,464 17,126 13,177 10,680 9,504 7,561 12,621 14,416 13,617 16,520 8,685 12,985 14,381 11,952 7,392 12,192 6,036 12,930 12,984 11,095 13,506 17,792 9,520 17,148 5,343 5,818 8,900 21,993 13,367 10,104 4,577 9,472 23,163 16,223 11,998 12,650 5,138 9,546 18,009 8,520 19,201 12,638 20,871 15,668 6,741 7,517 7,873 15,761 14,690 16,507 8,336 15,319 6,139 6,674 14,486 8,988 4.0% 6.6% 7.0% 3.1% 11.1% 5.9% 7.3% 7.1% 4.6% 7.1% 7.5% 8.0% 9,6% 9.9% 7.0% 12.4% 6.7% 6.0% 11.3% 5.5% 7.1% 7.2% 6.2% 4.5% 11.8% 10.5% 14.3% 2.9% 4.2% 3.0% 11.2% 16.9% 2.8% 5.2% 2.6% 16.3% 13.7% 7.5% 4.9% 1.6% 4.2% 7.9% 5.2% 127.7% 6.9% 16.0% 10.1% 2.1% 4.8% 5.1% 8.8% 7.0% 12.3% 3.2% 14.8% 6.5% 3.3% 5.4% 4.3% 72.9 73.8 77.6 73.9 63.7 86.2 75.0 86.5 55.2 93.1 74.8 94.8 92.4 67.6 88.2 79.3 112.1 85.1 73.2 71.1 90.1 87.9 75.8 95.7 72.5 84.2 82.3 76.1 87.2 81.2 71.6 98.5 77.8 43.1 81.3 78.7 61.9 67.4 80.3 70.2 68.2 81.9 65.9 87.3 98.8 73.7 70.2 75.1 63.7 77.6 74.8 59.6 64.7 52.6 82.3 73.6 57.7 93.5 84.8
Code Primary Care Trust 5HC 5M5 5F9 5J3 5J2 5G2 5DV 5G4 5CQ 5DK 5DT 5DW 5DL 5DM 5DX 5DY 5DP 5G3 5DN 5G5 5G6 5FD 5LY 5LX 5DG 5E9 5A1 5DF 5FE 5L1 5LL 5LM 5CM 5LN 5L2 5L3 5LP 5FF 5L4 5L8 5FH 5LQ 5MA 5KP 5KQ 5LR 5L5 5FJ 5MC 5FK 5L6 5L7 5LT 5L9 5FL 5JF 5JG 5KW
200304 200405 200304 per head 200405 per head 200304 % of Total of PCT 200405 % of Total of PCT thousands expenditure population thousands expenditure population 5,637 15,654 6,852 9,114 6,291 4,900 5,599 9,651 11,038 5,793 3,474 15,648 12,217 5,658 4,254 10,547 7,845 7,415 7,533 7,105 7,690 11,986 8,684 10,361 9,664 9,974 10,828 8,936 11,711 14,644 7,620 10,344 12,293 19,030 15,536 14,921 7,227 13,909 4,306 14,570 5,932 12,968 5,700 16,601 6,289 13,236 27,533 5,447 4,351 6,406 12,170 10,027 8,723 10,742 14,053 15,994 16,934 11,516 4.5% 8.3% 5.1% 4.7% 3.3% 5.7% 5.4% 7.3% 5.7% 6.9% 5.9% 7.9% 6.5% 4.8% 6.4% 6.6% 4.6% 5.1% 6.6% 5.8% 5.2% 6.7% 7.0% 5.9% 6.3% 6.1% 6.2% 5.1% 6.4% 6.2% 7.7% 6.1% 5.4% 7.4% 7.6% 6.3% 6.9% 8.8% 4.9% 6.0% 6.5% 4.7% 5.7% 6.2% 3.7% 6.7% 11.7% 5.3% 5.5% 5.3% 5.9% 5.6% 6.5% 5.1% 7.6% 5.9% 8.0% 8.2% 64.6 100.4 58.4 49.0 33.5 48.8 45.6 62.4 52.1 57.5 48.4 99.3 61.0 50.3 55.4 55.5 40.6 46.4 51.7 51.0 42.2 65.8 58.0 55.4 72.7 59.2 62.0 48.4 65.0 62.9 75.3 63.7 54.5 83.0 66.8 55.9 74.2 77.5 46.1 68.5 76.1 51.1 49.7 65.2 41.5 79.9 116.4 60.6 47.0 47.6 60.4 52.3 58.7 53.9 80.5 76.3 91.5 72.9 5,503 12,820 6,623 13,502 8,226 4,286 8,831 7,587 11,690 5,944 4,946 16,417 15,762 6,232 5,304 13,258 11,406 7,812 9,801 5,804 8,129 14,191 9,673 13,818 10,248 10,249 14,661 11,008 13,994 16,057 6,410 8,782 13,818 16,222 23,972 19,673 7,583 17,334 6,897 14,624 6,914 17,243 6,413 15,756 8,615 13,738 26,922 6,573 6,879 7,865 15,970 12,076 9,535 13,621 15,168 17,720 16,432 8,724 3.2% 6.0% 7.6% 6.9% 3.4% 2.7% 4.2% 5.6% 5.3% 2.8% 4.0% 22.0% 11.6% 4.8% 2.9% 6.4% 7.7% 5.3% 5.0% 3.4% 6.3% 6.8% 2.3% 9.6% 8.8% 7.9% 7.2% 6.7% 7.8% 6.6% 3.4% 3.1% 5.6% 13.6% 9.0% 18.9% 2.5% 17.1% 2.6% 6.8% 6.0% 8.0% 5.9% 9.0% 4.9% 9.1% 11.7% 4.8% 1.8% 3.9% 8.2% 4.6% 3.4% 4.7% 8.5% 7.8% 11.2% 3.5% 63.1 82.3 56.4 72.7 43.8 42.7 72.0 49.0 55.1 59.0 69.0 104.2 78.7 55.4 69.1 69.7 59.1 48.9 67.3 41.7 44.6 77.9 64.6 73.8 77.1 60.8 83.9 59.6 77.6 68.9 63.3 54.1 61.2 70.7 103.1 73.7 77.8 96.5 73.8 68.7 88.7 67.9 55.9 61.9 56.8 82.9 113.8 73.1 74.4 58.4 79.3 63.0 64.2 68.4 86.9 84.5 88.8 55.2
South Liverpool PCT South Sefton PCT Southport and Formby PCT St Helens PCT Warrington PCT Bracknell Forest PCT Cherwell Vale PCT Chiltern and South Bucks PCT Milton Keynes PCT Newbury and Community PCT North East Oxfordshire PCT Oxford City PCT Reading PCT Slough PCT South East Oxfordshire PCT South West Oxfordshire PCT Vale of Aylesbury PCT Windsor, Ascot and Maidenhead PCT Wokingham PCT Wycombe PCT Blackwater Valley and Hart PCT East Hampshire PCT Eastleigh and Test Valley South PCT Fareham and Gosport PCT Isle of Wight PCT Mid-Hampshire PCT New Forest PCT North Hampshire PCT Portsmouth City PCT Southampton City PCT Ashford PCT Canterbury and Coastal PCT Dartford, Gravesham and Swanley PCT East Kent Coastal PCT Maidstone Weald PCT Medway PCT Shepway PCT South West Kent PCT Swale PCT Adur, Arun and Worthing PCT Bexhill and Rother PCT Brighton and Hove City PCT Crawley PCT East Elmbridge and Mid Surrey PCT East Surrey PCT Eastbourne Downs PCT Guildford and Waverley PCT Hastings and St Leonards PCT Horsham and Chanctonbury PCT Mid-Sussex PCT North Surrey PCT Surrey Heath and Woking PCT Sussex Downs and Weald PCT Western Sussex PCT Bath and North East Somerset PCT Bristol North PCT Bristol South and West PCT Cheltenham and Tewkesbury PCT
Code Primary Care Trust
5KY Cotswold and Vale PCT 5K4 Kennet and North Wiltshire PCT 5M8 North Somerset PCT 5A3 South Gloucestershire PCT 5DJ South Wiltshire PCT 5K3 Swindon PCT 5KX West Gloucestershire PCT 5DH West Wiltshire PCT 5KT Central Cornwall PCT 5FT East Devon PCT 5FR Exeter PCT 5FV Mid Devon PCT 5KR North and East Cornwall PCT 5FQ North Devon PCT 5F1 Plymouth PCT 5CV South Hams and West Devon PCT 5FY Teignbridge PCT 5CW Torbay PCT 5FM West of Cornwall PCT 5CE Bournemouth PCT 5FX Mendip PCT 5CD North Dorset PCT 5KV Poole PCT 5FW Somerset Coast PCT 5FN South and East Dorset PCT 5K1 South Somerset PCT 5FP South West Dorset PCT 5K2 Taunton Deane PCT 5JE Barnsley PCT 5CK Doncaster Central PCT 5EK Doncaster East PCT 5EL Doncaster West PCT 5EE North SheYeld PCT 5H8 Rotherham PCT 5EP SheYeld South West PCT 5EN SheYeld West PCT 5EQ South East SheYeld PCT 5ED Amber Valley PCT 5FA Asheld PCT 5ET Bassetlaw PCT 5EV Broxtowe and Hucknall PCT 5AL Central Derby PCT 5EA Chestereld PCT 5H7 Derbyshire Dales and South Derbyshire PCT 5H9 East Lincolnshire PCT 5ER Erewash PCT 5EC Gedling PCT 5EX Greater Derby PCT 5HN High Peak and Dales PCT 5D3 Lincolnshire South West Teaching PCT 5AM Manseld District PCT 5AP Newark and Sherwood PCT 5EG North Eastern Derbyshire PCT 5EM Nottingham City PCT 5FC RushcliVe PCT 5D2 West Lincolnshire PCT 5JC Charnwood and North West Leicestershire PCT 5AC Daventry and South Northamptonshire PCT 5EY Eastern Leicester PCT 5JA Hinckley and Bosworth PCT 5EJ Leicester City West PCT
200304 200405 200304 per head 200405 per head 200304 % of Total of PCT 200405 % of Total of PCT thousands expenditure population thousands expenditure population 6.1% 6.5% 4.9% 7.6% 7.7% 5.1% 6.1% 7.4% 5.2% 5.6% 6.6% 5.2% 5.1% 5.4% 5.7% 5.0% 6.1% 4.5% 6.0% 5.9% 6.5% 6.2% 6.0% 6.4% 6.1% 5.5% 5.8% 4.9% 6.4% 5.4% 5.9% 5.2% 6.3% 5.2% 51.8 61.6 45.2 68.6 68.0 47.5 55.1 76.3 59.0 53.5 70.1 46.1 50.7 46.9 58.0 47.7 68.6 50.9 64.0 64.4 72.1 58.4 69.0 68.1 64.2 59.4 63.2 46.1 58.4 46.7 59.2 47.4 58.0 47.5 67.3 9,552 14,375 16,980 10,068 8,586 5,847 7,333 5,338 7,478 20,033 7,897 9,481 6,173 8,806 7,621 13,443 16,788 11,378 11,799 7,420 5,725 13,108 23,903 20,357 7,673 19,042 24,644 9,376 10,766 11,602 6,455 18,766 20,931 7,174 15,149 "37,465 3,670,133 6.8% 53,777,859 6.1% 7.3% 7.7% 3.4% 7.9% 3.2% 5.5% 1.3% 4.7% 6.7% 6.2% 5.2% 2.9% 7.2% 6.5% 11.5% 6.7% 3.9% 3.3% 7.4% 4.2% 5.6% 8.0% 9.4% 4.9% 9.9% 14.3% 5.0% 4.5% 4.0% 5.7% 12.1% 7.3% 10.5% 68.2 69.2 63.0 68.6 58.6 47.4 61.2 53.0 59.6 71.6 59.5 53.0 60.1 55.6 73.6 67.7 71.9 40.9 74.5 73.3 71.6 65.9 72.1 81.9 67.3 80.3 78.1 53.9 62.0 74.6 77.8 78.5 76.6 67.5
5EH Melton, Rutland and 7,252 Harborough PCT 5LW Northampton PCT 12,797 5LV Northamptonshire Heartlands 12,174 PCT 5JD South Leicestershire PCT 10,057 5DQ Burntwood, Licheld and 9,968 Tamworth PCT 5MM Cannock Chase PCT 5,865 5ML East StaVordshire PCT 6,598 5HW Newcastle-Under-Lyme PCT 7,681 5ME North Stoke PCT 7,401 5M2 Shropshire County PCT 14,973 5MF South Stoke PCT 9,307 5MN South Western StaVordshire 8,250 PCT 5HR StaVordshire Moorlands PCT 5,208 5MK Telford and Wrekin PCT 7,425 5HV Dudley Beacon and Castle 6,007 PCT 5HT Dudley South PCT 9,475 5MY Eastern Birmingham PCT 16,026 5MX Heart of Birmingham 14,159 Teaching PCT 5MW North Birmingham PCT 10,137 5MG Oldbury and Smethwick PCT 6,515 5MH Rowley Regis and Tipton PCT 5,765 5D1 Solihull PCT 11,624 5M1 South Birmingham PCT 22,900 5M3 Walsall PCT 16,918 5MJ Wednesbury and West 7,324 Bromwich PCT 5MV Wolverhampton City PCT 14,083 5MD Coventry PCT 19,946 5CN Herefordshire PCT 8,013 5MP North Warwickshire PCT 10,141 5MR Redditch and Bromsgrove 7,256 PCT 5M9 Rugby PCT 4,910 5MQ South Warwickshire PCT 11,329 5MT South Worcestershire PCT 15,859 5DR Wyre Forest PCT 5,049 All SHA 8,275 127,212 Other(1) 3,308,732 Total Net Cancer Spend(2) % of Total NHS Net Operating 6.3% Costs Total NHS Net Operating 52,329,783 Costs(2)
74.6
Source: Data collection forms PFR4 and HFR30 reported as part of PCT and SHA Annual Accounts. Raw population as per Department of Health PCT Allocations Formulae. Footnotes: 1. Other expenditure breakdown: NHS Litigation Authority (NHSLA) 127,682 37,983 Prescription Pricing Authority (PPA) 2,027 2,439 PHS Pharmaceutical Services 13,509 14,860 Intra DH Accounting Adjustments (16,003) (92,747) Total Other 127,213 (37,465) 2. As reported in DH Resource Accounts 200304 and 200405.
Table 7b GROSS NHS EXPENDITURE ON CANCER 200304 AND 200405

200304 200405 200304 per head 200405 per head 200304 % of Total of PCT 200405 % of Total of PCT thousands expenditure population thousands expenditure population 9,113 11,083 6,806 9,349 11,948 8,911 15,644 9,161 7,565 11,844 23,916 5,516 15,361 6,702 17,912 10,019 13,155 10,412 12,211 12,117 7,921 7,905 11,903 5,293 8,918 10,056 13,292 7,533 5,993 7,492 12,647 8,414 16,831 6,631 6,096 5,153 21,668 10,543 6,716 4,156 7,760 13,372 18,011 18,264 9,090 14,395 17,279 9,701 33,551 19,544 26,016 16,533 21,150 7.7% 7.5% 7.2% 6.4% 10.8% 5.7% 7.3% 8.3% 5.5% 5.8% 12.7% 6.1% 7.6% 5.8% 7.6% 7.5% 8.1% 6.0% 5.1% 8.3% 5.6% 3.7% 6.3% 6.1% 5.7% 8.3% 6.6% 5.0% 5.7% 3.5% 8.5% 6.0% 9.4% 6.0% 6.4% 6.7% 7.8% 7.1% 4.9% 2.3% 6.5% 3.8% 4.3% 7.5% 4.3% 4.6% 6.6% 3.6% 9.4% 5.2% 6.6% 5.6% 4.9% 79.5 89.0 70.3 65.7 131.5 60.4 110.2 93.6 72.8 91.6 236.8 61.8 75.7 69.3 77.6 82.0 92.0 71.9 50.4 84.2 90.4 43.7 65.3 69.4 50.9 79.6 78.5 78.7 57.8 54.8 76.8 69.8 102.8 63.2 74.2 64.0 134.4 79.1 46.9 59.3 58.0 48.6 57.1 113.7 47.3 61.2 78.4 57.1 178.6 62.4 129.6 64.6 92.1 9,581 12,208 7,585 11,706 10,123 11,227 17,403 10,890 13,336 13,113 9,625 5,933 21,199 7,549 20,116 11,464 14,699 12,287 16,728 13,229 11,910 9,696 17,897 7,108 10,480 12,992 19,006 9,776 8,157 9,158 11,959 10,739 18,701 7,817 7,440 5,788 31,788 14,239 7,987 6,293 9,830 15,874 23,588 17,603 11,146 16,377 18,229 16,314 17,029 20,095 35,292 20,316 20,297 7.4% 7.2% 6.8% 6.4% 8.7% 6.2% 7.1% 8.6% 5.2% 5.5% 7.8% 6.2% 9.2% 5.6% 7.0% 7.7% 8.0% 6.3% 6.0% 8.0% 7.0% 4.4% 8.2% 7.2% 5.9% 9.4% 8.5% 5.7% 6.7% 5.1% 7.1% 6.1% 8.8% 6.3% 7.1% 6.8% 10.6% 8.5% 5.0% 3.0% 7.0% 4.0% 4.9% 7.0% 4.7% 4.3% 6.0% 5.3% 4.6% 4.8% 7.8% 6.2% 4.2% 83.6 98.1 78.3 82.3 111.4 76.1 122.6 111.2 128.3 101.4 95.3 66.5 104.5 78.0 87.1 93.8 102.8 84.9 69.1 91.9 135.9 53.6 98.2 93.2 59.9 102.9 112.3 102.2 78.7 67.0 72.6 89.1 114.2 74.4 90.6 71.9 197.2 106.8 55.7 89.7 73.4 57.6 74.8 109.5 58.0 69.6 82.7 96.1 90.6 64.2 175.8 79.4 88.3
Code Primary Care Trust 5JL 5JH 5JT 5JK 5GT 5GF 5JQ 5JM 5AF 5A2 5JJ 5AG 5G1 5JR 5JW 5JV 5CY 5GD 5GE 5GW 5CP 5GC 5GH 5GK 5GJ 5GX 5GV 5GG 5GR 5GP 5JP 5JN 5GM 5AJ 5DC 5GL 5AK 5AH 5GQ 5GN TAG 5K5 5HX 5H1 5K6 5AT 5HY 5LA 5LC 5A9 5K7 5C1 5C9 Broadland PCT Cambridge City PCT Central SuVolk PCT East Cambridgeshire and Fenland PCT Great Yarmouth PCT Huntingdonshire PCT Ipswich PCT North Norfolk PCT North Peterborough PCT Norwich PCT South Cambridgeshire PCT South Peterborough PCT Southern Norfolk PCT SuVolk Coastal PCT SuVolk West PCT Waveney PCT West Norfolk PCT Bedford PCT Bedfordshire Heartlands PCT Dacorum PCT Hertsmere PCT Luton PCT North Hertfordshire and Stevenage PCT Royston, Buntingford and Bishops Stortford PCT South East Hertfordshire PCT St Albans and Harpenden PCT Watford and Three Rivers PCT Welwyn Hateld PCT Basildon PCT Billericay, Brentwood and Wickford PCT Castle Point and Rochford PCT Chelmsford PCT Colchester PCT Epping Forest PCT Harlow PCT Maldon and South Chelmsford PCT Southend on Sea PCT Tendring PCT Thurrock PCT Uttlesford PCT Witham, Braintree and Halstead Care Trust Brent PCT Ealing PCT Hammersmith and Fulham PCT Harrow PCT Hillingdon PCT Hounslow PCT Kensington and Chelsea PCT Westminster PCT Barnet PCT Camden PCT Eneld PCT Haringey Teaching PCT
Code Primary Care Trust 5K8 5C2 5C3 5A4 5NA 5C5 5C4 5NC TAK 5A7 5A8 5LD 5LF 5LE 5K9 5A5 5M6 5M7 5LG 5KF 5D7 5D8 TAC 5KG 5KL 5J9 5KA 5KC 5J8 5KD 5D9 5KN 5KM 5E1 5KE 5KJ 5E3 5E5 5KH 5AN 5EF 5KK 5E2 5E6 5E4 5AW 5CF 5CG 5J6 5HK 5E7 5LJ 5HJ 5HM 5HH 5CH 5J7 5LK 5HL 5E8 5CC Islington PCT Barking and Dagenham PCT City and Hackney PCT Havering PCT Redbridge PCT Newham PCT Tower Hamlets PCT Waltham Forest PCT Bexley Care Trust Bromley PCT Greenwich PCT Lambeth PCT Lewisham PCT Southwark PCT Croydon PCT Kingston PCT Richmond and Twickenham PCT Sutton and Merton PCT Wandsworth PCT Gateshead PCT Newcastle PCT North Tyneside PCT Northumberland Care Trust South Tyneside PCT Sunderland Teaching PCT Darlington PCT Derwentside PCT Durham and Chester-Le-Street PCT Durham Dales PCT Easington PCT Hartlepool PCT Langbaurgh PCT Middlesbrough PCT North Tees PCT Sedgeeld PCT Craven, Harrogate and Rural District PCT East Yorkshire PCT Eastern Hull PCT Hambleton and Richmondshire PCT North East Lincolnshire PCT North Lincolnshire PCT Scarborough, Whitby and Ryedale PCT Selby and York PCT West Hull PCT Yorkshire Wolds and Coast PCT Airedale PCT Bradford City PCT Bradford South and West PCT Calderdale PCT East Leeds PCT Eastern Wakeeld PCT Hudderseld Central PCT Leeds North East PCT Leeds North West PCT Leeds West PCT North Bradford PCT North Kirklees PCT South Hudderseld PCT South Leeds PCT Wakeeld West PCT Blackburn With Darwen PCT
200304 200405 200304 per head 200405 per head 200304 % of Total of PCT 200405 % of Total of PCT thousands expenditure population thousands expenditure population 14,309 14,864 18,411 13,581 4,607 5,689 11,451 21,276 11,160 8,784 5,866 9,583 20,451 15,108 10,747 13,081 3,572 14,431 13,427 5,643 17,147 13,665 18,717 14,362 4,489 5,064 9,982 14,985 15,084 4,829 12,480 9,228 6,347 4,546 11,363 9,775 5,865 15,955 7,064 9,276 6,391 5,287 7,109 14,536 13,066 6,025 3,640 16,587 13,116 5,672 4,261 10,798 10,770 8,166 7,567 7,107 7,880 14,841 9,157 8.2% 5.5% 7.4% 6.8% 5.8% 7.7% 8.4% 6.2% 6.7% 5.9% 5.3% 7.4% 6.1% 5.3% 4.4% 5.0% 4.2% 5.6% 5.5% 3.7% 5.5% 7.6% 6.7% 5.9% 4.5% 4.2% 7.2% 5.4% 5.7% 1.1% 6.6% 5.0% 6.6% 3.1% 6.0% 7.0% 4.3% 7.9% 5.1% 4.6% 3.3% 5.6% 5.9% 0.4% 6.1% 6.8% 4.5% 7.8% 6.7% 4.2% 5.2% 6.3% 4.8% 5.4% 6.4% 4.6% 4.7% 6.9% 7.0% 101.4 60.6 162.8 65.2 65.6 85.3 104.5 69.3 82.3 67.6 55.2 82.2 69.5 57.6 60.4 83.0 48.8 103.1 61.1 43.7 78.0 106.8 66.1 64.4 50.0 42.9 98.4 71.1 61.2 18.9 78.8 49.6 76.1 39.3 73.3 92.3 67.2 102.4 60.2 49.9 34.0 52.7 58.0 93.9 61.6 59.8 50.8 105.3 65.5 50.4 55.5 56.8 55.8 51.1 52.0 51.0 43.2 81.5 61.1 13,682 18,635 22,678 17,690 7,542 6,217 10,807 23,369 13,650 10,410 4,770 9,567 23,485 16,866 14,366 13,639 5,274 10,078 18,274 8,714 20,369 13,217 21,837 15,699 6,819 7,805 10,336 16,620 15,638 17,149 14,246 15,503 6,712 6,674 15,638 9,006 5,797 13,332 6,906 13,915 8,874 4,806 10,037 9,138 13,370 6,170 4,997 16,832 16,649 6,278 6,456 15,206 27,167 8,863 9,832 5,866 8,299 17,549 10,208 7.2% 5.9% 7.3% 7.9% 7.5% 7.2% 6.7% 5.9% 7.3% 5.6% 3.7% 6.6% 6.3% 5.4% 4.7% 4.7% 5.4% 4.3% 6.6% 5.1% 5.9% 6.8% 6.6% 5.8% 6.2% 5.7% 6.6% 5.2% 5.1% 3.2% 6.0% 7.2% 6.0% 3.7% 7.5% 5.5% 3.9% 5.7% 4.3% 5.6% 4.2% 4.4% 7.0% 0.2% 5.5% 6.0% 5.5% 7.6% 7.7% 4.0% 6.9% 7.6% 7.6% 5.4% 7.3% 3.4% 4.5% 7.1% 6.7% 97.0 76.0 200.5 84.9 107.5 93.2 98.6 76.1 100.6 80.1 44.9 82.1 79.8 64.4 80.8 86.6 72.0 72.0 83.1 67.4 92.6 103.3 77.1 70.4 75.9 66.1 101.9 78.9 63.5 67.2 89.9 83.3 80.5 57.7 100.9 85.0 66.4 85.5 58.9 74.9 47.3 47.9 81.8 59.1 63.1 61.2 69.7 106.9 83.2 55.8 84.1 80.0 140.8 55.5 67.5 42.1 45.5 96.4 68.1
5HP Blackpool PCT 5G8 Burnley, Pendle and Rossendale PCT 5D4 Carlisle and District PCT 5F2 Chorley and South Ribble PCT 5D5 Eden Valley PCT 5HE Fylde PCT 5G7 Hyndburn and Ribble Valley PCT 5DD Morecambe Bay PCT 5HD Preston PCT 5D6 West Cumbria PCT 5F3 West Lancashire PCT 5HF Wyre PCT 5HG Ashton, Leigh and Wigan PCT 5HQ Bolton PCT 5JX Bury PCT 5CL Central Manchester PCT 5F4 Heywood and Middleton PCT 5CR North Manchester PCT 5J5 Oldham PCT 5JY Rochdale PCT 5F5 Salford PCT 5AA South Manchester PCT 5F7 Stockport PCT 5LH Tameside and Glossop PCT 5F6 TraVord North PCT 5CX TraVord South PCT 5F8 Bebington and West Wirral PCT 5H2 Birkenhead and Wallasey PCT 5H4 Central Cheshire PCT 5HA Central Liverpool PCT 5H3 Cheshire West PCT 5H5 Eastern Cheshire PCT 5H6 Ellesmere Port and Neston PCT 5J1 Halton PCT 5J4 Knowsley PCT 5G9 North Liverpool PCT 5HC South Liverpool PCT 5M5 South Sefton PCT 5F9 Southport and Formby PCT 5J3 St Helens PCT 5J2 Warrington PCT 5G2 Bracknell Forest PCT 5DV Cherwell Vale PCT 5G4 Chiltern and South Bucks PCT 5CQ Milton Keynes PCT 5DK Newbury and Community PCT 5DT North East Oxfordshire PCT 5DW Oxford City PCT 5DL Reading PCT 5DM Slough PCT 5DX South East Oxfordshire PCT 5DY South West Oxfordshire PCT 5DP Vale of Aylesbury PCT 5G3 Windsor, Ascot and Maidenhead PCT 5DN Wokingham PCT 5G5 Wycombe PCT 5G6 Blackwater Valley and Hart PCT 5FD East Hampshire PCT 5LY Eastleigh and Test Valley South PCT
Code Primary Care Trust 5LX 5DG 5E9 5A1 5DF 5FE 5L1 5LL 5LM 5CM 5LN 5L2 5L3 5LP 5FF 5L4 5L8 5FH 5LQ 5MA 5KP 5KQ 5LR 5L5 5FJ 5MC 5FK 5L6 5L7 5LT 5L9 5FL 5JF 5JG 5KW 5KY 5K4 5M8 5A3 5DJ 5K3 5KX 5DH 5KT 5FT 5FR 5FV 5KR 5FQ 5F1 5CV 5FY 5CW 5FM 5CE 5FX 5CD 5KV Fareham and Gosport PCT Isle of Wight PCT Mid-Hampshire PCT New Forest PCT North Hampshire PCT Portsmouth City PCT Southampton City PCT Ashford PCT Canterbury and Coastal PCT Dartford, Gravesham and Swanley PCT East Kent Coastal PCT Maidstone Weald PCT Medway PCT Shepway PCT South West Kent PCT Swale PCT Adur, Arun and Worthing PCT Bexhill and Rother PCT Brighton and Hove City PCT Crawley PCT East Elmbridge and Mid Surrey PCT East Surrey PCT Eastbourne Downs PCT Guildford and Waverley PCT Hastings and St Leonards PCT Horsham and Chanctonbury PCT Mid-Sussex PCT North Surrey PCT Surrey Heath and Woking PCT Sussex Downs and Weald PCT Western Sussex PCT Bath and North East Somerset PCT Bristol North PCT Bristol South and West PCT Cheltenham and Tewkesbury PCT Cotswold and Vale PCT Kennet and North Wiltshire PCT North Somerset PCT South Gloucestershire PCT South Wiltshire PCT Swindon PCT West Gloucestershire PCT West Wiltshire PCT Central Cornwall PCT East Devon PCT Exeter PCT Mid Devon PCT North and East Cornwall PCT North Devon PCT Plymouth PCT South Hams and West Devon PCT Teignbridge PCT Torbay PCT West of Cornwall PCT Bournemouth PCT Mendip PCT North Dorset PCT Poole PCT
200304 200405 200304 per head 200405 per head 200304 % of Total of PCT 200405 % of Total of PCT thousands expenditure population thousands expenditure population 11,804 9,741 15,840 11,038 9,301 13,796 14,879 8,192 35,965 12,293 19,493 16,361 15,717 7,750 14,375 4,437 34,748 6,255 13,324 7,976 19,171 6,895 13,993 33,291 5,548 4,388 8,703 15,997 11,500 9,206 12,199 14,906 17,498 17,413 11,855 15,750 10,811 12,999 14,130 7,846 9,540 18,010 5,954 16,212 10,300 11,266 6,837 10,062 10,113 17,801 7,421 8,847 15,166 12,958 18,991 6,886 5,559 24,932 5.7% 6.3% 5.9% 6.0% 5.0% 6.4% 5.6% 6.4% 8.7% 5.2% 6.6% 7.4% 6.4% 6.7% 8.8% 4.9% 8.6% 6.5% 4.3% 6.3% 6.4% 3.7% 6.7% 11.8% 5.2% 3.4% 5.9% 5.9% 5.1% 6.5% 4.5% 7.4% 6.1% 7.4% 8.2% 7.9% 5.4% 7.1% 6.5% 6.7% 4.2% 8.1% 5.1% 7.7% 8.3% 7.5% 6.6% 5.9% 6.6% 6.3% 7.2% 8.1% 9.6% 7.2% 8.5% 6.5% 5.6% 11.8% 63.1 73.3 94.0 63.2 50.4 76.5 63.9 81.0 221.4 54.5 85.0 70.3 58.9 79.5 80.1 47.5 163.3 80.3 52.5 69.6 75.3 45.5 84.4 140.7 61.7 47.4 64.6 79.4 60.0 61.9 61.2 85.4 83.4 94.1 75.1 84.4 55.3 69.9 61.1 65.7 51.9 82.4 51.5 83.4 92.5 87.8 68.2 64.3 68.4 71.9 73.6 84.5 112.2 86.4 120.0 63.5 62.3 152.3 14,420 10,333 14,898 15,560 11,499 14,856 16,231 6,410 22,431 13,818 16,222 24,354 20,562 8,292 17,339 7,239 29,421 7,305 17,569 8,160 17,723 9,240 14,024 32,410 6,730 7,037 9,445 20,681 13,617 9,758 15,796 15,967 19,115 18,104 10,288 20,728 11,862 14,662 11,559 9,422 11,490 22,877 6,826 18,807 13,595 14,044 9,819 12,363 11,171 18,737 7,778 9,174 17,852 13,912 19,913 8,429 6,213 18,667 6.2% 6.2% 5.1% 7.2% 5.6% 6.2% 5.5% 4.6% 5.4% 5.4% 4.9% 9.2% 7.4% 6.2% 9.3% 6.7% 7.1% 6.8% 5.2% 5.7% 5.3% 4.8% 6.1% 10.2% 5.7% 6.3% 5.1% 6.9% 5.6% 6.1% 5.3% 7.4% 6.5% 7.4% 6.5% 9.0% 5.5% 7.0% 4.7% 7.0% 4.9% 8.8% 5.2% 7.3% 8.9% 7.4% 7.5% 6.4% 6.4% 5.9% 6.7% 7.0% 9.9% 6.8% 7.9% 6.8% 5.3% 7.7% 77.1 77.7 88.4 89.1 62.3 82.4 69.7 63.3 138.1 61.2 70.7 104.7 77.0 85.1 96.6 77.5 138.3 93.7 69.2 71.2 69.6 61.0 84.6 137.0 74.8 76.1 70.1 102.7 71.0 65.7 79.3 91.5 91.1 97.9 65.1 111.1 60.7 78.8 50.0 78.8 62.4 104.7 59.0 96.7 122.0 109.5 98.0 79.0 75.6 75.6 77.2 87.6 132.0 92.7 125.8 77.8 69.6 114.1
Code Primary Care Trust Somerset Coast PCT South and East Dorset PCT South Somerset PCT South West Dorset PCT Taunton Deane PCT Barnsley PCT Doncaster Central PCT Doncaster East PCT Doncaster West PCT North SheYeld PCT Rotherham PCT SheYeld South West PCT SheYeld West PCT South East SheYeld PCT Amber Valley PCT Asheld PCT Bassetlaw PCT Broxtowe and Hucknall PCT Central Derby PCT Chestereld PCT Derbyshire Dales and South Derbyshire PCT 5H9 East Lincolnshire PCT 5ER Erewash PCT 5EC Gedling PCT 5EX Greater Derby PCT 5HN High Peak and Dales PCT 5D3 Lincolnshire South West Teaching PCT 5AM Manseld District PCT 5AP Newark and Sherwood PCT 5EG North Eastern Derbyshire PCT 5EM Nottingham City PCT 5FC RushcliVe PCT 5D2 West Lincolnshire PCT 5JC Charnwood and North West Leicestershire PCT 5AC Daventry and South Northamptonshire PCT 5EY Eastern Leicester PCT 5JA Hinckley and Bosworth PCT 5EJ Leicester City West PCT 5EH Melton, Rutland and Harborough PCT 5LW Northampton PCT 5LV Northamptonshire Heartlands PCT 5JD South Leicestershire PCT 5DQ Burntwood, Licheld and Tamworth PCT 5MM Cannock Chase PCT 5ML East StaVordshire PCT 5HW Newcastle-Under-Lyme PCT 5ME North Stoke PCT 5M2 Shropshire County PCT 5MF South Stoke PCT 5MN South Western StaVordshire PCT 5HR StaVordshire Moorlands PCT 5MK Telford and Wrekin PCT 5HV Dudley Beacon and Castle PCT 5HT Dudley South PCT 5MY Eastern Birmingham PCT 5MX Heart of Birmingham Teaching PCT 5FW 5FN 5K1 5FP 5K2 5JE 5CK 5EK 5EL 5EE 5H8 5EP 5EN 5EQ 5ED 5FA 5ET 5EV 5AL 5EA 5H7
200304 200405 200304 per head 200405 per head 200304 % of Total of PCT 200405 % of Total of PCT thousands expenditure population thousands expenditure population 9,238 16,593 13,046 12,066 9,093 14,410 11,623 5,331 6,114 12,600 16,143 9,557 7,793 13,043 10,473 6,173 8,340 19,455 7,588 11,283 3,466 21,851 9,528 7,900 23,901 4,953 12,773 5,618 13,652 12,398 45,936 8,655 15,185 12,761 10,785 10,221 5,377 8,555 7,372 14,109 12,513 14,702 11,238 6,591 9,403 8,159 10,216 16,095 26,136 9,078 5,208 8,337 6,761 15,595 48,975 14,430 7.0% 6.8% 7.9% 7.4% 7.8% 4.6% 8.3% 5.4% 5.2% 7.8% 6.0% 6.7% 5.8% 6.6% 8.2% 7.4% 8.0% 6.2% 4.7% 5.6% 4.7% 7.7% 7.2% 4.7% 7.9% 4.4% 7.5% 5.4% 4.5% 7.0% 9.0% 6.6% 6.8% 5.6% 6.2% 5.3% 6.3% 5.6% 5.2% 6.5% 4.9% 9.7% 8.4% 4.8% 6.8% 5.0% 5.2% 5.6% 9.2% 5.5% 4.7% 5.2% 5.3% 6.1% 8.4% 4.4% 66.7 113.5 89.4 89.1 88.4 64.1 116.9 61.2 58.3 105.8 67.7 83.1 59.4 85.7 83.1 78.9 79.7 148.4 68.9 105.1 40.8 81.9 92.6 86.6 166.0 48.0 69.7 63.6 115.4 81.2 162.8 76.6 72.1 55.1 111.8 63.0 54.1 64.8 52.6 67.9 46.4 100.2 76.6 53.4 78.5 81.0 81.4 57.5 196.9 50.7 50.7 52.6 65.3 78.5 209.7 51.9 11,021 22,879 14,577 12,416 10,897 17,631 10,168 7,070 7,800 14,348 17,742 10,555 9,526 14,281 10,559 4,994 8,419 23,501 8,702 14,345 5,599 24,643 11,934 9,986 18,048 9,498 14,425 6,604 17,492 16,504 59,295 9,908 19,272 14,593 15,353 13,360 6,804 9,905 9,798 14,847 17,131 12,416 8,868 7,170 10,111 5,922 12,880 21,421 8,305 10,147 6,358 10,743 7,947 18,864 47,001 11,431 7.20.3% 8.2% 7.7% 6.5% 8.4% 4.6% 6.3% 6.0% 5.4% 7.3% 5.7% 6.6% 6.2% 6.4% 7.1% 5.2% 6.9% 6.9% 5.7% 6.4% 3.9% 7.7% 7.6% 5.4% 7.5% 7.3% 7.6% 5.6% 5.1% 8.2% 10.4% 6.8% 7.9% 5.7% 7.9% 5.2% 6.8% 5.7% 6.1% 6.5% 6.0% 8.1% 5.8% 4.4% 6.4% 4.5% 4.3% 6.6% 4.0% 5.2% 5.1% 5.6% 5.6% 6.3% 7.3% 3.1% 79.6 156.5 99.9 91.7 105.9 78.4 102.2 81.2 74.4 120.5 74.4 91.8 72.6 93.8 83.8 63.8 80.4 179.3 79.0 133.7 65.9 92.4 116.0 109.5 125.4 92.0 78.7 74.7 147.9 108.1 210.2 87.6 91.5 63.1 159.2 82.3 68.4 75.0 69.9 71.5 63.6 84.6 60.5 58.1 84.4 58.8 102.7 76.6 62.6 56.7 61.9 67.8 76.8 95.0 201.2 41.1
200304 200405 200304 per head 200405 per head 200304 % of Total of PCT 200405 % of Total of PCT thousands expenditure population thousands expenditure population 6.1% 5.9% 6.6% 6.1% 5.0% 6.3% 6.4% 5.3% 6.0% 4.7% 5.0% 5.1% 5.8% 5.2% 6.8% 5.3% 0.4% "10.3% 71.9 71.0 79.2 60.8 71.8 69.6 72.9 60.2 74.8 47.4 61.0 46.7 71.3 52.0 69.3 51.9 68.8 13,418 8,261 6,217 13,629 25,037 20,619 8,780 20,214 25,163 19,017 12,182 13,347 7,608 20,591 24,957 8,632 19,399 (540.502) 3,773,203 5.2% 71,922,179 6.3% 5.9% 5.7% 6.2% 4.7% 6.7% 6.0% 6.7% 6.2% 6.2% 5.2% 8.1% 6.7% 7.8% 7.5% 7.3% 0.5% "14.3% 84.7 81.6 77.7 68.5 75.5 82.9 77.0 85.3 79.7 109.4 70.1 85.8 91.7 86.1 91.3 81.2 76.7
5MW North Birmingham PCT 11,397 5MG Oldbury and Smethwick PCT 7,185 5MH Rowley Regis and Tipton PCT 6,336 5D1 Solihull PCT 12,093 5M1 South Birmingham PCT 23,809 5M3 Walsall PCT 17,300 5MJ Wednesbury and West 8,310 Bromwich PCT 5MV Wolverhampton City PCT 14,267 5MD Coventry PCT 23,620 5CN Herefordshire PCT 8,246 5MP North Warwickshire PCT 10,598 5MR Redditch and Bromsgrove 7,256 PCT 5M9 Rugby PCT 5,919 5MQ South Warwickshire PCT 12,435 5MT South Worcestershire PCT 18,942 5DR Wyre Forest PCT 5,518 All SHA 14,751 350,055 Other(1) (2) 3,385,750 Total Net Cancer Spend % of Total NHS Net Operating 5.0% Costs Total NHS Net Operating 67,601,317 Costs(2)
Data collection forms PFR4 and HFR30 reported as part of PCT and SHA Annual Accounts. Raw population as per Department of Health PCT Allocations Formulae. Footnotes: 1. Other expenditure breakdown: NHS Litigation Authority (NHSLA) 144,042 63,093 Prescription Pricing Authority (PPA) 2,108 2,462 PHS Pharmaceutical Services 26,109 27,840 Intra DH Accounting Adjustments (522,314) (633,897) Total Other (350,055) (540,502) 2. As reported in DH Resource Accounts 200304 and 200405.
1.4 Income from Charges 1.4.1 What has NHS income from charges been since 199798, by type of charge? (Q8) Answer The information requested is given in Table 8.
Table 8 BREAKDOWN OF NHS INCOME FROM CHARGES BY CHARGE TYPE FOR THE PERIOD 199798 to 200405
millions Charges 199798 199899 19992000 200001 200102 200203 200304 200405 113.8 75.8 266.0 316.6 1.5 0.4 453.1 386.9 9.8 2.3 34.1 0.1 1.8 0.3 1.2 1.6 52.4 57.7 1,665.3 1,732.5 2,176.2 2,473.4 2,720.8 65.8 98.3 268.2 340.8 24.5 0.2 472.1 413.1 6.2 3.0 36.7 1.6 0.4 1.6 3.5 105.0 126.3 366.7 259.8 61.6 295.4 0.2 486.7 423.0 2.9 41.3 0.9 0.4 2.5 4.7 105.6 136.8 383.9 394.9 72.2 404.1 0.8 483.6 428.3 2.1 6.4 117.5 205.1 313.8 464.3 105.1 592.7 1.0 425.9 424.6 2.0
Health Authorityfees and 67.7 90.1 92.0 charges(2) Road traYc accident income(5) 30.0 NHS Trustsfees and charges(4) 169.6 216.7 224.2 NHS Trustsprivate patients(4) 273.2 290.8 304.8 NHS TrustsLocal Authorities(4) (6) PCTs(3) PCTsLocal Authorities(6) NHS Supplies Authority fees(7) 39.1 36.1 20.3 Dental charges(8) 388.4 419.6 431.2 320.9 341.3 366.7 Prescription charges(8) Nursing home inspection fees(13) 4.8 8.8 9.5 Subsidised dried milk 2.5 2.6 2.4 Medicines Control Agency 28.1 26.6 29.4 licences and inspections Youth Treatment Service income 4.5 4.7 4.6 2.3 6.2 2.2 NHS Pensions Agency fees(9) 0.2 0.2 0.2 Medical Devices Agency Fees(10) Human Fertilisation and 1.3 1.4 1.6 Embryology Authority: licence fees English National Board for Nursing 1.6 1.6 (ENB): registration fees(11) (12) MHRA(14) Total 1,302.6 1,446.7 1,520.7
0.5 3.5
0.6 4.1
Footnotes: 1. The table has been restated to include NHS trust private patients, NHS trust income from Local Authorities and PCT income separately. 2. Health Authorities were established on 1 April 1996 and Strategic Health Authorities on 1 October 2002. 3. PCTs were established from 1 April 2000. 4. Figures for 200405 exclude income from charges for NHS Foundation Trusts. 5. Figures were not collected prior to 19992000. 6. Income from Local Authorities was separately identied for the rst time in 200203. 7. From 200001 NHS Supplies Authority split into NHS Purchasing and Supplies Agency and NHS Logistics. All fees for forward years score against the NHS Logistics. 8. Dental and prescription charge income prior to 200102 drawn from cash data in Appropriation Accounts. 200102 and subsequent years data drawn from resource data in Summarised Accounts. 9. No income generated prior to 199798. 10. The Agency was established in September 1994. 11. Figures prior to 199899 are not available. 12. In 200102 the Department of Health has directed that no ETR fees should be charged and that ETR fees held in reserve should be utilised to fund the ENBs ongoing students record function for the nal year of its operation. 13. From April 2002, the National Care Standards Commission (NCSC) regulated nursing homes. Health Authorities no longer collect the Fee income. 14. Medicines & Healthcare Regulatory Agency (MHRA) formed in 200304brings together work of Medical Device Agency & Medicines Control Agency.
2. Investment 2.1 Total investment 2.1.1 Could the department detail NHS capital spending by category of expenditure from 199798 to 200708? (Q9) Answer The information requested is given in Table 9.
Table 9 NHS CAPITAL SPENDING BY CATEGORY OF EXPENDITURE 199798 to 200708 millions 200506 199798 199899 19992000 200001 200102 200203 200304 200405 Forecast 200607 200708 Outturn Outturn Outturn Outturn Outturn Outturn Outturn Outturn outturn Plan Plan Government Spending (excluding Foundation Trusts) Foundation Trust Capital Expenditure(4) Receipts from Land Sales Total public capital funding available for capital investment(1) Percentage Real Terms Growth(3) PFI Investment(2) Total Investment Percentage Real Terms Growth(3) 1,089 471 1,560 812 963 552 1,515 13.2% 362 1,877 23.1% 1,246 624 1,870 21.8% 595 2,465 29.6% 1,732 374 2,106 9.9% 534 2,640 4.5% 1,903 338 2,241 3.1% 445 2,686 "1.4% 2,601 289 2,890 25.6% 527 3,417 23.9% 2,485 2,111 350 497 582 393 3,417 3,001 15.8% "14.2% 685 948 4,102 17.5% 3,949 "6.0% 4,862 365 205 5,432 76.6% 1,187 22 6,619 63.6% 5,798 401 130 6,329 13.5% 1,376 13 7,705 13.4%
500 1,312 "15.5% 58 183 1,495 "7.4%
1,618
Source: Footnotes: 1. Public capital spending gures up to and including 200405 are from 2000, 2001, 2004 and 2006 Departmental Reports. 200506s gure is the provisional outturn gure as at May 2006. 200607 and 200708 are the available resources. For 200607, we have a 735 million undercommitment (see question 108). 2. Figures estimated by DH Capital Investment Branch (see question 12). 3. Real increases/decreases calculated using December 2005 GDP Deators. 4. The 200607 and 200708 FT Capital Expenditure gures are for the 32 that existed at the start of 200607 only. At the time of writing (16 August), we are updating our estimates for this.
2.2 Publicly Funded 2.2.1 Could the Department list all publicly funded capital projects with a total cost above 10 million which are under construction? Could this include original and current estimated completion dates and costs and percentage time/cost overruns and savings? (Q10) Answer The information requested is given in Table 10.
Table 10 PUBLICLY FUNDED CAPITAL PROJECTS WITH A TOTAL COST OVER 10 MILLION WHICH ARE UNDER CONSTRUCTION
Org Code RX3 RJX RBQ RWJ RW6 RM2 RM2 RWA RCC RTR TAD RXF RHQ RHA RHA RHA RNQ RQ3 5DQ RT6 RDD RWN Trust/Project Tees, Esk and Wear Valley NHS Trust Calderstones NHS Trust The Cardiothoracic Centre Liverpool NHS Trust Stockport NHS Foundation Trust Pennine Acute Hospitals South Manchester UHT Breast Care and Cancer Prevention Centre South Manchester UHT Cardiac Improvements Hull and East Yorkshire Hospitals NHS Trust Scarborough & North East Yorkshire Healthcare Trust South Tees Hospitals Trust Bradford District Care Trust Mid Yorkshire Hospitals SheYeld Teaching Hospitals NHS Foundation Trust Nottinghamshire Healthcare NHS Trust Nottinghamshire Healthcare NHS Trust Nottinghamshire Healthcare NHS Trust Kettering General Hospital Birmingham Childrens Hospital NHS Trust Burntwood, Licheld and Tamworth PCT : Licheld Community Hospital SuVolk Mental Health Partnerships NHS Trust Basildon and Thurrock University Hospitals NHS Trust South Essex Partnership NHS Trust Description of Project Providing Mental Health and Learnining Disability services locally in Stockton and Hartlepool. New Medium Secure Unit to replace existing unit Cardiac Building Cardiac and Surgical Unit Centralisation of Pathology ServicesRoyal Oldham Hospital 2-storey building with breast cancer diagnosis rooms, counselling rooms, oYces and a Breast Cancer Prevention Unit at Wythenshawe 2-storey extension to the existing cardiac unit with investigations and outpatients on the ground oor and critical care on the rst oor at Wythenshawe Tertiary Cardiothoracic Services Development MRI, Endoscopy and Theatre redevelopment Friarage Hospital main redevelopmentWomens, Childrens and Pharmacy 60-bed Adult Mental Health Acute Unit Enabling Works for PFI schemes Critical Care Unit Arnold Lodge Medium Secure Unit Rampton Womens High Secure Unit High Secure Learning Disability Unit for Men New treatment centre Education and Burns Centre Licheld Community Hospital Modernisation of SuVolk Mental Health Services Tertiary Cardiothoracic centre Rochford Redevelopment Original Estimated Completion Date 31/11/2006 15/08/2008 30/10/2006 04/08/2006 30/06/2007 31/10/2007 31/10/2007 01/06/2008 18/06/2007 15/05/2006 01/11/2006 31/03/2007 22/12/2007 24/11/2006 01/10/2006 11/04/2008 03/04/2006 30/06/2006 15/03/2006 01/09/2009 20/04/2007 05/09/2007 Current Estimated Completion Date 31/11/2006 15/08/2008 30/10/2006 11/08/2006 30/10/2007 06/07/2007 31/01/2008 01/06/2008 18/06/2007 13/11/2006 02/02/2007 31/03/2007 22/12/2007 24/11/2006 16/10/2006 11/04/2008 04/09/2006 15/05/2007 15/09/2006 01/09/2009 16/06/2007 05/09/2007 % Time overrun (!)/ saving (") 0.00 0.00 0.00 ! 1.20 ! 16.66 "22.22 ! 16.66 0.00 0.00 ! 29.89 ! 23.00 0.00 0.00 0.00 ! 1.28 0.00 ! 30.00 ! 46.00 ! 33.00 0.00 ! 8.10 0.00 Original Estimated Cost Current Estimated Cost millions millions 9.38 14.20 77.50 16.22 17.50 14.25 19.85 31.50 12.20 21.80 10.86 10.40 16.00 16.17 24.47 20.00 8.00 16.01 17.05 26.30 34.98 16.50 10.30 14.20 77.50 16.22 17.40 14.25 19.85 31.50 12.20 21.70 10.80 12.79 16.00 16.17 24.17 20.00 12.30 18.26 17.52 26.30 34.98 16.50 % Cost overrun (!)/ saving (") ! 9.81 0.00 0.00 0.00 "0.56 0.00 0.00 0.00 0.00 "0.46 "0.55 ! 23.00 0.00 0.00 "1.23 0.00 ! 53.80 ! 14.00 ! 2.75 0.00 0.00 0.00
Org Code RAL
Trust/Project Royal Free Hampstead NHS Trust Whipps Cross University Hospital Central and North West London Mental Health Trust North West London Hospitals West London Mental Health Trust Oxleas NHS Foundation Trust Queen Marys Sidcup NHS Trust South London and the Maudsley NHS Trust South London and the Maudsley NHS Trust Crawley Hospital
Description of Project Fire and Statutory compliance works to achieve statutory compliance for re, health and safety and achieve condition B for the whole hospital. Maintain capacity. Upgrade of infrastructure New energy centre on the Whipps Cross Hospital site to ensure continuity of supply and to facilitate the originally planned redevelopment of the hospital site. Reprovision of Adult Acute Mental Health Services, mainly to replace the outdated Paterson Centre on the St. Marys Acute Hospital site. Redevelopment and refurbishment of maternity services at Central Middlesex and Northwick Park Hospitals. Womens Enhanced Medium Secure Service to transfer female patients from Broadmooor to the St Bernards site in Ealing Regeneration of Memorial and Goldie Leigh Hospitals. Redevelopment, reprovision and relocation of a range of adult and older adult mental health and adult learning disability services. Estate redevelopment to meet re, health and safety compliance. Upgrading of wards areas to enable single sex provision and increased numbers of single ` che. rooms. Upgrade of Outpatients. New cre Lambeth Forensic Development to create a 24-bed forensic medium secure unit for patients in Lambeth. Southwark Forensic Development to create an 89-bed forensic services unit to be provided at the Bethlem Hospital site for patients in the Southwark and Croydon areas. Refurbishment/extension of Walk-in Centre, Intermediate Care Ward, Ambulatory Clinic, Chronic Disease Management Centre, Pre-Assessment Clinic, Older Persons Mental Health Services Unit and backlog maintenance Renal and Vascular developments Cardiac Development Geratology relocation Cardiac Revascularisation New Build and Refurbishment Yate Community Healthcare Centre Expansion of the Southwest Cardiothoracic Centre
Original Estimated Completion Date 01/06/2012
Current Estimated Completion Date 01/06/2012
% Time overrun (!)/ saving (") 0.00
Original Estimated Cost Current Estimated Cost millions millions 50.69 50.69
% Cost overrun (!)/ saving (") 0.00
RGC
01/12/2004
Not known(1)
Not yet nalised
10.90
14.10
! 29.36
RV3 RV8 RKL RPG
01/04/2005 01/12/2004 01/07/2007 01/07/2008
01/08/2006 01/06/2006 01/07/2007 01/07/2008
! 60.00 ! 37.50 0.00 0.00
30.40 15.08 30.70 24.60
39.80 22.40 30.70 24.60
! 30.92 ! 48.53 0.00 0.00
RGZ
01/01/2007
01/01/2007
0.00
27.06
27.06
0.00
RV5 RV5
01/07/2006 01/02/2007
01/07/2006 01/02/2007
0.00 0.00
10.47 32.05
10.47 32.05
0.00 0.00
RTP
28/08/2006
23/01/2007
! 15.00
19.20
19.30
! 0.50
RVV RTH RTH RHM 5A3 RK9
East Kent NHS Trust Oxford RadcliVe Hospitals NHS Trust Oxford RadcliVe Hospitals NHS Trust Southampton University Hospitals NHS Trust South Gloucestershire PCT Plymouth Hospitals NHS Trust
30/04/2008 24/10/2008 01/10/2007 01/04/2007 27/06/2008 01/09/2006
30/04/2008 24/10/2008 01/10/2007 31/08/2007 27/06/2008 01/11/2006
0.00 0.00 0.00 0.00(2) 0.00 5.00
13.60 26.00 11.00 53.70 11.20 39.20
13.60 26.00 11.00 53.70 11.20 42.40
0.00 0.00 0.00 0.00 0.00 ! 8.16
Source: Strategic Health Authorities. Footnotes: 1. The Trust are reporting that this scheme is considerably over time and over budget. There are some outstanding issues with the main contractor which have delayed the issue of a practical completion certicate. Refer to the commentary in Question 11 for further information. 2. The Trust took the opportunity to add in Backlog maintenance work outside the original contract. There is no actual delay to original scheme programme for refurbishment element. The new build element completed on time in June 2006.
2.2.2 Could the Department provide a commentary on publicly funded capital projects where there are signicant discrepancies between original estimates of completion dates and/or expenditures and current estimates? (Q11) Answer
Pennine Acute Hospitals The delay to the estimated completion date is due to the Full Business Case approval being granted later than originally anticipated, which led to a delayed start of the construction works. The Main Contractor, however, is currently ahead of the contract programme, and an overall project underspend is currently forecast.
South Manchester UHT Breast Care and Cancer Prevention CentreWythenshawe This project is forecast to be delivered 16 weeks earlier than the original estimated date. This signicant time saving has been achieved by authorising design and enabling work at an early stage, thus allowing work to start on site earlier than originally planned.
South Manchester UHT Cardiac ImprovementsWythenshawe A slip in the original estimated completion date is due to a delayed start of construction works. This delay was caused as a result of the Full Business Case approval being granted three months later than originally anticipated. The project is currently forecast to be delivered within its original budget.
South Tees Hospitals TrustFriarage Hospital main development The original contract programme has been delayed due to variations on the original construction works. An additional 26 weeks was required for additional demolition works of the vacated accommodation, the provision of additional car parking and for further design development required after the discovery of contaminated land. Despite this delay, the project is currently within budget.
Bradford District Care Trust The original estimated completion date has slipped because of a delayed start on site which was due to complications over the transfer of the site to the Bradford District Care Trust. The original building programme of 13 months remains on track.
Mid Yorkshire Hospitals This project consists of a large number of enabling work packages. Unforeseen problems in modifying existing services in some buildings, the removal of asbestos, the implications of planning requirements, and VAT recovery issues have all contributed to an overall increase in the estimated cost.
Kettering General Hospital: Treatment Centre The time delay and cost overrun are due to poor performance by the Main Contractor and the design team. EVorts are under way to resolve existing problems and to mitigate any delays.
Birmingham Childrens Hospital NHS Trust The contract delay and an estimated cost increase have both been caused by the need to appoint a new Main Contractor to complete the works. The completion contract, which has been agreed with the new Main Contractor, is currently running to time and cost, with an expected completion date in May 2007, 11 months later than the original estimated date.
Burntwood, Licheld and Tamworth PCT: Licheld Community Hospital The original estimated completion date has slipped because the construction works started later than expected. This was due to a delay in the demolition of existing hospital buildings, which needed to be cleared from the site.
Whipps Cross University Hospital This project is currently considerably over time and over budget. The major elements of the overspend relate to costs associated with the delay to completion of the project, costs associated with rectifying aspects of the project, and the suitability and adequacy of the contract administration procedures. The Trust has commissioned an audit report on the failings of the project and is acting upon the recommendations of this report. Central and North West London Mental Health NHS Trust This has been a complex project which was designed to move services from accommodation no longer deemed appropriate for this client group. The main delays, in the view of the Trust, appear to be due to the completeness of design information and how this was appropriately communicated consistently to the various building contractors employed to undertake the work. This view is not shared by the design professionals involved. The Trust identied the potential for delay and overspend in 2004 and engaged professional advisers to assist in mitigating the impact. North West London Hospitals The Trust commissioned external auditors Deloitte & Touche to undertake a review of the delivery of this project. The review identied key areas for improvement and the implementation of an action plan has been agreed by the Trust Board and is currently being reviewed by the Trust with NHS London. The main areas relate to poor governance, performance and communications issues with contractors and design teams, and unsuccessful contract management processes. Crawley Hospital refurbishment at six locations The original estimated completion date has slipped due to a delay in work starting on site. This delay was necessary for a review of contracts to be undertaken following recommendations made by the Gateway review. 2.3 Private Finance Initiative (PFI) 2.3.1 Could the Department provide expenditure proles of capital expenditure on PFI schemes from 199798 onwards by (a) region and (b) scheme by broad capital cost of scheme? (Q12) Answer 1. The information requested is given in Table 12a to Table 12k. 2. The expenditure proles in the tables take into account the reduced capital values at the six PFI review schemes announced on 18 August. These were at Salford, Tameside, Leicester, Walsall, South Devon and North StaVordshire. The Department are in the process of reviewing the remaining PFI Schemes with values in excess of 75 million.
Table 12a EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

millions Regional Summary Schemes with capital cost 10m! North East North West Yorkshire & the Humber East Midlands West Midlands East of England London South East Coast South Central South West TOTAL 199798 199899 6.1 6.7 0.0 0.0 0.0 15.8 0.0 9.4 4.5 0.0 42.5 15.3 23.3 6.5 0.0 15.1 23.7 28.3 23.5 29.3 0.0 165.0 18.0 183.0 Spend Prole of the Total Capital Cost 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 44.4 46.7 20.9 1.7 40.5 47.4 77.2 44.5 11.3 10.0 344.5 17.0 361.5 63.5 43.4 61.8 10.8 87.9 48.9 207.5 33.1 0.0 16.1 572.8 22.6 595.4 63.1 13.3 39.0 4.2 63.8 35.0 212.7 8.4 3.0 36.7 479.1 54.4 533.5 61.0 0.0 6.9 0.0 73.9 13.5 179.7 18.9 24.9 36.9 415.5 29.6 445.1 33.9 14.0 10.7 45.4 118.1 3.8 167.6 7.3 57.1 42.6 500.3 27.1 527.4 16.0 87.2 46.0 88.0 142.4 7.6 204.5 3.6 42.3 21.3 658.8 25.9 684.7 56.9 70.8 104.5 98.7 179.3 78.0 0.0 0.0 117.1 194.6 203.6 313.4 376.1 392.7 351.3 173.8 90.5 126.5 125.2 136.4 108.5 95.0 93.0 52.0 102.6 121.6 198.4 198.8 255.9 239.9 142.2 142.2 96.3 138.5 173.3 300.6 358.6 426.7 301.8 190.6 22.6 82.3 121.8 229.6 301.8 383.7 311.8 243.9 275.6 230.3 250.7 427.8 465.0 501.4 332.0 160.4 23.4 51.8 64.1 106.9 85.5 85.5 42.8 0.0 106.8 99.5 87.8 104.6 89.3 73.0 54.0 62.0 36.4 45.4 46.4 100.6 195.4 306.1 305.8 202.4 928.2 1,161.2 1,375.6 2,017.4 2,415.3 2,581.9 1,934.6 1,227.2 19.6 19.2 1.8 1.1 1.1 0.0 0.0 0.0 0.0 100.0 52.0 71.1 81.7 88.0 63.3 0.0 40.0 111.7 607.8 0.0 607.8 0.0 50.0 26.0 0.0 0.0 0.0 0.0 0.0 40.0 40.0 156.0 0.0 156.0 Total 891.3 2,507.2 1,096.7 1,622.6 2,609.6 1,981.0 3,783.9 608.6 929.2 1,553.6 17,583.7 252.8 17,836.5
Schemes with capital cost between 1m10m(1) TOTAL 15.4 OVERALL TOTAL FOR PFI 57.9
947.8 1,180.4 1,377.4 2,018.5 2,416.4 2,581.9 1,934.6 1,227.2
Source: Footnotes: 1. In accordance with Treasury policy that no PFI schemes should be undertaken below 20 million, future sub 10 million investment has eVectively ceased. We therefore propose that this be the last occasion in which we collect data for these schemes.
Table 12b EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

millions Total Capital Cost to the Private Sector 50 40 40 78 24.0 298.6 31.8 55.1 121.9 48.0 61.0 15.7 10.4 17.8 892.3 20.4 912.7 Start on Site Date 200809 200607 200809 200708 21/07/2005 27/04/2005 10/05/2004 27/04/2001 16/08/1999 28/05/1999 31/03/1998 04/07/2003 30/05/2002 16/11/2000 Completion Date 199798 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 Being nalised 01/10/2008 Being nalised Being nalised 01/02/2007 01/10/2007 15/05/2006 12/07/2003 01/08/2003 08/06/2002 02/04/2001 20/08/2004 18/11/2003 25/03/2003 6.1 1.9 8.0 15.3 2.3 17.6 44.4 2.0 46.4 1.8 63.5 1.4 64.9 11.6 63.1 7.7 70.8 6.1 15.3 2.9 36.6 12.0 18.9 36.6 7.3 18.3 5.0 4.0 4.0 7.8 2.4 29.9 20.7 15.6 44.8 8.0 2.5 6.0 74.7 59.7 59.7 29.9 19.5 32.5 26.0 26.0 35.1 12.5 10.0 10.0 15.6
North East Schemes with capital cost 10m! Northumberland, Tyne & Wear
Status SOC
Total 50.0 40.0 40.0 78.0 24.0 298.6 31.8 54.1 121.9 48.0 61.0
Langaburgh PCT OBC Tees, Esk & Wear Valleys/Derwentside PCT OBC Tees, Esk & Wear Valleys Northgate & Prudoe TrustNeuro Disability Centre Newcastle Upon Tyne Hospitals Newcastle, North Tyneside and Northumberland MH Northumbria HealthcareHexham 1 South Tees Acute Hospitals County Durham & Darlington Acute HospitalsSouth County Durham & Darlington Acute HospitalsNorth Tees, Esk & Wear ValleysWest Park County Durham & Darlington Acute HospitalsChester-le-street Northumbria Health CareWansbeck TOTAL OBC FC FC OP OP OP OP OP OP OP OP
3.2
16.0
6.5
12.2 4.8 27.5
18.3 31.2 12.2
1.0 4.5 61.0 3.1 64.0
1.6 6.8
10.2 2.6
3.9
15.7 10.4 17.8 891.3 20.4 911.7
33.9 2.0 35.9
16.0 0.0 16.0
56.9 0.0 56.9
70.8 0.0 70.8
104.5 0.0 104.5
98.7 0.0 98.7
179.3 0.0 179.3
78.0 0.0 78.0
0.0 0.0 0.0
0.0 0.0 0.0
0.0 0.0 0.0
0.0 0.0 0.0
Schemes with capital cost between 1m10m TOTAL OVERALL TOTAL FOR PFI
1. 25 variation to contract took place and commenced construction in 200607.
Table 12c EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

millions Total Capital Cost to the Start on Site Private Sector Date 500 192 300 42.2 51.0 109.3 190.0 338.0 511.6 30.1 109.6 66.7 66.7 2,507.2 30.2 2,537.4 200910 200809 200809 200708 200809 200708 200708 01/06/2006 14/12/2004 13/10/2003 09/07/2003 08/06/1998 03/11/1997 Completion Date 199798 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 Being nalised Being nalised Being nalised Being nalised Being nalised 200910 201011 01/10/2008 01/01/2009 23/05/2006 08/07/2006 25/07/2001 10/04/2000 3.0 11.0 6.7 6.7 1.9 8.6 6.7 16.7 23.3 2.3 25.7 16.7 30.0 46.7 2.0 48.7 30.0 13.3 43.4 1.4 44.8 13.3 13.3 7.7 21.0 0.0 3.1 3.1 14.0 2.0 16.0 87.2 4.5 91.7 117.1 0.8 117.9 194.6 1.1 195.7 203.6 1.2 204.8 313.4 1.1 314.5 376.1 1.1 377.2 392.7 0.0 392.7 351.3 0.0 351.3 173.8 0.0 173.8 100.0 0.0 100.0 50.0 19.2 30.0 4.2 27.4 5.1 10.9 19.0 50.7 102.3 16.4 28.5 84.5 102.3 28.8 45.0 10.6 33.2 32.8 57.0 67.6 51.2 12.8 32.8 57 67.6 16.4 28.50 33.8 75.0 57.6 90.0 125.0 57.6 90.0 100.0 28.8 45.0 100.0 50.0
North West
Status
Total 500.0 192.0 300.0 42.2 51.0 109.3 190.0 338.0 511.6
Schemes with capital cost 10m! Royal Liverpool & Broadgreen University SOC Hospital Mersey Care SOC Royal Liverpool Childrens Hospital Aintree Blackpool PCT Tameside & Glossop Acute Services Salford Royal Hospitals St Helens & Knowsley Hospitals Central Manchester & Manchester Childrens University Hospitals East Lancashire HospitalsBurnley East Lancashire HospitalsBlackburn South Manchester University Hospitals North CumbriaCumberland Inrmary TOTAL SOC SOC OBC OBC OBC FC FC OP OP OP OP
51.2 19.6 16.4
76.7 7.5 32.9
33.8 127.9
32.9
16.4
30.1 109.6 66.7 66.7 50.0 2,507.2 0.0 30.2
50.0 2,537.4
Table 12d EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

Yorkshire & Humber Schemes with capital cost 10m! Leeds Teaching HospitalsChildrens Mid Yorkshire HospitalsWakeeld Hull & East Yorkshire Hospitals SheYeld Teaching Hospitals Leeds Teaching Hospitals North Kirklees PCT Doncaster and South Humber Leeds Teaching HospitalsWharfedale Hull & East Yorkshire Hospitals Maternity & Acute Leeds CommunityHigh Royds Reprovision Calderdale and Hudderseld Healthcare TOTAL Status SOC OBC FC FC FC OP OP OP OP OP OP Total Capital Cost to the Private Sector 260 280.0 67.0 35.0 265.0 27.0 15.0 14.1 22.0 47.0 64.6 1,096.7 Start on Site Date 200910 200607 21/02/2006 19/12/2004 15/10/2004 21/04/2004 11/08/2003 20/09/2002 08/12/2000 01/03/2000 31/07/1998 millions
Completion Date 199798 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 Being nalised 201011 01/04/2008 01/10/2006 01/08/2008 14/11/2005 01/01/2005 30/11/2004 29/03/2003 16/12/2002 08/04/2001 0.0 6.5 6.5 4.7 16.2 20.9 26.0 28.0 16.8 8.8 66.3 6.8 42.0 30.2 53.0 70.0 13.4 53.0 56.0 39.0 56.0 65.0 28.0 52.0 52.0 26.0
Total 260.0 280.0 67.0 35.0 265.0 27.0 15.0 14.1 22.0 47.0
2.2 30.6 29.1 61.8
14.3 11.8 12.9 39.0
1.4 5.5
1.5 9.2
3.5 26.5 2.7 9.8 3.5
6.7 22.8 39.8 17.6 3.8
26.5
6.9
10.7
46.0
90.5
126.5
125.2
136.4
108.5
95.0
93.0
52.0
52.0
64.6 26.0 1,096.7
20.4 1,117.1
1.9 1.9
2.3 8.8
2.0 22.8
1.4 63.3
7.7 46.7
3.1 10.0
2.0 12.7
0.0 46.0
0.0 90.5
0.0 126.5
0.0 125.2
0.0 136.4
0.0 108.5
0.0 95.0
0.0 93.0
0.0 52.0
0.0 52.0
0.0
20.4
26.0 1,117.1
Table 12e EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

millions Total Capital Cost to the Private Sector 50.0 711.0 32.0 36.0 29.4 26.0 35.8 326.0 28.2 19.4 312.2 16.6 1,622.6 Start on Site Date 200809 200809 200809 200809 200708 01/10/2006 01/12/2006 29/10/2005 03/03/2005 23/12/2004 12/09/2003 24/05/1999 Completion Date 199798 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201112 201213 Being nalised Being nalised 200809 01/10/2008 01/12/2008 01/04/2009 01/01/2008 01/02/2007 01/05/2008 01/10/2000 0.0 0.0 5.0 71.1 3.2 3.6 2.9 16.9 23.3 81.5 7.1 66.7 198.4 19.1 6.5 9.0 65.2 32.5 106.7 20.8 23.4 7.4 12.5 177.8 8.0 9.0
East Midlands Schemes with capital cost 10m! Leicestershire Partnership University Hospitals of Leicester Melton, Rutland & Harborough PCT Hinckley & Bosworth PCT Derbyshire Mental Health East Lincolnshire PCT Northamptonshire Healthcare Sherwood Forest Hospitals Daventry & South Northamptonshire PCT Nottinghamshire Healthcare Derby Hospitals Nottingham University Hospital TOTAL
Status SOC OBC OBC OBC OBC OBC OBC FC FC FC FC OP
Total 50.0 711.0 32.0 36.0
142.2
142.2
71.1
45.4 1.7 1.7 10.8 10.8 4.2 4.2 0.0 45.4
1.9 86.1 88.0
32.6 2.8 12.6 54.6 102.6
2.6 3.6 48.9 18.3 4.9 43.3 121.6
65.2
32.6
16.1 198.8 255.9 239.9 142.2 142.2 71.1
29.4 26.0 35.8 326.0 28.2 19.4 312.2 16.6 0.0 1,622.6
24.3 1,646.9
0.0 0.0
0.0 0.0
1.6 3.3
3.1 13.9
5.2 9.3
0.0 0.0
0.0 45.4
6.0 94.0
0.0 102.6
8.4 130.0
0.0 198.4
0.0 198.8
0.0 255.9
0.0 239.9
0.0 142.2
0.0 142.2
0.0 71.1
0.0
24.3
0.0 1,646.9
Table 12f EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

millions Total Capital Cost to the Start on Site Private Sector Date 317.0 500.0 142.0 272.0 627.0 378.9 26.1 12.8 137.0 18.0 28.1 64.1 86.6 2,609.6 9.9 2,619.5 200809 200809 200708 200708 08/06/2006 27/11/2002 19/12/2002 20/03/2002 01/05/2001 15/08/2000 08/12/1999 31/03/1999 18/03/1999 Completion Date 199798 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 Being nalised Being nalised Q2 2009 Being nalised Q1 2010 10/07/2006 15/10/2004 23/06/2003 01/12/2004 18/03/2002 01/09/2001 01/03/2002 18/03/2002 0.0 0.0 0.0 31.7 50.0 14.2 27.2 62.7 75.8 94.1 37.9 21.3 40.8 156.8 47.6 75.0 42.6 68.0 125.4 79.3 125.0 42.6 54.4 125.4 63.4 100.0 21.3 54.4 62.7 63.4 100.0 31.7 50.0
West Midlands Schemes with capital cost 10m! Royal Wolverhampton Hospitals Sandwell & W Birmingham2010
Status SOC SOC
Total 317.0 500.0 142.0 272.0 627.0 378.9
Walsall Hospitals OBC University Hospitals of North StaVordshire OBC University Hospitals Birmingham University Hospitals Coventry & WarwickshireWalsgrave Sandwell & W BirminghamCity Hospital The Royal Wolverhampton Hospitals Dudley Group of Hospitals Birmingham & Solihull Mental Health North StaVordshire Combined Healthcare Hereford Hospitals Worcestershire Acute TOTAL FC OP OP OP OP OP OP OP OP
27.2
37.9 2.6 8.3 20.6 4.5
56.8 17.0 3.2 41.1
94.7 6.5 41.1
75.8
6.4 8.7 15.1 0.0 15.1
2.8 16.0 21.7 40.5 1.6 42.1
1.8 18.2 28.8 39.0 87.9 3.1 91.0
1.3 13.7 11.7 7.0 12.8 17.3 63.8 5.2 69.0
20.6
73.9 0.0 73.9
118.1 0.0 118.1
142.4 0.0 142.4
96.3 0.0 96.3
138.5 0.0 138.5
173.3 0.0 173.3
300.6 0.0 300.6
358.6 0.0 358.6
426.7 0.0 426.7
301.8 0.0 301.8
190.6 0.0 190.6
81.7 0.0 81.7
26.1 12.8 137.0 18.0 28.1 64.1 86.6 0.0 2,609.6 0.0 9.9
0.0 2,619.5
Table 12g EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

millions Total Capital Cost to the Start on Site Private Sector Date 550 330 148.0 100.0 307.0 29.9 186.0 30 36.1 76.0 15.0 15.0 158.0 1,981.0 21.6 2,002.6 200809 200809 200809 200809 200708 200607 200607 29/06/2006 27/03/2006 27/10/2004 04/05/2001 21/11/2000 09/01/1998 Completion Date 199798 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 Being nalised Being nalised Q3 2011 Q1 2012 Q1 2012 200809 Q2 2009 01/08/2008 20/11/2007 01/02/2007 28/04/2003 09/09/2002 21/09/2001 1.5 9.8 23.7 35.0 5.2 40.2 9.8 3.8 13.5 0.0 13.5 3.8 55.0 33.0 14.8 10.0 46.1 7.5 55.8 7.5 82.5 49.5 22.2 15.0 76.8 55.8 137.5 82.5 44.4 30.0 61.4 27.9 110.0 66.0 44.4 30.0 61.4 110.0 66.0 22.2 15.0 30.7 55.0 33.0
East of England Schemes with capital cost 10m! East & North Hertfordshire West Hertfordshire Papworth Hospitals Southend Hospital Peterborough Hospitals South Essex Partnership Mid Essex Hospitals Brentwood, Billericay & Wickford PCT Ipswich Hospital Cambridge University Hospitals Addenbrookes Royston, Buntingford & Bishops Stortford Luton & Dunstable Norfolk & Norwich TOTAL
Status SOC SOC SOC SOC OBC OBC OBC FC FC FC OP OP OP
Total 550.0 330.0 148.0 100.0 307.0 29.9 186.0 30.0 36.1 76.0
7.6
3.6 19.0
3.0 18.6 3.0 23.5 34.2
30.7 19.4 27.9 19.5 9.0 15.2
15.8 15.8 0.0 15.8
23.7 23.7 0.0 23.7
47.4 47.4 1.6 49.0
1.5 47.4 48.9 6.5 55.4
3.8 6.0 9.8
7.6 2.3 9.9
22.6 0.0 22.6
82.3 0.0 82.3
121.8 0.0 121.8
229.6 0.0 229.6
301.8 0.0 301.8
383.7 0.0 383.7
311.8 0.0 311.8
243.9 0.0 243.9
88.0 0.0 88.0
15.0 15.0 158.0 0.0 1,981.0 0.0 21.6
0.0 2,002.6
Table 12h EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

millions Total Capital Cost to the Start on Site Private Sector Date 328.0 305.0 144.0 337.9 40.0 108.0 1,000.0 32.7 72.0 238.0 31.9 75.4 54.8 69.3 21.9 60.0 14.5 422.0 10.8 10.8 46.1 75.5 54.3 117.9 15.0 96.1 3,781.9 35.2 3,817.1 200809 200809 200708 200708 200708 200708 27/04/2006 23/11/2004 08/07/2004 15/01/2004 09/10/2002 06/05/2004 27/01/2004 06/11/2003 05/12/2002 30/01/2001 05/09/2000 12/07/2000 04/07/2000 04/07/2000 20/03/2000 06/12/1999 01/02/1999 19/11/1998 11/12/1998 01/07/1998 Completion Date 199798 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 Being nalised Q4 2010 Q2 2010 Q2 2010 01/05/2009 200910 01/09/2013 01/10/2006 01/12/2006 15/11/2006 01/09/2006 10/03/2006 08/07/2006 16/03/2006 21/04/2005 16/05/2003 11/06/2002 12/06/2005 20/12/2001 04/03/2002 11/09/2003 07/10/2002 02/03/2002 29/03/2003 30/03/2000 28/02/2001 0.0 2.1 2.1 14.4 33.8 6.0 10.8 150.0 32.8 30.5 21.6 50.7 26.0 16.2 250.0 49.2 45.8 43.2 84.5 10.0 32.4 200.0 82.0 76.3 43.2 67.6 32.4 200.0 65.6 61.0 21.6 67.6 16.2 100.0 65.6 61.0 32.8 30.5
London Schemes with capital cost 10m! Whipps Cross University Hospital
Status SOC
Total 328.0 305.0
North West London HospitalsNorthwick SOC Park Royal National Orthopaedic Hospital SOC Hillingdon Hospital SOC Barnet & Chase Farm Hospitals SOC North Middlesex Hospitals OBC Barts & The London FC Kingston Hospital FC Lewisham Hospital FC Barking Havering & Redbridge Hospitals FC The Whittington Hospital FC Wandsworth PCTRoehampton OP Newham Healthcare OP North West London Hospitals OP Brent PCTWillesden OP West Middlesex University Hospitals OP East London & the City Mental Health OP University College London Hospitals OP Oxleas OP North East London Mental Health OP St Georges Hospital OP Kings Healthcare OP Barnet & Chase Farm Hospitals OP Bromley Healthcare OP Queen Marys Hospital Sidcup OP Queen Elizabeth Hospital OP TOTAL Schemes with capital cost between 1m"10m TOTAL OVERALL TOTAL FOR PFI
33.8
3.2
23.8 20.7 5.5 6.9 14.2 12.0 84.4
5.4 11.8 1.5 9.6 28.3 4.1 32.4
4.6 7.6 13.6 17.7 9.8 24.0 77.2 1.4 78.6
6.0 1.5 42.2 1.1 1.1 30.0 18.9 24.4 35.4 3.8 43.2 207.5 0.1 207.6
15.0 9.4 63.3 7.0 7.0 11.5 34.0 10.9 35.4 19.2 212.7 13.4 226.1
2.2 27.0 3.6 105.5 2.7 2.7 15.1 17.7
3.3 7.2 35.7 8.0 7.5 35.6 17.3 5.5
21.3 46.8 71.4 49.0 13.7 31.2
100.0 8.2 18.0 71.4 18.9 13.9
35.7
84.4
42.2
179.7 12.0 191.7
167.6 0.1 167.7
204.5 0.1 204.6
275.6 1.1 276.7
230.3 0.2 230.5
250.7 0.6 251.3
427.8 0.0 427.8
465.0 0.0 465.0
501.4 0.0 501.4
332.0 0.0 332.0
160.4 0.0 160.4
63.3 0.0 63.3
144.0 337.9 42.0 108.0 1,000.0 32.7 72.0 238.0 31.9 75.4 54.8 69.3 21.9 60.0 14.5 422.0 10.8 10.8 46.1 75.5 54.3 117.9 15.0 96.1 0.0 3,783.9 0.0 35.2
0.0 3,819.1
Table 12i EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

millions Total Capital Cost to the Start on Site Private Sector Date 427.6 36.0 29.0 22.0 94.0 608.6 36.8 645.4 01/11/2006 10/06/2004 29/10/2001 24/06/1999 30/07/1997 Completion Date 199798 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 01/08/2010 30/04/2007 01/11/2003 31/01/2001 11/09/2000 42.8 9.0 64.1 106.9 85.5 85.5 42.8
South East Coast Schemes with capital cost 10m! Maidstone & Tunbridge Wells Brighton and Sussex University Hospitals Guildford & Waverley PCTFarnham Sussex Partnership Dartford & Gravesham TOTAL
Status OBC FC OP OP OP
Total 427.6 36.0 29.0 22.0 94.0 608.6 36.8 645.4
3.6 2.2 42.3 44.5 1.6 46.1 14.3 18.8 33.1 1.8 34.9 2.9 5.5 8.4 0.8 9.2 18.9 7.3
23.4
9.4 9.4 2.5 11.9
23.5 23.5 2.3 25.8
18.9 2.8 21.7
7.3 5.0 12.3
3.6 6.5 10.1
23.4 4.0 27.4
51.8 9.5 61.3
64.1 0.0 64.1
106.9 0.0 106.9
85.5 0.0 85.5
85.5 0.0 85.5
42.8 0.0 42.8
0.0 0.0 0.0
0.0 0.0 0.0
0.0 0.0 0.0
Table 12j EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

millions Total Capital Cost to the Start on Site Private Sector Date 200.0 80.0 193.0 129.0 36.0 134.0 37.0 46.6 18.8 29.7 45.1 949.2 37.0 986.2 2010/11 2008/09 01/09/2005 14/08/2005 18/11/2004 19/12/2003 20/04/2002 21/05/2004 04/07/2002 02/05/2001 14/12/1997 Completion Date 199798 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 Being nalised Q4 2010 01/06/2009 01/04/2008 29/12/2006 30/05/2007 01/10/2006 15/04/2006 01/03/2004 29/04/2003 17/10/2000 20.0 8.0 57.9 38.7 12.0 57.9 19.4 24.0 29.0 30.0 24.0 50.0 12.0 40.0 40.0
South Central Schemes with capital cost 10m! Heatherwood & Wexham Park Southampton University Hospitals Portsmouth Hospitals Oxford RadcliVe Hospitals New Forest PCTLymington Oxford RadcliVe Hospitals NuYeld Orthopaedic Centre Buckinghamshire HospitalsStoke Mandeville Newbury PCT Berkshire Health Care Buckinghamshire Hospitals TOTAL
Status SOC SOC FC FC FC FC FC OP OP OP OP
Total 180.0 80.0 193.0 129.0 36.0 134.0 37.0 46.6 18.8 29.7 45.1 929.2 37.0 966.2
3.7
13.4 24.1
3.6 20.1 9.3 4.7 4.7
12.9 23.4 40.2 30.3
19.3 19.4 9.0 40.2 11.7
29.0 38.7 20.1
3.0 4.5 4.5 2.5 7.0 29.3 29.3 2.3 31.6 11.3 11.3 1.6 12.9 0.0 1.8 1.8 3.0 0.8 3.8
1.9 19.3 24.9 2.8 27.7
12.2 7.4 57.1 5.0 62.1
42.3 6.5 48.8
106.8 13.7 120.5
99.5 0.0 99.5
87.8 0.0 87.8
104.6 0.0 104.6
89.3 0.0 89.3
73.0 0.0 73.0
54.0 0.0 54.0
62.0 0.0 62.0
40.0 0.0 40.0
40.0 0.0 40.0
Table 12k EXPENDITURE PROFILE OF CAPITAL SPEND ON PFI SCHEMES

millions Total Capital Cost to the Private Sector 400.0 209.0 104.0 80.0 317.0 163.0 20.7 83.0 24.1 10.4 32.0 10.2 100.2 1,553.6 16.8 1,570.4 Start on Site Date 200910 200809 200809 200809 200809 200708 07/08/2006 01/03/2004 04/03/2004 01/07/2002 01/05/2002 31/10/2000 05/10/1999 Completion Date 199798 199899 19992000 200001 200102 200203 200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 Being nalised Being nalised Being nalised Being nalised Being nalised Being nalised 01/05/2008 13/06/2006 19/05/2006 25/05/2004 30/11/2004 01/06/2002 03/12/2002 0.0 2.5 2.5 0.0 2.3 2.3 40.0 20.9 10.4 8.0 31.7 16.3 2.1 37.4 6.0 13.5 16.6 24.5 5.2 31.4 15.6 12.0 47.6 48.9 60.0 62.7 31.2 24.0 79.3 48.9 100.0 62.7 31.2 24.0 63.4 24.5 80.0 31.4 15.6 12.0 63.4 31.7 80.0 40.0
South West Schemes with capital cost 10m! Plymouth Hospitals Plymouth Hospitals United Bristol Taunton & Somerset North Bristol/South Gloucestershire South Devon Healthcare Taunton & Somerset Avon & Western Wiltshire Mentral Health Salisbury Healthcare Mid Devon PCT Gloucestershire Royal Cornwall Healthcare Swindon & Marlborough TOTAL Schemes with capital cost between 1m-10m TOTAL OVERALL TOTAL FOR PFI
Status SOC SOC SOC SOC SOC SOC OBC OP OP OP OP OP OP
Total 400.0 209.0 104.0 80.0 317.0 163.0
10.0 10.0 1.6 11.6
1.0 15.0 16.1 1.8 17.9
6.6 30.1 36.7 0.8 37.5
1.0 3.2 2.6 30.1 36.9 2.8 39.7
6.8 20.8 15.0 42.6 5.0 47.6
8.3 2.4 2.6 8.0
20.8 15.7
21.3 0.0 21.3
36.4 0.0 36.4
45.4 0.0 45.4
46.4 0.0 46.4
100.6 0.0 100.6
195.4 0.0 195.4
306.1 0.0 306.1
305.8 0.0 305.8
202.4 0.0 202.4
111.7 0.0 111.7
20.7 83.0 24.1 10.4 32.0 10.2 100.2 40.0 1,553.6 0.0 16.8
40.0 1,570.4
2.3.2 Could the Department detail increases to the capital cost of PFI schemes and comment on any increases over 10%? (Q13)
Answer The information requested is given in Table 13a to Table 13j. Table 13a INCREASES TO THE CAPITAL COST OF PFI SCHEMES A North East B Capital Cost at OBC Stage millions Tees, Esk & Wear Valleys Northumberland, Tyne & Wear Langaurgh PCT Tees, Esk & Wear Valleys/Derwentside PCT Total North East 73.0 50.0 40.0 40.0 203.0 C Capital Cost Reported Last Year millions 78.0 50.0 N/A N/A 128.0 D Capital Value This Year millions 78.0 50.0 40.0 40.0 208.0 6.8% 0.0% 0.0% 0.0% N/A 0.0% N/A N/A E % Increase Since OBC Stage F % Increase Since Last Year
Comment on any increases over 10% since last year None Table 13b INCREASES TO THE CAPITAL COST OF PFI SCHEMES A North West B Capital Cost at OBC Stage millions St Helens & Knowsley Salford Royal Hospitals Tameside & Glossop Aintree Hospitals Mersey Care Royal Liverpool Childrens Hospital Royal Liverpool University Hospital Blackpool PCT Total North West 229.8 114.0 41.0 50.0 120.0 300.0 500.0 51.0 1,405.8 C Capital Cost Reported Last Year millions 380.1 190.0 114.7 50.0 120.0 300.0 500.0 N/A 1,654.8 D Capital Value This Year millions 338.0 190.0 109.3 42.2 170.0 300.0 500.0 51.0 1,700.5 47.1% 66.7% 166.6% "15.6% 41.7% 0.0% 0.0% 0.0% "11.1% 0.0% "4.7% "15.6% 41.7% 0.0% 0.0% N/A E % Increase Since OBC Stage F % Increase Since Last Year
Comment on any increases over 10% St Helens & Knowsley Hospitals OBC costs Exclusion of Primary Care Elements (inc Newton, Millennium Centre, Elyn Lodge) Consumerism/Capacity Planning/Service changes Additional on cost items (inc Highways, drainage, contamination) Functional content changes Exclusion of IT elements 229.8 "21.8 17.8 15.8 18.4 "6.1
Equipment requirements Ination Adjustment Indexation to MIPS 415 (VOP) Revised PSC costs (inc VAT) 150 beds and two theatres shelled for possible future use at Whiston Hospital. Top oor of diagnostic and treatment centre and two theatres shelled for possible future use at St Helens. Final Capital cost at nancial close Salford SOC cost Building Ination Improving the patient experience Estates standard A&E Shift to HDU beds Post acute bed Neonatal & Childrens On costs Ceiling limits Decked car park Equipment Contingency Reduction in VAT free costs Increase in Health and Social centre costs Withdrawal of HSCCs from scheme costs (now being procured under NHS LIFT) Reconciliation Reduction of new build following review in 2003 395 Acute wards, Childrens Unit omitted Researchretained in existing Womensretained in existing (previously adapted) General changes in dermatology/diabetes etc Ination to out-turn Planned out-turn capital value The recently announced re-appraisal value of 112 million represented the PFI element of the scheme at a present MIPS level. The 190 million is the whole scheme cost including publicly funded elements at outturn MIPS. Tameside & Glossop SOC cost Improving the Patient Experience/modernisation Equipment Renal MRI Opthamology NBI growth EMI Total OBC Increase in MIPs from 395 to 425 Original scheme at MIPs 425 Reduction in scheme content Revised scheme at MIPs 425 Ination adjustment to out-turn Planned out-turn capital value This scheme had a PFI re-appraisal value of 68 million. This represented the PFI only elements of the scheme. 109.3 million is the total post re-appraisal capital cost including publicly funded elements. Aintree Hospitals 50 million was the Aintree element of the original Pan-Merseyside SOC (2004). Once the constituent parts were separated, Aintree emerged with a SOC of 42 million.
16.5 47.1 62.6 380.1 "42.1 338
114 12 10 9 4.1 3.8 2.5 2.2 18.3 1.5 4 4.6 3.9 3.1 3.3 "19.4 "3.2 "3.6 16.1 "16.0 "4.0 "6.0 "8.2 38.0 190.0
41.0 18.3 3.5 1.0 1.6 4.2 4.5 10.1 84.2 7.4 91.6 "8.3 83.3 30.5 114.7
Mersey Care 120 million was the Mersey Care element of the original Pan-Merseyside SOC (2004). The same value expressed at an outturn price basis plus VAT is 170 million. This scheme is part of the PFI re-appraisal exercise and is in the process of being reviewed; scope and capital cost are therefore subject to further change.
Table 13c
INCREASES TO THE CAPITAL COST OF PFI SCHEMES A Yorkshire & the Humber B Capital Cost at OBC Stage millions Mid Yorkshire Hospitals Hull & East Yorkshire Hospitals (Oncology) Leeds Teaching HospitalsChildrens Total Yorkshire & the Humber 164.1 37.6 229.0 430.7 C Capital Cost Reported Last Year millions 265.7 63.6 260.0 589.3 D Capital Value This Year millions 280.0 67.0 260.0 607.0 70.6% 78.2% 13.5% 5.4% 5.3% 0.0% E % Increase Since OBC Stage F % Increase Since Last Year
Comment on any increases over 10% Mid Yorkshire Hospitals Capital cost at SOC stage Increase relating to the NHS Estates Departmental Cost Allowance Guides (DCAGs) taking into account the new principles in order to produce a better patient environment Changes in functional content Additional scope and space requirements MIPS to present base Increase at BAFO stage Decreases post preferred bidder Other reductions Current Capital value This scheme is part of the PFI re-appraisal exercise and is in the process of being reviewed; scope and capital cost are therefore subject to further change. Hull and East Yorks Capital cost at SOC stage Improving the patient environment Increased linnear accelerators (3 to 6) Ination Undergraduate teaching accommodation Reprovision of boiler house Other functional and infrastructure changes Increase in planning contingency Increased equipment costs MIPS increases Leeds Teaching Hopsitals Addition of Optimism bias This scheme is part of the PFI re-appraisal exercise and is in the process of being reviewed; scope and capital cost are therefore subject to further change. 164.1 23.3 12.6 3.2 80.9 21.4 "17.6 "7.9 280
37.6 2.9 6.1 9.2 1.2 1.5 1.4 0.3 0.8 6.0 67
Table 13d INCREASES TO THE CAPITAL COST OF PFI SCHEMES A East Midlands B Capital Cost at OBC Stage million Sherwood Forest Hospitals University Hospitals of Leicester Northamptonshire Healthcare Derbyshire Mental Health East Lincolnshire PCT Leicestershire Partnership Melton, Rutland & Harborough PCT Hinckley & Bosworth PCT Total East Midlands Comments on any increases over 10% Sherwood Forest Hospital including emergency care and pathology, development of the clinical design, inclusion of backlog maintenance, equipment requirements and increasing car park capacity and indexation. University Hospitals of Leicester UHL Pathway project initially increased by 56.3% since SOC approval. This was due to a number of factors: the application of improving the patient environment standards, ination and the inclusion of the reprovision of academic space due to be replaced within the PFI, design development costs and MIPS. Last years gures of 574 million was the Public Sector Comparator Cost at preferred bidder stage which equates to a PFI outturn cost of 761 million. Building cost ination and RPI increases for the two years slippage in forecast nancial close took the cost to 906 million from which the PFI reappraisal exercise cut almost 200 million. Northampton Healthcare Change due to MIPs ination and variations to scheme regarding Low Secure accommodation and car parking. Leicestershire Partnership Currently in the process of drafting an OBC and rening the required scope of the scheme. Table 13e INCREASES TO THE CAPITAL COST OF PFI SCHEMES A West Midlands B Capital Cost at OBC Stage millions University Hospital of North StaVordshire University Hospitals Birmingham Royal Wolverhampton Walsall Hospitals Sandwell & West Birmingham Hospitals Total West Midlands 224.0 291.0 110.0 43.0 591.0 1,259.0 C Capital Cost Reported Last Year millions 391.3 696.0 317.0 164.5 591.0 2.159.8 D Capital Value This Year millions 272.0 627.0 317.0 140.9 500.0 1,856.9 21.4% 115.5% 188.2% 227.7% "15.4% "30.5% "9.9% 0.0% "14.3% "15.4% E % Increase Since OBC Stage F % Increase Since Last Year 66.0 286.0 19.5 31.6 24.1 52.0 30.00 36.0 545.2 C Capital Cost Reported Last Year million 296.0 574.0 31.2 28.5 24.1 67.2 N/A N/A 1,021.0 D Capital Value This Year millions 326.0 711.0 35.8 29.4 26.0 50.0 32.0 36.0 1,246.2 393.9% 148.6% 83.6% "7.0% 7.9% "3.8% 6.7% 0.0% 10.1% 23.9% 14.7% 3.2% 7.9% "25.6% N/A N/A E % Increase Since OBC Stage F % Increase Since Last Year
Comments on any increases over 10% North StaVordshire Hospitals The increase from 224 million to 391.3 million was a result of: Uplift from MIPS 345 to MIPS 415. Inclusion of expansiona nd eduction space. Adjustment to outturn prie level. As a result of the PFI re-appraisal the value of the scheme was cut to 272 million. University Hospitals Birmingham The change from 291 million to 696 million was as a result of MIPS Increases (including shift to outturn MIPS reporting), Additional carparks and miscellaneous works including Trend Growth, enhanced external fac ade, extra curtain walling, comfort cooling, patient hotel etc. The gure quoted last year of 696 million was the Public Sector Comparator. The actual nal outturn capital cost to the private sector plus publicly funded elements (which is calculated on a diVerent basis) at nancial close was 627 million. This compares to a gure of 637 million immediately before the PFI reappraisal ie it resulted in a fall to the capital cost of approximately 10 million. Walsall Hospitals Initial increases from 43 million to 164.5 million was due to MIPS and the inclusion of the Multi Professional Education Scheme in PFI (peviously a separate scheme). As a result of the PFI re-appraisal the capital value has fallen to 140.9 million. Sandwell & West Birmingham Hospitals This scheme is part of the PFI re-appraisal exercise and is in the process of being reviewed; scope and capital cost are threfore subject to further change. Table 13f INCREASES TO THE CAPITAL COST OF PFI SCHEMES A East of England B Capital Cost at OBC Stage millions Peterborough & Stamford Hospitals Mid Essex hospitalsChelmsford Ipswich Hospital Billericay, Brentwood & Wickford PCT South Essex Partnership Papworth Hospital Southend Hospital East & North Hertfordshire1 West Hertfordshire Hospitals1 Total East of England 135.0 80.0 24.9 20.0 29.9 148.0 100.0 550.0 330.0 1,417.8 C Capital Cost Reported Last Year millions 381.0 186.0 35.0 25.8 29.9 148.0 100.0 N/A N/A 905.7 D Capital Value This Year millions 307.0 186.0 36.1 30.0 29.9 148.0 100.0 550.0 330.0 1,717.0 127.4% 132.5% 45.0% 50.0% 0.0% 0.0% 0.0% 0.0% 0.0% "19.4% 0.0% 3.1% 16.3% 0.0% 0.0% 0.0% N/A N/A E % Increase Since OBC Stage F % Increase Since Last Year
1. Single 880 million scheme in Hertfordshire has now been split into two separate schemes. Comment on any increases over 10% Peterborough The original increase from 135 to 381 million was a result of the inclusion of new DCAGs for improving the patient environment, expansion of cancer, renal and neo-natal intensive care services, inclusion of 23.8 million Mental Health scheme and change to outturn MIPS. Last years gure of 381 million represented the PSC value of the Acute element only. The PFI value of all three elements (Acute, Mental Health and Intensive Care Centre) is 307 million.
This scheme is part of the PFI re-appraisal exercise and is in the process of being reviewed; scope and capital cost are therefore subject to further change. Ipswich Capital cost now based on outturn MIPS. Billericay, Brentwood & Wickford Capital cost now based on outturn MIPS. Table 13g INCREASES TO THE CAPITAL COST OF PFI SCHEMES A London B Capital Cost at OBC Stage millions Barts & The London North Middlesex Barnet & Chase Farm Whipps Cross North West London Hospitals Northwick Park Royal National Orthopaedic Hospital Hillingdon Hospital Total London Comments on any increases over 10% Barts and the London The Barts and The London OBC was approved at a cost of 462 million. The gure reported previously (620 million) included an estimate for building cost ination, due to the complexity and duration of the scheme. The increase to the current forecast outturn is explained as follows: m OBC approved capital cost (MIP295) Changes in scope of project (MIP295) Building cost ination Current forecast outturn cost (equivalent to MIPS 460) Mothballing of three oors and removal of refurbishment components Final outturn capital cost at nancial close 462 237 429 1,128 128 1,000 620.0 73.0 41.0 184.0 305.0 121.0 314.9 1,658.9 C Capital Cost Reported Last Year millions 1,128.0 108.0 79.8 328.0 305.0 121.0 337.9 2,407.7 D Capital Value This Year millions 1,000.0 108.0 40.0 328.0 305.0 144.0 337.9 1,934.9 61.3% 47.9% "2.4% 78.3% 0.0% 19.0% 7.3% "11.3% 0.0% "49.9% 0.0% 0.0% 19.0% 0.0% E % Increase Since OBC Stage F % Increase Since Last Year
It should be noted that the increase from 620 million to 1,128 million was the cumulative increase over the last four years since the OBC was approved but prior to the decreases arising from the PFI reappraisal exercise. North Middlesex Hopsital NHS Trust The main reason for the increase is the 18% increase in out-turn ination of 13.2 million due to upwards revision of MIPS indices since OBC. Pressures on accommodation requirements, including the issue of new building standard notes has resulted in an increase in functional content of 4.8 million, or 4.6%. The active switching element of IT1.2 millionwas expected to be funded directly by the Trust, however there is insuYcient block capital funding available. The overall increase in the net cost of equipment is 3.7 million. The scheme also now includes Ophthalmology1.7 million, which the PCTs have asked to be included but was not in the original OBC, and approximately 2,200 m2 of shelll space3.0 million. In addition, a separate Business Case for a new energy centre and 100% standby generation facility for the site which is now part of the project scope was approved in July. This scheme is part of the PFI re-appraisal exercise and is in the process of being reviewed; scope and capital cost are therefore subject to further change. Barnet & Chase Farm This scheme is part of the PFI re-appraisal exercise and is in the process of being reviewed; scope and capital cost are therefore subject to further change.
Whipps Cross University Hospital NHS Trust Scheme costs increased from the 184 million whaich appeared in its SOC to the 328 million in its approved OBC. This was due to changes in the MIPS index, change in location factor and the consequent increases in associated costs (fees, contingencies etc) and taking into account the full improving the patient experience and revised space standards. Due to the withdrawal of one of the biders and aVordability concerns, the trust decided in June 2006 not to proceed with the scheme as currently congured. A new OBC is now being prepared based on a phased development which will be submitted to DH when ready. The scheme will not therefore be part of the PFI re-appraisal process.
Royal National Orthopaedic Hospital The 121 million value quoted last year was the value of the preferred option in the original SOC. This rose to 153 million in the rst draft OBC to reect changing MIPS levels and then to 170 million in the second draft OBC for the same reason. The value has now been rescoped with a reduced value of 144 million. This scheme is part of the PFI re-appraisal exercise and is in the process of being reviewed; scope and capital cost are therefore subject to further change. Table 13h INCREASES TO THE CAPITAL COST OF PFI SCHEMES A South East Coast B Capital Cost at OBC Stage millions Maidstone & Tunbridge Wells Total South East Coast 175.0 175.0 C Capital Cost Reported Last Year millions 427.6 427.6 D Capital Value This Year millions 427.6 427.6 144.3% 0.0% E % Increase Since OBC Stage F % Increase Since Last Year
Comments on any increases over 10% since last year Maidstone & Tunbridge Wells MIPS, VAT and optimism bias. This scheme is subject to the PFI re-appraisal process and has not yet been reviewed. The nal agreed scope and capital cost are not known at present. Table 13i INCREASES TO THE CAPITAL COST OF PFI SCHEMES A South Central B Capital Cost at OBC Stage millions Portsmouth Hospitals Oxford RadcliVe HospitalsCancer Southampton Heatherwood & Wexham Park Hospitals Total South Central 127.7 60.0 52.0 550.0 789.7 C Capital Cost Reported Last Year millions 193.0 129.0 80.0 550.0 952.0 D Capital Value This Year millions 236.0 129.0 69.0 200.0 634.0 84.8% 115.0% 32.7% "63.6% 22.3% 0.0% "13.8% "63.6% E % Increase Since OBC Stage F % Increase Since Last Year
Comments on any increases over 10% Portsmouth Hospitals The change in capital value from 127 million to 193 million was a result of: Impact of change from MIPs 378 to MIPs 415. Additional 20 Maternity beds. Impact of building regulations. Thje value quoted last year of 193 million was not Outturn. Final outturn value of scheme is 236 million.
Oxford RadcliVe Capital cost at MIPS 325 Elderly care scheme added Elderley scheme subsequently removed Uplift from MIPS 325 to 438 Addition of variant proposals; Private pateints, Theatres, PET/MRI build 00046timism bias and VAT Final Capital cost at Financial close Southampton The change in capital value from 52 million to 80 million is the result of MIPS and a 15% contingency been applied to the SOC. The latest capital value of the draft OBC is 69 million. This scheme is part of the PFI re-appraisal exercise and is in the process of being reviewed; scope and capital cost are therefore subject to further change. 60.0 27.2 "27.2 20.8 19.1 29.3 129.2
Heatherwood & Wexham The gure of 550 million represented the most costly option in the initial Strategic Outline Case. 200 million represents scaled down plans which feature in the schemes draft OBC. This scheme is part of the PFI re-appraisal exercise and is in the process of being reviewed; scope and capital cost are therefore subject to further change. Table 13j INCREASES TO THE CAPITAL COST OF PFI SCHEMES A South West B Capital Cost at OBC Stage millions Taunton and SomersetCardiac South Devon Taunton & Somerset Plymouth Hospitals Plymouth Hospitals North Bristol/South Gloucestershire Total South West 16.0 65.0 75.0 200.0 400.0 310.0 1,066.0 C Capital Cost Reported Last Year millions 18.0 341.2 75.0 200.0 400.0 310.0 1,344.2 D Capital Value This Year millions 20.7 163.0 80.0 209.0 400.0 317.0 1,189.7 29.4% 150.8% 6.7% 4.5% 0.0% 2.3% 15.0% "52.2% 6.7% 4.5% 0.0% 2.3% E % Increase Since OBC Stage F % Increase Since Last Year
Comments on any increases over 10% Taunton & Somerset Increase from MIPS 325 to MIPS 489
South Devon Healthcare SOC value The gure of 65 million was the anticipated cost at the SOC stage. the SOC for Torbay was focused on an improvement in Surgical Services and A&E only and the refurbishment of 15,600m2 of existing buildings. Following the SOC and as a consequence of a review of the Torbay site conducted by external advisers to the NHS Estates Design Panel, it was recognised that this solutionw as impractical due to the fragmented nature of previous developments on this site. Consequently a wider review of the services provided on site was undertaken which resulted in the recognistion of the need for a more comprehensive development at Torbay, which reected the objectives of the NHS Plan. In carrying out this further evalution it was also possible to include many of the items included in Improvements to the Patient Environment agenda, which had not been refpected in the original review. The SOC at Newton Abbot had an allowance for the purchase of industrial land at a cost of 0.9 million which was subsequently rezoned and re-valued at 2.5 million. Additionally, with the review of the services at Torbay it was recognised that a number of these services would be more appropriately located at Newton Abbot. The movement in MIPS to take us from current cost, which teh estimate last year was bsed on, to outturn cost when the hospital has completed its 76 million. In addition some further minor amendments were made to the scheme to incorporate the Breast Care Unit, the TAIRU Unit and Occupational Therapy Building. Previously the services provided in these areas were not being included within the PFI project. In addition the gure submitted last year of 250 million was an estimated gure prior to the completion of an OBC which was completed and signed oV by the SHA in May of this year. The work conducted for the OBC provided a more accurate costing and movement in capital cost of 9 million. Value quoted last year
65 130
42
1.6 11.4 76 6
341
Since last year, rescoping work had already cut the scheme to 222 million from which the PFI reappraisal exercise subsequently reduced the value further to 163 million. 2.3.3 Could the Department provide an update of Tables 5.3.5, showing for projects over 25 million in value, a comparison between the PFI price and the publicly nanced option? The publicly nanced comparators costings should be broken down into (a) basic construction contract, distinguishing pre-implementation and post-implementation costs, (b) the value of risk adjustment, again distinguishing pre-implementation and postimplementation costs, in both m and percentage terms, and (c) the nal total real full-life cost of both options. (Q14) Answer 1. The information requested is given in Table 14a to Table 14h. Table 14a BILLERICAY, BRENTWOOD AND WICKFORD PCT Publicly funded option PFI option NPC Risk NPC Risk ( millions) ( millions) Risk (%) ( millions) ( millions) 40.6 32.0 72.6 83.5 2.6 8.3 10.9 6.4 25.9 15.0 n/a n/a 79.4 81.7 0.4 1.9 2.3
Phase of project Pre-implementation Post-implementation Total Risk adjusted total
Risk (%) n/a n/a 2.9
Table 14b IPSWICH HOSPITAL Publicly funded option PFI option NPC Risk NPC Risk ( millions) ( millions) Risk (%) ( millions) ( millions) 29.4 30.2 59.6 70.5 4.7 6.2 10.9 16.0 20.5 18.3 n/a n/a 67.3 69.3 0.6 1.4 2.0
Table 14c
BARTS AND THE LONDON Publicly funded option PFI option NPC Risk NPC Risk ( millions) ( millions) Risk (%) ( millions) ( millions) 3,884.0 3,929.0 7,813.0 8,110.0 230.0 67.0 297.0 5.9 1.7 3.8 3,395.0 4,314.0 7,709.0 7,815.0 80.5 26.0 106.0
Risk (%) 2.4 0.6 1.3
Table 14d
ST HELENS AND KNOWSLEY HOSPITALS Publicly funded option PFI option NPC Risk NPC Risk ( millions) ( millions) Risk (%) ( millions) ( millions) 1,204.2 2,729.6 3,933.8 4,030.7 29.1 67.8 96.9 2.4 2.5 2.5 n/a n/a 3,950.6 3,980.6 1.6 28.4 30.0
Table 14e
HULL & EAST YORKSHIRE HOSPITALS Publicly funded option PFI option NPC Risk NPC Risk ( millions) ( millions) Risk (%) ( millions) ( millions) 62.4 524.7 587.1 600.3 6.5 6.7 13.2 10.4 1.3 2.2 n/a n/a 594.6 596.6 1.2 0.8 2.0
Table 14f
SHERWOOD FOREST HOSPITALS Publicly funded option PFI option NPC Risk NPC Risk ( millions) ( millions) Risk (%) ( millions) ( millions) 995.2 2,631.4 3,626.6 3,724.7 24.4 73.7 98.1 2.5 2.8 2.7 n/a n/a 3,638.5 3,658.8 4.1 16.2 20.3
Table 14g PORTSMOUTH HOSPITALS Publicly funded option PFI option NPC Risk NPC Risk ( millions) ( millions) Risk (%) ( millions) ( millions) 193.1 154.2 347.3 421.9 18.3 56.3 74.6 9.5 36.5 21.5 n/a n/a 380.7 (1) 405.0 4.0 20.3 24.3
Footnotes: 1. Portsmouth is the second of two pilot schemes to sign that utilises the Credit Guarantee Finance (CGF) 2. Under CGF, instead of the private sector raising the money through traditional bond or bank debt nance, the government provides the project funding (senior debt) through issuing Government gilts. Benets are that Government gilts are always cheaper than provate sector borrowing. The private sector still retains the anncial risks on the projects for which it adds a premium. Table 14h OXFORD RADCLIFFE HOSPITALS Publicly funded option PFI option NPC Risk NPC Risk ( millions) ( millions) Risk (%) ( millions) ( millions) 170,946.0 491,385.0 662,331.0 707,531.0 19,032.0 26,168.0 45,200.0 11.1 5.3 6.8 n/a n/a 697,935.0 702,654.0 3,152.0 1,597.0 4,749.0
2.3.4 What is the value of annual unitary payments made in the lastest available year for each PFI scheme in operation? what is the Reference Cost Index (excluding Market Forces Factor) position of each trust, where the England average equals 100? (Q15) Answer 1. The information requested is given in Table 15. Table 15 UNITARY PAYMENTS AND REFERENCE COSTS FOR LATEST AVAILABLE YEAR 200405 Organisationwide index including excess bed days(1) 97 112 96 101 110 100 101 100 98
Scheme Avon & Western Wiltshire MH NHS Trust Barnet and Chase Farm Hospitals NHS Trust Berkshire Healthcare NHS Trust Birmingham & Solihull Mental Health NHS Trust Brent PCT Bromley Hospitals NHS Trust Buckinghamshire Hospitals NHS Trust Buckinghamshire Hospitals NHS TrustStoke Mandeville Cornwall Partnership NHS Trust County Durham & Darlington Acute Hospitals NHS Trust Bishop Auckland County Durham & Darlington Acute Hospitals NHS Trust Chester-le-street
Operational date 13/06/2006 02/03/2002 29/04/2003 18/03/2002 21/04/2005 29/03/2003 17/10/2000 15/04/2006 01/06/2002 08/06/2002 30/05/2002
Unitary payment (m) 200607 6.3 15.1 4.5 6.4 2.9 20.1 11.6 8.6 2.7 9.3 2.2
Scheme County Durham & Darlington Acute Hospitals NHS Trust Dryburn Dartford and Gravesham Hospital NHS Trust Doncaster & South Humber Healthcare NHS Trust Dudley Group of Hospitals NHS Trust East Lancashire Hospitals NHS TrustBlackburn East Lancashire Hospitals NHS TrustBurnley East London & the City Mental Health NHS Trust Guildford & Waverley PCT Hereford Hospitals NHS Trust Hull and East Yorkshire Hospitals NHS Trust Kings College Hospital NHS Trust Leeds Mental Health Teaching NHS Trust Leeds Teaching Hospitals NHS TrustWharfedale Mid Devon PCT Newbury & Community PCT Northumberland, Tyne & Wear NHS Trust Newham Healthcare NHS Trust Norfolk and Norwich Health Care NHS Trust North Cumbria Acute Hospitals NHS Trust North East London Mental Health NHS Trust North Kirklees PCT North StaVordshire Combined Healthcare NHS Trust North West London Hospitals NHS Trust Nottingham University Hospitals NHS TrustQueens Medical Centre Queen Elizabeth Hospital NHS Trust Queen Marys Hospital Sidcup NHS Trust Royston, Buntingford & Bishops Stortford PCT Salisbury Health Care NHS Trust Sandwell & West Birmingham Hospitals NHS Trust South Manchester University Hospitals NHS Trust South Tees Acute Hospital NHS Trust St Georges Healthcare NHS Trust Sussex Partnership NHS Trust Swindon & Marlborough NHS Trust Tees, Esk & Wear Valleys NHS TrustWest Park The Royal Wolverhampton Hospitals NHS Trust University Hospitals Coventry & Warwickshire NHS Trust Wandsworth PCT West Middlesex University Hospital NHS Trust Worcestershire Acute Hospitals NHS Trust Total unitary payments made in 200607 Footnotes: 1. Latest available year. 2. Specifc data issues highlighted by organisation. 3. Information is not provided for Foundation Trusts.
Operational date 02/04/2001 11/09/2000 06/06/2005 01/04/2005 08/07/2006 23/05/2006 11/06/2002 01/11/2003 01/03/2002 29/03/2003 07/10/2002 16/12/2002 04/11/2004 25/05/2004 01/03/2004 15/05/2006 08/07/2006 21/09/2001 10/04/2000 04/03/2002 14/11/2005 01/09/2001 19/03/2006 01/10/2000 28/02/2001 30/03/2000 28/04/2003 19/05/2006 28/11/2005 25/07/2001 01/08/2003 11/09/2003 31/01/2001 03/12/2002 13/12/2004 23/06/2003 10/07/2006 10/03/2006 16/05/2003 18/03/2002
Unitary payment (m) 200607 13.5 20.5 1.8 18.2 8.5 3.1 1.6 3.2 11.9 2.2 18.3 9.1 1.8 1.4 3.2 5.0 11.2 42.7 15.1 1.3 2.1 3.9 7.1 3.0 21.1 2.1 2.0 2.5 3.2 22.2 28.2 7.8 4.0 19.5 0.8 3.3 41.0 10.2 11.0 23.4 501.9
200405 Organisationwide index including excess bed days(1)
96 96 95 96 130 2 79 97 97 118 104 111 95 110 97 110 98 98 98 72 94 109 88 113 102 117 88 98 96 101 123 96 106 98 106 98 132 128 102
2.3.5 Could the Department list PFI schemes subject to an increase in the unitary fee, including the increases and explanation of them? (Q16) Answer 1. The information requested is given in Table 16.
Table 16 INCREASE IN UNITARY FEE DURING THE LAST YEAR

Trust Worcestershire Acute Hospitals Barking, Havering & Redbridge Hospitals Unitary fee at FC 000 19,399 31,003 Revised Unitary Fee 000 23,481 36,103 % change 21.0 16.5 Reason Additional services extended to Newtown Site; additional equipment and other design and building changes required by the Trust. The original baseline gure was quoted at a April 2002 price basis but the scheme actually signed in January 2004. Present unitary payment gures have therefore been put on a 2002 price basis to enable an accurate statement of increases caused by variations. The 5.1 million increase is due to the eVects of increased FM costs arising from enhanced NHS pay and conditions from Agenda for Change per RoE staV (1.2 million), the eVects of Capital Variations to the build (1.8million) and for the need to revise upwards the level of equipment required in the Managed Equipment Service (2.1 million). The capital variations were anticipated at nancial close and related to the tting out of shell space as inpatient ward areas. These were nanced by a variation bond. Expansion of Cardio facilities, soft/hard FM increases in service, Academic centre. The increase from last year is to reect the fact that the payment prole is uneven and has therefore been smoothed in the Trust accounts (as agreed with the trusts External Auditors). 21,768 million is the amount reported in the year end accounts. Additional services and upgrade costs required by the Trust. Since last year a further 398k has been added to the unitary payment for pay harmonisation. Increases this year are to reect the increase in TUPE/ROEd transferred staV costs due to Agenda for Change and Supperannuation. The gure of 18.2 million presented last year was at an incorrect price basis and has now been readjusted to prices at FC. In addition, minor adjustments have been made since last year relating to reduced services to the education centre ("27k), increased linen/laundry services for patient patient volume (!22k), reduced volume on snack boxes ("10k), increased catering charges relating to patient volumes (!59k), additional for security (!5k), additional wall washing (!86k) and additional waste relating to patient volumes (!19k). In this rst negotiation of the new Retention of Employment (ROE) model, trust accepted risk that Whitley pay rises would exceed RPI. Capital contract variations to include equipment on Digital Equipment package and other woks variations with a net revenue impact in unitary charge. 0.9% Pathology Contract variation; Extension of IT services Minor variations In addition to the Comfort cooling systems identied last year there have been subsequent increases for a Surgeons Theatre Panels upgrade and Endoscopy Wash room upgrade. Minor variation at Fromeside Unit Minor variations Since last year, the increases previously reported have been oVset by the exclusion of the managed IM&T service within the contract. This has been brought back in-house to facilitate an intergrated IM&T service between the two Trust sites and to ensure congruence with the roll out of the Connecting for Health oVerings.
South Tees Hospital South Manchester University Hospital Trust Hereford Hospitals Kings Healthcare Wandsworth PCTQueen Marys Roehampton Queen Elizabeth Hospital
21,935 19,754 9,690 17,989 9,700 16,649
24,760 21,768 10,482 19,209 10,187 17,460
12.9 10.2 8.2 6.8 5.0 4.9
University Hospitals Coventry & Warwickshire Dudley East Lancashire HospitalsBlackburn Cambridge University Hospitals Avon & Wilshire Mental Health East Lancashire HospitalsBurnley Barnet & Chase Farm Hospitals
50,211 26,727 11,653 6,295 6,730 3,132 16,679
52,513 27,277 11,864 6,351 6,783 3,138 15,075
4.6 2.1 1.8 0.9 0.8 0.2 "9.6
2.4 Primary Care 2.4.1 Could the Department list all NHS LIFT schemes and their expected capital costs? (Q17) Answer The information requested is given in Table 17. Table 17 NHS LIFT SCHEMES
LIFT Scheme 1st Wave Barnsley Camden & Islington East London Manchester, Salford & TraVord Financial close date 30/01/2004 16/07/2004 01/05/2003 01/07/2004 LIFT Company Global Solutions/Babcock & Brown Community Solutions for Primary Care Ltd Global Solutions/Babcock & Brown Excellcare Capital cost Capital Capital Capital of tranche 1cost of tranchecost of tranchecost of tranche 2 3 4 13.12 3.5 24.5 18.4 3.6 19 13 12.7 Buildings open to patients GoldthorpeDec 2004 WorsbroughOct 2004 ThurnscoeNov 2004 Hanley RoadJune 2005 Bingeld StreetAugust 2005 The Centre Manor ParkSept 2004 Boleyn Centre, Barking RoadAugust 2005 Special Addiction Unit, Mile EndMarch 2006 Douglas Green Centre, SalfordNov 2005 PartingtonJanuary 2006 BenchillJanuary 2006 WythenshaweMay 2006 Brunton ParkMarch 2005 ShiremoorMarch 2005 WalkerJune 2005 KentonSeptember 2005 Birmingham Rd Health CentreMarch 2005 Oldbury Health CentreMay 2005 WhiteheathSeptember 2005 0 ThamesviewApril 2005 Broad StreetJune 2005 Harold Hill CentreOct 2005 (partially open) Church Elm Lane, DagenhamNov 2005 CranhamDecember 2005 South HornchurchApril 2006 Marks GateJune 2006 Chelmsley WoodJuly 2005 Woodgate ValleyJuly 2005 Low MoorJanuary 2006 (partially open) Westbourne GreenMarch 2006 Liskeard Health CentreJune 2005 Roche Health Centre, BodminDec 2005 Longford Primary Care Centre April 2006 Keresley Green Medical CentreApril 2006 BacupMarch 2005 NelsonMay 2005 DarwenJune 2005 millions
Newcastle and North Tyneside
11/05/2004
Robertson
13.4
Sandwell Total capital cost wave 1 2nd Wave Barking & Havering
15/01/2004
Excellcare
7.4 80.32
2.4 38 12.7
04/12/2004
Primaria
46.7
Birmingham & Solihull Bradford Cornwall & Isles of Scilly Coventry East Lancashire
21/07/2004 19/10/2004 24/05/2004 08/12/2004 24/10/2003
Birmingham & Solihull Solutions B & N Group Ltd 1st Health Solutions GB Consortium Eric Wright Group
6.3 14.8 3.46 7 23
4.7
18.95
1.4
14.79
Table 17 (continued) NHS LIFT SCHEMES

Financial close date 20/09/2004 18/08/2004 18/06/2004 15/12/2005 03/02/2005 05/08/2004 Capital cost of tranche 1 LIFT Company Sewell Excellcare GB Consortium Ryhurst Prime Ryhurst 6.8 8.9 10.64 18.2 6.9 15.06 167.76 31/01/2004 Eric Wright Group 17 Capital cost of tranche 2 2.1 6.5 16.2 Capital cost of tranche 3 Capital cost of tranche 4
millions
LIFT Scheme Hull Leicester Liverpool & Sefton Medway North StaVordshire Redbridge & Waltham Forest Total capital cost wave 2 3rd Wave Ashton, Leigh & Wigan
Buildings open to patients MareetSeptember 2005 NewlingtonFebuary 2006 Narborough Road Medical PracticeNov 2005 AinsdaleJune 2005 West EvertonJuly 2005 LitherlandSeptember 2005 (partially open) PackmoorApril 2006 Comely Bank, Waltham ForestSept 2005 Manford WaySeptember 2005 Wood Street, Waltham ForestMarch 06
54.45 13
1.4
14.79 AthertonJanuary 2005 Lower InceMay 2005 Worsley MesnesJune 2005 KidgloveJanuary 2006 Vale DriveDecember 2005 (Partially open) Forest RoadMarch 06 Monks Park, WembleyJune 2006 Fishponds CentreJune 2005 Hampton HouseNovember 2005 Colchester Primary Care CentreApril 2006 Eden SurgeryAugust 2005 The Lighthouse ChaddesdenMarch 2006 Long EatonMay 2006
Barnet, Eneld & Haringey Brent, Harrow & Hillingdon Bristol Bromley, Bexley & Greenwich Colchester & Tendring Derby Doncaster Dudley Ealing, Hammersmith & Hounslow East Hampshire, Fareham & Gosport Greater Notts
15/07/2004 22/12/2004 07/05/2004 01/03/2005 07/07/2004 03/12/2004 29/09/2005 07/10/2005 22/03/2005 09/02/2005 14/06/2004
GB Consortium Global Solutions / Babcock & Brown Infracare (South West) Global Solutions / Babcock & Brown Mill Group Excellcare Community Solutions for Primary Care Ltd Infracare (South West) Building Better Health Community Solutions for Primary Care Ltd Excellcare
13.6 17.5 15.9 54.8 35.8 16.8 8.89 13.2 28.6 7.8 33.5
8 12.1
24.8
Cloister RoadFenruary 2006 RownerDecember 2005 Oak Park Phase 1March 2006 CarltonJanuary 2006 StaplefordMarch 2006 Clifton CornerstoneApril 2006
Table 17 (continued) NHS LIFT SCHEMES

millions Financial close date 06/12/2005 28/09/2004 Capital cost of tranche 1 31 18.1 13.6 ArmleyNovember 2005 MiddletonOctober 2005 WoodhouseDecember 2005 ParksideJanuary 2006 Plowright Medical Centre, SwaVhamMay 2005 Sherringham Health CentreAugust 2005 MoorsideFebruary 2006 The Leys Health CentreJanuary 2006 Ernstelle GreenSeptember 2005 Tower HillDecember 05 Widnes Resource CentreFebruary 06 Lawson Street, StocktonMarch 05 Phoenix Centre, ParkeldsJanuary 2006 Gem Centre, Bentley BridgeApril 2006 0 0 Capital cost of tranche 2 Capital cost of tranche 3 Capital cost of tranche 4
LIFT Scheme Lambeth, Southwark & Lewisham Leeds
LIFT Company Building Better Health Primaria
Buildings open to patients
Norfolk North Notts Oldham Oxford Plymouth SheYeld South West London St Helens, Knowsley, Halton and Warrington Tees Wolverhampton Total capital cost wave 3 4th Wave Bolton, Rochdale, Heywood and Middleton Bury, Glossop and Tameside Southend, Castle Point and Rochford South East Midlands South Midlands South West Hampshire Wiltshire Total capital cost wave 4 Overall capital cost totals
21/05/2004 01/12/2005 17/11/2004 29/11/2004 21/10/2004 13/10/2005 28/04/2005 20/10/2004 13/10/2004 10/11/2004
Guildhouse Investment Management Excellcare 1st Health Solutions Infracare (South West) Midas Sutton Harbour 1st Health Solutions Building Better Health William Pears Family Holding Bradford & Northern Group Group 4 & Babcock & Brown
3.98 32 2.52 16 14.6 5 18.48 12.3 7 8 432.37
5 6
16.4 10.1 109
OJEU02/11/05 OJEU30/09/05 OJEU19/05/05 OJEU27/10/05 OJEU27/10/05 OJEU21/12/05 OJEU
0 0 0 0 0 0 0 0 910.79
Footnotes: 1. This table represents data as at 30 June 2006.
2.4.2 What has revenue spending on GP premises been in each year since 199798? Could the Department comment on the consistency of this series? (Q18) Answer 1. The data requested is given in Table 18. 2. In the main, revenue spend on GP premises is to support capital borrowed by GPs who build and own their own premises or invested by private landlords who rent the premises to GPs and their staV. In addition, revenue funding grants made to practices as a contribution towards the cost of improvements to premises; for example to build an extension to better deliver services. 3. As indicated in the table, spend on PMS premises was not collected until 200405 and the sharp decrease in the totals from 200102 reects proportionate increased take-up of PMS. Whilst accurate comparisons cannot be made between pre and post 2004 data, around 40% of practices are covered by PMS and it is expected that a similar proportion will comprise total premises spend. Table 18 REVENUE SPEND ON GP PREMISES SINCE 199798 Year 199798 199899 19992000 200001 200102 200203 200304 200405(3) 200506(3) Source: PCT FIMS returns. Footnotes: 1. Personal medical services (PMS) was introduced in 1998 and premises spend data not collected until 200405. 2. Sharp decrease in spend between 200102 to 200405 reects proportionate increased take-up of PMS. 3. GMS and PMS allocations. Actual spend returns being validated. 2.5 Personal Social Services (PSS) Investment 2.5.1 Could the Department tabulate Local Authority Personal Social Services capital expenditure, broken down into maintenance and new acquisitions, and income, broken down into sale of buildings and sale of equipment, from 199798 to 200506? (Q19) Answer 1. The information requested is given in Table 19. Table 19 LOCAL AUTHORITY PERSONAL SOCIAL SERVICES CAPITAL EXPENDITURE AND INCOME 199798 TO 200607
millions 200506 (provisional) 200607 (provisional)
millions 292.2 319.3 321.5 334.2 302.5 282.3 270.4 577.0 661.0
199798 Maintenance New acquisitions TOTAL SPEND Sale of buildings Sale of equipment TOTAL RECEIPTS NET SPEND 11.8 138.2 150 34.4 8.6 43 107.0
199899 19992000 10.9 129.1 140 42.4 10.6 53 87.0 10.4 123.6 134 40.8 10.2 51 83.0
200001 12.3 143.7 156.1 50 12 63 93.3
200102 12.5 145.5 158.3 64.5 5.5 70.4 87.9
200203(2)
200304
200405
199.3 75.0 124.3
260.0 74.5 185.5
284.5 77.0 207.5
286.0 75.0 211.0
469.0 126.0 343.0
Source: COR (Outturn to 200405), CPR4 (Provisional) and CER (Forecast) returns. Footnotes: 1. Figures may not sum due to rounding. 2. From 200203 the breakdown between maintenance and new acquisitions and the sale of buildings is no longer available.
2.5.2 What Personal Social Services PFI projects have been (a) approved and (b) given ministerial approval? Could details of value, approval date and completion date be included? (Q20) Answer 1.The information requested is given in Table 20. 2. The table shows, in alphabetical order, the PFI credits awarded to all the social care PFI schemes, including those that have reached nancial close. Approval date and, where available, estimated completion date, are included. 3. In the 2005 HSC response, ve schemes were noted as having bid. These (Birmingham, East Sussex, Medway, Tower Hamlets and Wolverhampton) all received Ministerial approval and are included in the table. They are currently undergoing the OBC approval stage, and will be applying for Treasury endorsement of the PFI credits award in the next few months. 4. The bidding round in 2005 also included the 200607 year in order to fund the ve preferred bids. As this took up the bulk of the availble funding, new bids will only be invited from 200708 onwards. It has not yet been decided whether this will be via a formal bidding round (as in 2005) or through ad hoc bids (as was the approach before 2005). 5. Ministerial approval is the rst stage in the approvals process. A Local Authority may put forward a social care proposal to DH via either an Expression of Interest (EoI) or a Strategic Outline Case (SOC). If this meets the evaluation criteria, Ministerial approval of an initial allocation of PFI credits is given. 6. The second approval stage is approval by Treasury, and when social care projects have been approved, the award of the PFI credits by the DH Minister is formally endorsed. This approval is based on Outline Business Cases (OBC); the subsequent Full Business Case, prior to contract signature, is approved by the sponsoring department (ie DH) only. (However, if the amount requested for PFI credits increases, further Treasury endorsement may be necessary.)
Table 20 SOCIAL CARE PFI SCHEMES(1)

Council Birmingham Coventry Croydon Dudley Ealing East Sussex Greenwich Hammersmith and Fulham Harrow Harrow Hertfordshire Kent Kent Leeds Medway Newham Northampton Portsmouth Richmond Sandwell SheYeld Shropshire StaVordshire Surrey Tower Hamlets Westminster Wolverhampton Type of scheme Four special care centres for older people New Homes for Older People Older People Health and Social Care community resource centre. Resource Centres for Older People Four centres for older peoples services Neighbourhood Resource Centres for Older People Nursing Care and Extra Care Housing for Older People Care Services for Older People Mixed Services for People with Learning Disability and Mental Health needs Childrens Homes Project Integrated Health and Social Care Services Integrated Health and Social Care Services Housing units for people with learning and other disabilities Two centres of excellence for older people Centre for people with disabilities Specialist Care Services for Older People with Dementia Mixed Services for People with Learning Disabilities Care Services for Older People Leisure and community centre Intermediate Care Community Services for people with Learning Disabilities and Older People including a Joint Service Centre Childrens Small Homes Services for Older People Three health and social care centres for independent living for people with disabilities Resource Centre for Older People Six centres, cross-linked, to provide a range of adult social services to older people and adults with disabilities PFI credits ( million) 34.700 6.900 32.026 1.500 24.200 34.700 23.900 7.300 2.400 10.000 19.400 9.100 13.700 14.200 17.340 2.500 14.300 5.300 9.500 10.000 17.200 18.120 5.300 28.800 15.970 4.300 22.600 Approved(2) Oct 2005 (DH) Oct 2003 (HMT) Sept 2004 (HMT) 199899 Oct 2001 Oct 2005 (DH) Oct 2002 (HMT) April 2001 (HMT) 199798 (HMT) 2000 (HMT) June 2004 (HMT) Dec 2000 (HMT) Oct 2001 (HMT) July 2006 (HMT) Oct 2005 (DH) Not yet approvable April 2000 (HMT) Aug 1999 (HMT) 199899(HMT) April 2000 (DH) Feb 2005 (DH) Aug 2003 (HMT) Aug 1999 (HMT) 199798 (HMT) Oct 2005 (DH) 199798 (HMT) Oct 2005 (DH) Completion date End 2008(3) 24 March 2006 (contract signed) September 2006 Contract signed 19992000(4) 31 March 2005 (contract signed) End 2008 End 2004 (contract signed) End 2004 (contract signed) End 1999 (contract signed) End 2001(contract signed) End 2007 19 November 2003 19 November 2003(5) End 2007 End 2008 End 2003 (contract signed) End 2001 (contract signed) End 2000 (contract signed) End 2008(6) End 2007 19 May 2005 (contract signed) End 2003 (contract signed) End 1997 (contract signed) End 2008 End 199798 (contract signed) End 2008
Footnotes: 1. Eneld, shown in last years HSC return, was considering an application for PFI credits but this was not taken forward. The council is therefore no longer in the table. 2. The later approval date. ie Treasurys is shown where that has been given. 3. The schemes receiving DH ministerial approval in 2005 are currently estimated to reach completion by end of 2008. More precise dates will be provided once Treasury endorsement has been received. 4. Where contract signature is shown as within a nancial year, or by the end of a calendar year, the exact date is not currently available. 5. The two Kent schemes were rolled into one, with the same contract signature date. 6. The Sandwell scheme has experienced problems and has not yet received Treasury endorsement. As with the successful 2005 bidders, it is at OBC stage, so has been given the same estimated completion date of end 2008.
2.5.3 Could the Department compare actual capital spend by social services departments with allocations in each year since 199798? Could the Department comment on comparability through the period? (Q21) Answer 1. Table 21 compares total actual capital spend by social services departments with the funding provided by the Department of Health through supported capital expenditure. 2. The table shows that annual total capital spend has doubled between 199798 and 200405. Provisional estimates for 200506 suggest total capital expenditure will be 386 million. 3. Capital support provided by the Department is only one source of capital for local authorities. Local authorities can fund their capital requirements in other ways, for example through capital receipts, joint funding, EU funding and through the Private Finance Initiative. 4. Additional capital support is also provided by the Department for Education and Skills which took over responsibility for childrens social services from 1 April 2003. Table 21 LOCAL AUTHORITY PERSONAL SOCIAL SERVICES CAPITAL EXPENDITURE, DEPARTMENTAL SUPPORTED CAPITAL EXPENDITURE 199798 TO 200506
millions 200506 (pro200405 visional) 299.0 386.0(4) 25.0
Total spend Capital grants Credit approvals/ supported capital expenditure (revenue) Total provision
199798 150.0 13.2
199899 19992000 140.0 134.0 8.2 6.2
200001 163.0 8.2
200102 158.0 9.3
200203 199.3 40.7
200304 260.0 25.0
68.2 81.4
53.7 62.0
55.7 62.0
55.7 63.9
55.7 65.0
55.7 96.5
50.2 75.2
52.9 77.9
Source: Local Government Finance Statistics. Footnotes: 1. Figures may not sum due to rounding. 2. Figures to include childrens services up to 200203. 3. Credit approvals abolished 31 March 2004. 4. Financing gures for 200506 provisionally anticipated to be available November 2006.
3. NHS Plan & Reform 3.1 StaV 3.1.1 How many (a) total doctors (b) consultants (c) GPs (d) total qualied nursing and midwifery staV (e) midwives (f) practice nurses (g) total qualied scientic and therapeutic staV (h) radiographers (i) clinical psychologists (j) total NHS infrastructure support staV (k) clerical and administrative staV and (l) managers and senior managers have been employed by the NHS in each year since 1997, in headcount and full time equivalent terms? Where available, what are the latest quarterly gures? (Q22) Answer The information requested is given in Table 22a (headcount) and Table 22b (full time equivalent). Quarterly gures are not available.
Table 22a NHS STAFF IN EACH SPECIFIED GROUP IN ENGLAND AS AT 30 SEPTEMBER EACH SPECIFIED YEAR
headcount 1997 1998 1999 2000 2001 2002 2003 2004 2005 Increase Percentage since 1997 Increase since 1997 32,726 5,913 10,519 85,305 4,515 2,423 38,236 2,768 2,336 432 3,084 49,764 17,218 72,695 36.52% 20.12% 48.98% 26.75% 24.55% 10.82% 39.71% 23.52% 22.54% 30.70% 76.37% 29.17% 77.65% 45.30%
All doctors (excl retainers)(1) of which GPs (excl retainers)(2)(3) Consultants (including directors of public health) Total qualied nursing staV(3) of which GP practice nurses(2) Registered midwife Total qualied scientic, therapeutic & technical staV of which Radiography staV Diagnostic radiography Therapeutic radiography Clinical psychology NHS infrastructure support of which Manager & senior manager Administrative and clerical staV(5) Source: The Information Centre for health and social care
89,619 29,389 21,474 318,856 18,389 22,385 96,298 11,771 10,364 1,407 4,038 170,623 22,173 160,479
91,837 29,697 22,324 323,457 18,894 22,841 99,656 12,118 10,645 1,473 4,408 168,448 22,693 162,521
93,981 29,987 23,321 329,637 19,495 22,799 102,391 12,330 10,839 1,491 4,572 171,205 24,287 167,451
96,319 30,252 24,401 335,952 19,200 22,572 105,910 12,489 11,036 1,453 5,032 173,733 25,256 174,347
99,169 30,685 25,782 350,381 19,846 23,075 110,241 12,706 11,163 1,543 5,514 179,783 27,424 184,229
103,350 31,182 27,070 367,520 20,983 23,249 116,598 13,031 11,489 1,542 6,092 189,274 32,294 195,009
108,993 32,593 28,750 386,359 21,667 23,941 122,066 13,344 11,687 1,657 6,757 199,808 35,321 209,952
117,036 34,085 30,650 397,515 22,144 24,844 128,883 13,900 12,147 1,753 7,051 211,489 37,726 223,131
122,345 35,302 31,993 404,161 22,904 24,808 134,534 14,539 12,700 1,839 7,122 220,387 39,391 233,174
Footnotes: 1. All doctors (excluding GP Retainers) also excludes hospital practitioners and clinical assistants, most of whom are GPs working part time in hospitals. 2. GP Data as at 1 October 19951999 and 30 September 20002004. 3. Nursing and midwifery gures exclude students on training courses leading to a rst qualication as a nurse or midwife. 4. Headcount Practice Nurse gures are estimated for 1998 and 1999 based on the 1997 fte to headcount ratio. 5. Administrative and clerical staV gures are made up of those counted with support to clinical staV and NHS infrastructure support.
Table 22b NHS STAFF IN EACH SPECIFIED GROUP IN ENGLAND AS AT 30 SEPTEMBER EACH SPECIFIED YEAR
full time equivalent 1997 1998 1999 2000 2001 2002 2003 2004 2005 Increase Percentage since 1997 Increase since 1997 29,493 4,023 9,951 65,444 3,711 896 31,613 2,254 1,900 354 2,187 44,500 16,115 59,669 34.80% 14.54% 50.61% 25.55% 36.81% 4.96% 38.74% 22.76% 22.02% 27.76% 64.77% 31.42% 75.18% 45.25%
All doctors (excl retainers)(1) of which GPs (excl retainers)(2)(3) Consultants (including directors of public health) Total qualied nursing staV(4) of which GP practice nurses(2) Registered midwife Total qualied scientic, therapeutic & technical staV of which Radiography staV Diagnostic radiography Therapeutic radiography Clinical psychology NHS infrastructure support of which Manager & senior manager Administrative and clerical staV(5)
84,758 27,660 19,661 256,093 10,082 18,053 81,601 9,901 8,626 1,275 3,376 141,637 21,434 131,859
86,594 27,848 20,432 257,597 10,359 18,168 84,560 10,193 8,860 1,333 3,660 139,469 21,854 132,958
88,371 28,033 21,410 261,340 10,689 17,876 86,837 10,368 9,009 1,358 3,763 142,071 23,378 136,900
90,248 28,154 22,186 266,987 10,711 17,662 89,632 10,478 9,169 1,309 4,052 144,048 24,253 142,263
92,495 28,439 23,064 277,334 11,163 18,048 93,085 10,655 9,264 1,391 4,399 149,598 26,285 150,317
96,999 28,740 24,756 291,285 11,998 18,119 98,397 10,863 9,489 1,374 4,846 158,026 30,914 158,978
102,037 29,777 26,341 304,892 12,967 18,444 102,912 11,111 9,642 1,469 5,331 167,916 33,810 171,707
109,224 30,762 28,141 315,440 13,563 18,854 108,585 11,560 10,015 1,545 5,518 178,098 36,007 183,338
114,251 31,683 29,613 321,537 13,793 18,949 113,214 12,155 10,526 1,629 5,562 186,137 37,549 191,528
Source: The Information Centre for health and social care. Footnotes: 1. All doctors (excluding GP Retainers) also excludes hospital practitioners and clinical assistants, most of whom are GPs working part time in hospitals. 2. GP Data as at 1 October 19951999 and 30 September 20002004. 3. GP full time equivalent (FTE) data has been estimated using the results from the 199293 GMP Workload Survey. For 19952003Full time % 1.00 fte; three quarter time % 0.69 fte; job share % 0.65 fte; half time % 0.60 fte. For 2004 all Part time% 0.6, and therefore may not be fully comparable with previous years. 4. Nursing and midwifery gures exclude students on training courses leading to a rst qualication as a nurse or midwife. 5. Administrative and clerical staV gures are made up of those counted with support to clinical staV and NHS infrastructure support. 6. Full time equivalent gures are rounded to the nearest whole number.
3.1.2 How many GPs (a) joined and (b) left the NHS in each year since 1997? (Q23) Answer 1. Information on the numbers of GPs that joined and left the NHS in each year since 1997 is given in Table 23. 2. The number of joiners and leavers in the GP workforce are tracked as part of the NHS workforce census. 3. In 2004 (the last year for which complete gures are available), 1,649 Practitioners (excluding GP registrars and GP retainers) left the NHS in England. This equated to 5.2% of the Practitioner workforce. In the same year, 2,930 Practitioners (excluding GP registrars and GP retainers) joined the workforce. This equated to 9.3% of the workforce. The information collected shows only the numbers and proportion of leavers and joiners, it does not specify which of the leavers had to be replaced. 4. This information is not available for other staV groups. Table 23 ALL GENERAL MEDICAL PRACTITIONERS (EXCLUDING REGISTRARS AND RETAINERS)(1), FOR ENGLAND, JOINERS AND LEAVERS, 19972005 England 1997 England All Practitioners (excluding registrars and retainers)(1) Joiners in this year Leavers from this year 28,046 28,251 28,467 28,593 28,802 29,202 30,358 31,523 32,738 .. 1,331 1,536 1,268 1,484 1,408 1,737 2,112 1,282 1,528 1,712 1,491 2,647 1,765 2,930 1,649 2,864 .. 1998 1999 2000 2001 2002 numbers (headcount) 2003 2004 2005
Source: The Information Centre for health and social care General and Personal Medical Services Statistics. Footnotes: 1. General Medical Practitioners (excluding retainers and registrars) includes Contracted GPs, GMS Others and PMS Others. 2. .. denotes data not available. 3. The gures in the table above are arrived at by checking if a Practitioners GMC number appears in consecutive years of the census. A joiner is a practitioner whose GMC number was present in a census but not observed in the previous census a leavers GMC number was in 2003 but not 2004. These gures are therefore snapshots from two specic points in time and only represent the national position at these times. They do not cover movement in and out of the NHS between these two points, nor do they relate to the local level turnover of staV between NHS Trusts. 3.1.3 How many (a) doctors (b) nurses (c) midwives and (d) radiographers are projected to complete undergraduate or pre-registration training in each of the next ve years? How many are projected to reach retirement age in each of the next ve years? Could the Department comment on relative trends? (Q24) Answer 1. The information requested is given in Table 24a and Table 24b. 2. We are now moving away from year-on-year growth in the NHS workforce to more of a steady state where there is a closer match between aVordable demand and supply. We expect workforce growth to stabilise over the next few years and the numbers of nurses, midwives and radiographers projected to complete undergraduate or pre-registration training over the next ve years reects this closer match. 3. It is the responsibility of Health Authorities and Primary Care Trusts to ensure that appropriate workforce is available to meet the needs of the local health economy. The Workforce Review Team works at national level on behalf of the NHS in England and makes recommendations on the future workforce in the NHS to inform decisions about investment in training to secure a workforce with the right skills, in the right places and in the right numbers to meet future staYng requirements. These recommendations take into account the projected numbers of graduates and the forecast retirements in the professions.
Table 24a TOTAL PROJECTED NEW GRADUATES EACH YEAR Numbers 200607 Nurses(1) Midwives(2) Therapeutic Radiographers(3) Diagnostic Radiographers(3) Doctors(4) 19,400 1,205 225 782 4,390 200708 20,200 1,340 248 782 4,910 200809 20,800 1,320 255 782 5,610 200910 18,700 1,320 255 782 5,860 201011 17,800 1,320 255 782 5,860
Source: WRT Diagnostic Radiography radiography WRT Therapeutic Radiography radiography Information centre Census 2005
proformaN:\wrt\proformas\2006\AHPs\060515-prf-diagnostic proformaN:\wrt\proformas\2006\AHPs\060515-prf-therapeutic
Footnotes: 1. The projections assumed that nursing commissions have peaked and that there will be some reduction in attrition rates. Course length has been assumed to be on average three years. 2. No future growth in commissions, attrition rate during training is 18%, (does not include second registrations). 3. The 2006 modelling has been updated for information received following the production of the 2005 proformas. 4. Data based on HEFCE actual intakes for England in years 200001 to 200506. Course duration is assumed to be ve years. Attrition rate is assumed to be 6.9% 5. Course length has been assumed to be on average three years. Diagnostic Radiography graduate numbers are based on the Higher Education Statistics Agency (HESA) data for 200405. Therapeutic radiography graduate numbers are based on the declared commssions for 200405. 6. All data rounded to three signicant gures. Table 24b TOTAL PROJECTED NHS STAFF REACHING RETIREMENT AGE EACH YEAR Numbers 200607 Nurses(1) Midwives(1) Radiographers(2) GPs(3) HCHS Doctors(4) 5,210 459 235 836 795 200708 5,570 461 179 853 837 200809 5,940 474 268 867 901 200910 6,380 497 253 882 938 201011 6,700 521 295 903 923
Source: WRT Diagnostic Radiography proformaN:\wrt\proformas\2006\AHPs\060515-prf-diagnostic radiography WRT Therapeutic Radiography proformaN:\wrt\proformas\2006\AHPs\060515-prf-therapeutic radiography These proformas will be available from the portal www.healthcareworkforce.nhs.uk in Autumn 2006 Information centre Census 2005 Footnotes: 1. Based on a retirement prole, rather than a xed retirement age. The retirement prole is arrived at by assessing past trends in retirement and applying these trends for the future. 2. The 2006 modelling has been updated for information received following the production of the 2005 proformas.
3. GP projections are based on numbers forecast to leave the workforce aged 55 and over. The gures assume the proportion of leavers in each age group will remain the same as the average number of leavers over the period 19992003. The year 200607 is taken to run from 30 September 2005 to 30 September 2006. 4. Based on numbers of consultants aged 55 and over expected to leave the profession. Retirements from the training workforce, Associate Specialists and StaV Grades are not included. Numbers represent the sum of the expected retirements in each specialty. Data source: WRT All specialties proforma 2005 (projection from the 2004 DH Census) N:\WRT\Proformas\2005\060314-SPRE-All Specialities 2005Proforma-V1-JPC.xls 5. Retirement age has been assumed to be 60. The 200607 predicted retirement gure includes all staV aged 58 as of September 2005. The model assumes that all staV aged 59 and over at september 2005 will have retired in the year 200506. Potentially there may be 30 additional retirements per year on average from this source. 6. All data rounded to three signicant gures. 3.1.4 What was total expenditure on (a) agency nurses and (b) other agency staV in each year since 199798? (Q25) Answer 1. The information requested is given in Table 25. 2. Information is collected from all Strategic Health Authorities, Primary Care Trusts and NHS Trusts in England on expenditure on agency staV. The latest year for which this data is available is 200405. 3. Foundation Trusts (FTs) came into existence for the rst time in 200405. Spend at FTs is not recorded on DH Trust or PCT Financial Returns, but is published in Annual Reports Accounts for each FT. FT Annual Reports do not report agency spend by staV category and therefore this spending is not included in this answer. 4. For England the total expenditure in 200405 under the heading of nursing, midwifery and health visiting agency staV was about 400 million (excluding trusts which became Foundation Trusts in 200405). 5. For England the total expenditure in 200405 on all other agency staV was about 862 million (excluding trusts which became Foundation Trusts in 200405). 6. The year on year trend in rising expenditure on all agency staV has started to decline. In 200405, the spend showed a decrease of 184 million over the previous year. For agency nursing, midwifery and health visiting staV 200405 was the second year in which spending has reduced, decreasing by 190 million since 200203. 7. These reductions reect the continuing impact of targeted action by the NHS Purchasing and Supply Agency, Agency Framework Agreements (AFAs), NHS Professionals and initiatives such as the National Agency StaYng Project. Table 25 SALARIES AND WAGES NON-NHS STAFF (AGENCY, ETC) Year 199798 199899 19992000 200001 200102 200203 200304 200405(1) Nursing, midwifery and health visiting () 239,077,683 292,200,951 380,197,259 435,431,882 554,323,821 589,739,230 524,675,129 399,995,000 Other staV () 300,870,876 348,922,299 404,434,567 476,883,644 634,749,545 831,218,820 921,455,247 862,053,000
Source: Annual nancial returns of NHS trusts, PCTs and SHAs. Footnotes: 1. 200405 does not include spend at trusts with foundation status.
3.1.5 What was expenditure on (a) agency nurses and (b) other agency staV in each NHS Trust, Primary Care Trust and Strategic Health Authority in 200304 and 200405, in s and as a percentage of turnover? (Q26) Answer 1. The information requested is given in Table 26a to Table 26c. 2. Information is collected from all Strategic Health Authorities, Primary Care Trusts and NHS Trusts in England on expenditure on agency staV. The latest year for which this data is available is 200405. 3. Foundation Trusts (FTs) came into existence for the rst time in 200405. Spend at FTs is not recorded on DH Trust or PCT Financial Returns, but is published in Annual Reports Accounts for each FT. FT Annual Reports do not report agency spend by staV category and therefore this spending is not included in this answer. 4. For England the total expenditure in 200304 on nursing, midwifery and health visiting agency staV was about 525 million. In 200405, total expenditure (excluding trusts which became Foundation Trusts in 200405) was about 400 million, a reduction of 125 million. 5. For England, the total expenditure in 200304 on all other agency staV was about 921 million. In 200405, total expenditure (excluding trusts which became Foundation Trusts in 200405) was about 862 million. This is a reduction of 59 million. 6. The year on year trend in rising expenditure on all agency staV has started to decline. For agency nursing, midwifery and health visiting staV this is the second year in which spending has reduced. 7. These reductions reect the continuing impact of targeted action by the NHS Purchasing and Supply Agency, Agency Framework Agreements (AFAs), NHS Professionals and initiatives such as the National Agency StaYng Project.
Table 26a SALARIES AND WAGES NONNHS STAFF (AGENCY, ETC) (BY NHS CLASSIFICATION) ENGLAND
Code NHS trust Nursing, midwifery and health visiting () RA2 RA3 RA4 RA7 RA9 RAE RAJ RAL RAN RAP RAS RAT RAX RB1 RB4 RB5 RB6 RB7 RB8 RBA RBB RBD RBF RBK RBL ROYAL SURREY COUNTY HOSPITAL NHS TRUST 1,199,238 WESTON AREA HEALTH NHS TRUST 1,488,872 EAST SOMERSET NHS TRUST 412,372 UNITED BRISTOL HEALTHCARE NHS TRUST 2,091,432 SOUTH DEVON HEALTH CARE NHS TRUST 357,005 BRADFORD TEACHING HOSPITALS NHS TRUST 758,000 SOUTHEND HOSPITAL NHS TRUST 802,394 ROYAL FREE HAMPSTEAD NHS TRUST 4,771,833 ROYAL NATIONAL ORTHOPAEDIC HOSPITAL NHS 1,153,209 TRUST NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS 2,056,863 TRUST THE HILLINGDON HOSPITAL NHS TRUST 1,133,579 NORTH EAST LONDON MENTAL HEALTH NHS 7,662,560 TRUST KINGSTON HOSPITAL NHS TRUST 3,919,036 AVON AMBULANCE SERVICE NHS TRUST 0 ESSEX AMBULANCE SERVICE NHS TRUST 0 GLOUCESTERSHIRE AMBULANCE SERVICES NHS TRUST 0 MERSEY REGIONAL AMBULANCE SERVICE NHS TRUST 0 STAFFORDSHIRE AMBULANCE SERVICE TRUST 0 SOUTH YORKSHIRE AMBULANCE SERVICE NHS TRUST 0 TAUNTON AND SOMERSET NHS TRUST 809,477 ROYAL NATIONAL HOSPITAL RHEUMATIC 53,653 DISEASES NHS TRUST WEST DORSET GENERAL HOSPITALS NHS TRUST 1,863,030 NUFFIELD ORTHOPAEDIC CENTRE NHS TRUST 155,596 WALSALL HOSPITALS NHS TRUST 821,065 WIRRAL HOSPITAL NHS TRUST 1,240,237 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.6 3.9 1.0 1.1 0.4 0.6 0.8 2.8 3.5 2.9 1.5 11.4 4.2 0.0 0.0 0.0 0.0 0.0 0.0 1.0 0.7 3.2 0.6 1.0 1.0 2,576,749 1,417,091 1,247,639 3,777,544 1,244,733 4,194,000 3,635,957 6,183,015 1,859,989 3,148,033 2,790,204 7,719,955 4,242,010 170,716 2,142,188 15,478 9,460 46,491 167,401 1,128,861 248,503 1,322,835 716,167 4,462,685 922,718 3.5 3.8 3.0 2.0 1.5 3.4 3.7 3.6 5.7 4.4 3.8 11.5 4.6 1.1 6.9 0.2 0.0 0.3 1.1 1.3 3.2 2.3 2.6 5.6 0.7 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.0 2.3 0.8 0.3 0.6 0.6 1.9 4.5 1.7 0.4 11.2 2.7 0.0 0.0 0.0 0.0 0.0 0.0 1.2 0.1 3.4 1.8 0.3 0.5 2,236,000 2,004,000 1,446,000 2,211,000 976,000 4,297,000 6,657,000 1,445,000 2,839,000 2,474,000 4,801,000 1,583,000 81,000 2,435,000 40,000 208,000 61,000 84,000 899,000 199,000 1,706,000 448,000 3,481,000 1,221,000 2.7 4.3 3.0 1.0 1.0 3.8 3.4 4.0 3.4 3.0 6.8 1.5 0.6 6.8 0.4 0.6 0.3 0.4 0.9 2.4 2.5 1.5 4.0 0.8
() 816,000 1,083,000 393,000 615,000 561,000 689,000 3,750,000 1,621,000 1,401,000 360,000 7,898,000 2,827,000 0 0 0 0 0 0 1,115,000 11,000 2,318,000 537,000 258,000 783,000
Table 26a (Continued) SALARIES AND WAGES NONNHS STAFF (AGENCY, ETC) (BY NHS CLASSIFICATION) ENGLAND
Code NHS trust Nursing, midwifery and health visiting () RBN RBQ RBS RBT RBV RBX RBZ RC1 RC3 RC9 RCB RCC RCD RCF RCS RCU RCX RD1 RD3 RD7 RD8 RDD RDE RDR RDU RDY RDZ RE6 RE9 REF ST HELENS AND KNOWSLEY HOSPITALS NHS TR THE CARDIOTHORACIC CNTR LIVERPOOL NHST ROYAL LIVERPOOL CHILDRENS NHS TRUST THE MID CHESHIRE HOSPITALS NHS TRUST CHRISTIE HOSPITAL NHS TRUST LINCOLNSHIRE AMBULANCE NHS TRUST NORTHERN DEVON HEALTHCARE NHS TRUST BEDFORD HOSPITAL NHS TRUST EALING HOSPITAL NHS TRUST LUTON AND DUNSTABLE HOSPITAL NHS TRUST YORK HOSPITALS NHS TRUST SCARBOROUGH AND NE YORKS NHS TRUST HARROGATE HEALTH CARE NHS TRUST AIREDALE NHS TRUST NOTTINGHAM CITY HOSPITAL NHS TRUST SHEFFIELD CHILDRENS NHS TRUST KINGS LYNN AND WISBECH HOSPITALS NHS TR ROYAL UNITED HOSPITAL BATH NHS TRUST POOLE HOSPITAL NHS TRUST HEATHERWOOD AND WEXHAM PARK HOSPS TRUST MILTON KEYNES GENERAL HOSPITAL NHS TRUST BASILDON & THURROCK UNIVERTSITY HOSPITAL NHS TRUST ESSEX RIVERS HEALTHCARE NHS TRUST SOUTH DOWNS HEALTH NHS TRUST FRIMLEY PARK HOSPITAL NHS TRUST DORSET HEALTH CARE NHS TRUST ROYAL BOURNEMOUTH AND CHRISTCHURCH TRUST CUMBRIA AMBULANCE SERVICE NHS TRUST SOUTH TYNESIDE HEALTH CARE NHS TRUST ROYAL CORNWALL HOSPITALS NHS TRUST 338,579 325,750 741,775 682,746 210,574 0 145,214 1,427,560 1,479,149 865,337 871,372 289,382 480,433 138,933 1,376,575 479,938 91,659 2,291,714 724,903 0 562,470 2,302,365 2,160,184 1,045,977 2,564,870 236,411 675,287 0 4,070 1,779,945 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.3 1.0 1.1 1.1 0.4 0.0 0.3 2.2 2.5 1.2 1.0 0.6 1.0 0.2 1.0 1.1 0.2 2.4 0.9 0.0 0.9 2.8 2.7 1.9 3.4 0.6 0.8 0.0 0.0 1.4 607,198 207,747 1,064,673 1,297,210 835,658 64,523 1,374,457 2,487,198 2,076,230 2,920,483 448,524 1,446,927 1,503,309 1,820,465 2,885,424 603,578 1,416,133 1,591,263 1,173,644 5,502,650 1,956,889 2,644,149 2,676,963 1,825,536 3,979,355 1,973,742 1,785,248 29,665 851,040 2,131,321 0.6 0.6 1.6 2.0 1.7 0.4 3.1 3.8 3.5 3.9 0.5 2.8 3.2 3.2 2.1 1.4 2.4 1.6 1.5 5.5 3.2 3.3 3.4 3.3 5.2 4.7 2.1 0.3 1.6 1.7 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.6 0.4 1.2 0.8 0.6 0.0 0.8 1.7 2.5 0.9 0.6 0.7 1.0 0.1 0.4 1.0 0.2 4.5 1.0 1.2 0.0 0.7 2.2 2.8 0.4 0.3 0.0 0.0 0.8 1,213,000 288,000 1,109,000 1,193,000 834,000 169,000 867,000 3,268,000 2,324,000 3,767,000 557,000 1,643,000 1,065,000 1,372,000 2,503,000 678,000 1,519,000 3,261,000 1,428,000 3,432,000 1,504,000 2,827,000 1,680,000 4,760,000 2,750,000 2,294,000 99,000 991,000 1,534,000 1.1 0.8 1.4 1.6 1.5 0.8 1.7 4.4 3.6 4.2 0.5 2.8 2.7 2.2 1.6 1.4 2.2 3.0 1.5 3.1 2.3 3.1 2.7 5.7 5.7 2.4 0.9 2.3 1.1
() 730,000 162,000 932,000 592,000 342,000 0 399,000 1,242,000 1,642,000 771,000 640,000 439,000 371,000 55,000 556,000 477,000 113,000 4,862,000 918,000 1,338,000 3,000 653,000 1,331,000 2,316,000 209,000 254,000 0 0 1,179,000
Code NHS trust Nursing, midwifery and health visiting () REM REN REP RET RF4 RFF RFK RFR RFS RFU RFW RG2 RG3 RGC RGD RGH RGM RGN RGP RGQ RGR RGT RGZ RH1 RH5 RH8 RHA RHM RHP RHQ RHR RHU AINTREE HOSPITALS NHS TRUST CLATTERBRIDGE CENTRE FOR ONCOLOGY TRUST LIVERPOOL WOMENS HOSPITAL NHS TRUST WALTON NEUROLOGY CENTRE NHS TRUST BARKING, HAVERING AND REDBRIDGE HOSP NH BARNSLEY DISTRICT GEN HOSPITAL NHS TRUST QUEENS MEDICAL NOTTS UNI HOSP NHS TRUST ROTHERHAM GENERAL HOSPITALS NHS TRUST CHESTERFIELD AND N DERBYSHIRE HOSP TRUST BEDS AND HERTS AMBULANCE AND PARAMEDIC T WEST MIDDLESEX UNIVERSITY HOSP NHS TRUST QUEEN ELIZABETH HOSPITAL NHS TRUST BROMLEY HOSPITALS NHS TRUST WHIPPS CROSS UNIVERSITY HOSP NHS TRUST LEEDS MENTAL HEALTH TEACHING NHS TRUST WEST YORKSHIRE AMBULANCE SERVICE TRUST PAPWORTH HOSPITAL NHS TRUST PETERBOROUGH HOSPITALS NHS TRUST JAMES PAGET HEALTHCARE NHS TRUST IPSWICH HOSPITAL NHS TRUST WEST SUFFOLK HOSPITALS NHS TRUST ADDENBROOKES NHS TRUST QUEEN MARYS SIDCUP NHS TRUST ROYAL BERKSHIRE AMBULANCE SERVICE TRUST SOMERSET PARTNERSHIP NHS AND SOC CARE TR ROYAL DEVON & EXETER HEALTHCARE NHS TRUST NOTTINGHAMSHIRE HEALTHCARE NHS TRUST SOUTHAMPTON UNIVERSITY HOSPS NHS TRUST DORSET AMBULANCE NHS TRUST SHEFFIELD TEACHING HOSPITALS NHS TRUST WILTSHIRE AMBULANCE SERVICE NHS TRUST PORTSMOUTH HOSPITALS NHS TRUST 1,076,798 211,087 41,496 115,890 2,831,585 308,961 2,545,044 1,583,576 318,346 0 1,651,320 1,096,737 7,228,968 7,664,581 2,844,891 0 544,978 1,626,075 726,423 1,418,647 304,408 1,025,135 301,479 0 33,657 632,970 903,076 5,546,575 0 1,094,819 0 8,295,505 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.0 1,861,594 1.3 218,649 0.1 573,151 0.6 98,549 1.5 10,606,593 0.5 1,533,927 1.5 2,682,076 2.1 107,302 0.5 1,050,974 0.0 123,670 2.8 2,720,165 1.4 2,848,744 9.5 2,334,145 8.0 6,108,467 4.5 2,771,089 0.0 11,029,982 1.6 428,033 1.9 2,034,001 1.1 2,985,904 1.5 1,711,280 0.5 2,155,253 0.6 3,105,758 0.5 1,399,556 0.0 206,685 0.1 2,602,944 0.5 2,926,774 0.6 5,012,251 2.7 3,532,455 0.0 85,802 0.3 3,450,131 0.0 237,145 4.7 11,624,261 1.8 1.3 1.7 0.5 5.5 2.4 1.6 0.1 1.5 0.6 4.7 3.7 3.1 6.4 4.4 11.6 1.2 2.4 4.4 1.8 3.2 1.8 2.4 1.8 8.9 2.5 3.4 1.7 0.9 1.1 3.2 6.6 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.4 1,796,000 1.1 106,000 0.1 314,000 1.5 184,000 1.1 11,500,000 0.4 163,000 1.3 2,177,000 0.0 1,322,000 0.9 1,039,000 0.0 291,000 1.7 1,892,000 0.5 1,364,000 6.1 3,061,000 8.3 5,492,000 3.3 2,950,000 0.0 702,000 3.3 52,000 1.0 4,164,000 1.0 1,580,000 0.5 1,560,000 0.6 771,000 0.5 1,600,000 0.2 429,000 0.4 2,561,000 0.5 6,680,000 1.6 2,647,000 0.0 112,000 0.4 1,108,000 0.0 155,000 2.3 10,072,000 1.5 0.6 0.8 0.7 5.2 0.3 1.1 1.5 1.7 1.2 2.9 1.6 3.4 5.0 4.1 1.7 0.5 5.2 1.4 2.0 1.5 2.4 3.0 7.6 3.9 1.1 0.7 1.3 1.7 5.3
() 489,000 218,000 39,000 376,000 2,530,000 217,000 2,438,000 0 523,000 0 1,086,000 379,000 5,544,000 9,112,000 2,318,000 17,000 323,000 837,000 1,102,000 401,000 312,000 324,000 23,000 124,000 813,000 3,856,000 0 341,000 0 4,324,000
Code NHS trust Nursing, midwifery and health visiting () RHW RHX RHY RJ1 RJ2 RJ5 RJ6 RJ7 RJ8 RJ9 RJC RJD RJE RJF RJH RJL RJN RJR RJX RJZ RK5 RK9 RKA RKB RKD RKE RKL RL1 RL4 RL5 RL6 RLN RLQ ROYAL BERKSHIRE AND BATTLE HOSPS NHS TR OXFORD LEARNING DISABILITY NHS TRUST TWO SHIRES AMBULANCE NHS TRUST GUYS AND ST THOMAS NHS TRUST THE LEWISHAM HOSPITAL NHS TRUST ST MARYS NHS TRUST MAYDAY HEALTHCARE NHS TRUST ST GEORGES HEALTHCARE NHS TRUST CORNWALL PARTNERSHIP NHS TRUST WESTCOUNTRY AMBULANCE SERVICES NHS TRUST SOUTH WARWICKSHIRE GEN HOSPS NHS TRUST MID STAFFORDSHIRE GEN HOSPITALS TRUST UNIV HOSP NORTH STAFFORDSHIRE NHS TRUST BURTON HOSPITALS NHS TRUST GOOD HOPE HOSPITAL NHS TRUST NORTH LINCOLNSHIRE AND GOOLE HOSPS NHS T EAST CHESHIRE NHS TRUST COUNTESS OF CHESTER HOSPITAL NHS TRUST CALDERSTONES NHS TRUST KINGS COLLEGE HOSPITAL NHS TRUST SHERWOOD FOREST HOSPITALS NHS TRUST PLYMOUTH HOSPITALS NHS TRUST WEST MIDLANDS AMBULANCE SERVICE NHS TR UNIV HOSPS COVENTRY & WARWICKSHIRE NHSTR HAMPSHIRE AMBULANCE SERVICE NHS TRUST THE WHITTINGTON HOSPITAL NHS TRUST WEST LONDON MENTAL HEALTH NHS TRUST ROB JONES AND A HUNT ORTHOPAEDIC NHS TR ROYAL WOLVERHAMPTON HOSPITAL NHS TRUST HEREFORD AND WORCESTER AMBULANCE NHS TR COVENTRY & WARWICKSHIRE AMBULANCE NHS TR CITY HOSPITALS SUNDERLAND NHS TRUST HEREFORD HOSPITALS NHS TRUST 1,358,925 968,092 0 9,947,540 2,130,325 6,379,239 3,373,059 3,889,266 293,882 0 305,040 351,811 2,751,301 1,099,569 1,733,201 820,088 392,343 607,831 0 2,637,958 447,627 4,366,267 0 1,714,847 3,584,664 2,929,157 3,605,473 29,420 3,192,476 0 0 256,504 781,052 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.1 3,329,853 4.8 23,445 0.0 96,371 3.2 15,223,591 2.4 3,422,404 4.3 10,590,750 3.7 2,825,633 2.0 9,871,049 0.6 622,625 0.0 428,655 0.6 1,596,162 0.5 671,406 1.6 3,819,993 1.8 665,060 2.6 1,144,093 0.7 1,580,877 0.8 1,259,743 0.8 1,464,668 0.0 1,087,470 1.4 7,478,624 0.5 2,014,976 2.9 2,400,213 0.0 241,866 1.0 8,506,999 12.6 318,710 3.7 4,466,226 2.7 6,827,883 0.1 173,526 2.7 2,572,372 0.0 66,658 0.0 44,499 0.2 1,998,156 1.8 1,183,533 2.8 0.1 0.5 4.9 3.9 7.2 3.1 5.1 1.3 1.2 3.2 1.0 2.2 1.1 1.7 1.3 2.6 2.0 3.7 3.8 2.4 1.6 0.6 5.0 1.1 5.6 5.1 0.7 2.2 0.8 0.5 1.6 2.8 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.7 0.1 0.0 2.3 2.0 3.9 3.2 1.6 1.0 0.0 0.7 0.5 0.9 0.8 1.5 0.8 1.0 0.0 1.3 1.9 2.4 0.0 0.3 0.0 2.8 1.0 0.3 2.2 0.0 0.0 0.1 0.9 3,378,000 1,407,000 75,000 3,718,000 3,968,000 9,882,000 3,754,000 9,631,000 968,000 199,000 1,689,000 787,000 3,758,000 869,000 1,305,000 4,288,000 1,591,000 1,088,000 6,016,000 1,966,000 3,364,000 96,000 6,980,000 105,000 3,624,000 5,334,000 317,000 1,849,000 169,000 79,000 322,000 1,935,000 2.6 5.8 0.4 4.3 3.8 6.1 3.6 4.3 1.8 0.5 2.9 1.0 1.9 1.3 1.7 3.0 2.8 3.4 2.7 2.0 2.0 0.2 3.7 0.5 4.2 3.6 1.1 1.4 1.5 0.5 0.9 4.0
() 932,000 33,000 0 1,942,000 2,153,000 6,293,000 3,326,000 3,657,000 565,000 0 438,000 378,000 1,886,000 523,000 1,160,000 1,115,000 566,000 0 2,813,000 1,911,000 4,146,000 0 479,000 0 2,457,000 1,543,000 88,000 2,986,000 0 0 40,000 442,000
Code NHS trust Nursing, midwifery and health visiting () RLT RLU RLY RM1 RM2 RM3 RM4 RM6 RMA RMC RMD RMP RMY RMZ RN1 RN3 RN5 RN7 RNA RNH RNJ RNK RNL RNN RNP RNQ RNS RNU RNY RNZ RP1 RP4 RP5 GEORGE ELIOT HOSPITAL NHS TRUST BIRMINGHAM WOMENS HEALTH CARE NHS TRUST NORTH STAFFS COMBINED HC NHS TRUST NORFOLK AND NORWICH UNI HOSP NHS TRUST SOUTH MANCHESTER UNIV HOSP NHS TRUST SALFORD ROYAL HOSPITALS NHS TRUST TRAFFORD HEALTHCARE NHS TRUST NORTHGATE AND PRUDHOE NHS TRUST GREATER MANCHESTER AMBULANCE NHS TRUST BOLTON HOSPITALS NHS TRUST LANCASHIRE AMBULANCE SERVICE NHS TRUST TAMESIDE AND GLOSSOP ACUTE SERVS NHS TR NORFOLK & WAVENEY MH PARTNERSHIP NHS TR EAST ANGLIAN AMBULANCE NHS TRUST WINCHESTER AND EASTLEIGH HLTHCRE NHS TR SWINDON AND MARLBOROUGH NHS TRUST NORTH HAMPSHIRE HOSPITALS NHS TRUST DARTFORD AND GRAVESHAM NHS TRUST DUDLEY GROUP OF HOSPITALS NHS TRUST NEWHAM UNIVERSITY HOSPITAL NHS TRUST BARTS AND THE LONDON NHS TRUST TAVISTOCK AND PORTMAN NHS TRUST NORTH CUMBRIA ACUTE HOSPITALS NHS TRUST NTH CUMBRIA MH AND LEARNING DISAB NHS TR NEWC, N TYNESIDE AND NTHUMBERLND MH NHS KETTERING GENERAL HOSPITAL NHS TRUST NORTHAMPTON GENERAL HOSPITAL NHS TRUST OXFORDSHIRE MENTAL HEALTHCARE NHS TRUST OXFORDSHIRE AMBULANCE NHS TRUST SALISBURY HEALTH CARE NHS TRUST NORTHAMPTONSHIRE HEALTHCARE NHS TRUST GREAT ORMOND ST HOSP FOR CHILDREN NHS TR DONCASTER & BASSETLAW HOSPITALS NHS TRUST 665,346 926,152 170,966 531,068 1,115,000 2,124,085 546,436 0 0 1,501,050 5,872 830,071 893,153 0 1,129,489 4,244,648 2,646,931 615,262 1,603,701 4,058,108 6,217,948 0 0 181,709 267,141 731,304 1,525,648 152,748 0 902,001 2,392,891 1,859,760 272,698 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.3 2.5 0.3 0.4 0.9 1.9 1.0 0.0 0.0 1.7 0.0 1.3 1.7 0.0 1.6 5.7 4.0 1.2 1.9 6.2 2.4 0.0 0.0 0.7 0.3 1.1 1.7 0.3 0.0 1.2 4.4 1.7 0.2 2,198,365 290,720 2,173,678 749,743 1,037,000 1,472,558 908,475 796,239 103,198 1,370,474 126,143 2,017,413 1,679,706 151,250 1,660,420 1,902,856 2,117,116 1,319,753 1,609,255 5,656,414 7,712,891 521,980 1,115,111 826,227 2,910,733 1,480,661 2,617,049 1,274,350 49,457 1,314,897 1,818,301 5,212,346 2,318,156 4.2 0.8 3.9 0.5 0.9 1.3 1.6 1.8 0.3 1.5 0.5 3.2 3.3 0.5 2.3 2.5 3.2 2.6 1.9 8.7 3.0 4.1 1.3 3.3 3.6 2.2 2.9 2.7 0.7 1.8 3.3 4.7 1.7 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.4 1.0 0.2 0.4 0.7 1.4 0.8 0.0 0.0 0.6 0.0 0.8 2.4 0.0 1.0 2.1 0.5 0.9 1.1 3.4 2.4 0.0 0.0 0.0 0.7 0.4 1.1 0.0 0.0 1.1 1.8 1.1 2,112,000 290,000 1,538,000 716,000 910,000 1,294,000 1,309,000 662,000 83,000 2,232,000 89,000 2,359,000 1,908,000 5,540,000 3,003,000 1,436,000 845,000 342,000 1,939,000 4,011,000 5,526,000 488,000 1,235,000 795,000 2,940,000 1,664,000 1,926,000 581,000 93,000 1,550,000 1,865,000 4,711,000 3.6 0.7 2.5 0.4 0.7 1.0 2.2 1.4 0.2 2.2 0.4 3.4 3.3 11.7 3.6 1.7 1.1 0.6 2.0 5.2 1.8 3.3 1.2 2.9 3.2 2.1 1.9 1.2 1.0 1.9 3.0 3.8
() 788,000 406,000 105,000 684,000 949,000 1,742,000 479,000 0 0 580,000 0 565,000 1,417,000 0 872,000 1,731,000 390,000 545,000 1,041,000 2,643,000 7,097,000 0 0 13,000 623,000 281,000 1,162,000 15,000 0 906,000 1,125,000 1,315,000
Code NHS trust Nursing, midwifery and health visiting () RP6 RP7 RPA RPC RPG RPH RPL RPQ RPR RPY RQ2 RQ3 RQ6 RQ8 RQM RQN RQQ RQW RQX RQY RR1 RR2 RR7 RR8 RRD RRE RRF RRJ RRK RRP RRU RRV MOORFIELDS EYE HOSPITAL NHS TRUST LINCOLNSHIRE PARTNERSHIP NHS TRUST MEDWAY NHS TRUST THE QUEEN VICTORIA HOSPITAL NHS TRUST OXLEAS NHS TRUST KENT AMBULANCE NHS TRUST WORTHING AND SOUTHLANDS HOSPITALS TRUST SURREY AMBULANCE SERVICE NHS TRUST ROYAL WEST SUSSEX NHS TRUST THE ROYAL MARSDEN NHS TRUST SUSSEX AMBULANCE SERVICE NHS TRUST BIRMINGHAM CHILDRENS HOSPITAL NHS TRUST ROYAL LIVERPOOL BROADGREEN UNIV HOSP TR MID ESSEX HOSPITAL SERVICES NHS TRUST CHELSEA AND WESTMINSTER HEALTHCARE TRUST HAMMERSMITH HOSPITALS NHS TRUST HINCHINGBROOKE HEALTH CARE NHS TRUST PRINCESS ALEXANDRA HOSPITAL NHS TRUST HOMERTON UNIVERSITY HOSPITAL NHS TRUST SW LONDON AND ST GEORGES MENTAL HLTH TR BIRMINGHAM HEARTLANDS AND SOLIHULL TRUST ISLE OF WIGHT HEALTHCARE NHS TRUST GATESHEAD HEALTH NHS TRUST LEEDS TEACHING HOSPITALS NHS TRUST N ESSEX MENTAL HEALTH PARTNERSHIP NHS TR SOUTH STAFFORDSHIRE HEALTHCARE NHS TRUST WRIGHTINGTON, WIGAN AND LEIGH NHS TRUST ROYAL ORTHOPAEDIC HOSPITAL NHS TRUST UNIVERSITY HOSPITAL BIRMINGHAM NHS TRUST BARNET, ENFIELD AND HARINGEY MH NHS TR LONDON AMBULANCE SERVICE NHS TRUST UNIVERSITY COLLEGE LONDON HOSPITAL NHS TRUST 1,417,324 485,150 1,213,933 453,496 1,523,671 0 1,355,966 0 1,182,960 1,237,222 0 2,833,250 1,121,291 3,607,612 3,256,497 8,806,444 212,986 3,914,860 7,268,979 7,547,169 2,043,451 1,286 969,105 2,420,146 3,032,696 986,027 783,075 568,157 2,069,290 1,517,441 0 7,343,332 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 3.6 1,499,494 1.1 1,446,981 1.5 2,711,384 2.1 217,588 2.5 3,321,796 0.0 65,385 1.7 2,373,013 0.0 38,930 1.9 2,387,106 1.9 6,040,434 0.0 69,754 3.7 2,138,129 0.8 2,016,055 3.8 4,408,883 3.2 1,902,924 4.0 17,683,401 0.5 1,033,760 5.7 2,946,789 9.9 2,435,653 7.5 9,777,228 1.5 4,122,016 0.0 1,788,780 1.3 1,421,357 0.6 5,679,156 5.3 7,987,550 1.8 724,057 0.8 1,218,001 2.7 1,446,240 1.1 5,074,281 1.8 5,431,083 0.0 2,395,090 3.3 10,055,978 3.8 3.3 3.4 1.0 5.4 0.4 3.0 0.2 3.9 9.3 0.3 2.8 1.4 4.6 1.9 8.1 2.5 4.3 3.3 9.8 3.0 2.6 1.9 1.4 14.1 1.3 1.2 6.9 2.8 6.5 2.0 4.5 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.8 1,482,000 0.7 2,083,000 2.1 54,000 1.6 2,680,000 0.0 0 0.8 2,109,000 0.0 77,000 0.7 1,513,000 0.0 115,000 1.8 1,686,000 0.2 1,924,000 0.9 4,782,000 3.0 3,064,000 1.9 13,112,000 0.4 1,144,000 2.0 2,911,000 7.6 13,694,000 1.0 4,030,000 0.1 1.0 0.3 4.7 1.8 1.2 1.9 0.6 2.1 0.0 1.8 775,000 1,173,000 4,398,000 8,473,000 572,000 1,435,000 1,158,000 1,130,000 5,272,000 2,201,000 2,012,000 2.9 2.3 0.9 3.8 0.0 2.3 0.4 2.1 0.4 1.9 1.2 4.4 2.7 5.4 2.4 3.8 12.1 2.5 1.0 1.8 1.0 13.1 1.0 1.3 4.8 2.2 5.1 1.5 3.3
() 927,000 638,000 125,000 1,155,000 0 749,000 0 514,000 0 1,597,000 321,000 929,000 3,344,000 4,586,000 191,000 1,568,000 8,607,000 1,516,000 70,000 659,000 1,286,000 3,028,000 1,041,000 1,322,000 444,000 314,000 2,178,000 0 1,111,000
Code NHS trust Nursing, midwifery and health visiting () RT1 RT2 RT3 RT5 RT6 RTC RTD RTE RTF RTG RTH RTJ RTK RTM RTN RTP RTQ RTR RTV RTX RV1 RV3 RV5 RV6 RV7 RV8 RV9 RVJ RVK RVL RVN CAMBS & PETERBOROUGH MH PARTNERSHIP TR PENNINE CARE NHS TRUST ROYAL BROMPTON AND HAREFIELD NHS TRUST LEICESTERSHIRE PARTNERSHIP NHS TRUST SUFFOLK MENTAL HEALTH PARTNERSHIP NHS TR COUNTY DURHAM AND DARLINGTON PRIOR SRV T NEWCASTLE UPON TYNE HOSPITALS NHS TRUST GLOUCESTERSHIRE HOSPITALS NHS TRUST NORTHUMBRIA HEALTH CARE NHS TRUST SOUTHERN DERBYSHIRE ACUTE HOSPITALS NHS TRUST OXFORD RADCLIFFE HOSPITALS NHS TRUST SURREY HAMPSHIRE BORDERS NHS TRUST ASHFORD AND ST PETERS HOSPITALS NHS TR EAST KENT NHS AND SC PARTNERSHIP TRUST SURREY OAKLANDS NHS TRUST SURREY AND SUSSEX HEALTHCARE NHS TRUST GLOUCESTERSHIRE PARTNERSHIP NHS TRUST SOUTH TEES HOSPITALS NHS TRUST 5 BOROUGHS PARTNERSHIP NHS TRUST MORECAMBE BAY HOSPITALS NHS TRUST TEES EAST AND NTH YORKSHRE AMB SERV NHS CENTRAL AND NORTH WEST LONDON MH NHS TR SOUTH LONDON AND MAUDSLEY NHS TRUST EAST MIDLANDS AMBULANCE SERVCE NHS TRUST BEDFORDSHIRE AND LUTON COMMUNITY NHS TR NORTH WEST LONDON HOSPITALS NHS TRUST HULL AND EAST RIDING COMM HEALTH NHS TR NORTH BRISTOL NHS TRUST NORTH EAST AMBULANCE SERVICE NHS TRUST BARNET AND CHASE FARM HOSPITALS NHS TR AVON AND WILTSHIRE MHP NHS TRUST 1,874,492 1,687,826 1,881,954 1,131,054 860,991 124,362 1,764,434 2,892,512 448,649 805,371 3,774,963 761,306 1,836,469 382,956 4,253,251 4,401,109 2,259,210 1,498,081 873,844 184,377 3,784 2,534,801 3,825,109 0 1,420,488 3,836,245 1,468,029 6,565,877 0 3,975,737 3,088,761 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 2.6 3.0 2.0 1.4 1.7 0.3 0.6 1.8 0.3 0.6 1,754,262 2,314,723 1,465,412 3,726,448 1,183,675 638,156 4,518,025 3,034,268 1,347,775 3,452,773 2.4 4.1 1.6 4.7 2.4 1.3 1.6 1.9 1.0 2.5 3.0 3.2 4.4 5.2 4.8 6.3 0.7 1.5 3.7 2.4 2.2 6.7 8.2 0.3 1.6 5.0 6.3 1.7 0.3 5.6 5.1 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 2.2 3.1 1.1 1.2 1.3 0.3 0.4 1.8 0.3 0.5 2,391,000 3,165,000 1,346,000 3,026,000 1,423,000 1,760,000 4,771,000 808,000 959,000 874,000 2.9 4.8 1.3 3.3 2.5 3.4 1.5 1.8 0.6 2.2 3.4 4.6 3.6 3.6 4.7 4.8 0.7 0.7 2.6 2.3 1.1 6.5 8.1 0.4 1.3 3.6 4.2 1.4 0.3 3.1 3.1
() 1,768,000 2,078,000 1,135,000 1,079,000 725,000 169,000 1,377,000 813,000 420,000 214,000 5,223,000 251,000 1,334,000 393,000 4,612,000 4,949,000 1,676,000 716,000 1,222,000 185,000 0 1,659,000 3,123,000 0 1,653,000 3,064,000 1,404,000 1,828,000 3,000 3,115,000 2,523,000
1.4 7,994,767 1.9 1,319,209 1.9 4,289,296 1.0 1,987,999 5.8 3,535,448 4.6 6,044,807 4.5 367,257 0.9 2,645,576 1.5 2,146,260 0.2 2,634,743 0.0 715,916 2.8 6,012,021 2.3 13,864,076 0.0 107,709 3.1 721,889 2.4 8,054,502 2.4 3,868,398 3.0 3,658,197 0.0 117,655 3.1 7,218,060 3.2 4,928,901
1.8 9,612,000 0.8 1,457,000 1.3 3,768,000 0.9 1,540,000 6.6 3,310,000 4.3 5,463,000 3.0 373,000 0.4 1,350,000 1.8 1,800,000 0.1 2,943,000 0.0 390,000 1.6 6,647,000 1.6 15,928,000 0.0 192,000 3.1 679,000 1.7 6,477,000 2.7 2,187,000 0.8 3,301,000 0.0 118,000 2.1 4,648,000 2.3 3,450,000
Code NHS trust Nursing, midwifery and health visiting () RVR RVV RVW RVX RVY RW1 RW3 RW4 RW5 RW6 RW7 RW8 RW9 RWA RWC RWD RWE RWF RWG RWH RWJ RWK RWN RWP RWQ RWR RWT RWV RWW RWX RWY RXA RXC EPSOM AND ST HELIER UNI HOSPS NHS TRUST EAST KENT HOSPITALS NHS TRUST NORTH TEES AND HARTLEPOOL NHS TRUST TEES AND NORTH EAST YORKSHIRE NHS TRUST SOUTHPORT AND ORMSKIRK HOSPITAL NHS TR HAMPSHIRE PARTNERSHIP NHS TRUST CENT MANCHESTER/ MANCHESTER CHILD NHS TR MERSEY CARE NHS TRUST LANCASHIRE CARE NHS TRUST PENNINE ACUTE HOSPITALS NHS TRUST NORTH WEST SURREY MH NHS PARTNERSHIP TR WEST SUSSEX HEALTH AND SOCIAL CARE NHSTR SOUTH OF TYNE AND WEARSIDE MH NHS TRUST HULL AND EAST YORKSHIRE HOSPITALS NHS TR DONCASTER AND SOUTH HUMBER HLTHCARE NHS UNITED LINCOLNSHIRE HOSPITALS NHS TRUST UNIVERSITY HOSPITALS OF LEICESTER NHS TR MAIDSTONE AND TUNBRIDGE WELLS NHS TRUST WEST HERTFORDSHIRE HOSPITALS NHS TRUST EAST AND NORTH HERTFORDSHIRE NHS TRUST STOCKPORT NHS TRUST EAST LONDON AND THE CITY MH NHS TRUST SOUTH ESSEX PARTNERSHIP NHS TRUST WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST WORCESTERSHIRE MH PARTNERSHIP NHS TRUST HERTFORDSHIRE PARTNERSHIP NHS TRUST BUCKINGHAMSHIRE MENTAL HEALTH NHS TRUST DEVON PARTNERSHIP NHS TRUST NORTH CHESHIRE HOSPITALS NHS TRUST BERKSHIRE HEALTHCARE NHS TRUST CALDERDALE AND HUDDERSFIELD NHS TRUST CHESHIRE AND WIRRAL PARTNERSHIP NHS TR EAST SUSSEX HOSPITALS NHS TRUST 677,015 1,620,270 446,172 343,815 412,937 2,452,031 5,415,659 3,306,859 644,203 5,329,503 618,911 1,813,051 8,191 566,582 420,801 1,855,620 8,524,976 4,102,212 5,682,388 1,097,568 1,516,723 2,037,788 1,826,873 5,484,466 462,200 2,262,595 1,362,242 1,428,355 3,105,131 3,259,238 255,774 0 4,297,948 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.5 0.9 0.4 0.5 0.5 3.6 2.3 2.7 0.9 2.1 3.2 3.3 0.0 0.3 0.7 1.1 2.9 3.2 4.3 0.9 1.7 2.6 3.2 4.4 1.4 2.5 4.3 2.3 3.2 5.7 0.2 0.0 3.2 3,371,584 9,576,999 922,773 952,209 1,252,266 2,591,150 5,784,544 5,612,749 5,008,055 6,272,896 401,565 4,517,937 1,519,794 3,855,591 686,390 4,323,680 5,003,712 6,008,170 5,769,298 4,886,468 1,753,373 4,562,039 5,979,369 2,844,216 319,658 4,351,097 97,732 2,193,592 1,213,228 1,228,995 2,401,489 1,939,000 4,085,739 2.5 5.1 0.9 1.4 1.7 3.8 2.4 4.5 6.8 2.5 2.1 8.1 3.4 2.2 1.2 2.6 1.7 4.7 4.4 4.0 1.9 5.9 10.6 2.3 0.9 4.8 0.3 3.6 1.3 2.2 1.8 3.0 3.1 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.3 0.7 0.8 0.4 0.5 2.5 2.3 2.0 0.7 0.8 1.8 2.5 0.0 0.2 0.6 0.3 1.3 1.4 3.0 0.6 1.8 1.4 4.5 0.2 2.1 0.5 2.5 0.7 4.8 0.2 0.0 1.5 2,635,000 9,550,000 1,024,000 1,553,000 1,570,000 2,404,000 6,091,000 5,545,000 4,442,000 6,236,000 279,000 3,308,000 1,390,000 3,471,000 1,209,000 2,967,000 5,044,000 5,805,000 7,073,000 4,411,000 5,517,000 1,718,000 3,699,000 251,000 3,926,000 483,000 2,525,000 1,852,000 2,747,000 2,562,000 3,080,000 2,908,000 1.7 4.4 0.9 1.9 1.9 2.7 2.3 4.3 5.1 2.2 1.4 5.4 2.8 1.7 1.9 1.6 1.5 4.1 4.6 3.1 6.2 2.9 2.6 0.6 3.9 1.6 3.7 1.8 4.7 1.7 4.1 2.0
() 450,000 1,581,000 902,000 329,000 375,000 2,280,000 6,039,000 2,550,000 571,000 2,278,000 355,000 1,530,000 12,000 492,000 394,000 488,000 4,422,000 2,063,000 4,680,000 904,000 1,605,000 831,000 6,393,000 61,000 2,157,000 144,000 1,722,000 737,000 2,770,000 259,000 0 2,145,000
Code NHS trust Nursing, midwifery and health visiting () RXD RXF RXG RXH RXJ RXK RXL RXM RXN RXP RXQ RXR RXT RXV RXW TAD TAE TAF TAH TAJ EAST SUSSEX COUNTY HEALTHCARE NHS TRUST MID YORKSHIRE HOSPITALS NHS TRUST SOUTH WEST YORKSHIRE MENTAL HEALTH NHSTR BRIGHTON AND SUSSEX UNIV HOSPS NHS TRUST WEST KENT NHS AND SOCIAL CARE TRUST SANDWELL & WEST BIRMINGHAM HOSPS NHS TR BLACKPOOL, FYLDE AND WYRE HOSPS NHS TR DERBYSHIRE MENTAL HEALTH SERVICES NHS TR LANCASHIRE TEACHING HOSPITALS NHS TRUST CO DURHAM & DARLINGTON ACUTE HOSP NHS TR BUCKINGHAMSHIRE HOSPITALS NHS TRUST EAST LANCASHIRE HOSPITALS NHS TRUST BIRMINGHAM AND SOLIHULL MH NHS TRUST BOLTON SALFORD AND TRAFFORD MH NHS TRUST SHREWSBURY & TELFORD HOSPITALS NHS TRUST BRADFORD DISTRICT CARE TRUST MANCHESTER MENTAL HLTH & SOCIAL CARE TR CAMDEN & ISLINGTON MH & SOCIAL CARE TR SHEFFIELD CARE TRUST SANDWELL MENTAL HEALTH NHS & SOCIAL CT England Source: Annual nancial returns of NHS trusts Footnotes: 1. 200405 data does not include agency spend after trusts obtained foundation status. These trusts do not report agency spend broken down by staV group. NHS trusts that became foundation trusts at 1 April 2004 have been shown as a in the 200405 gures. 1,071,402 2,017,750 431,944 6,236,799 1,964,298 1,068,143 64,300 1,026,261 1,530,891 1,681,660 2,386,748 2,437,135 1,443,029 922,806 244,419 449,697 1,018,785 4,875,214 1,817,115 683,541 442,672,685 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 2.7 1.1 0.6 3.8 2.8 0.6 0.1 1.8 1.1 1.1 1.9 1.6 1.4 1.4 0.2 0.8 2.3 7.4 2.9 2.6 3,072,672 8,802,075 2,533,642 4,653,292 2,465,840 3,959,254 1,690,196 1,894,453 2,175,551 3,710,893 2,887,107 2,694,733 2,107,426 1,203,006 911,605 3,584,206 1,227,084 2,931,192 1,588,675 315,629 736,492,325 7.6 4.9 3.8 2.8 3.6 2.2 1.6 3.4 1.5 2.5 2.3 1.7 2.0 1.8 0.8 6.0 2.8 4.5 2.5 1.2 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.7 0.9 0.1 1.0 3.3 0.7 0.0 3.4 0.7 0.7 0.0 1.6 1.7 1.2 0.1 1.0 1.8 2.0 2.4 0.5 1,765,000 8,117,000 4,025,000 4,474,000 1,715,000 3,554,000 2,324,000 2,315,000 1,721,000 4,614,000 3,990,000 3,490,000 2,194,000 3,078,000 558,000 4,164,000 1,134,000 2,343,000 2,272,000 132,000 649,577,000 4.1 4.2 5.8 2.4 2.2 1.7 1.9 3.6 1.1 2.8 2.8 2.0 1.8 4.0 0.4 6.0 2.3 3.2 3.2 0.5
() 719,000 1,762,000 95,000 1,950,000 2,569,000 1,380,000 34,000 2,165,000 1,090,000 1,192,000 6,000 2,831,000 2,134,000 920,000 176,000 692,000 860,000 1,444,000 1,690,000 126,000 319,247,000
Table 26b SALARIES AND WAGES NONNHS STAFF (AGENCY, ETC) (BY NHS CLASSIFICATION) ENGLAND
Code NHS trust Nursing, midwifery and health visiting () 5A1 5A2 5A3 5A4 5A5 5A7 5A8 5A9 5AA 5AC 5AF 5AG 5AH 5AJ 5AK 5AL 5AM 5AN 5AP 5AT 5AW 501 5C2 5C3 504 5C5 5C9 5CC 5CD 5CE 5CF 5CG 5CH NEW FOREST PCT NORWICH PCT SOUTH GLOUCESTERSHIRE PCT HAVERING PCT KINGSTON PCT BROMLEY PCT GREENWICH TEACHING PCT BARNET PCT SOUTH MANCHESTER PCT DAVENTRY AND SOUTH NORTHAMPTONSHIRE PCT NORTH PETERBOROUGH PCT SOUTH PETERBOROUGH PCT TENDRING PCT EPPING FOREST PCT SOUTHEND ON SEA PCT CENTRAL DERBY PCT MANSFIELD DISTRICT PCT NORTH EAST LINCOLNSHIRE PCT NEWARK AND SHERWOOD PCT HILLINGDON PCT AIREDALE PCT ENFIELD PCT BARKING AND DAGENHAM PCT CITY AND HACKNEY TEACHING PCT TOWER HAMLETS PCT NEWHAM PCT HARINGEY TEACHING PCT BLACKBURN WITH DARWEN PCT NORTH DORSET PCT BOURNEMOUTH TEACHING PCT BRADFORD CITY TEACHING PCT BRADFORD SOUTH AND WEST PCT NORTH BRADFORD PCT 642,865 1,470,546 43,146 1,416,294 760,068 560,957 347,463 774,602 375,003 322,000 1,251 0 592,323 562,806 67,573 529,325 14,008 0 0 432,330 4,091 321,866 524,310 1,347,593 1,291,851 1,545,562 702,140 13,320 503,749 0 526 62,414 209,413 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 3.4 3.3 0.4 5.5 4.0 2.0 1.8 2.4 3.0 3.7 0.0 0.0 5.3 4.4 0.8 4.9 0.1 0.0 0.0 1.3 0.1 1.3 3.0 5.9 3.2 4.3 2.8 0.1 2.2 0.0 0.0 0.7 2.8 746,090 292,730 221,116 1,597,336 855,185 1,096,390 1,441,599 2,144,337 216,929 188,000. 189,396 17,509 493,467 781,878 110,309 283,938 391,790 58,286 79,977 2,248,739 89,820 2,292,070 1,282,291 1,575,882 2,865,334, 1,411,765 2,830,662 417,721 479,350 378,253 304,385 159,086 154,874 3.9 0.7 2.2 6.2 4.5 3.8 7.3 6.7 1.7 2.2 1.2 8.5 4.4 6.1 1.3 2.6 3.1 0.7 1.7 6.6 1.1 8.9 7.3 6.9 7.1 3.9 11.1 3.5 2.1 4.0 2.4 1.8 2.0 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 3.4 1.8 0.2 5.1 2.4 1.8 0.4 2.0 2.7 0.3 0.0 0.0 4.4 3.5 1.6 2.1 0.1 0.0 0.0 2.7 0.0 0.8 1.8 5.1 2.6 4.2 1.5 0.2 1.9 0.0 0.7 1.7 1.4 421,000 526,000 372,000 2,120,000 707,000 1,063,000 1,426,000 2,567,000 363,000 353,000 1,023,000 13,000 999,000 892,000 98,000 603,000 369,000 67,000 135,000 1,606,000 94,000 2,629,000 1,359,000 2,014,000 3,510,000 1,629,000 1,993,000 512,000 439,000 465,000 361,000 202,000 184,000 1.9 1.1 3.5 6.8 3.3 3.1 6.0 6.7 2.6 3.3 3.6 6.4 7.6 6.0 0.9 4.8 2.5 0.6 2.3 4.5 0.8 8.5 6.6 7.4 7.2 3.7 6.2 3.6 1.6 4.0 2.2 1.7 1.7
() 745,000 853,000 24,000 1,582,000 509,000 606,000 89,000 786,000 378,000 37,000 2,000 0 571,000 516,000 183,000 259,000 10,000 0 0 943,000 0 251,000 370,000 1,378,000 1,255,000 1,853,000 486,000 27,000 528,000 0 120,000 201,000 148,000
Table 26b (Continued) SALARIES AND WAGES NONNHS STAFF (AGENCY, ETC) (BY NHS CLASSIFICATION) ENGLAND
Code NHS trust Nursing, midwifery and health visiting () 5CK 5CL 5CM 5CN 5CP 5CQ 5CR 5CV 5CW 5CX 5CY 5D1 5D2 5D3 5D4 5D5 5D6 5D7 5D8 5D9 5DC 5DD 5DF 5DG 5DH 5DJ 5DK 5DL 5DM 5DN 5DP 5DQ 5DR 5DT DONCASTER CENTRAL PCT CENTRAL MANCHESTER PCT DARTFORD, GRAVESHAM AND SWANLEY PCT HEREFORDSHIRE PCT HERTSMERE PCT MILTON KEYNES PCT NORTH MANCHESTER PCT SOUTH HAMS AND WEST DEVON PCT TORBAY PCT TRAFFORD SOUTH PCT WEST NORFOLK PCT SOLIHULL PCT WEST LINCOLNSHIRE PCT LINCOLNSHIRE SOUTH WEST TEACHING PCT CARLISLE AND DISTRICT PCT EDEN VALLEY PCT WEST CUMBRIA PCT NEWCASTLE PCT NORTH TYNESIDE PCT HARTLEPOOL PCT HARLOW PCT MORECAMBE BAY PCT NORTH HAMPSHIRE PCT ISLE OF WIGHT PCT WEST WILTSHIRE PCT SOUTH WILTSHIRE PCT NEWBURY AND COMMUNITY PCT READING PCT SLOUGH PCT WOKINGHAM PCT VALE OF AYLESBURY PCT BURNTWOOD, LICHFIELD AND TAMWORTH PCT WYRE FOREST PCT NORTH EAST OXFORDSHIRE PCT 0 100,633 116,370 541,135 150,890 558,997 21,953 39,622 70,887 21,266 195,629 191,121 615 28,019 18,466 0 0 15,926 1,211 0 1,200 212,217 455,076 0 66,268 978 173,417 387,580 102,097 78,798 92,125 63,151 28,085 182,413 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.0 0.4 0.7 2.0 2.4 2.1 0.2 0.4 0.6 0.4 1.2 1.0 0.0 0.3 0.3 0.0 0.0 0.1 0.0 0.0 0.0 0.4 3.6 0.0 0.4 0.0 1.7 3.0 1.0 0.9 0.6 0.4 0.2 6.6 147,188 505,366 447,715 1,163,475 286,722 911,940 90,323 277,474 70,082 70,818 404,761 375,101 1,284,474 -10,930 122,706 80,158 177,366 591,477 165,184 176,195 48,134 1,502,074 586,402 36,737 237,595 146,496 529,056 195,342 226,576 108,837 180,092 336,262 41,909 85,136 1.7 1.8 2.7 4.2 4.6 3.4 0.9 2.6 0.6 1.4 2.5 1.9 8.8 -0.1 1.8 0.7 1.4 2.6 1.1 2.6 0.9 2.7 4.7 0.7 1.3 2.3 5.3 1.5 2.1 1.3 1.1 2.2 0.4 3.1 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.0 0.3 0.4 2.2 1.1 1.7 0.0 0.1 0.7 0.7 0.5 0.6 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.2 2.1 0.0 0.7 0.3 0.0 4.3 1.1 0.6 0.0 0.3 0.4 2.1 153,000 428,000 707,000 1,098,000 896,000 720,000 172,000 536,000 144,000 181,000 109,000 352,000 710,000 265,000 61,000 133,000 308,000 684,000 223,000 184,000 71,000 1,473,000 196,000 128,000 86,000 580,000 429,000 181,000 331,000 250,000 81,000 310,000 46,000 365,000 1.7 1.5 3.5 3.3 11.0 2.4 1.5 4.8 1.1 1.8 0.6 1.5 4.5 2.1 0.8 1.0 2.0 2.5 1.2 2.1 1.2 2.3 1.4 2.2 0.4 6.3 3.7 1.2 2.5 2.1 0.4 1.8 0.3 10.8
() 0 97,000 84,000 725,000 87,000 494,000 1,000 7,000 89,000 73,000 88,000 139,000 5,000 4,000 0 0 0 6,000 32,000 0 0 147,000 297,000 0 142,000 26,000 0 656,000 145,000 77,000 0 44,000 50,000 70,000
Code NHS trust Nursing, midwifery and health visiting () 5DV 5DW 5DX 5DY 5E1 5E2 5E3 5E4 5E5 5E6 5E7 5E8 5E9 5EA 5EC 5ED 5EE 5EF 5EG 5EH 5EJ 5EK 5EL 5EM 5EN 5EP 5EQ 5ER 5ET 5EV 5EX 5EY 5F1 5F2 CHERWELL VALE PCT OXFORD CITY PCT SOUTH EAST OXFORDSHIRE PCT SOUTH WEST OXFORDSHIRE PCT NORTH TEES PCT SELBY AND YORK PCT EAST YORKSHIRE PCT YORKSHIRE WOLDS AND COAST PCT EASTERN HULL PCT WEST HULL PCT EASTERN WAKEFIELD PCT WAKEFIELD WEST PCT MID-HAMPSHIRE PCT CHESTERFIELD PCT GEDLING PCT AMBER VALLEY PCT NORTH SHEFFIELD PCT NORTH LINCOLNSHIRE PCT NORTH EASTERN DERBYSHIRE PCT MELTON, RUTLAND AND.HARBOROUGH PCT LEICESTER CITY WEST PCT DONCASTER EAST PCT DONCASTER WEST PCT NOTTINGHAM CITY PCT SHEFFIELD WEST PCT SHEFFIELD SOUTH WEST PCT SOUTH EAST SHEFFIELD PCT EREWASH PCT BASSETLAW PCT BROXTOWE AND HUCKNALL PCT GREATER DERBY PCT EASTERN LEICESTER PCT PLYMOUTH TEACHING PCT CHORLEY AND SOUTH RIBBLE PCT 201,778 355,166 274,670 333,223 8,414 45,043 280 268,306 66,312 0 0 0 4,121 13,394 34,823 179,115 3,321 288 12,465 154,914 1,322 0 0 1,022,761 4,891 4,035 984 73,996 59,083 81,227 6,164 2,042 456,802 54,186 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.8 3.1 5.0 2.9 0.1 0.1 0.0 3.1 1.0 0.0 0.0 0.0 0.1 0.1 0.6 1.6 0.0 0.0 0.1 1.4 0.0 0.0 0.0 3.3 0.1 0.0 0.0 0.7 1.0 0.7 0.0 0.0 1.0 0.4 454,014 84,126 237,244 207,201 100,215 121,931 92,690 155,291 158,533 120,630 148,492 123,415 175,349 835,731 38,577 436,803 251,881 54,324 151,685 159,523 458,590 32,303 37,959 879,014 1,010,324 708,609 2,759,864 165,616 207,514 74,878 227,480 185,793 1,311,069 191,374 4.1 0.7 4.4 1.8 0.8 0.3 1.8 1.8 2.4 1.5 1.2 1.2 2.4 3.3 0.7 3.9 3.3 0.6 1.1 1.4 2.9 0.7 0.6 2.9 12.5 5.2 20.1 1.5 3.6 0.7 1.7 2.3 2.8 1.3 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.7 1.3 10.8 2.0 0.0 0.2 0.0 4.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.6 0.0 0.0 0.1 1.5 0.9 0.0 0.0 2.6 0.0 0.0 4.3 1.3 0.3 0.7 0.0 0.0 1.0 2.1 1,231,000 104,000 240,000 876,000 91,000 267,000 415,000 202,000 191,000 190,000 142,000 242,000 57,000 305,000 42,000 494,000 309,000 55,000 328,000 77,000 482,000 69,000 143,000 830,000 1,491,000 843,000 2,044,000 175,000 243,000 47,000 321,000 989,000 1,113,000 427,000 9.5 0.9 7.1 5.7 0.7 0.6 2.7 2.1 1.6 1.5 0.9 1.8 0.6 1.1 0.7 3.5 3.4 0.6 2.0 0.5 2.7 1.1 1.7 2.3 13.7 4.9 13.5 1.3 3.4 0.3 2.2 8.6 2.1 2.4
() 218,000 156,000 366,000 310,000 0 71,000 0 409,000 0 0 0 0 0 0 0 363,000 1,000 0 9,000 245,000 166,000 0 0 929,000 2,000 4,000 655,000 175,000 21,000 99,000 2,000 0 555,000 377,000
Code NHS trust Nursing, midwifery and health visiting () 5F3 5F4 5F5 5F6 5F7 5F8 5F9 5FA 5FC 5FD 5FE 5FF 5FH 5FJ 5FK 5FL 5FM 5FN 5FP 5FQ 5FR 5FT 5FV 5FW 5FX 5FY 5G1 5G2 5G3 5G4 5G5 5G6 5G7 5G8 5G9 WEST LANCASHIRE PCT HEYWOOD AND MIDDLETON PCT SALFORD PCT TRAFFORD NORTH PCT STOCKPORT PCT BEBINGTON AND WEST WIRRAL PCT SOUTHPORT AND FORMBY PCT ASHFIELD PCT RUSHCLIFFE PCT EAST HAMPSHIRE PCT PORTSMOUTH CITY TEACHING PCT SOUTH WEST KENT PCT BEXHILL AND ROTHER PCT HASTINGS AND ST LEONARDS PCT MID-SUSSEX PCT BATH AND NORTH EAST SOMERSET PCT WEST OF CORNWALL PCT SOUTH AND EAST DORSET PCT SOUTH WEST DORSET PCT NORTH DEVON PCT EXETER PCT EAST DEVON PCT MID DEVON PCT SOMERSET COAST PCT MENDIP PCT TEIGNBRIDGE PCT SOUTHERN NORFOLK PCT BRACKNELL FOREST PCT WINDSOR, ASCOT AND MAIDENHEAD PCT CHILTERN AND SOUTH BUCKS PCT WYCOMBE PCT BLACKWATER VALLEY AND HART PCT HYNDBURN AND RIBBLE VALLEY PCT BURNLEY, PENDLE AND ROSSENDALE PCT NORTH LIVERPOOL PCT 2,668 20,793 183,587 3,226 137,461 0 5,925 205 336,399 1,321,529 1,284,475 67,877 54,980 0 0 1,573,536 65,480 58,658 267,170 24,614 96,930 130,015 56,533 141,597 176,879 59,085 40,502 289,649 145,658 58,606 82,435 119,961 50,951 93,216 56,012 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.0 0.2 0.6 0.1 0.8 0.0 0.1 0.0 2.2 3.4 3.8 0.5 0.7 0.0 0.0 6.9 0.5 0.4 2.9 0.2 0.8 0.9 0.5 1.2 1.8 0.5 0.5 3.2 1.5 0.8 0.7 0.6 0.3 0.4 0.5 291,268 176,566 780,008 178,331 94,329 170,575 171,645 49,756 860,801 1,808,360 2,734,858 623,946 136,823 10,198 294,005 287,959 72,167 599,967 18,500 100,233 325,123 137,850 211,389 207,747 342,867 121,199 355,088 968,473 178,589 57,701 680,555 480,407 53,313 399,712 318,247 2.8 1.5 2.7 3.4 0.6 2.0 2.1 0.8 5.5 4.6 8.1 4.3 1.9 0.2 3.8 1.3 0.5 3.9 0.2 0.8 2.7 1.0 1.8 1.8 3.4 1.1 4.1 10.8 1.8 0.8 5.8 2.6 0.3 1.7 2.8 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.0 0.6 0.2 0.0 0.0 0.2 0.0 0.0 0.0 4.1 0.6 0.2 0.4 0.0 0.0 6.3 1.2 0.6 9.6 0.1 0.3 1.3 0.6 0.1 1.3 0.6 0.8 0.3 1.1 0.0 0.1 0.6 0.2 0.4 1.6 250,000 193,000 995,000 121,000 374,000 130,000 192,000 97,000 1,288,000 1,320,000 1,969,000 578,000 69,000 39,000 115,000 596,000 52,000 602,000 854,000 121,000 346,000 240,000 275,000 436,000 688,000 135,000 118,000 629,000 337,000 140,000 500,000 195,000 37,000 830,000 312,000 2.0 1.4 2.9 1.9 1.9 1.2 2.0 1.3 7.1 3.0 4.8 3.5 0.8 0.7 1.1 2.4 0.3 3.6 6.5 0.8 2.4 1.5 1.9 3.1 5.5 1.1 1.2 5.8 3.1 1.5 3.7 1.0 0.2 2.9 2.0
() 6,000 84,000 77,000 0 10,000 17,000 3,000 1,000 0 1,789,000 267,000 39,000 37,000 0 0 1,577,000 218,000 96,000 1,259,000 20,000 43,000 214,000 81,000 19,000 167,000 72,000 83,000 36,000 118,000 0 17,000 109,000 57,000 103,000 240,000
Code NHS trust Nursing, midwifery and health visiting () 5GC 5GD 5GE 5GF 5GG 5GH 5GJ 5GK 5GL 5GM 5GN 5GP 5GQ 5GR 5GT 5GV 5GW 5GX 5H1 5H2 5H3 5H4 5H5 5H6 5H7 5H8 5H9 5HA 5HC 5HD 5HE 5HF 5HG 5HH LUTON PCT BEDFORD PCT BEDFORDSHIRE HEARTLANDS PCT HUNTINGDONSHIRE PCT WELWYN HATFIELD PCT NORTH HERTFORDSHIRE AND STEVENAGE PCT SOUTH EAST HERTFORDSHIRE PCT ROYSTON BUNTNGFRD & BISHPS STRTFORD PCT MALDON AND SOUTH CHELMSFORD PCT COLCHESTER PCT UTTLESFORD PCT BILLERICAY, BRENTWOOD AND WICKFORD PCT THURROCK PCT BASILDON PCT GREAT YARMOUTH PCT WATFORD AND THREE RIVERS PCT DACORUM PCT ST ALBANS AND HARPENDEN PCT HAMMERSMITH AND FULHAM PCT BIRKENHEAD AND WALLASEY PCT CHESHIRE WEST PCT CENTRAL CHESHIRE PCT EASTERN CHESHIRE PCT ELLESMERE PORT AND NESTON PCT DERBYSHIRE DALES & SOUTH DERBYSHIRE PCT ROTHERHAM PCT EAST LINCOLNSHIRE PCT CENTRAL LIVERPOOL PCT SOUTH LIVERPOOL PCT PRESTON PCT FYLDE PCT WYRE PCT ASHTON, LEIGH AND WIGAN PCT LEEDS WEST PCT 211,629 59,963 555,362 0 88,268 83,285 97,485 341,582 343,720 1,153,925 433,785 759,185 0 15,000 12,181 74,604 936 0 1,284,978 89,267 0 18,342 19,970 76,772 137,564 0 223,600 371,047 51,581 36,362 0 0 50,472 0 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 1.7 0.5 3.7 0.0 1.3 0.5 1.5 4.8 3.2 5.4 8.1 9.0 0.0 0.2 0.2 0.7 0.0 0.0 5.4 0.6 0.0 0.1 0.2 0.9 2.8 0.0 1.5 1.1 0.4 0.2 0.0 0.0 0.2 0.0 122,714 164,255 126,129 321,043 79,845 582,445 114,113 78,784 280,058 359,232 370,748 1,256,888 2,001,017 555,451 354,963 1,181,751 424,164 449,555 2,012,621 192,768 463,849 269,395 193,429 186,195 156,499 435,016 86,218 1,981,341 362,249 488,482 181,963 653,315 476,430 64,119 1.0 1.4 0.8 2.1 1.2 3.7 1.8 1.1 2.6 1.7 6.9 14.8 14.6 6.9 6.5 11.6 5.4 6.4 8.4 1.2 3.6 1.5 1.8 2.2 3.2 1.6 0.6 5.7 2.8 3.2 2.3 5.7 1.8 0.9 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 5.7 0.7 2.3 2.8 1.5 0.0 2.4 1.9 2.4 5.0 2.7 7.9 0.0 0.0 0.3 3.3 0.2 3.7 2.7 0.0 1.2 0.0 0.2 0.9 1.7 0.0 2.0 0.3 0.2 0.7 0.0 0.0 0.5 0.0 316,000 228,000 154,000 142,000 68,000 131,000 42,000 572,000 597,000 270,000 341,000 757,000 1,552,000 604,000 384,000 1,296,000 493,000 264,000 1,220,000 282,000 128,000 378,000 203,000 73,000 164,000 362,000 68,000 2,206,000 370,000 528,000 73,000 429,000 333,000 167,000 2.1 1.5 0.8 0.7 0.8 0.7 0.6 6.8 5.1 1.0 5.7 7.8 9.7 6.2 6.0 10.0 5.0 3.2 4.8 1.4 0.8 1.7 1.5 0.7 2.7 1.1 0.4 5.4 2.5 2.5 0.7 3.2 1.0 1.5
() 844,000 112,000 425,000 532,000 125,000 0 183,000 160,000 279,000 1,305,000 162,000 762,000 0 0 22,000 420,000 17,000 301,000 686,000 -1,000 189,000 4,000 25,000 85,000 103,000 0 374,000 137,000 34,000 155,000 0 0 160,000 0
Code NHS trust Nursing, midwifery and health visiting () 5HJ 5HK 5HL 5HM 5HN 5HP 5HQ 5HR 5HT 5HV 5HW 5HX 5HY 5J1 5J2 5J3 5J4 5J5 5J6 5J7 5J8 5J9 5JA 5JC 5JD 5JE 5JF 5JG 5JH 5JJ 5JK 5JL 5JM 5JN LEEDS NORTH EAST PCT EAST LEEDS PCT SOUTH LEEDS PCT LEEDS NORTH WEST PCT HIGH PEAK AND DALES PCT BLACKPOOL PCT BOLTON PCT STAFFORDSHIRE MOORLANDS PCT DUDLEY SOUTH PCT DUDLEY BEACON AND CASTLE PCT NEWCASTLE-UNDER-LYME PCT EALING PCT HOUNSLOW PCT HALTON PCT WARRINGTON PCT ST HELENS PCT KNOWSLEY PCT OLDHAM PCT CALDERDALE PCT NORTH KIRKLEES PCT DURHAM DALES PCT DARLINGTON PCT HINCKLEY AND BOSWORTH PCT CHARNWOOD AND NW LEICESTERSHIRE PCT SOUTH LEICESTERSHIRE PCT BARNSLEY PCT BRISTOL NORTH PCT BRISTOL SOUTH AND WEST PCT CAMBRIDGE CITY PCT SOUTH CAMBRIDGESHIRE PCT EAST CAMBRIDGESHIRE AND FENLAND PCT BROADLAND PCT NORTH NORFOLK PCT CHELMSFORD PCT 2,089 190,028 68,762 26,843 59,394 3,373 252 68,563 8,676 438,881 4,112 1,063,000 362,789 34,981 38,165 12,755 0 0 0 282 28,144 18,855 0 93,268 35,832 203,722 3,281 22,340 344,590 13,920 127,483 50,579 781,075 0 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.0 0.9 0.5 0.2 0.4 0.0 0.0 0.6 0.0 2.0 0.1 3.3 2.1 0.2 0.2 0.1 0.0 0.0 0.0 0.0 0.4 0.3 0.0 0.4 0.5 0.5 0.0 0.1 2.7 0.2 0.9 1.2 9.9 0.0 357,475 258,614 828,388 453,591 102,727 165,546 544,245 338,631 366,208 866,334 240,864 3,335,000 1,351,211 187,033 481,186 136,489 559,363 846,143 57,103 333,489 85,121 90,539 123,342 522,265 227,356 1,004,379 353,372 529,338 419,568 101,647 397,481 7,515 148,410 58,960 4.2 1.2 6.1 3.6 0.6 1.6 2.1 3.1 1.9 4.0 3.2 10.4 7.7 1.2 3.1 1.2 3.5 5.3 0.6 2.9 1.1 1.b 1.6 2.1 3.1 2.4 2.3 2.9 3.3 1.6 2.8 0.2 1.9 1.4 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.0 1.4 0.1 0.0 0.2 0.1 0.0 1.3 0.0 0.7 0.2 2.3 1.1 0.5 0.8 0.2 0.0 0.3 0.1 0.0 0.0 0.0 0.0 0.4 1.1 0.8 1.6 0.4 2.0 0.1 1.6 1.1 17.2 1.8 321,000 611,000 1,298,000 486,000 155,000 221,000 628,000 263,000 404,000 1,438,000 228,000 3,321,000 1,241,000 235,000 704,000 57,000 709,000 1,508,000 178,000 210,000 209,000 118,000 38,000 1,339,000 355,000 857,000 82,000 592,000 525,000 64,000 405,000 81,000 141,000 87,000 3.0 2.5 7.8 3.1 0.8 1.6 1.9 2.1 1.7 5.6 2.4 9.2 6.0 1.4 3.4 0.4 3.5 7.1 1.4 1.7 1.9 1.2 0.4 4.3 3.8 1.8 0.4 3.6 4.4 0.9 2.5 1.4 1.4 1.7
() 2,000 359,000 15,000 0 35,000 14,000 1,000 165,000 6,000 177,000 19,000 831,000 235,000 90,000 154,000 27,000 0 60,000 18,000 0 2,000 2,000 0 114,000 105,000 385,000 303,000 60,000 236,000 5,000 253,000 63,000 1,681,000 92,000
Code NHS trust Nursing, midwifery and health visiting () 5JP 5JQ 5JR 5JT 5JV 5JW 5JX 5JY 5K1 5K2 5K3 5K4 5K5 5K6 5K7 5K8 5K9 5KA 5KC 5KD 5KE 5KF 5KG 5KH 5KJ 5KK 5KL 5KM 5KN 5KP 5KQ 5KR 5KT 5KV CASTLE POINT AND ROCHFORD PCT IPSWICH PCT SUFFOLK COASTAL PCT CENTRAL SUFFOLK PCT WAVENEY PCT SUFFOLK WEST PCT BURY PCT ROCHDALE PCT SOUTH SOMERSET PCT TAUNTON DEANE PCT SWINDON PCT KENNET AND NORTH WILTSHIRE PCT BRENT TEACHING PCT HARROW PCT CAMDEN PCT ISLINGTON PCT CROYDON PCT DERWENTSIDE PCT DURHAM AND CHESTER-LE-STREET PCT EASINGTON PCT SEDGEFIELD PCT GATESHEAD PCT SOUTH TYNESIDE PCT HAMBLETON AND RICHMONDSHIRE PCT CRAVEN, HARROGATE AND RURAL DISTRICT PCT SCARBOROUGH, WHITBY AND RYEDALE PCT SUNDERLAND TEACHING PCT MIDDLESBROUGH PCT LANGBAURGH PCT EAST ELMBRIDGE AND MID SURREY PCT EAST SURREY PCT NORTH AND EAST CORNWALL PCT CENTRAL CORNWALL PCT POOLE PCT 206,157 22,258 130,352 99,682 148,947 56,305 137,313 31,611 0 87,269 476,407 263,386 2,267,470 81,579 3,829,638 1,408,562 1,459,741 2,350 0 1,370 26,396 117,152 20,399 78,614 172,522 100,265 14,511 52,662 243,113 867,685 218,161 19,501 9,280 92,847 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 2.4 0.3 1.8 1.2 2.1 0.5 1.0 0.2 0.0 1.5 3.4 0.9 7.3 0.4 11.0 5.3 5.4 0.0 0.0 0.0 0.4 0.8 0.2 0.5 1.1 0.6 0.1 0.4 2.5 4.4 1.4 0.1 0.1 1.2 320,253 107,900 154,694 30,356 46,585 413,922 152,123 415,344 73,672 163,131 297,328 650,306 2,538,317 353,961 1,607,257 2,376,708 1,648,294 46,236 713,765 332,408 96,209 369,528 225,413 152,643 145,960 224,478 278,208 168,562 121,690 960,599 768,126 103,569 109,445 339,293 3.7 1.4 2.1 0.4 0.7 3.7 1.1 3.2 0.7 2.7 2.1 2.3 8.2 1.8 4.6 8.9 6.1 0.9 6.0 4.1 1.3 2.7 1.8 1.0 0.9 1.3 1.6 1.2 1.2 4.9 4.8 0.7 0.7 4.4 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.3 0.2 1.4 0.4 2.0 0.6 1.9 1.0 0.0 2.8 0.4 0.4 7.7 0.8 7.1 6.5 2.2 0.0 0.2 0.0 0.1 1.2 0.0 0.5 0.8 0.4 0.0 0.5 2.4 3.0 2.0 0.7 0.1 0.6 373,000 89,000 246,000 113,000 58,000 179,000 68,000 677,000 66,000 209,000 620,000 887,000 3,580,000 369,000 4,321,000 2,774,000 2,282,000 0 688,000 409,000 184,000 170,000 430,000 98,000 132,000 373,000 224,000 241,000 201,000 742,000 796,000 128,000 94,000 296,000 3.8 0.9 2.9 1.1 0.7 1.4 0.4 4.2 0.6 2.8 3.7 3.2 9.0 1.8 9.3 8.8 7.4 0.0 3.5 3.7 2.0 1.0 2.8 0.5 0.6 2.0 0.9 1.4 1.6 3.2 4.4 0.8 0.5 3.0
() 34,000 17,000 117,000 36,000 166,000 79,000 316,000 162,000 2,000 207,000 67,000 107,000 3,065,000 173,000 3,331,000 2,049,000 667,000 0 38,000 5,000 5,000 218,000 0 91,000 174,000 73,000 12,000 89,000 310,000 689,000 353,000 120,000 21,000 57,000
Code NHS trust Nursing, midwifery and health visiting () 5KW 5KX 5KY 5L1 5L2 5L3 5L4 5L5 5L6 5L7 5L8 5L9 5LA 5LC 5LD 5LE 5LF 5LG 5LH 5LJ 5LK 5LL 5LM 5LN 5LP 5LQ 5LR 5LT 5LV 5LW 5LX 5LY 5M1 5M2 CHELTENHAM AND TEWKESBURY PCT WEST GLOUCESTERSHIRE PCT COTSWOLD AND VALE PCT SOUTHAMPTON CITY PCT MAIDSTONE WEALD PCT MEDWAY PCT SWALE PCT GUILDFORD AND WAVERLEY PCT NORTH SURREY PCT SURREY HEATH AND WOKING PCT ADUR, ARUN AND WORTHING PCT WESTERN SUSSEX PCT KENSINGTON AND CHELSEA PCT WESTMINSTER PCT LAMBETH PCT SOUTHWARK PCT LEWISHAM PCT WANDS WORTH PCT TAMESIDE AND GLOSSOP PCT HUDDERSFIELD CENTRAL PCT SOUTH HUDDERSFIELD PCT ASHFORD PCT CANTERBURY AND COASTAL PCT EAST KENT COASTAL PCT SHEPWAY PCT BRIGHTON AND HOVE CITY PCT EASTBOURNE DOWNS PCT SUSSEX DOWNS AND WEALD PCT NORTHAMPTONSHIRE HEARTLANDS PCT NORTHAMPTON PCT FAREHAM AND GOSPORT PCT EASTLEIGH AND TEST VALLEY SOUTH PCT SOUTH BIRMINGHAM PCT SHROPSHIRE COUNTY PCT 0 0 152,366 449,908 98,646 246,440 499,455 690,212 759,993 324,860 487,182 313,994 2,985,520 1,554,305 1,367,772 844,599 337,416 926,755 183,249 0 0 0 730,824 59,865 79,218 0 164 131,705 2,178 75,074 791,064 10,691 4,167,543 481,880 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.0 0.0 0.6 1.2 0.7 1.1 4.9 3.0 2.5 3.0 2.9 2.1 9.8 5.2 5.1 3.0 1.0 2.1 1.0 0.0 0.0 0.0 5.8 0.4 1.6 0.0 0.0 0.9 0.0 0.6 2.9 0.1 5.0 1.1 11,281 233,067 250,065 1,350,137 567,493 777,201 92,715 798,280 812,168 385,448 348,598 127,147 7,036,608 3,615,048 2,530,867 1,180,899 1,760,370 3,007,727 1,414,117 73,713 73,359 0 266,518 125,039 70,870 92,322 384,192 243,464 736,481 283,926 610,128 168,286 3,085,004 974,432 0.2 1.4 0.9 3.6 4.0 3.4 0.9 3.5 2.7 3.6 2.1 0.8 23.0 12.2 9.5 4.2 5.1 6.8 7.5 1.0 1.7 0.0 2.1 0.9 1.5 2.7 3.5 1.7 3.8 2.2 2.3 1.9 3.7 2.2 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.0 0.0 0.2 0.2 0.4 0.8 3.7 1.4 2.6 2.3 1.1 1.5 3.1 2.2 4.2 3.1 2.0 1.3 1.3 0.0 0.0 0.7 0.1 2.2 0.1 0.0 0.0 0.5 0.3 0.0 2.0 0.1 4.8 1.3 74,000 121,000 140,000 1,406,000 448,000 646,000 197,000 1,011,000 667,000 240,000 1,119,000 207,000 2,913,000 1,583,000 2,374,000 2,116,000 1,818,000 3,026,000 990,000 124,000 129,000 562,000 228,000 312,000 21,000 202,000 512,000 380,000 776,000 377,000 620,000 108,000 1,847,000 1,450,000 0.7 0.6 0.5 3.3 2.6 2.3 1.5 3.6 2.0 1.8 3.7 1.1 8.8 4.3 7.0 6.6 4.6 5.8 4.4 1.4 2.6 3.3 1.6 1.8 0.3 4.2 4.1 2.2 3.4 2.2 2.1 1.1 1.9 2.8
() 0 6,000 72,000 101,000 69,000 225,000 484,000 396,000 865,000 312,000 332,000 268,000 1,021,000 820,000 1,421,000 991,000 802,000 662,000 293,000 0 0 121,000 20,000 380,000 4,000 0 D 86,000 78,000 5,000 614,000 8,000 4,565,000 653,000
Code NHS trust Nursing, midwifery and health visiting () 5M3 5M5 5M6 5M7 5M8 5M9 5MA 5MC 5MD 5ME 5MF 5MG 5MH 5MJ 5MK 5ML 5MM 5MN 5MP 5MQ 5MR 5MT 5MV 5MW 5MX 5MY 5NA 5NC TAC TAG TAK WALSALL TEACHING PCT SOUTH SEFTON PCT RICHMOND AND TWICKENHAM PCT SUTTON AND MERTON PCT NORTH SOMERSET PCT RUGBY PCT CRAWLEY PCT HORSHAM AND CHANCTONBURY PCT COVENTRY TEACHING PCT NORTH STOKE PCT SOUTH STOKE PCT OLDBURY AND SMETHWICK PCT ROWLEY REGIS AND TIPTON PCT WEDNESBURY AND WEST BROMWICH PCT TELFORD AND WREKIN PCT EAST STAFFORDSHIRE PCT CANNOCK CHASE PCT SOUTH WESTERN STAFFORDSHIRE PCT NORTH WARWICKSHIRE PCT SOUTH WARWICKSHIRE PCT REDDITCH AND BROMSGROVE PCT SOUTH WORCESTERSHIRE PCT WOLVERHAMPTON CITY PCT NORTH BIRMINGHAM PCT HEART OF BIRMINGHAM TEACHING PCT EASTERN BIRMINGHAM PCT REDBRIDGE PCT WALTHAM FOREST PCT NORTHUMBERLAND CARE TRUST WITHAM, BRAINTREE AND HALSTEAD CARE TR BEXLEY CARE TRUST 260,995 0 433,990 72,152 0 20,614 173,203 62,348 0 42,193 34,048 0 9,086 0 176,563 0 22,097 3,933 1,625,055 903,337 158,336 161,188 329,656 104,272 136,153 2,358,540 1,078,542 1,274,708 5,186 48,082 225,583 81,998,420 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.7 0.0 3.7 0.2 0.0 0.6 3.4 1.3 0.0 0.4 0.3 0.0 0.2 0.0 1.2 0.0 0.4 0.0 2.8 2.3 1.6 0.7 0.8 1.2 0.7 9.8 6.1 6.9 0.0 0.5 1.5 1,944,080 202,365 836,915 2,445,309 70,220 38,714 206,878 363,878 4,909,341 75,146 156,228 684,776 92,597 105,299 458,227 63,590 126,839 224,110 829,199 1,874,075 92,122 259,197 2,206,162 329,466 816,844 1,106,849 1,236,384 1,378,499 495,203 337,501 352,416 173,168,993 5.3 1.6 7.1 6.2 0.8 1.2 4.1 7.4 9.9 0.7 1.3 6.0 2.0 1.7 3.2 1.3 2.1 2.7 1.4 4.8 0.9 1.2 5.1 3.7 4.0 4.6 6.9 7.5 1.3 3.6 2.3 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.6 1,334,000 0.0 0 4.5 1,132,000 0.2 3,466,000 0.0 95,000 1.6 446,000 1.1 166,000 0.0 239,000 0.0 5,546,000 1.1 154,000 0.1 96,000 0.0 405,000 0.0 49,000 0.0 344,000 1.2 729,000 0.1 74,000 0.1 156,000 0.0 257,000 2.8 924,000 1.4 2,395,000 1.0 53,000 0.3 222,000 0.6 2,421,000 0.4 249,000 1.7 971,000 1.8 1,163,000 7.4 1,030,000 4.9 1,528,000 0.0 12,167,000 0.7 285,000 2.6 393,000 197,607,000 3.4 0.0 7.3 7.5 0.9 9.1 2.7 3.7 9.0 0.8 0.6 2.9 0.9 4.1 4.2 1.2 2.0 2.5 1.4 5.3 0.4 0.9 4.9 2.2 3.7 4.0 5.0 6.8 30.0 2.5 2.0
() 225,000 0 706,000 112,000 0 78,000 69,000 1,000 0 215,000 16,000 0 0 0 203,000 5,000 11,000 0 1,870,000 638,000 119,000 71,000 273,000 45,000 451,000 522,000 1,521,000 1,095,000 0 76,000 506,000 80,748,000
England Source: Annual nancial returns of primary care trusts
Table 26c SALARIES AND WAGES NONNHS STAFF (AGENCY, ETC) (BY NHS CLASSIFICATION) ENGLAND
Code NHS trust Nursing, midwifery and health visiting 200304 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 76,571 221,983 470,124 318,325 425,939 647,329 197,660 49,899 154,736 76,336 29,997 60,269 108,334 119,610 53,300 234,219 134,793 152,836 436,954 257,691 457,141 97,104 6,465,300 80,837 172,531 102,675 155,312 36,124 11,793,929 1.6 6.9 10.4 6.3 6.6 19.3 3.1 1.0 3.2 2.5 1.0 0.7 2.6 2.2 1.2 4.5 2.0 4.1 5.8 7.5 8.2 2.9 29.3 2.1 3.4 4.0 1.3 0.8 Nursing, midwifery and health visiting 200405 Nursing, Other staV Other StaV midwifery and as a % of health visiting as total a % of total organisation organisation pay pay bill bill (%) () (%) 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 287,000 364,000 113,000 414,000 203,000 2,207,000 302,000 89,000 162,000 34,000 42,000 1,138,000 720,000 304,000 52,000 419,000 199,000 112,000 163,000 531,000 430,000 86,000 5,650,000 75,000 107,000 426,000 215,000 27,000 14,871,000 4.3 7.6 2.1 6.0 3.0 26.3 4.1 1.5 2.9 1.1 1.0 16.3 12.2 2.4 0.7 4.6 2.1 2.3 2.7 7.1 7.3 2.2 24.3 2.0 2.6 8.3 1.5 0.5
() Q01 Q02 Q03 Q04 Q05 Q06 Q07 Q08 Q09 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 Q19 Q20 Q21 Q22 Q23 Q24 Q25 Q26 Q27 Q28 NORFOLK, SUFFOLK AND CAMBRIDGESHIRE SHA BEDFORDSHIRE AND HERTFORDSHIRE SHA ESSEX STRATEGIC HA NORTH WEST LONDON STRATEGIC HA NORTH CENTRAL LONDON STRATEGIC HA NORTH EAST LONDON STRATEGIC HA SOUTH EAST LONDON STRATEGIC HA SOUTH WEST LONDON STRATEGIC HA NORTHUMBERLAND, TYNE & WEAR STRATEGIC HA COUNTY DURHAM AND TEES VALLEY SHA NORTH & EAST YORKSHIRE & N LINCS SHA WEST YORKSHIRE STRATEGIC HA CUMBRIA AND LANCASHIRE STRATEGIC HA GREATER MANCHESTER STRATEGIC HA CHESHIRE & MERSEYSIDE STRATEGIC HA THAMES VALLEY STRATEGIC HA HAMPSHIRE AND ISLE OF WIGHT STRATEGIC HA KENT AND MEDWAY STRATEGIC HA SURREY AND SUSSEX STRATEGIC HA AVON, GLOUCESTERSHIRE AND WILTSHIRE SHA SOUTH WEST PENINSULA STRATEGIC HA DORSET AND SOMERSET STRATEGIC HA SOUTH YORKSHIRE STRATEGIC HA TRENT STRATEGIC HA LEICS, NORTHANTS AND RUTLAND SHA SHROPSHIRE AND STAFFORDSHIRE SHA BIRMINGHAM AND THE BLACK COUNTRY SHA WEST MIDLANDS SOUTH STRATEGIC HA England 0 0 0 0 4,024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4,024
() 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Source: Annual nancial returns of strategic health authorities
3.2 Pay and Contracts 3.2.1 What has the top (discretionary and non-discretionary, and including merit or distinction awards where appropriate) and bottom of the payscale and average full time earnings been for: (a) Nursing and Midwifery Grades D - I (b) Nursing/Midwifery/Health Visitor Consultants (c) House OYcers (d) Senior House OYcers (e) Specialist Registrars (f) Associate Specialists (g) StaV Grade (h) Consultants (i) General Practitioners and (j) Salaried General Practitioners employed by PCTs been in each year since 199798? Why do average full time earnings exceed the top of payscales in some cases? (Q27) Answer 1. Table 27a to Table 27c shows the top and bottom of each pay scale from 199798 to the present. This takes into account changes as a result of pay reform with the introduction of Agenda for Change for nonmedical staV in October 2004 and a new contract for consultants in April 2003. 2. Table 27d provides forecasts of the net prots (pay) achieved by GPs up to 200304 (the year the new GMS contract came into force). Prior year gures reect the Average Intended Net Remuneration gure (AINR) set by the review body on Doctors and Dentists Remuneration. To all intents and purposes, these reect the GMS income/prot received by a GP in years recommendations were made. 3. Table 27e provides information on the average earnings per head for health and community health staV (HCHS) from 199798 to 200506. 4. Average full time earnings are an indication of the actual amounts of take home earnings individual members of staV receive. This takes into account all earnings such as unsocial hours payments, overtime payments, bonus payments and professional awards such as discretionary payments or clinical excellence awards. It is not unusual therefore to see earnings in excess of the top of the pay scale.
Table 27a CHANGES TO PAY SCALES FOR QUALIFIED NURSES SINCE 199798 (WHITLEY PAY SCALES) Grade D E F 01/04/97 12,230 13,990 13,990 16,200 15,520 19,010 18,300 21,170 20,445 23,380 01/12/97 12,385 14,165 14,165 16,410 15,715 19,250 18,535 21,440 20,710 23,680 01/04/98 12,630 14,450 14,450 16,735 16,030 19,635 20,750 18,905 21,875 23,005 21,125 24,155 25,325 23,385 26,495 27,665 01/12/98 12,855 14,705 14,705 17,030 16,310 19,985 21,115 19,240 22,255 23,410 21,495 24,580 25,775 23,795 26,965 28,160 01/04/99 14,400 15,905 15,395 17,830 17,075 20,925 22,105 20,145 23,300 24,515 22,505 25,735 26,990 24,920 28,240 29,485 27,460 42,010 01/04/00 14,890 16,445 15,920 19,220 17,655 21,635 22,860 20,830 24,090 25,350 23,270 26,110 27,910 25,770 29,205 30,490 28,395 43,440 01/04/01 15,445 17,055 16,510 19,935 18,310 22,865 23,710 21,605 25,420 26,290 24,135 28,045 28,945 26,725 30,720 31,620 29,450 45,050 01/04/02 16,005 17,670 17,105 20,655 18,970 23,690 24,565 22,385 26,340 27,245 25,005 29,065 29,990 29,990 27,695 31,830 32,760 32,760 33,940 46,675 01/04/03 16,525 18,240 17,660 21,325 19,585 24,455 25,360 23,110 27,190 28,125 25,815 30,005 30,960 30,960 28,590 32,860 33,820 33,820 35,035 48,185 01/04/04 17,060 18,830 18,230 22,015 20,220 25,250 26,180 23,860 28,070 29,035 26,650 30,975 31,960 31,960 29,515 33,920 34,920 34,920 36,165 49,740
Min Max Min Max Min Max With DPs(1) Min Max With DPs(1) Min Max With DPs(1) Modern Matron(2) Min Max With DPs(1) Modern Matron(2) Min Max
22,635 25,655
22,925 25,975
Nurse Consultant(3)
Source: Whitley pay scales. Footnotes: 1. Discretionary Points introduced 01/04/1998 and eVective from 11/09/1998. 2. Modern Matrons introduced 01/04/2002. 3. Nurse Consultants introduced September 1999.
Table 27b NURSING AND MIDWIFERY PAY SCALESAGENDA FOR CHANGE (BAND 5 AND ABOVE) Band 5 6 7 8a 8b 8c 8d 9 Min Max Min Max Min Max Min Max Min Max Min Max Min Max Min Max 01/04/05 18,698 24,198 22,328 30,247 26,948 35,527 34,372 41,246 40,036 49,496 48,176 59,395 57,745 71,494 68,194 86,240 01/04/06 19,166 24,803 22,886 31,004 27,622 36,416 35,232 42,278 41,038 50,733 49,381 60,880 59,189 73,281 69,899 88,397
Table 27c CHANGES TO PAY SCALES FOR DOCTORS SINCE 199798 01/04/97 01/12/97 01/04/98 01/12/98 01/04/99 01/04/00 01/04/01 01/04/02 01/04/03 01/04/04 01/04/05 01/04/06 PRHO SHO SpR Consultant (pre-2003 contract) Consultant (2003 contract) Assoc Specialist minimum maximum minimum maximum minimum maximum minimum maximum with DAs/CEAs minimum maximum with DAs/CEAs minimum maximum with DPs minimum maximum minimum maximum with optional points minimum maximum 25,585 44,510 51,168 23,070 34,410 25,945 45,120 51,885 23,390 34,880 23,390 31,050 34,880 26,560 46,180 53,105 23,940 35,700 23,940 31,780 39,620 27,120 47,175 54,255 24,465 36,465 24,465 32,465 40,465 28,065 48,825 56,150 25,320 37,740 25,320 33,600 41,880 28,995 50,435 58,000 26,150 38,990 26,150 34,710 43,270 30,125 52,400 60,200 27,170 40,520 27,170 36,070 44,970 31,210 56,105 64,525 28,150 41,980 28,150 39,675 48,985 15,230 17,190 18,995 24,115 21,230 30,970 43,165 55,705 109,350 15,440 17,430 19,260 24,440 21,530 31,400 43,750 56,470 110,115 15,800 17,840 19,715 26,340 22,040 32,135 44,780 57,800 112,710 16,145 18,225 20,135 26,910 22,510 32,830 45,740 59,040 115,130 16,710 18,860 20,845 27,845 23,300 33,965 47,345 61,605 120,130 17,260 19,480 21,535 28,760 24,070 35,080 48,905 63,640 124,100 17,935 20,245 22,380 29,880 28,810 36,460 50,810 66,120 128,935 18,585 20,975 23,190 32,520 25,920 37,775 52,640 68,505 133,585 19,185 21,655 23,940 33,570 26,760 39,000 54,340 70,715 137,895 65,035 88,000 155,180 32,220 57,915 68,790 29,060 45,720 29,060 40,960 52,860 46,455 70,710 19,703 22,240 24,587 34,477 27,483 41,733 55,699 72,483 141,830 67,133 90,838 160,185 33,090 60,000 72,882 29,845 46,955 29,845 42,500 56,732 47,710 72,478 20,295 22,907 25,324 35,511 28,307 42,985 57,370 74,658 146,241 69,298 93,768 165,351 34,158 61,935 75,233 30,808 48,469 30,808 43,871 58,562 49,248 74,816 20,741 23,411 25,882 36,292 28,930 43,931 57,944 75,504 147,803 69,991 94,706 167,005 34,977 63,422 77,039 31,547 49,632 31,547 44,924 59,968 50,332 76,462
StaV Grade (pre-1997 contract) StaV Grade (1997 contract) Salaried GP
Table 27d GP PAY Year 199798(1) 199899(1) 19992000(1) 200001(1) 200102(1) 200203(1) 200304(2), (3) 200405(2), (4), (5) 200506(2), (4), (5) Remuneration/Income (IANI) ()(1) 46,031 48,037 52,606 54,219 56,510 64,443 72,752 87,076 95,350
Source: The Information Centre for health and social careGeneral Practitioner Finance and Patients Statistics Unit DDRB on GP earnings. Footnotes: 1. Net prots achieved by GPs. These gures reect intended Average Net Remuneration (IANR). IANI gures represent the average remuneration (take-home pay) DDRB intended to be paid through the fee scale. 2. Under the new GMS contract the IANI concept ceased. The gure for 200304 is an IANI equivalent amount agreed with the Technical Steering Committee (TSC). 3. Calculated using NHS Pension Agency nal 200304 dynamisation factor. 4. Calculated using TSC forecast interim dynamisation factor. 5. Forecast amount. To be agreed with Technical Steering Committee (TSC).
Table 27e HCHS EARNINGS PER HEAD(1) s 199798 Consultants Other Career Grades Registrars and Senior Registrars SHOs and HOs Other Hospital Medical Grades Qualied nursing 63,877 46,010 37,152 30,252 42,004 20,153 199899 19992000 67,890 48,466 39,612 31,779 43,537 20,359 71,722 50,274 41,354 34,470 49,050 21,677 200001 78,292 53,782 45,126 36,084 52,985 22,762 200102 83,539 60,747 51,401 41,015 52,653 23,920 200203 86,746 63,399 56,362 43,668 55,214 24,825 200304 99,168 69,455 61,700 46,672 62,658 25,303 200405
(2) (3)
200506 (4) 109,974 74,570 59,049 45,851 69,841 27,868
103,648 72,241 57,328 44,514 67,659 26,339
Footnotes: 1. Figures for NHS staV only and exclude agency. 2. Includes estimated for Foundation Trusts. 3. Includes 334 million other provision, assumed to be for Agenda for Change. 4. Figures are projections and are subject to change. Actual outturn gures for 200506 are not yet available.
3.2.2 What are the expected costs of Agenda for Change in each year from 200506 to 200809? Have these estimates changed, and if so, can the changes be explained? (Q28)
Answer 1. The funding envelope for Agenda for Change from 200506 to 200708, and a projection to 200809 is set out in Table 28. 2. Monitoring of the costs of Agenda for Change in 28 sample sites in 2005 suggested that in the rst 12 months from October 2004 to September 2005 direct earnings costs exceeded those originally estimated by 0.5% of the Agenda for Change paybill, or around 120 million a year in cash terms. In the same period, this data suggested that the indirect costs of replacing additional hours and leave arising from Agenda for Change exceeded those originally estimated by at least 100 million a year. However, these indirect costs are based on trust estimates rather than actual payroll records, and are susceptible to management action. Subsequent management accounts data (FIMs data) suggests that actual spend may in fact be less than these estimates, although we will need to await nal accounts in September 2006 to conrm the position. 3. In addition, from October 2005, a signicant minority of staV who were previously on their scale maxima, or on spot salaries, will have gained access to some further pay progression. This was allowed for in the cost estimates in the table above. But, whether actual experience of progression is more than expected, or less than expected is not known, and we are currently considering what further information and analysis is necessary to measure this. But, it is important to note that it will become increasingly diYcult to separate out costs due to the new system from other changes as time goes on. 4. In terms of the reasons for the cost overruns suggested by the 28 sample sites data, for direct costs (basic pay, unsocial hours, overtime, geographic allowances etc) most elements came close to their original forecast except overtime where an expected small saving of around 0.1% of pay bill became a small cost of 0.1%. The original estimate was based on the assumption that the savings from abolition of higher premium rates for Sunday working for signicant numbers of staV would exceed by small amount the additional cost from paying overtime at premium rates to some smaller groups who had not previously been entitled to that, and the eVect on overtime of increases in basic pay. This variation accounted for nearly half the overall variance in direct costs. The remainder was the net eVect of small variations (both up and down). 5. In terms of indirect costs there is a signicant diVerence between the sample site Trusts stated policies on replacement of hours and leave compared to assumptions in the original forecasts. There was also an assumption in the original estimatesbased on the evidence we had at that timethat the old NHS extrastatutory days (additional bank holiday days) were still being staVed at premium rates or had been bought out by additional leave on the basis of three days normal leave for the two extra-statutory bank holidays. Whereas evidence from the sites monitored during assimilation suggested that in most cases these had already been bought out with additional leave on a two for two basis in some cases with unrelated concessions (for example on car-parking). This contributed around 80 million to the estimated variance in indirect costs within the sample sites. 6. There are a number of benets from the pay reform which will arise over time and are not taken into account in the analysis above. One example is that the net eVect of harmonisation of working hours on nursing hours (37.5 hours per week) will be to gradually increase the total hours available to the NHS, including hours available from key groups such as radiographers. Table 28 ESTIMATED COST OF IMPLEMENTING AGENDA FOR CHANGE Year 200506 200607 200708 200809 Cumulative total million (1) 950 1,390 1,780 2,200
Footnotes: 1. Totals rounded to nearest 10 million. 2. The funding envelope for Agenda for Change agreed with HMT in 2002 extended to 200708. The gure for 200809 has been previously provided to the HSC as a projection of the trend in the envelope.
3.2.3 What is the current Agenda for Change assimilation rate? Can the Department comment on this gure? (Q29) Answer 1. According to our central monitoring of assimilation to Agenda for Change 99% of staV are now assimilated onto the pay system. Our focus is now on supporting the small number of trusts who have not yet achieved 100% assimilation. NHS Employers are actively helping trusts to overcome obstacles such as band evaluation disparities and technical payroll issues, in order that 100% assimilation can be achieved as quickly as possible. Unions are supportive of this action and are content with progress so far. 3.2.4 What are the expected costs of the new consultant contract in each year from 200506 to 200809? Have these estimates changed, and if so, can the changes be explained? What have consultant earnings been in each year since 200102? (Q30) Answer The information requested is given in Table 30a and Table 30b. Representations from trusts in late 2005 suggested that the costs of the consultant contract had exceeded plans by as much as 150 million, mainly due to higher levels of programmed activities. We uplifted the tariV for 200506 by this amount. Evidence obtained subsequently, however, from the rst consultant contract survey (on data as at October 2004), suggested that while the levels of programmed activities were higher than expected, the diVerence suggested an excess cost of the order of 90 million rather than 150 million. Data from the recent consultant contract survey has shown a further reduction in average programmed activities. It has also shown a reduction in the proportion of consultants receiving on-call supplements, which had also been cited as a cause of cost pressures.
Table 30a
CONSULTANT PAY REFORM ENVELOPES millions 200405 200506 200607 200708 Consultant contract Cons. increase on previous year 252 252 325 73 396 71 444 48
Table 30b
HCHS CONSULTANT EARNINGS BILL(1), (4) Year 200102 200203 200304 200405(2) 200506(3) Source: Paybill. Footnotes: 1. Figures for HCHS NHS StaV only and exclude agency. 2. Includes estimated for Foundation Trusts. 3. Figures are projections and are subject to change. Actual outturn gures for 200506 are not yet available. 4. Consultants earnings bill is estimated by removing the estimating employers contributions from the total paybill. million 1,994 2,224 2,720 3,088 3,448
3.2.5 What are the expected costs of the new GMS contract in each year from 200304 to 200607? (Q31) Answer The estimated cost of implementing the new GMS contract is given in Table 31. The introduction of the contract was underpinned by a three-year deal ending in 200506. From 2006 onwards, the contract will be reviewed annually and is the subject of negotiations with the General Practitioners Committee (GPC). Negotiations have agreed there will be not uplift to any existing element of the contract for ination or cost pressures in 200607. Table 31 EXPECTED COST OF IMPLEMENTING NEW GMS CONTRACT Year 200304 200405 200506 (1) 200607 (1) billions 5.8 6.9 7.7 7.7
Footnotes: 1. Estimated cost subject to validation/agreement with GPC. 2. The increase in spending over the period 200304 to 200607 is largely due to increased investment in the Quality Outcomes Framework (c 1.1 billion) and Enhanced Services (c 0.5 billion). 3.2.6 What is the funding for the new pharmacy contract in 200506 and 200607 and what will be the basis for such funding in subsequent years? Could the Department comment on the provision, and funding, of enhanced and advanced services? (Q32) Answer 1. The provision for the new pharmacy contractual framework in 200506 was 1,766 billion as agreed with the Pharmaceutical Services Negotiating Committee (PSNC). This covers essential and advanced services. Provision for 200607 is still under discussion with the PSNC. 2. Funding for future years will be determined by the factors agreed in the framework, which are: the GDP deator; increases in dispensing volumes at marginal cost; increase in staV salaries in excess of GDP deator levels; the cost of signicant regulatory burdens; and an eYciency assumption which reects eYciency targets in the NHS as a whole. 3. Considering these factors, the funding agreed for 200607 is 1.911 billion. 4. In addition, medicines purchase prots available to the independent pharmacy sector are monitored to ensure the agreed amount to fund the new pharmacy contractual framework is delivered. As a result, there will be a further reduction to generic medicine prices from 1 October 2006, yielding a net saving to PCTs in 200607 of 150 million. 5. Enhanced services within the pharmacy contract are commissioned and funded locally by PCTs to meet local health needs. Emerging ndings published by the Information Centre in July 2006 indicate a total of 16,835 local enhanced services provided by community pharmacy contractors in 200506. This is equivalent to 1.7 local enhanced services per community pharmacy contractor. 3.2.7 What are the expected costs of the new dental contract in each year from 200506 to 200809? (Q33) Answer 1. The new dental contracts took eVect from 1 April 2006. They do not in themselves increase costs. Rather, they alter the commissioning relationship between the NHS and dentists and improve the method of remuneration so that dentists are no longer paid on a fee-per-item basis. 2. Previously dentists in the General Dental Services could set up practice where they wished and decide what levels of NHS dentistry to provide from one month to the next, claiming payment from a national budget. The fee-per-item method of remuneration encouraged an inappropriate emphasis on intensive interventions to the detriment of preventative care. Under the new arrangements, PCTs have devolved budgets for dentistry and hold local contracts with dentists. Instead of a fee-per-item system, the contracts are based on a xed annual contract value and an agreed annual level of service provision based on overall courses of treatment.
3. For 200607, dentists contract values are generally the same as their gross NHS earnings during the reference period October 2004 to September 2005, adjusted to reect subsequent pay uplifts (in line with the recommendations of the Doctors and Dentists Review Body). 4. For 200506, before the new contracts were introduced, provisional accounts data suggest that the combined gross expenditure (including income from patient charges) on General Dental Services and Personal Dental Services pilots was [2,190] million. For 200607, the Department has allocated net resource budgets of 1,765 million for primary care dentistry. This, together with the predicted level of charge income, should support total gross expenditure of nearly 2,400 million. This is the minimum resource that PCTs are expected to commit to primary care dentistry. They can commit additional funding from their general NHS allocation if they judge this a local priority. 5. The Department has not yet decided the level of primary dental care allocations for 200708 and 200809, but they will be at least the level of current allocations with an allowance for pay uplift. 6. The increase of around 200 million in projected expenditure between 200506 and 200607 does not arise from the new contracts. It largely reects growth in the volume of dental services during 200506 (which was reected in PCT budgets for 200607), together with the eVect of the 200607 pay uplift recommended by the Pay Review Body. Similarly, any growth in future years (over and above the annual pay uplift) will reect decisions to expand the volume of dental services commissioned by PCTs. 3.2.8 What are the expected costs of the Options for Excellence social care workforce scheme, by year? Could the Department comment on the progress of the scheme? (Q34) Answer 1. Options for Excellence is a national review of the social care workforce. It is jointly sponsored by DH and DfES ministers. The Reviews work is expected to be complete by autumn 2006 and it is not possible to provide the nancial information requested at this stage. 2. The remit of the Review is to consider social care workforce development options, including recruitment and retention, education and development, leadership and expanding professional regulation. A review Board was established, comprising key social care organisations, and detailed work looked at: (a) Quality of practice and quality within the workforce. (b) Recruitment and retention. (c) The role of social workers, including what tasks only social workers should do, qualications and skills needed. (d) Developing a vision of the workforce in the longer term. 3. At present, the Review Board is considering a number of proposals which are currently only tentative, with the aim of submitting rm options to Ministers by autumn 2006. The proposals are being developed in more detail, being prioritised and having costings worked up. Some proposals have been identied as achievable in the short term within existing resources, but others will require new resources, which may be available in the longer term.
3.3 Treatment Outside the NHS 3.3.1 What has NHS expenditure on the purchase of healthcare from non-NHS bodies been in each year since 199798? How much activity did this purchase? Could the Department provide a detailed breakdown of these data where available? (Q35) Answer 1. The information requested is given in Table 35a and Table 35b. 2. The gures include expenditure on services provided by all non-NHS bodies, including local authorities and other statutory bodies, as well as independent healthcare providers (including ISTCs). They include nursing care spend (for non-NHS staV). 3. The non-NHS spend is based on aggregating nancial returns from individual NHS bodies (PCTs, NHS Trusts, SHAs). Since these are typically responsible for a mixture of acute, non-acute and mental health work, and their returns do not give any details of their non-NHS commissions beyond the total amount, we are unable to provide any futher disaggregation. There is no data on activity procured by this expenditure. 4. The expenditure is derived from nancial returns that are not audited.
Table 35a EXPENDITURE BY NHS BODIES ON THE PURCHASE OF HEALTHCARE FROM NON-NHS BODIES thousands Health Authorities/ Strategic Health Authorities 985,746 1,108,471 1,166,412 1,328,208 1,136,793 27,234 3,329 0 Primary Care Trusts n/a n/a n/a 33,774 409,936 1,873,925 2,903,763 3,353,036 Total Expenditure 1,108,182 1,230,425 1,301,196 1,549,172 1,792,967 2,239,331 3,315,893 3,666,024
Year 199798 199899 19992000 200001 200102 200203 200304 200405
NHS Trusts 122,436 121,954 134,784 187,190 246,238 335,172 408,801 312,988
Source: Annual Financial Returns of Health Authorities, 199798 to 200102. Annual Financial Returns of Strategic Health Authorities, 200203 to 200405. Annual Financial Returns of NHS Trusts, 199798 to 200405. Annual Financial Returns Primary Care Trusts, 200001 to 200405. Note: 200405 NHS trusts data does not include NHS Foundation Trusts.
Table 35b
EXPENDITURE BY NHS BODIES IN THE PURCHASE OF HEALTHCARE FROM NON-NHS BODIES BY SHA thousands
Org code Q01 Q02 Q03 Q04 Q05 Q06 Q07 Q08 Q09 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 Q19 Q20 Q21 Q22 Q23 Q24 Q25 Q26 Q27 Q28 Strategic Health Authority Name Norfolk, SuVolk and Cambridgeshire Bedfordshire and Hertfordshire Essex North West London North Central London North East London South East London South West London Northumberland, Tyne and Wear County Durham & Tees Valley North and East Yorkshire and Northern Lincolnshire West Yorkshire Cumbria & Lancashire Greater Manchester Cheshire & Merseyside Thames Valley Hampshire and Isle of Wight Kent and Medway Surrey and Sussex Avon, Gloucestershire & Wiltshire South West Peninsula Somerset & Dorset South Yorkshire Trent Leicestershire, Northamptonshire & Rutland Shropshire and StaVordshire Birmingham and the Black Country West Midlands South England Total 199899 39,806 44,021 36,180 94,586 58,232 39,271 69,142 43,275 31,493 6,380 39,672 40,121 30,159 52,884 73,311 35,746 35,704 47,449 95,556 76,807 39,375 9,534 24,982 31,461 18,607 17,684 63,231 35,755 1,230,425 19992000 46,762 49,133 26,600 66,732 54,160 45,214 87,534 33,613 43,645 9,911 39,136 45,932 36,990 58,949 77,722 26,565 43,214 32,986 109,838 89,234 38,780 15,078 30,528 38,371 24,072 31,947 74,600 23,952 1,301,196 200001 42,090 55,356 46,867 66,537 52,487 66,741 95,202 56,803 45,013 26,593 46,451 65,013 53,316 75,451 85,389 12,376 28,212 39,078 138,250 72,097 49,692 13,921 33,069 90,466 27,436 39,914 84,870 40,484 1,549,172 200102 73,882 48,211 24,628 70,142 52,931 62,032 91,889 43,171 54,871 41,517 47,217 86,975 26,391 82,670 121,558 25,565 47,052 43,304 159,064 151,874 66,326 23,252 12,679 137,533 29,869 56,816 92,899 18,649 1,792,967 200203 68,237 47,660 53,407 119,629 104,568 80,048 86,462 63,877 77,570 52,830 46,438 97,819 64,958 99,738 88,475 89,803 81,381 70,697 222,605 97,303 101,657 55,846 28,357 114,289 37,228 55,682 84,621 48,146 2,239,331 200304 140,457 119,754 106,468 172,271 114,221 81,619 115,428 92,037 77,219 79,283 92,699 104,696 115,729 128,916 169,490 109,123 108,239 98,475 247,173 135,731 98,717 84,253 91,931 179,144 63,235 90,956 179,801 118,828 3,315,893 200405 149,726 169,105 109,839 195,550 124,498 113,435 146,168 105,592 109,415 69,452 92,168 142,239 133,162 134,738 182,589 126,816 104,347 111,495 237,768 194,153 113,718 69,942 83,797 155,591 69,430 113,858 199,758 107,675 3,666,024
Source: Annual Financial Returns of Health Authorities, 199798 to 200102. Annual Financial Returns of Strategic Health Authorities, 200203 to 200405. Annual Financial Returns of NHS Trusts, 199798 to 200405. Annual Financial Returns Primary Care Trusts, 200001 to 200405.
3.3.2 Could the Department provide a list of all Independent Sector Treatment Centres (ISTCs) currently in operation, or with contracts already signed, including (a) name and location (b) company running the ISTC (c) services contracted for, by type and volume (by Healthcare Resource Group if possible) (d) value of contract per year, the period of the contract and whether it is on a take or pay basis and (e) a comparison with the cost at national tariV prices of providing the same type and volume of services? (Q36) Answer 1. The information requested is shown in the Table 36 for agreed wave 1 Independent Sector Treatment Centres (ISTCs). There are three further wave 1 facilities subject to negotiation. 2. All wave 1 ISTC contracts are on a take or pay basis. The amounts paid to individual independent sector providers are commercially sensitive and cannot be disclosed. This is because the ISTC programme is a rolling procurement and release of this information could adversely impact upon the Departments ability to secure the best possible value for money when procuring public health care services. Total expenditure on agreed wave 1 ISTC contracts was 3.4 million in 200304, 14.1 million in 200405 and 118.3 million in 200506. 3. A range of indicators were considered to ensure that we could measure and report on Value for Money secured. This included as reference points, both NHS tariV and historic prices the NHS had achieved when spot purchasing from the NHS. 4. It is not possible to directly compare the ISTC prices to tariV. To the extent that prices can be compared, we estimate that across the full period of wave 1 contracts, the average cost above the NHS equivalent cost of all wave 1 ISTCs is approximately 11.2%.
Table 36 INDEPENDENT SECTOR TREATMENT CENTRES

Provider Name Capio UK Capio UK Capio UK Capio UK Capio UK Capio UK Capio UK Capio UK Thames Valley (TV3500) Kidderminster Cheshire & Merseyside Nottingham Capio UK Capio UK InterHealth InterHealth Nations Healthcare (Nottingham) Limited PHG Contract Start Date October 2005 April 2005 April 2005 January 2006 April 2005 April 2005 April 2005 April 2005 January 2006 April 2005 February 2005 February 2005 December 2007 Service Contract end Commencement date October 2005 April 2005 April 2005 January 2006 July 2005 April 2005 May 2005 April 2005 August 2006 April 2005 February 2005 June 2006 December 2007 March 2010 March 2010 March 2010 December 2011(3) March 2010 March 2010 March 2010 March 2010 December 2011(3) March 2010 January 2010 May 2011 November 2012 Total Total Procedures Diagnostics for contract(1) for contract(1) 26,767 7,263 6,365 11,197 9,964 11,468 10,080 2,000
Program(2) East Cornwall East Lincs West Lincs North Oxford (Horton) NEYNL Southampton Northumberland
Facility Bodmin NHS Treatment Centre Boston NHS Treatment Centre Gainsborough NHS Treatment Centre Horton NHS Treatment Centre Clifton Park NHS Treatment Centre Capio New Hall NHS Treatment Centre Cobalt NHS Treatment Centre Blakelands NHS Treatment Centre Horton NHS Treatment Centre Capio Reading NHS Treatment Centre Kidderminster NHS Treatment Centre Cheshire & Merseyside NHS Treatment Centre Queens Medical Centre Nottingham
Specialties Ophthalmology, General Surgery, Gastroenterology, Gynaecology, Urology Ophthalmology, urology, hernias, varicose veins, colonoscopies and minor skin Ophthalmology, gastroscopies, colonoscopies, orthopaedic, urology and minor skin Orthopaedics General Surgery and orthopaedics Orthopaedics Upper scopes, hernias, varicose veins, minor skin General Surgery, Urology, Trauma and orthopaedics, Dermatology, Gynaecology Orthopaedics General Surgery, Urology, Trauma and orthopaedics, Dermatology, Gynaecology Orthopaedics Orthopaedics Orthopaedic, Gynaecology, General surgical, Dermatology, Endoscopies, Oral and Maxillofacial Surgery, Vascular Surgery, Chronic Pain, Diagnostics Chemotherapy, minor surgery and endoscopes Ophthalmology, Orthopaedics, ENT, Oral, General Surgery, Urology Orthopaedics
17,417(4)
9,000 24,817 110,683
Maidstone
Maidstone Hospital King George Hospital
October 2006 December 2006
October 2006 February 2007 June 2006
October 2011 November 2011 May 2011
55,589 55,615 26,451
Outer North East PHG London Brighton Mercury Health
Sussex Orthopaedics NHS Treatment February 2005 Centre
Table 36 (continued) INDEPENDENT SECTOR TREATMENT CENTRES

Provider Name Mercury Health Mercury Health Mercury Health Mercury Health Nations Healthcare (Bradford) Limited Contract Start Date August 2005 October 2005 Service Contract end Commencement date August 2005 October 2005 July 2010 September 2010 Total Total Procedures Diagnostics for contract(1) for contract(1) 74,880 19,770 34,155 27,416 48,450 78,600 73,750
Program(2) Wycombe Medway Portsmouth Havant Bradford
Facility Mid and South Buckingham Diagnostic Centre Will Adams NHS Treatment Centre
Specialties Diagnostics only (MRI, x-ray, echo and ultrasound) General Surgery, Gastroenterology, ENT, Orthopaedics, Urology, Diagnostics endoscopy only Walk in centre/minor injuries unit, day surgery, diagnostics Diagnostics only General Surgery, Gastroenterology, ENT, Gynae, Opthalmics, Orthopaedics, Plastics, Urology, Oral Surgery, Ultrasound scansgeneral, Ultrasound scansdoppler, CT scans, MRI scans, Plain lms and x-rays, Fluoroscopy General Surgery, ENT, Gynaecology, Ophthalmology, Orthopaedics, Plastics, Urology, Oral Surgery, Rheumatology, Pain procedures, Ophthalmology Orthopaedics Ophthalmology, Orthopaedics, Plastics, Oral Surgery, Upper GI Endoscopy Orthopaedics, ophthalmology, general surgery and endoscopy Orthopedic, general surgery, ENT and Diagnostics Orthopaedics Ophthalmology
St Marys NHS Treatment Centre November 2005 December 2005 November 2010 TBA TBA Eccleshill NHS Treatment Centre April 2005 January 2008 June 2005 December 2010 June 2010
Burton
Nations Healthcare (Burton) Limited CUAH (Trent) Limited The Birkdale Clinic (Rotherham) Limited UK Specialist Hospitals Netcare Healthcare UK Limited Partnership Health Group Limited Netcare Healthcare UK Limited
Midlands NHS Treatment Centre May 2006
July 2006
May 2011
64,814
Trent & South Yorkshire Daventry Shepton Mallet Greater Manchester Plymouth Ophthalmic Chain
Barlborough NHS Treatment Centre Birkdale Clinic
April 2005 October 2003
April 2005 October 2003 July 2005 May 2005 May 2005 January 2004
March 2010 February 2006 July 2010 May 2010 May 2010 March 2009
22,000 5,959 56,242 11,284 16,512 44,737
Shepton Mallet NHS Treatment July 2005 Centre Greater Manchester Surgical May 2005 Centre Peninsula NHS Treatment Centre May 2005 Mobile units January 2004
Source: Department of Health. Footnotes: 1. Current expected total volume over the contract period. Independent sector treatment centre (ISTC) contracts stipulate the expected casemix and volume of healthcare to be completed during the ve year period of the contract. Actual volumes may change depending on the casemixes that are referred. 2. Figures are for agreed Wave 1 ISTC contracts and the Ophthalmic Chain. There is a further wave 1 contract in negotation. 3. Subject to negotiation. 4. Total for the contract. Provided from the 3 Thames Valley facilities.
3.3.3 What has NHS expenditure on healthcare provided in other EEA member states or Switzerland been in each year since 200203? What is it expected to be in future years? (Q37) Answer 1. There have been two separate systems in operation. Regulations (EEC) 1408/71 and 574/72 coordinate the social security and health care systems of the member states of the European Union the European Economic Area and Switzerland. These Regulations cover, amongst other things, medically necessary health care for temporary visitors (the E111/European Health Insurance Card (EHIC) arrangements) and referral of patients specically for treatments of pre-existing conditions (the E112 scheme). 2. A direct referral scheme outside the scope of the European Community arrangements was available in England until 31 March 2005. Between January and April 2002 there was a pilot scheme in south-east England whereby a number of surgical procedures were commissioned directly by the NHS from healthcare providers in France and Germany. One hundred and ninety patients were treated under this pilot at a cost of 1.1 million. 3. This was extended for orthopaedic treatment overseas, with patients drawn from ve diVerent areas. A total of 917 patients have been referred for treatment abroad as part of the overseas treatment programme at a cost of 6.5 million. The option of receiving treatment abroad was also been oVered as part of two patient Choice pilot schemes. This includes all programme costs, for treatment, travel, comprehensive rehabilitation and outpatient clinics run within the UK by European clinicians. 4. A total of 21 cardiac patients have also been treated abroad at a cost of 300,000. 5. The data in Table 37 shows, in resource terms, costs of treatment provided under the terms of the Regulations to UK insured persons. Actual treatment costs are used for both medically necessary health care (E111/EHIC) and for patients referred specically for treatment (E112) as well as some other categories of persons covered. But, in practice claims do not necessarily distinguish between categories so that no cost distribution between E111/EHIC and E112 arrangements is available. Patient numbers are not available since claims may cover several episodes of care for a single individual. However, the UK approved the following number of patient referrals under E112 arrangements as follows: 200506 % 281. 6. Lump sum costs cover, in particular, state pensioners who have relocated to other member states; the costs of their health care lie with the member state paying the pension (unless they also have a pension from the member state of residence). 7. No precise information is available on types of treatment covered. For E111/EHIC, medically necessary health care covers the range from minor ambulatory care to major trauma. E112s cover ongoing treatment begun in the UK, specialised care not available in the UK and care for which there is a long UK waiting time. 8. It is estimated that the overall resource requirement for treatment given to UK insured person under the Regulation in other EEA member states in 200607 is expected to be around 641 million. This increase is due to a number of factors: An increase in Health care costs in other member states over which the UK has no control. The increasing trend of UK state pensioners to relocate to other member states (the UK pays a lump sum for their health care). An extension of rights to third country nationals. An alignment of rights which has given increased healthcare rights. Enlargement of the EU. Table 37 RESOURCE OUTTURN 200203 TO 200506 Member States claims against the United Kingdom thousands 26,500 233,200 249,700 40,091 273,909 314,000 UK claims against Member States thousands 14,200 17,300 31,500 15,248 9,926 25,174
Year 200203
Claim type Actual cost Lump sums Total Actual cost Lump sums Total
200304
Year 200405
Claim type Actual cost Lump sums Total Actual cost Lump sums Total
Member States claims against the United Kingdom thousands 49,500 331,900 381,500 59,100 404,100 463,100
UK claims against Member States thousands 18,700 12,500 31,200 20,600 14,400 35,000
200506
Source: The 200506 Resource Accounting and Budgeting (RAB) outturn excercise. Footnotes: 1. The information is compiled in line with the requirements of Government Accounting 2000 and National Audit OYce (NAO). 2. Claims against the UK are made in national currency and converted in to sterling by using the quarterly mean exchange rates published by the EU commission. 3. Actual costs under Article 93 of Regulation 574/72 include E111s/EHIC (temporary visitors and E112 cases (referrred patients). 4. Lump sums under Articles 94 and 95 of Regulation 574/72 include 121s (pensioners). 5. Figures may not add up due to rounding. 3.4 Other Reforms 3.4.1 Could the Department detail expenditure and projected expenditure on the National Programme for IT? Can the Department estimate the extent of local additions to NHS Connecting for Health funding? Could the Department comment on any cost overruns and delays? (Q38) Answer 1. Information is given in Table 38a and Table 38b. 2. The projected expenditure that was identied by the NAO in their recent report amounted to 12.4 billion. However, this did not take account of known and estimated cost reductions based on early implementations. The projected expenditure, taking these factors into account amounts to 7.55 billion and this is explained in Table 38b. This gure does not take into account the benets that will be realised from the programme. 3. There have been no cost overruns. Local additions are included in Table 38b. 4. There have been some delays but the programme is broadly on track within the context of a 10 year programme. The Programme was set ambitious and challenging targets to deliver systems to provide essential benets for the NHS. Many systems are on or ahead of schedule and implementation is accelerating. Additional systems such as the Quality Management and Analysis System and Payment by Results which were not within the original programme plans have also been taken on and delivered. The cost of any delays is being met by suppliers, not the taxpayer. Table 38a CONTRACT EXPENDITURE ON THE NATIONAL PROGRAMME FOR IT (excl local NHS expenditure(1)) TO 31 MARCH 2006 millions Programme area Spine N3 Broadband network Choose and Book London LSP North East LSP NW/WM LSP Eastern LSP Southern LSP Total Contractor BT BT Atos Origin BT (CCA) Accenture CSC Accenture Fujitsu Lifetime contract value 620.0 530.0 64.5 996.0 1,099.0 973.0 934.0 986.0 6,202.5 Expenditure 239.8 130.5 27.1 1.3 51.6 119.3 57.9 26.5 654.0
Source: NHS Connecting for Health internal accounts. Footnote: 1. Figures for NHS expenditure on implementing the National Programme, separate from the totality of NHS spending on IM&T, are not collected centrally.
Table 38b PROJECTED LIFETIME CENTRAL AND LOCAL EXPENDITURE ON THE NATIONAL PROGRAMME FOR IT Expenditure type Original contracts Increased scope Additional services Total contracts Central expenditure Total contracts and central expenditure Cost reductions (EWAs, NHSMail, PACS) Total net central costs Local NHS expenditure (estimate gross) Estimated local cost reductions Net local costs Total gross programme costs Total net programme costs millions 6,220 382 239 6,841 1,500 8,341 1,731 6,610 3,400 2,457 943 11,741 7,553 Sources 1 1 1 2 3 4 5
Source: 1. Fixed price contracts. 2. NAO estimate (1,900 million) adjusted for costs relating to non-NPfIT activity and future reduction in size of NHS Connecting for Health. 3. DiVerence between cost of central procurements and cost of equivalent procurements by individual NHS bodies. 4. NAO estimate. 5. Estimates based on case studies following early deployments. Footnote: 1. Considerable further savings are anticipated from wider programme benets, eg improvements in patient safety. 3.4.2 What have the costs of implementing Choose and Book been to date? How does this compare with original estimates? (Q39) Answer 1. The cost to date of developing and beginning to implement the system is 29.2 million. The total committed contract cost is 65 million. 2. The cost continues to remain within the planned budget. 3.4.3 How has the Department deployed the additional funding granted as a result of the Health Committees report into New Medical Technologies towards improving the management of patients through the use of telecare in liaison with social services? How was the funding for such schemes deployed in the last nancial year and how much will it be in the future? Is this money ring-fenced? (Q40) Answer 1. In April 2006, a Preventative Technology Grant of 80 million over two years was provided to enable councils to invest in Telecare to help an additional 160,000 older people nationally to remain independent at home and reduce the number of avoidable admissions to residential/nursing care and hospital. 2. The grant has been allocated using the Relative Share for Older Peoples Relative Needs formulae. 30 million is available in 200607 and 50 million in 200708. 3. The grant is not ring fenced and is paid under Section 31 of the Local Government Act 2003 to all councils. Three Star Councils received the grant in one payment in April 2006 for 200607 nancial year and will receive another payment in April 2007 for 200708 nancial year. 4. At 31 March 2006, all local councils were required to complete the Commission for Social Care Inspection (CSCI), Delivery and Improvement Statement (DIS). The statement specically requested that councils provide information on the number of existing service users with Telecare and projected numbers of Telecare users at 31 March 2007 and 2008 following introduction of the Preventative Technology Grant. It also asked councils to report on how much the council was intending to spend on Telecare in 200607 and 200708 and to give a brief description of the, service they were planning to implement. 5. The information collected from councils through the delivery and improvement statement is currently being analysed by the Department of Health.
6. The Care Services Improvement Partnership (CSIP) is leading on implementation of the Preventative Technology Grant. CSIP also has information on the current state of play with councils implementing Telecare. This information is being collated alongside the information collected through the DIS at 31 March and will be available shortly. CSIP have been very active over the past year in promoting Telecare and have run a number of events, workshops, learning sets and master classes to help support the take-up of Telecare. 7. We know from CSIP that a variety of diVerent models of Telecare service are being developed some are based around extensions of basic community alarm, systems to include other sensors such as motion, ood and smoke detectors. Some areas are piloting models of Telecare service aimed at specic client groups eg those with dementia, people at risk of falls etc. We know other areas such as Kent, Cheshire, Durham, Cumbria, Norfolk, Newham and Sandwell are now moving towards or already mainstreaming their Telecare service. 8. In July 2006, NHS PASA launched a National Framework Agreement for the procurement of Telecare and telehealth equipment (including installation and maintenance) and response services (including control centres, monitoring and response). The framework has been developed to support spend through the 80 million Preventative Technology Grant. 9. We know that around 100 local authdrities have registered to access the electronic catalogue that supports this framework. PASA have developed a benets tracking tool, this will enable them to get feedback from suppliers about who is purchasing what and where. The rst information from this tracking tool should be available by November 2006. However, it will be limited to purchases from the framework and will not pick up any purchases made through other routes eg suppliers not on the framework agreement. 3.4.4 How many, and what proportion of, practices are involved in practice-based commissioning (PBC), and what is progress towards the universal coverage of PBC? (Q41) Answer 1. As of 31 August 2006, 6,260 GP practices (74%) had taken up an incentive payment to become involved in practice based commissioning (PBC). 2. Universal coverage of PBC is dened as PCTs putting in place the right environment to facilitate practices to take up PBC. This is dened in Practice based commissioning: achieving universal coverage (January 2006). All PCTs have agreed to meet universal coverage by the end of 2006. 3. As of 31 August, 69% of all PCTs had put in place the factors required for universal coverage. 4. PCTs have agreed trajectories with the DH for universal coverage and the DH expects this target to be met. 3.4.5 How much is available to PCTs to provide out-of-hours services? What proportion of practices have opted out of providing out-of-hours services? (Q42) Answer 1. In 200405, the Department provided support for the new out-of-hours arrangements through greatly increased funding. Some 316 million was allocated to primary care trusts (PCTs) to fund the provision of out-of-hours services. In 200506, the Department continued to support PCTs that commission and in some cases provide out-ofhours services by allocating a total of 322 million nationally. 2. The out-of-hours service budget was one of 110 diVerent budgets issued to the NHS in 200506. These centrally held funds were the responsibility of specic DH budget managers, who arranged distribution of the funding to PCTs and SHAs throughout the year. Potentially these allocations for a single budget may have been to all PCTs and SHAs (331 organisations in total). This presented major planning and operational diYculties for PCTs, as adjustments may have been required on a weekly basis. 3. For 200607, the arrangements for funding all central budgets, including provision of the out-of-hours service have changed. Out-ofhours funding has become part of a separately allocated NHS Central Budget Bundle, which covers all programmes formerly allocated under the centrally funded initiatives and services (CFISSA) programme. The purpose of the bundle is to ensure that all funds that were intended for allocation to the NHS, over and above PCT initial allocations, reach the NHS quickly and eYciently. This will maximise the opportunity for the NHS to plan with the total resources available. 4. A total of 5.5 billion is available to SHAs, and is accompanied by a service level agreement (SLA) that sets out the required outputs from the funding. However, it is for SHAs to decide, in consultation with other local stakeholders, how to deploy the funding. We believe local NHS decision makers are in a better position than the Department to determine funding priorities, and ensure that the money is used most eVectively. 5. PCTs should also be thinking beyond specic allocations and making most eVective use of their unied budgets to establish integrated networks of urgent care provision.
6. The National Audit OYce report on The Provision of Out-of-Hours Care in England makes it clear that if PCTs had commissioned eVectively the NHS could have lived within the 322 million provided last year. The report also highlights that there is signicant scope to reduce the costs of out-of-hours services in future by more than 53 million. 7. By 1 January 2005, all those practices, which wished to transfer outof-hours responsibility, had done so. Approximately 10% of practices chose to retain responsibility for out-of-hours services. 3.4.6 How much NHS expenditure was paid, or is forecast to be paid, to trusts via the national tariV in each year from 200405 to 200708? How much activitiy did this purchase? (Q43)
Answer 1. NHS expenditure on tariV activity is not separately identied within DH accounts. 2. Each year forecast estimates are made of the nancial coverage to support PbR implementation planning. 3. Estimates of the nancial coverage of PbR in 200405, 200506 and 200607 are detailed in Table 43. 4. Figures for 200708 are not yet available because of the overall tariV uplift upon 200607 has not yet been nalised. Table 43 ESTIMATED VALUE OF FINANCIAL COVERAGE billions Estimated value of activity covered by PbR 2.0 9.0 22.0
Year 200405 200506 200607
Coverage of PbR FTselective, non-elective, outpatients and A&E. Non-FTsPbR on growth activity on selected HRGs. FTselective, non-elective, outpatients and A&E. Non-FTselective only. All NHS organisationselective, non-elective, outpatients and A&E.
Footnotes: 1. These gures are based on 200405 activity. 2. Figures include MFF (market forces factor). 3. Figures are best estimates as at end of 2005. 3.4.7 Can the Department detail the current timetable for the implementation of Payment by Results, explaining any delays? (Q44) Answer 1. The current timetable for the implementation of Payment by Results (PbR) can be expressed in two ways: Scope of services commissioned under PbR; and Transition from local prices to national tariV.
Scope of Services Commissioned Under PbR 2. Table 44a summarises the planned growth in the range of services covered by PbR. 3. In terms of the diVerence between the planned scope of services commissioned under PbR, and actual roll-out, there was a delay in the timetable during 200506 when implementation of PbR for A&E, outpatients and non-elective admissions was deferred by a year for all Trusts other than the FTs and early implementers. The reasons for this delay were set out in evidence to the HSCs Public Expenditure Inquiry in 2005. From April 2006, these services are included within the scope of PbR for all relevant providers, as originally planned. 4. The exception is in adult critical care where we have developed revised casemix measures/currencies (aka Healthcare Resource Groups (HRGs), which Ministers have decided to allow to operate in shadow form in 200607 and 200708. Whilst funding for adult critical care therefore remains excluded from PbR and negotiated locally, this approach enables providers and commissioners to monitor activity using the new currencies and therefore calculate baseline activity and costs.
Table 44a PLANNED PbR IMPLEMENTATION TIMETABLE: SCOPE OF SERVICES COMMISSIONED UNDER PbR
Scope of services commissioned under PbR 200304 National timetable TariV applied to elective activity growth in 15 HRGs(1)
200405 TariV applied to elective activity growth in 48 HRGs(2)
200506
200607
200708 Introduce the exibility to unbundle the tariV for diagnostics and post-acute care(5). Start to apply the tariV to activity delivered in communitybased alternatives to acute hospitals(5) Introduce the exibility to unbundle the tariV for diagnostics and post-acute care(5). Start to apply the tariV to activity delivered in communitybased alternatives to acute hospitals(5)
200809 HRGs V4 introduced(6)
HRGs V3.5 TariV applied introduced. to adult TariV applied critical care(4) to baseline and growth in A&E; outpatients; elective spells (c550 HRGs(3)); non-elective spells (c550 HRGs)
Early transition (FTs and other early implementers)
TariV applied to elective activity growth in 15 HRGs(1)
HRGs V3.5 No change introduced. TariV applied to baseline and growth in A&E; outpatients; elective spells (c550 HRGs(3)); non-elective spells (c550 HRGs)
TariV applied to adult critical care(4)
HRGs V4 introduced(6)
Footnotes: 1. Healthcare Resource Groups (HRGs) are casemix measures used as currencies for the national tariV. HRGs represent clinically-related groups of cases (ie diagnoses and treatment combinations) that consume similar average levels of healthcare resource. The 15 HRGs are described in reformaing NHS Financuial Flows: Introducing Payment by results (DH, 2002). 2. See Payment by Results: Core Tools (DH, 2004). 3. See Payment by Results: Technical Guidance (DH, 2005). 4. See Payment by Results: Implementation Support Guide (DH, 2006). 5. See Our Heath, Our Care, Our Say (DH, 2005). 6. See Draft HRG V4 documents to preview (Information Centre, 2006) at www.ic.nhs.uk/casemix/sub000/preview
Transition from Local Prices to National Tariff 5. Table 44b summarises the planned transitional arrangements for NHS providers. 6. We remain on target to complete the transition from local pricing to national tariV for NHS Trusts and NHS Foundation Trusts (FTs) by 200809. First wave FTs and other early implementers will complete the transition by 200708. Future of PbR 7. In Autumn 2006, the Department will publish proposals for consultation on the Future of PbR: 200809 and beyond. This will include a policy update on extension of PbR to cover critical care, mental health, ambulance services and long-term conditions.
Table 44b PLANNED PbR IMPLEMENTATION TIMETABLE: SCOPE OF SERVICES COMMISSIONED UNDER PbR Scope of services commissioned under PbR 200405 200506 200607 National timetable 200708 200809
Transition period (ie movement from historic, local prices to national tariV over four equal, annual increments) Transition n/a 25% of transition 50% of transition 75% of transition completed Early transition Transition period (ie movement from historic, local prices to national (FTs and other tariV over four equal, annual increments) early 25% of Transition implementers) transition 50% of transition 75% of transition completed n/a
3.4.8 How much extra funding is being provided to NHS bodies to assist with the continued phasing-in of Payment by Results in 200607 and 200708? (Q45) Answer 1. Table 45 sets out funding, made to and taken from, the NHS under the 200607 PbR transitional arrangements. These transition paths were calculated on the basis that they would be cost neutral to the Department. However, a number of early implementer Foundation Trusts were eligible to apply for Minimum Income Guarantee (MIG). The cost of this adjustment has been funded centrally by the Department. 2. Transitional adjustments for 200708 have not yet been calculated. Table 45 200607 PbR TRANSITIONAL ADJUSTMENTS millions Funding allocated to the NHS Increase to PCT allocations (1) Transitional payments to providers (2) Total additional funding to the NHS Funding removed from the NHS Reduction to PCT allocations (1) Payments in-years from gaining providers (2) Total funding removed from the NHS Balance (3) Footnotes: 1. Based on 50% purchaser parity. 2. Based on the following published transition paths for providers:
Organisation type Activity type Elective; nonelective; A&E; outpatient 200607 200708 200809
482.0 201.0 683.0 "162.0 "497.0 "659.0 25.0
Wave 1 FT gainer
Wave 1 FT loser
Elective; nonelective; A&E; outpatient
NHS trusts and future NHS FTs
Elective; nonelective; A&E; outpatient
75% X gain 50% X loss capped at 2% change pa (4.04% in 200607) 50% X loss/gain capped at 2% change pa (4.04% in 200607)
100% 75% X loss capped at 2% change pa (6.10% in 200708) 75% X loss/gain capped at 2% change pa (6.10% in 200708)
100%
100%
100%
3. Net additional funding allocated to the NHS in 200607 under the PbR transitional arrangements.
3.5 National Institute for Health & Clinical Excellence (NICE) 3.5.1 What are the expected costs of implementing each NICE recommendation, technology appraisal and clinical guideline in 200607? (Q46) Answer Technology appraisals 1. Table 46a shows the technology appraisals issued by NICE. The column headed cost shows the gross cost to the NHS of implementing NICE guidance in England. 2. NICE provides estimates of the cost of implementing the recommendations in its guidance upon publication of the nal guidance. All estimates are based on gures published in NICEs appraisal guidance.
Table 46a ESTIMATED COSTS OF NICE TECHNOLOGY APPRAISAL GUIDANCE (AS AT JULY 2006) TA number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Title of guidance Wisdom Teeth Hip Replacement Taxanes for Ovarian Cancer Coronary Artery Stents Liquid Based Cytologycervical screening Taxanes for Breast Cancer Proton Pump Inhibitors Hearing Aids Rosiglitazone for Type 2 Diabetes Inhaler systems for under 5s Implantable cardioverter debrillators Glycoprotein IIb/IIIa inhibitors Methylphenidate for ADHD Ribavirin and Interferon Alpha for Hepatitis C Zanamivir for Inuenza Autologous Cartilage transplantation in Knee Joints Laparoscopic surgery for Colorectal Cancer Laparoscopic surgery for Inguinal Hernia Donepezil, Rivastigmine and Galantamine for Alzheimers Riluzole for Motor Neurone Disease Pioglitazone for Type 2 Diabetes Orlistat for Obesity Temozolomide for Brain Cancer DiYcult to heal surgical wounds Gemcitabine for Pancreatic cancer Nonsmall cell lung cancer Date of Issue March2000 April2000 May2000 May2000 June2000 June2000 July2000 July2000 August2000 August2000 September2000 September2000 October2000 October2000 November2000 December2000 January2001 December2000 January2001 January2001 March2001 March2001 April2001 April2001 May2001 June2001 Recommendation (4) Selective Selective Selective Selective Research Selective Selective Selective Selective Routine Selective Routine Routine Selective Selective Research Research Selective Selective Routine Selective Selective Selective Routine Selective Routine Cost ( millions) "5.00 "8.00 7.00 0.00 0.00 16.00 "45.00 0.00 14.50 0.00 35.00 30.70 44.00 60.00 7.00 0.00 0.00 0.00 42.00 5.00 "12.00 9.50 1.00 0.00 1.90 9.55 Comment
This assumes an oVset of 1520 million to gross costs of 45 million. NICE made separate estimates of the year 1 drug and associated running costs, and of the cost of initial assessment of potentially eligible patients.
This is the longrun annual costNICE expected a slow build-up over several years. See comment on Rosiglitazone above. 6 million for drug costs and 34 million for overheads.
These are the short-run costsNICE comment that take-up may increase in the longer term.
Table 46a (Continued) ESTIMATED COSTS OF NICE TECHNOLOGY APPRAISAL GUIDANCE (AS AT JULY 2006) TA number 27 28 29 30 31 32 33 Title of guidance Cox II for Osteoarthritis and Rheumatoid Arthritis Topetecan for advanced Ovarian Cancer Fludarabine for B-cell chronic lymphocytic leukaemia Taxanes for Breast Cancerreview Sibutramine for Obesity in adults Beta interferon & glatiramer Colorectal Cancer Date of Issue July2001 August2001 September2001 September2001 October2001 January2002 March2002 Recommendation (4) Selective Selective Routine Selective Routine Research Selective Cost ( millions) 25.00 7.00 0.00 0.00 19.20 0.00 41.00 Estimated to be broadly cost neutralno detailed costings given. Earlier guidance unchanged. Year 3 gure. NICE estimate 21 million for 1st line and 20 million for 2nd line use. They indicate that costs in 2nd line use could be considerably lower, but do not give a lower bound. Comment
34 35 36 37 38 39 40 41 42 43 44 45 46 47
Tratuzumab breast cancer Enteracept juvenile arthritis Enteracept & iniximab rheumatoid arthritis Rituximab lymphoma Inhalers 515 Zyban & NRT Iniximab Crohns disease Routine anti D rhesus negative women Human growth hormone children Atypical antipsychotics Metal on Metal PLDH (Caelyx) for ovarian cancer Surgery for morbid obesity Glycoproteins (review)
March2002 March2002 March2002 March2002 March2002 March2002 May2002 May2002 May2002 June2002 June2002 July2002 July2002 September2002
Selective Selective Selective Selective Routine Routine Selective Routine Routine Routine Selective Selective Selective Routine
17.00 3.00 62.50 0.00 1.20 41.00 2.50 4.00 38.00 55.00 3.40 3.10 21.00 0.00
NICE do not attempt a quantative estimate, but information in the guidance suggests a gure of around 1.2 million. NICE estimated 2.5 million for the rst year costs. They expected lower costs in subsequent years but did not quantify.
NICE say cost is more likely to be at lower end of range. Initial costs will be lower, but will build as service provision increases. Replacement of the September 2000 guidance with this revised guidance is not expected to increase costs to the NHS.
Table 46a (Continued) ESTIMATED COSTS OF NICE TECHNOLOGY APPRAISAL GUIDANCE (AS AT JULY 2006) TA number 48 49 50 51 52 53 Title of guidance Home vs hospital haemodialysis Ultrasonic locating devices for pacing central venous lines Imatinib for CML Computerised Cognitive behavioural therapy Thrombolysis Long acting insulin analogues (glargine) Date of Issue September2002 September2002 October2002 October2002 October2002 December2002 Recommendation (4) Selective Routine Routine Research Routine Selective Cost ( millions) 0.00 0.00 15.80 0.00 33.50 16.00 Comment 200,000 procedures x less than 10 per procedure. Number of additional machines w 715K not quantied. Estimated increase in the rst year is between 11.8 million and 15.8 million for England and Wales. Further research recommended. Estimate on the high sidebased on all potentially eligible patients switching to this treatmentactual costs will be proportionately less depending on uptake. Unlikely that additional costs to the NHS will result from this review. Further research recommended. NICE suggest costs will be at the bottom end of the range. Cost impact depends on the severity of an outbreak in any given year. No anticipated increase over previous estimated guresas savings/pressures balance out between the three drugs. Guidance recommends the use of ECT only in certain restricted circumstances. 160 centres for England each with running costs of 64,500 pa %10.3 million Assumes 3,500 each use capecitabine or tegafur uracil in preference to existing treatment options. Saving is for combination capecitabine/docetaxel relative to docetaxel monotherapy. Revision to previous guidance reduces by about 30% the previous estimated saving of 12 million pa.
54 55 56 57 58
Vinorelbine for breast cancer Paclitaxelovarian cancer Tension free vaginal tape Subcutaneous insulin infusion (insulin pumps) Zanamivir oseltamivir amantidine treatment of u ECT Patient education models diabetes Capecitabine & tegafur with uracil for metastatic colorectal cancer Capecitabine for locally advance breast cancer Glitazones for type 2 diabetes (review)
December2002 January2003 February2003 February2003 February2003
Selective Routine Routine Selective Routine and no hence tabled as selective Selective Routine Routine Routine Selective
6.50 0.00 0.00 5.25 0.00
59 60 61 62 63
April2003 April2003 May2003 May2003 August 2003
0.00 0.00 "16.00 "1.20 "16.00
Table 46a (Continued) ESTIMATED COSTS OF NICE TECHNOLOGY APPRAISAL GUIDANCE (AS AT JULY 2006) TA number 64 65 66 67 68 69 Title of guidance Human Growth Hormone in adults Rituximab for aggressive non Hodgkins lymphoma Olanzapine & valporate semisodium for bipolar 1 disorder Oseltamivir and amantidine for prophylaxis of u PDT for macular degeneration Use of liquid-based cytology for cervical screening Use of imatanib for chronic myeloid leukaemia Use of coronary artery stents Date of Issue August2003 September2003 September2003 September2003 September2003 October2003 Recommendation (4) Selective Selective Routine Routine and no hence tabled as selective Selective Routine Cost ( millions) 0.00 13.15 0.00 10.00 8.30 10.20 Comment Cost savingbut no gures estimated. NICE say incidence is rising by 4% pa and quote an upper limit of 27.3 for 2007 but basis is not clear. Unlikely to be net costs or savings. Costs will vary with severity of inuenza outbreak.
70 71
October2003 October2003
Selective Selective
5.00 "4.00
Running costs are likely to be similar with some possible (unquantied) time savings in diagnosis. Running costs are likely to be similar to the start-up costs. Steady-state (year 5) costs. This is the net cost of using drug-eluting stents vs bare metal stents. NICE estimate a possible 4 million oVsetting saving from reducing the restenosis rate.
72 73 74 75 76 77 78 79 80
Rheumatoid arthritisanakinra Myocardial perfusion scintigraphy for the diagnosis and management of angina and myocardial infarction Pre-hospital initiation of uid replacement therapy in trauma Hepatitis Cpegylated interferons, ribavarin and alfa interferon Newer drugs for epilepsy in adults Newer hypnotic drugs for insomnia Fluid-lled thermal balloon and microwave endometrial ablation techniques for heavy menstrual bleeding Newer drugs for epilepsy in children Acute coronary syndromesclopidogrel
November2003 November2003 January2004 January2004 March2004 April2004 April2004 April2004 July2004
Research Selective Selective Selective Selective Selective Selective Selective Routine
"0.07 27.00 0.00 10.50 0.00 0.00 "30.50 0.00 26.50 Cost neutral. Cost savingbut no gures estimated. NICE quote a range of "29 to "32 million. However it is unlikely that such savings would be realised.
Table 46a (Continued) ESTIMATED COSTS OF NICE TECHNOLOGY APPRAISAL GUIDANCE (AS AT JULY 2006) TA number 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 Title of guidance Atopic dermatitis (eczema)topical steroids Atopic dermatitis (eczema)pimecrolimus and tacrolimus Hernialaparoscopic surgery (review) Sepsis (severe)drotrecogin Renal transplantationimmunosuppressive regimens (adults) Gastro-intestinal stromal tumours (GIST) imatinib Secondary osteoporosis Dual-chamber pacemakers for the treatment of symptomatic bradycardia Cartilage injuryautologous chondrocyte implantation (ACI) (review) (No 89) Vascular diseaseclopidogrel and dipyridamole Ovarian cancer (advanced)paclitaxel, pegylated liposomal doxorubicin hydrochloride and topotecan (review) Tooth DecayHealozone Colorectal cancer (advanced)irinotecan, oxaliplatin and raltitrexed (review) Cardiovascular diseasestatins Arrhythmiaimplantable cardioverter debrillators (ICDs) (review) Hepatitis B (chronic)adefovir dipivoxil and pegylated interferon alpha-2a Depression and anxietycomputerised cognitive behavioural therapy (CCBT) Attention decit hyperactivity disorder (ADHD)methylphenidate, atomoxetine and dexamfetamine (review) (No 98) Date of Issue August2004 August2004 September2004 September2004 September2004 October2004 January2005 February2005 May2005 May2005 May2005 July2005 August2005 January2006 January2006 February2006 February2006 March2006 Recommendation (4) Selective Selective Selective Routine Selective Selective Selective Selective Research Selective Selective Research Selective Selective Selective Selective Selective Selective Cost ( millions) "31.00 33.55 1.00 15.00 0.00 4.70 36.50 10.00 0.00 27.40 2.25 0.00 56.00 8.50 49.90 7.08 48.00 0.00 Unlikely to result in a signicant change to the use of NHS resources. No impact on NHS services. May be small expenditure to fund research. Comment Cost saving. Possible range of cost extremely variable, but as NICEs recommendation was not positive it is likely that costs will trend towards the lower end.
Table 46a (Continued) ESTIMATED COSTS OF NICE TECHNOLOGY APPRAISAL GUIDANCE (AS AT JULY 2006) TA number 99 100 101 102 Title of guidance Immunosuppressive therapy for renal transplantation in children and adolescents Capecitabine and oxaliplatin in the adjuvant treatment of stage III (Dukes C) colon cancer Docetaxel for hormone refractory prostate cancer Parent-training/education programmes in the management of children with conduct disorders Etanercept and efalizumab for psoriasis Etanercept and iniximab for psoriatic arthritis Date of Issue April2006 April2006 June2006 July2006 July2006 July2006 Selective Routine Research Recommendation (4) Selective Routine Routine Routine Selective Selective 67 29 8 Cost ( millions) 0.36 10.30 19.90 28.80 25.20 13.70 1,044.12 Comment
103 104 Total cost Total number of appraisals
Source: National Institue for Health and Clinical Excellence (NICE). Footnotes: 1. The table above shows the technology appraisals issued by NICE since March 2000. The column headed cost shows the gross cost to the NHS of implementing NICE guidance in England. 2. NICE provides estimates of the cost of implementing the recommendations in its guidance upon publication of the nal guidance. 3. All estimates are based on gures published in NICEs appraisal guidance. 4. Routine % NICE has approved the use of a technology, Selective % NICE has approved technology, but only for use under specic conditions, Research % NICE has not approved the technology and recommends that further research on eVectiveness is needed.
Clinical guidelines 3. Table 46b provides details of the clinical guidelines published by NICE since 1 April 2006. 4. NICE only provides estimates of the cost of implementing the recommendations contained in clinical guidelines upon publication of the nal guidance. 5. NICE assesses the cost of certain key recommendations within their guidelines i.e. those that are likely to have the highest costs associated with them, but does not cost all the recommendations within a guideline. 6. NICE has not provided a cost impact for all its clinical guidelines published to date. The rst detailed costings were provided for three of the guidelines published in 2004 (fertility; familial breast cancer and lung caner) and since then NICE has been providing detailed cost information on clinical guidelines with more regularity. Seven of the nine guidelines published in 2005 have been costed. 7. There has been no assessment of the actual cost impact of NICE guidance, due to the inherent logistical diYculties in measuring the uptake of NICE guidance. Table 46b GUIDELINES COSTINGS PUBLISHED TO DATECOST OF IMPLEMENTATION
Recommendations with signicant resource impact Increase in provision of IVF services. Additional annual mamographs and specialist nurse training. Psychological Interventions Increases in PET Scanning, chemotherapy and lung cancer nurses. StaV training in PCTs and in-patient psychiatric settings. Cost of increase in therapy. Active psychological intervention. None identiable. Net recurrent implementation costs ( thousands) 81,000 2,470 54,500 23,248 20,019 25,988 19,466
Guideline number Guideline/Appraisal name CG11 CG14 CG23 CG24 CG25 CG26 CG28 CG29 Fertility Familial breast cancer Depression in adults Lung cancer Violence (England) PTSD Depression in children & young people. Pressure ulcer managementreport produced, but no cost impact estimated. LARC OCD Nutrition support in adults. Tuberculosis.
Date published Feb 2004 June 2004 Dec 2004 Feb 2005 May 2005 July 2005 Oct 2005 Sept 2005
CG30 CG31 CG32
Dec 2005 Dec 2005 Feb 2006
CG33
Mar 2006
CG34 update CG35 CG36
Hypertension Parkinsons disease. Atrial brillation.
June2006 June2006 June2006
Savings from unplanned pregnancies being avoided. Cost of adult, young person and child interventions. Costs of screening and nurse interventions, oVset by reductions in length of in-patient stays. Additional directly observed therapy for the homeless, problem drug user and prison populationcost of additional staV. Pharmacological interventions. Regular access to specialist nursing care and access to therapy services. The use of an ECG on all patients in whom a diagnosis of AF is suspected based on the detection of an irregular pulse, the provision of appropriate antithrombotic therapy according to the stroke risk algorithm, and the cost implications arising, such as strokes avoided and haemorrhages incurred, from additional anticoagulation.
"102,258 31,650 "13,562
"3,448
"221,869 3,777 21,863
Guideline number Guideline/Appraisal name CG37 Postnatal care
Date published July2006
Recommendations with signicant resource impact The implementation of an externally evaluated structured programme that encourages breastfeeding. The svings arising from an improvement in breast-feeding. The costing work has concentrated on changes in pharmacological prescribing, increases in psychological therapy, introducing an annual review for all people with bipolar disorder and improved access to weight management programs.
Net recurrent implementation costs ( thousands) "727
CG38
Bipolar disorder
July2006
20,149
Total Source: National Institute for Health and Clinical Excellence (NICE).
"37,734
4. Breakdown of Spending Programme 4.1 General Breakdown 4.1.1 What was HCHS expenditure by service sector and age group in (a) 200304 and (b) 200405? (Q47) Answer 1. The information for 200304 is given in Table 47a to Table 47c. From 200405 the data required to calculate HCHS expenditure by service sector and age group ceased to be collected. Instead, DH initiated a replacement data collection to collect expenditure on a Programme Budgeting basissee questions 6 and 7 for further details. 2. Services aimed specically, or mainly, at the elderly account for 6% of total HCHS expenditure. However, those aged 65 and over accounted for 43% of total expenditure despite being only 16% of the population. This is mainly due to high levels of spend in other sectors, with 56% of acute expenditure, and signicant proportions of expenditure on services for mentally ill people being used by this age group. Table 47a HCHS EXPENDITURE BY PROGRAMME OF CARE 200304 Programme of care Acute services Mental health Services intended primarily for the elderly other services Learning disability Maternity Total Source: Financial returns of PCTs and NHS Trusts. Footnote: 1. Total does not sum to 100% due to rounding. Expenditure (m) 21,510 5,088 2,346 6,253 1,627 1,327 38,151 Proportion of expenditure 56.4 13.3 6.1 16.4 4.3 3.5 100.00
Table 47b PROPORTION OF HCHS EXPENDITURE BY AGE GROUP Age band All births Age 04 Age 515 Age 1644 Age 4564 Age 6574 Age 7584 Age 85! Total Expenditure (m) 1,577 2,376 1,461 9,245 7,021 5,890 6,763 3.818 38,151 Proportion of expenditure 4.1 6.2 3.8 24.2 18.4 15.4 17.7 10.0 100.0
Source: Financial returns of PCTs and NHS Trusts. Footnote: 1. Total does not sum to 100% due to rounding. Table 47c HCHS EXPENDITURE PER HEAD OF POPULATION 200304 Age band All births Age 04 Age 515 Age 1644 Age 4564 Age 6574 Age 7584 Age 85! All Total Expenditure (m) 1,577 2,376 1,461 9,245 7,021 5,890 6,763 3,818 38,151 Population 575,224 2,272,935 6,955,359 20,134,099 11,971,190 4,158,665 2,851,924 936,344 49,855,740 Per Head of Population () 2,742 210 210 459 586 1,416 2,371 4,077 765
Source: Financial returns of PCTs and NHS Trusts. 4.1.2 Could a table be provided detailing gross expenditure on HCHS and FHS by sector in each year since 199798? (Q48) Answer 1. The information requested is contained in Table 48. 2. No data is available for 200405. The data required to calculate HCHS expenditure was collected for the nal time in 200304. A replacement data collection was initiated on new Programme Budgeting basis see questions 6 and 7 for further details. For FHS, data for GMS/PMS is no longer available in the current format due to the introduction of the new GMS contract in 2004; data after this point is not comparable with previous. Table 48 HCFHS PROGRAMME BUDGET EXPENDITURE 199798 TO 200304 (CASH AND RESOURCE) million Cash Resources 199798 199899 19992000 200001 200102 200203 200304 Acute IP Acute IP (Pats using a bed) inc DC Acute OP Acute OP without Day Cases Obstetric IP Obstetric OP Geriatric IP Units for YD Geriatric & YD OP 8,958 3,650 730 137 1,210 46 9,762 3,884 764 147 1,137 50 10,414 4,093 801 158 1,216 53 11,166 4,334 844 170 1,308 57 12,417 4,795 752 151 1,312 61 13,765 5,524 854 183 1,254 68 15,061 6,449 918 216 1,223 74
million Cash Resources 199798 199899 19992000 200001 200102 200203 200304 Learning Disability IP Learning Disability OP Mental Health IP Mental Health OP Non Psychiatric DP (gen & acute) Learning Disability (Day Pats ) Mental Illness DP Other Hospital Total Hospital Chiropody Family Planning Immunisation & surveillance Screening Professional advice & support General Patient Care Community MI Nursing Community MH Nursing Community Maternity Health Promotion Community Dental Services to GPs Other CHS Total Community Ambulances HQ Administration Joint Finance Total HCHS Total HCHS (Excluding J/F) Total GMS of which: Non-Discretionary Discretionary Total Other FHS of which: Drugs PMS (discretionary)(1) GDS PDS (discretionary)(1) Dispensing Costs GOS Total HCFHS 833 22 1,754 312 109 56 303 455 18,575 90 55 263 53 266 952 521 413 210 68 78 271 372 3,612 617 779 237 23,820 23,584 3,033 2,198 835 6,465 4,107 n/a 1,349 n/a 768 241 33,318 825 21 1,819 334 105 62 318 527 19,754 101 63 303 61 330 1,050 580 457 223 79 88 314 469 4,118 617 768 237 25,494 25,258 3,121 2,243 878 6,857 4,356 37 1,439 4 781 240 35,472 855 21 2,044 370 115 62 328 1,011 21,539 110 70 325 67 338 1,041 670 484 208 83 97 396 549 4,438 706 781 169 27,633 27,464 3,336 2,451 885 7,516 4,852 84 1,479 12 808 281 38,485 889 20 2,303 411 126 62 338 1,568 23,597 120 77 352 74 348 1,030 775 514 191 87 107 491 642 4,807 808 797 91 30,099 30,008 3,449 2,510 940 8,067 5,168 174 1,556 21 856 292 41,615 902 23 2,444 490 96 50 318 1,560 25,372 158 98 240 88 163 780 810 484 283 42 71 653 649 4,519 932 1,100 54 31,977 31,923 3,230 2,271 959 9,258 5,714 689 1,638 36 879 302 44,465 843 43 2,689 655 85 58 344 1,563 27,928 231 135 218 131 110 743 911 526 162 86 182 996 1,212 5,644 932 582 0 35,087 35,087 2,932 2,068 864 10,470 6,345 1,152 1,709 41 919 304 48,489 854 84 2,857 882 94 49 316 1,137 30,214 232 129 224 149 138 722 1,033 640 193 107 169 1,019 1,441 6,197 1,176 564 0 38,151 38,151 2,684 1,903 781 11,998 6,963 1,939 1,767 48 959 322 52,833
Footnotes: 1. Personal Medical Services (PMS) and Personal Dental Services (PDS) schemes are Primary Care Act pilots designed to test locally-managed approaches to the delivery of primary care. PDS and PMS expenditure gures exclude any related capital investment by NHS Trusts; PDS expenditure gures are also gross of patient charge income. 2. All HCFHS gures are on a cash basis for the years 199798 to 200001, whereas from 200102 is a resource basis. 3. The 200304 Drugs expenditure has been revised to 6,963 million from 6,948 million (2005 PEI) in line with FHS gross expenditure gures from the Departmental Report 2006, gure 6.10. 4.2 Primary Care Trust (PCT) Allocations 4.2.1 Can the Department detail (a) Primary Care Trust allocations (b) distance from target allocation in 000s and in percentage terms and (c) allocations per weighted and unweighted head of population in each year from 200304 to 200708 in each Strategic Health Authority area? Can data for individual PCTs be provided as an appendix? (Q49) Answer 1. The information requested is given in Table 49a and Table 49b.
Table 49a 200304 TO 200708 PCT ALLOCATIONS IN EACH NEW SHA

Code SHA 200304 allocation 200405 allocation 200506 200607 200708 allocation allocation(1) allocation(1) 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 200405 200506 200607 allocation allocation allocation allocation per per per per weighted weighted weighted weighted head(2) head(2) head(2) head(2) 893 901 955 902 903 922 939 920 884 918 916 979 987 1,050 989 990 1,007 1,025 1,006 970 1,004 1,003 1,171 1,186 1,249 1,176 1,172 1,206 1,224 1,207 1,164 1,200 1,198 1,244 1,248 1,339 1,264 1,259 1,272 1,298 1,261 1,242 1,279 1,274 200708 200304 200405 200506 200607 200708 allocation allocation allocation allocation allocation allocation per per per per per per weighted unweighted unweighted unweighted unweighted unweighted head(2) head(3) head(3) head(3) head(3) head(3) 1,364 1,368 1,447 1,379 1,372 1,385 1,410 1,373 1,360 1,390 1,388 838 817 1,020 991 973 796 878 855 881 917 903 914 889 1,114 1,087 1,066 866 954 928 965 1,000 986 1,087 1,061 1,317 1,295 1,260 1,032 1,131 1,106 1,155 1,193 1,172 1,193 1,157 1,421 1,419 1,378 1,119 1,224 1,198 1,261 1,295 1,274 1,309 1,268 1,531 1,551 1,503 1,219 1,329 1,305 1,382 1,407 1,388
000s Q33 Q35 Q36 Q30 Q31 Q38 Q37 Q39 Q34 Q32 East Midlands East of England London North East North West South Central South East Coast South West West Midlands Yorkshire and the Humber England 3,481,857 4,466,529 7,548,174 2,516,147 6,659,190 3,149,274 3,641,595 4,269,286 4,690,874
000s 3,815,289 4,894,261 8,295,415 2,756,923 7,302,478 3,441,393 3,977,808 4,664,126 5,146,747
000s 4,168,245 5,357,297 9,104,892 3,009,557 7,986,723 3,756,088 4,339,076 5,081,825 5,632,331
000s 5,031,288 6,451,803 10,707,134 3,588,123 9,461,985 4,488,824 5,168,529 6,101,254 6,757,447 6,553,209 64,309,595
000s
000s
000s
000s
000s
000s "120,209 "117,558 449,625 "15,250 "94,374 "12,283 82,797 "56,961 "139,917 24,130 0
% "1.8 "1.3 3.9 "1.8 "2.3 1.4 2.4 0.7 "3.0 0.5 0.0
% "1.7 "1.2 3.8 "1.7 "2.1 1.3 2.2 0.6 "2.8 0.4 0.0
% "1.7 "1.1 3.7 "1.7 "1.8 1.1 1.9 0.4 "2.5 0.3 0.0
% "2.7 "2.1 4.9 "0.6 "1.0 "0.2 1.8 "0.9 "2.4 0.6 0.0
% "2.1 "1.6 4.0 "0.4 "0.9 "0.2 1.5 "0.8 "1.9 0.3 0.0
4,604,254 5,033,804 5,488,942 45,027,181 49,328,244 53,924,975
5,549,315 "69,330 "72,270" 76,036 "139,251 7,118,775 "61,634 "62,846 "61,808 "140, 165 11,611,069 304,800 322,356 340,240 498,505 3,920,663 "49,510 "51,754 "55,916 "21,846 10,340,179 "163,112 "162,367 "157,085 "96,781 4,914,589 46,438 46,004 43,248 "9,410 5,644,193 90,577 90,601 87,165 90,466 6,690,860 31,512 27,324 19,849 "53,971 7,421,993 "153, "156,633 "155,933 "164,082 630 7,143,061 23,889 19,584 16,275 36,535 70,354,697 0 0 0 0
200304 TO 200708 PCT ALLOCATIONS IN EACH OLD SHA

Code SHA 2003"04 allocation 200405 allocation 200506 200607 200708 allocation allocation(1) allocation(1) 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 2007"08 closing closing DFT DFT 200304 200405 200506 200607 allocation allocation allocation allocation per per per per weighted weighted weighted weighted head(2) head(2) head(2) head(2) 920 909 874 891 886 892 909 909 886 909 925 911 892 907 931 967 868 1,001 915 896 964 990 929 906 956 919 894 916 916 1,006 996 961 981 973 977 995 994 973 995 1,010 997 976 992 1,017 1,061 963 1,096 1,001 981 1,058 1,085 1,014 992 1,044 1,005 980 1,002 1,003 1,215 1,191 1,150 1,167 1,163 1,177 1,173 1,188 1,169 1,175 1,209 1,188 1,162 1,197 1,210 1,254 1,160 1,285 1,186 1,177 1,266 1,296 1,209 1,179 1,247 1,204 1,175 1,207 1,198 1,273 1,257 1,241 1,260 1,249 1,231 1,269 1,255 1,255 1,251 1,271 1,263 1,241 1,237 1,273 1,340 1,265 1,369 1,276 1,255 1,359 1,377 1,249 1,274 1,321 1,272 1,246 1,287 1,274 200708 200304 200405 200506 200607 200708 allocation allocation allocation allocation allocation allocation per per per per per per weighted unweighted unweighted unweighted unweighted unweighted head(2) head(3) head(3) head(3) head(3) head(3) 1,385 1,374 1,360 1,375 1,369 1,350 1,378 1,369 1,375 1,366 1,381 1,383 1,367 1,358 1,381 1,445 1,379 1,472 1,388 1,369 1,469 1,484 1,362 1,388 1,428 1,388 1,362 1,397 1,388 822 808 945 981 970 821 944 866 828 988 830 856 799 815 861 1,068 1,027 1,031 1,008 843 1,045 920 891 977 892 769 860 925 903 893 880 1,038 1,080 1,066 896 1,031 940 905 1,080 902 930 870 884 937 1,164 1,133 1,120 1,105 923 1,145 1,001 966 1,069 969 836 939 1,007 986 1,073 1,046 1,240 1,285 1,276 1,075 1,213 1,117 1,082 1,272 1,075 1,101 1,030 1,057 1,112 1,365 1,357 1,303 1,311 1,105 1,368 1,188 1,143 1,269 1,151 997 1,120 1,210 1,172 1,160 1,134 1,355 1,406 1,403 1,175 1,320 1,213 1,185 1,396 1,163 1,198 1,136 1,153 1,206 1,468 1,478 1,398 1,431 1,206 1,478 1,276 1,237 1,382 1,240 1,083 1,225 1,312 1,274 1,262 1,239 1,484 1,536 1,542 1,290 1,436 1,324 1,300 1,524 1,265 1,312 1,252 1,266 1,311 1,579 1,608 1,499 1,559 1,319 1,594 1,370 1,350 1,507 1,339 1,182 1,341 1,422 1,388
000s Q20 Q02 Q27 Q15 Q10 Q28 Q13 Q22 Q03 Q14 Q17 Q18 Q25 Q01 Q11 Q05 Q06 Q04 Q09 Q26 Q07 Q08 Q21 Q23 Q19 Q16 Q24 Q12 Avon, Gloucestershire and Wiltshire Bedfordshire and Hertfordshire Birmingham and The Black Country 1,804,844 1,325,496 2,175,882
000s 1,972,269 1,451,691 2,391,372 2,552,541 1,222,828 1,390,899 1,972,068 1,136,014 1,465,825 2,777,869 1,627,112 1,501,484 1,318,517 1,976,745 1,535,353 1,429,122 1,754,155 2,067,064 1,534,096 1,364,476 1,730,005 1,315,069 1,555,843 1,369,372 2,476,324 1,814,281 2,496,772 2,129,079
000s 2,151,254 1,587,168 2,622,886 2,802,103 1,336,875 1,517,652 2,152,300 1,237,940 1,612,617 3,032,321 1,774,693 1,640,446 1,440,317 2,157,512 1,670,397 1,565,192 1,946,486 2,259,850 1,672,682 1,491,793 1,895,135 1,438,228 1,692,631 1,495,863 2,698,629 1,981,395 2,727,928 2,322,682
000s 2,593,069 1,892,779 3,131,112 3,324,266 1,606,461 1,838,087 2,535,446 1,484,905 1,938,718 3,602,273 2,117,042 1,962,275 1,739,242 2,620,305 1,987,872 1,829,509 2,313,183 2,621,558 1,981,662 1,788,248 2,243,470 1,699,414 2,023,280 1,773,589 3,206,254 2,371,782 3,292,047 2,791,748 64,309,595
000s
000s
000s
000s
000s
000s
% 0.7 "0.1 "4.2 "3.8 "3.5 "1.8 "0.9 "0.2 "3.3 "1.8 1.2 "0.7 "1.6 "0.6 2.3 4.9 "5.5 8.6 "0.5 "2.0 5.0 8.5 1.3 "1.5 4.3 1.5 "1.9 0.4 0.0
% 0.6 "0.0 "3.8 "3.2 "3.2 "1.7 "0.9 "0.3 "3.0 "1.8 1.1 "0.7 "1.6 "0.6 2.1 4.6 "4.9 8.2 "0.5 "1.9 4.6 8.1 1.1 "1.4 4.0 1.4 "1.8 0.3 0.0
% 0.4 "0.1 "3.4 "2.6 "3.1 "1.8 "0.9 "0.4 "2.6 "1.7 0.8 "0.9 "1.6 "0.6 1.8 4.3 "4.0 7.7 "0.6 "1.7 4.1 7.7 0.9 "1.3 3.7 1.3 "1.7 0.3 0.0
% 0.1 "1.2 "2.5 "0.9 "1.8 "3.2 "0.3 "1.3 "2.1 "1.6 "0.1 "1.4 "3.9 "2.8 0.1 5.3 "1.8 7.5 0.4 "1.4 6.5 8.2 "1.8 0.1 3.9 "0.3 "2.1 1.2 0.0
% "0.0 "1.0 "1.8 "0.7 "1.1 "2.5 "0.5 "1.1 "1.7 "1.4 "0.3 "1.0 "3.0 "2.0 "0.3 4.3 "1.9 6.2 0.2 "1.2 5.7 7.1 "1.7 0.2 3.1 "0.2 "1.7 0.8 0.0
Cheshire and Merseyside 2,319,596 County Durham and Tees Valley 1,114,222 Coventry, Warwickshire, Herefordshire 1,269,343 and Worcestershire Cumbria and Lancashire 1,801,810 Dorset and Somerset 1,038,896 Essex 1,334,192 Greater Manchester 2,537,784 Hampshire and Isle of Wight 1,489,983 Kent and Medway 1,372,381 Leicestershire, Northamptonshire and 1,204,190 Rutland Norfolk, SuVolk and Cambridgeshire 1,806,841 North and East Yorkshire and Northern 1,406,451 Lincolnshire North Central London 1,302,450 North East London 1,582,024 North West London 1,887,023 Northumberland, Tyne and Wear 1,401,925 Shropshire and StaVordshire 1,245,649 South East London 1,576,425 South West London 1,200,252 South West Peninsula 1,425,546 South Yorkshire 1,249,993 Surrey and Sussex 2,269,214 Thames Valley 1,659,291 Trent 2,277,668 West Yorkshire 1,947,810 England
2,837,133 13,405 2,079,041 "777 3,435,003 "101, 519 3,633,535 "96,070 1,764,200 "42,395 2,027,377 "25,462 2,766,036 1,630,168 2,136,438 3,940,609 2,314,056 2,164,348 1,927,548 "17,667 "1,912 "48,570 "49,375 19,378 "9,923 "21,350
12,477 10,038 1,529 "593 "521 "1,681 "23,545 "21,420 "101,746 "98,176 "78,737 "64,698 "90,168 "80,518 "30,111 "26,262 "43,344 "45,062 "28,786 "20,155 "26,552 "29,395 "60,813 "52,026 "19,751 "3,379 "48,988 "52,448 18,306 "11,968 "23,107 "21,630 "5,628 "45,417 "54,938 15,936 "15,262 "25,256 "6,789 "19,418 "42,192 "59,880 "1,261 "28,560 "70,215 "13,129 "18,796 "37,606 "54,982 "5,859 "21,599 "59,130
2,903,296 "12,287 "13,336 "14,710 "74,427 "58,532 2,167,126 34,333 33,268 30,976 1,781 "5,466 1,982,811 2,529,130 2,834,865 2,156,463 1,959,612 2,426,366 1,837,897 2,223,559 1,937,489 3,479,845 2,600,534 3,621,767 3,038,445 70,354,697 64,465 "98,878 158,275 "7,115 "26,649 80,158 100,780 20,018 "19,679 100,500 27,060 "47,981 9,235 0 66,730 "95,031 165,306 "8,410 "28,334 79,943 105,409 18,226 "20,564 102,569 27,699 "49,164 6,881 0 67,839 "85,219 170,416 "10,853 "28,361 78,155 109,050 15,439 "21,154 102,428 27,312 "50,780 6,453 0 91,792 "43,184 183,926 6,939 "24,532 136,899 129,072 "36,082 2,443 119,026 "8,148 "69,036 32,311 0 81,298 "49,113 165,965 4,905 "23,193 129,807 121,668 "37,573 4,800 104,396 "6,424 "61,079 24,797 0
45,027,181 49,328,244 53,924,975
Source: PCT data aggregated to SHA from 200304 to 200506 and 200607 and 200708 PCT revenue resource limits exposition books available at www.dh.gov.uk/allocations Footnotes: 1. 200607 and 200708 allocations are not comparable with 200304 to 200506 allocations because they include additional funding for primary medical services 2. 2002 ADS scaled to 2001 ONS sub-national population estimates 3. 2004 ADS scaled to 2003 based ONS sub-national population projections
Table 49b 200304 TO 200708 PCT ALLOCATIONS IN EACH NEW SHA

Code PCT 200304 allocation 200405 allocation 200506 allocation 200607 allocation 200708 allocation 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 200405 200506 200607 allocation allocation allocation allocation per per per per weighted weighted weighted weighted head(1) head(1) head(1) head(1) 000s 000s 000s 000s 924 972 890 796 915 900 784 995 872 842 835 916 1,015 875 884 977 931 956 874 846 886 915 877 907 945 833 888 904 918 928 960 942 967 924 874 891 903 947 1,063 1,015 866 939 911 875 897 924 907 837 936 1,236 916 946 877 873 925 884 938 900 873 865 989 864 956 900 915 902 983 939 1,011 1,059 976 893 1,000 987 882 1,087 958 934 919 1,000 1,105 959 969 1,064 1,019 1,043 960 930 972 999 962 993 1,030 916 974 993 1,005 1,014 1,045 1,025 1,057 1,009 960 977 989 1,032 1,157 1,116 951 1,023 997 961 983 1,009 994 937 1,022 1,347 1,000 1,032 961 957 1,009 970 1,022 986 968 951 1,077 949 1,041 986 1,005 990 1,071 1,024 1,208 1,280 1,154 1,107 1,214 1,159 1,080 1,293 1,131 1,119 1,133 1,243 1,298 1,172 1,157 1,241 1,220 1,221 1,143 1,115 1,143 1,206 1,136 1,181 1,165 1,135 1,183 1,171 1,193 1,207 1,240 1,231 1,261 1,199 1,124 1,175 1,156 1,224 1,399 1,309 1,164 1,220 1,179 1,156 1,186 1,210 1,222 1,117 1,206 746 1,176 1,184 1,173 1,148 1,206 1,185 1,215 1,165 1,141 1,144 1,274 1,134 1,249 1,170 1,216 1,196 1,277 1,198 1,315 1,344 1,227 1,208 1,259 1,243 1,232 1,378 1,215 1,235 1,211 1,283 1,369 1,232 1,210 1,347 1,285 1,292 1,242 1,227 1,279 1,264 1,245 1,280 1,223 1,231 1,229 1,340 1,271 1,283 1,300 1,267 1,328 1,297 1,260 1,255 1,243 1,316 1,355 1,366 1,239 1,282 1,247 1,235 1,231 1,227 1,240 1,228 1,211 811 1,261 1,270 1,267 1,215 1,267 1,278 1,279 1,243 1,253 1,232 1,330 1,210 1,309 1,249 1,310 1,277 1,355 1,272 200708 200304 200405 200506 200607 200708 allocation allocation allocation allocation allocation allocation per per per per per per weighted unweighted unweighted unweighted unweighted unweighted head(1) head(2) head(2) head(2) head(2) head(2) 000s 000s 1,417 1,445 1,338 1,336 1,376 1,352 1,364 1,482 1,336 1,371 1,336 1,391 1,476 1,347 1,347 1,448 1,395 1,409 1,356 1,340 1,388 1,381 1,357 1,391 1,337 1,337 1,337 1,453 1,387 1,393 1,407 1,382 1,430 1,398 1,376 1,364 1,355 1,421 1,457 1,463 1,351 1,391 1,355 1,350 1,343 1,338 1,354 1,344 1,337 981 1,375 1,384 1,382 1,346 1,382 1,389 1,391 1,354 1,365 1,342 1,431 1,337 1,408 1,367 1,412 1,389 1,461 1,386 1,003 922 828 851 820 972 936 940 993 905 837 784 976 815 731 1,074 878 803 1,064 963 1,080 712 948 949 753 950 937 1,048 959 965 889 789 881 884 989 789 899 941 787 1,217 813 899 902 792 811 863 887 1,121 1,052 1,063 799 783 779 743 863 921 752 820 1,188 758 841 905 810 800 890 797 1,004 874 1,090 997 903 950 883 1,063 1,045 1,017 1,087 1,002 916 852 1,062 886 793 1,161 957 875 1,168 1,059 1,183 779 1,038 1,036 820 1,036 1,020 1,162 1,044 1,052 967 851 955 964 1,089 863 982 1,024 852 1,317 890 967 984 866 882 933 970 1,257 1,141 811 867 852 851 805 941 1,008 819 894 1,310 830 911 994 879 877 973 873 1,091 950 1,293 1,196 1,061 1,170 1,055 1,245 1,270 1,197 1,278 1,198 1,123 1,054 1,247 1,072 938 1,346 1,141 1,024 1,391 1,268 1,387 940 1,223 1,229 926 1,271 1,229 1,381 1,234 1,249 1,145 1,012 1,132 1,143 1,278 1,037 1,145 1,213 1,022 1,522 1,086 1,140 1,158 1,037 1,057 1,108 1,190 1,501 1,338 981 1,013 975 1,033 955 1,123 1,229 975 1,051 1,536 993 1,071 1,189 1,050 1,041 1,172 1,054 1,297 1,109 1,389 1,287 1,152 1,293 1,133 1,360 1,435 1,282 1,395 1,337 1,219 1,136 1,349 1,158 1,022 1,445 1,233 1,113 1,521 1,386 1,509 1,026 1,335 1,328 1,009 1,378 1,335 1,502 1,336 1,349 1,235 1,094 1,215 1,233 1,401 1,133 1,249 1,310 1,096 1,621 1,182 1,222 1,262 1,126 1,145 1,196 1,296 1,643 1,515 1,063 1,099 1,061 1,123 1,045 1,222 1,332 1,058 1,141 1,671 1,079 1,152 1,328 1,131 1,137 1,262 1,144 1,398 1,206 1,491 1,379 1,257 1,434 1,237 1,483 1,581 1,374 1,537 1,488 1,348 1,230 1,455 1,266 1,137 1,552 1,339 1,215 1,663 1,514 1,636 1,123 1,457 1,439 1,105 1,496 1,449 1,632 1,449 1,460 1,331 1,195 1,306 1,331 1,534 1,238 1,362 1,415 1,175 1,727 1,294 1,322 1,374 1,234 1,252 1,304 1,417 1,798 1,668 1,161 1,199 1,159 1,223 1,159 1,335 1,449 1,152 1,247 1,818 1,178 1,239 1,466 1,217 1,245 1,359 1,245 1,508 1,316
000s 5L8 5AW 5ED 5FA 5LL 5HG 5C2 5A9 5JE 5GR 5ET 5FL 5F8 5GD 5GE 5FH TAK 5GP 5H2 5CC 5HP 5G6 5HQ 5CE 5G2 5CF 5CG 5K5 5LQ 5JF 5JG 5JL 5A7 5EV 5G8 5DQ 5JX 5J6 5JH 5K7 5MM 5LM 5D4 5JP 5H4 5KT 5AL 5HA 5CL 5JT 5JC 5JN 5KW 5DV 5H3 5EA 5G4 5F2 5C3 5GM 5KY 5MD 5KJ 5MA 5K9 5GW 5J9 5CM Adur, Arun and Worthing Airedale Amber Valley Asheld Ashford Ashton, Leigh and Wigan Barking and Dagenham Barnet Barnsley Basildon Bassetlaw Bath and North East Somerset Bebington and West Wirral Bedford Bedfordshire Heartlands Bexhill and Rother Bexley Billericay, Brentwood and Wickford Birkenhead and Wallasey Blackburn with Darwen Blackpool Blackwater Valley and Hart Bolton Bournemouth Teaching Bracknell Forest Bradford City Teaching Bradford South and West Brent Teaching Brighton and Hove City Bristol North Bristol South and West Broadland Bromley Broxtowe and Hucknall Burnley, Pendle and Rossendale Burntwood, Licheld and Tamworth Bury Calderdale Cambridge City Camden Cannock Chase Canterbury and Coastal Carlisle and District Castle Point and Rochford Central Cheshire Central Cornwall Central Derby Central Liverpool Central Manchester Central SuVolk Charnwood and North West Leicestershire Chelmsford Cheltenham and Tewkesbury Cherwell Vale Cheshire West Chestereld Chiltern and South Bucks Chorley and South Ribble City and Hackney Teaching Colchester Cotswold and Vale Coventry Teaching Craven, Harrogate and Rural District Crawley Croydon Dacorum Darlington Dartford, Gravesham and Swanley 214,725 103,170 106,085 67,595 85,546 291,575 153,449 303,125 225,444 92,468 87,893 140,354 99,993 119,136 180,455 83,865 181,941 110,867 224,569 143,881 151,874 130,643 250,490 150,577 76,897 131,335 132,203 291,023 246,949 204,387 171,215 91,622 264,585 114,187 241,264 115,514 161,739 182,246 104,212 264,700 100,757 150,208 102,316 130,401 203,159 172,173 105,312 286,884 183,485 73,268 183,850 95,614 124,221 91,592 138,205 99,371 117,675 171,696 266,159 125,696 159,474 289,858 166,668 91,225 295,063 115,040 97,212 196,417
000s 234,957 112,404 116,318 75,814 93,528 319,620 172,755 331,170 247,651 102,530 96,740 153,237 108,879 130,688 197,768 91,316 199,058 120,876 246,463 158,299 166,655 142,742 274,908 164,922 83,840 144,557 144,974 319,856 270,223 223,245 186,424 99,760 289,086 124,634 264,963 126,639 177,168 198,557 113,476 290,805 110,660 163,549 111,989 143,260 222,612 188,064 115,332 321,165 200,235 80,231 200,628 104,247 136,208 100,434 150,791 108,985 128,126 188,153 295,102 138,152 173,643 318,398 181,585 99,909 323,996 126,173 105,912 214,153
000s 256,892 122,014 127,044 84,729 102,199 348,930 194,169 361,133 270,678 114,813 107,701 167,238 118,128 143,053 216,400 99,280 217,632 131,581 269,198 175,336 182,076 155,893 300,262 180,054 91,268 160,758 158,353 350,993 295,465 243,728 202,688 108,230 315,280 135,677 289,574 138,312 193,365 215,534 123,356 318,747 120,944 177,927 122,216 157,017 242,996 204,875 125,909 358,315 217,943 87,559 218,365 113,482 148,726 109,922 164,098 119,049 139,308 205,458 326,068 151,451 188,390 348,012 197,111 109,285 355,404 138,186 114,968 233,267
000s 303,436 147,328 150,096 104,419 123,752 410,731 240,688 425,930 319,935 137,269 130,267 206,371 138,522 174,220 259,834 115,209 258,661 154,036 321,016 207,706 213,766 188,003 355,301 212,879 103,444 195,932 192,836 407,601 349,706 287,627 239,350 130,588 373,188 160,094 339,612 166,710 226,689 254,621 148,311 368,783 147,814 211,688 144,903 187,964 292,951 246,106 154,800 418,642 269,581 106,743 257,457 130,594 181,446 133,313 196,578 144,555 165,335 242,737 380,906 181,421 222,132 425,221 235,518 129,436 424,028 165,791 136,390 273,269
000s 328,196 159,132 164,754 116,353 137,086 449,115 267,023 460,640 353,531 153,039 144,874 224,569 149,618 192,096 291,858 124,603 281,904 168,212 350,999 227,152 232,537 205,787 388,481 231,530 113,495 214,724 210,881 440,836 381,965 312,296 258,885 143,891 403,632 173,163 371,238 182,390 247,864 275,396 160,403 398,848 162,102 231,695 158,474 207,004 322,527 271,217 169,503 457,809 298,924 117,346 282,738
000s "611 6,887 "2,816 10,636 258 "10,706 "28,141 24,864 "14,082 "9,705 "8,421 1,273 9,472 "5,504 "5,087 5,094 2,803 5,264 "12,781 "12,854 "6,446 751 "14,306 "993 2,949 "12,481 "3,762 "4,306 "508 1,406 7,609 3,219 13,624 1,482 "13,847 "2,757 "3,490 6,392 16,939 21,643 "5,727 3,491 116 "6,212 "5,620 1,173 "483 "35,564 1,969 "989 2,597
000s "619 7,001 "2,899 "9,827 226 "11,073 "26,615 25,648 "14,563 "9,399 "8,696 1,087 9,851 "5,665 "5,209 5,141 2,373 5,189 "13,194 "13,282 "6,661 644 "14,775 "1,006 2,829 "12,881 "3,870 "4,402 "490 1,187 7,443 3,049 13,543 1,254 "14,312 "2,834 "3,590 6,046 18,003 22,321 "5,911 3,044 109 "6,400 "5,789 994 "484 "31,593 1,659 "1,004 2,207
000s "634 6,975 "3,072 "8,743 200 "11,786 "24,474 26,049 "15,510 "7,694 "7,376 905 10,110 "6,009 "5,498 5,074 1,922 4,952 "14,031 "11,933 "7,087 549 "15,718 "1,044 2,595 "11,074 "4,100 "4,630 "477 977 7,025 2,740 13,085 1,016 "15,234 "2,999 "3,801 5,422 18,981 22,665 "6,284 2,463 107 "6,793 "6,138 824 "497 "26,470 1,340 "1,050 1,802
000s 10,021 7,800 "5,469 "5,554 "2,673 "9,633 "12,124 32,535 "15,048 "7,302 "6,521 1,757 9,842 "5,845 "14,042 6,402 1,652 430 "7,640 "7,646 1,117 "1,142 "7,612 1,374 "4,192 "6,689 "6,838 20,376 "89 2,549 5,151 "535 15,729 3,067 "3,400 "2,241 "5,294 8,418 8,989 25,278 "3,886 1,030 "2,901 "7,383 "9,690 "9,009 "3,935 "14,986 "13,579 "1.1 "2,214
000s 7,432 6,457 "5,840 "4,220 "2,707 "11,006 "9,685 29,794 "12,822 "5,551 "5,255 978 9,240 "6,095 "10,586 5,464 937 336 "7,544 "7,627 534 "611 "8,065 1,089 "4,116 "7,788 "7,649 20,258 712 1,824 4,071 "316 12,622 1,660 "2,402 "2,829 "5,475 6,921 7,794 20,988 "4,094 113 "3,513 "7,508 "10,081 "9,437 "3,839 "13,845 "10,842 "1.1 "2,116
% "0.3 6.6 "2.4 "12.8 0.3 "3.4 "14.7 8.3 "5.6 "9.0 "8.2 0.8 9.8 "4.1 "2.5 6.1 1.5 4.6 "5.1 "7.7 "3.8 0.5 "5.1 "0.6 3.7 "8.1 "2.6 "1.4 "0.2 0.7 4.4 3.4 5.1 1.2 "5.1 "2.2 "2.0 3.4 17.7 8.4 "5.0 2.2 0.1 "4.3 "2.5 0.6 "0.4 "10.6 1.0 "2.8 1.3 4.1 "3.4 "3.4 1.1 "2.8 4.7 "1.5 "5.0 "4.8 8.4 "5.3 6.0 "1.6 0.3 "1.7 7.2 2.2
% "0.2 6.2 "2.3 "10.8 0.2 "3.2 "12.7 7.9 "5.3 "8.0 "7.7 0.7 9.3 "3.9 "2.4 5.6 1.1 4.2 "4.8 "7.3 "3.6 0.4 "4.8 "0.6 3.2 "7.6 "2.4 "1.3 "0.2 0.5 3.9 2.9 4.6 0.9 "4.8 "2.0 "1.9 2.9 17.2 7.9 "4.7 1.8 0.1 "4.0 "2.4 0.5 "0.4 "8.6 0.8 "2.7 1.0 3.6 "3.2 "3.2 0.9 "2.6 4.2 "1.4 "4.7 "4.6 7.9 "5.0 5.6 "1.5 0.2 "1.6 6.7 1.8
% "0.2 5.6 "2.2 "8.8 0.2 "3.1 "10.7 7.3 "5.1 "6.0 "6.0 0.5 8.8 "3.8 "2.3 5.1 0.8 3.7 "4.7 "6.0 "3.5 0.3 "4.7 "0.5 2.7 "6.0 "2.4 "1.2 "0.2 0.4 3.4 2.4 4.1 0.7 "4.7 "2.0 "1.8 2.4 16.6 7.4 "4.6 1.3 0.1 "3.9 "2.3 0.4 "0.4 "6.6 0.6 897 0.8 3.1 "3.1 "3.1 0.7 "2.6 3.7 "1.4 "4.5 "4.4 7.3 "4.8 5.0 "1.4 0.2 "1.5 6.2 1.3
% 3.4 5.6 "3.5 "5.1 "2.1 "2.3 "4.8 8.3 "4.5 "5.1 "4.8 0.9 7.6 "3.2 "5.1 5.9 0.6 0.3 "2.3 "3.6 0.5 "0.6 "2.1 0.6 "3.9 "3.3 "3.4 5.3 "0.0 0.9 2.2 "0.4 4.4 2.0 "1.0 "1.3 "2.3 3.4 6.5 7.4 "2.6 0.5 "2.0 "3.8 "3.2 "3.5 "2.5 "3.5 "4.8 982 "0.9 "0.2 "0.4 "5.1 "0.4 0.5 0.6 "2.3 "3.3 "3.2 4.6 "4.9 2.9 "1.8 3.0 0.4 6.6 "0.0
% 2.3 4.2 "3.4 "3.5 "1.9 "2.4 "3.5 6.9 "3.5 "3.5 "3.5 0.4 6.6 "3.1 "3.5 4.6 0.3 0.2 "2.1 "3.2 0.2 "0.3 "2.0 0.5 "3.5 "3.5 "3.5 4.8 0.2 0.6 1.6 "0.2 3.2 1.0 "0.6 "1.5 "2.2 2.6 5.1 5.6 "2.5 0.0 "2.2 "3.5 "3.0 "3.4 "2.2 "2.9 "3.5 1,197 "0.7 "0.1 "0.2 "3.5 "0.2 0.3 0.5 "2.2 "3.5 "3.1 3.3 "3.5 1.7 "1.3 1.9 0.3 5.5 0.1
143,032 4,025 3,911 3,655 "216 "73 198,605 "4,692 "4,819 "5,102 "712 "380 149,384 "3,464 "3,554 "3,760 "7,091 "5,418 215,305 1,638 1,390 1,136 "786 "450 157,594 "3,085 "3,176 "3,366 752 491 179,862 5,726 5,659 5,422 965 818 266,714 "2,878 "2,957 "3,124 "5,714 "5,999 416,671 "14,800 "15,263 "16,218 "12,916 "15,112 199,216 "6,874 "7,079 "7,513 "5,908 "6,288 240,253 13,167 13,587 13,807 9,720 7,727 469,451 "17,297 "17,851 "18,980 "21,778 "17,027 254,740 10,258 10,360 10,230 6,660 4,164 141,706 "1,568 "1,604 "1,690 "2,367 "1,882 458,633 807 692 606 12,236 8,515 180,733 "2,122 "2,177 "2,299 651 572 147,509 6,978 7,132 7,156 8,388 7,739 298,896 4,564 3,979 3,221 "19 278
Table 49b (continued)

Code PCT 200304 allocation 200405 allocation 200506 allocation 200607 allocation 200708 allocation 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 200405 200506 200607 allocation allocation allocation allocation per per per per weighted weighted weighted weighted head(1) head(1) head(1) head(1) 000s 000s 000s 000s 908 888 889 889 905 846 853 895 933 927 967 738 863 950 1,017 940 902 989 884 890 977 979 982 846 1,010 904 841 844 909 969 957 905 934 889 924 932 971 894 940 846 894 971 990 920 993 1,029 903 942 969 905 880 920 815 875 950 965 968 972 888 1,209 943 930 922 870 907 913 1,021 948 1,082 998 793 982 915 958 919 966 992 974 976 975 992 931 938 981 1,017 1,012 1,057 829 948 1,034 1,109 1,023 989 1,077 970 976 1,065 1,066 1,069 931 1,100 991 925 928 994 1,056 1,042 994 1,018 975 1,009 1,016 1,058 981 1,024 931 980 1,067 1,079 1,008 1,081 1,130 993 1,027 1,058 992 966 1,010 914 960 1,036 1,123 1,055 1,062 973 1,291 1,030 1,014 1,004 956 994 1,000 1,122 1,032 1,188 1,091 888 1,079 1,002 1,044 1,002 1,053 1,217 1,121 1,178 1,151 1,169 1,119 1,125 1,172 1,190 1,214 1,236 1,005 1,145 1,226 1,344 1,229 1,168 1,281 1,161 1,172 1,276 1,264 1,266 1,102 1,331 1,167 1,106 1,126 1,205 1,272 1,219 1,207 1,236 1,183 1,211 1,217 1,235 1,156 1,255 1,120 1,163 1,291 1,285 1,188 1,302 1,305 1,181 1,229 1,280 1,166 1,157 1,197 1,117 1,150 1,252 1,218 1,271 1,259 1,158 1,493 1,200 1,218 1,230 1,166 1,191 1,179 1,280 1,215 1,363 1,309 1,042 1,303 1,187 1,257 1,214 1,253 1,242 1,204 1,243 1,242 1,265 1,234 1,234 1,282 1,280 1,282 1,367 1,167 1,193 1,271 1,392 1,299 1,264 1,373 1,208 1,221 1,354 1,279 1,353 1,211 1,379 1,274 1,211 1,211 1,265 1,292 1,282 1,275 1,313 1,314 1,264 1,274 1,301 1,265 1,341 1,207 1,223 1,315 1,356 1,281 1,312 1,363 1,286 1,301 1,377 1,235 1,272 1,279 1,213 1,208 1,325 1,337 1,328 1,330 1,208 1,231 1,340 1,300 1,258 1,268 1,267 1,225 1,397 1,263 1,374 1,407 1,211 1,441 1,279 1,321 1,272 1,355 200708 200304 200405 200506 200607 200708 allocation allocation allocation allocation allocation allocation per per per per per per weighted unweighted unweighted unweighted unweighted unweighted head(1) head(2) head(2) head(2) head(2) head(2) 000s 000s 1,381 1,337 1,353 1,355 1,379 1,345 1,349 1,392 1,388 1,390 1,479 1,336 1,338 1,385 1,501 1,399 1,379 1,485 1,336 1,336 1,459 1,386 1,452 1,337 1,487 1,387 1,337 1,336 1,380 1,390 1,390 1,388 1,420 1,414 1,378 1,392 1,396 1,384 1,446 1,336 1,337 1,416 1,463 1,389 1,406 1,468 1,393 1,405 1,486 1,346 1,386 1,393 1,337 1,336 1,430 1,006 1,428 1,432 1,337 1,342 1,451 1,402 1,373 1,380 1,383 1,336 1,501 1,377 1,454 1,512 1,336 1,560 1,389 1,428 1,387 1,467 691 754 1,017 961 955 967 908 846 898 1,007 1,013 1,038 787 943 848 886 1,015 1,073 877 793 866 816 1,059 1,037 862 978 876 950 735 817 938 922 882 887 834 796 942 1,042 884 917 818 1,031 828 1,058 774 1,114 1,035 956 910 1,039 1,032 913 974 810 884 1,102 858 923 719 760 992 939 725 930 879 966 1,375 762 1,083 873 1,091 1,156 990 908 786 993 745 818 1,113 1,054 1,046 1,064 999 928 979 1,100 1,108 1,174 852 1,017 919 963 1,107 1,170 949 863 940 881 1,142 1,137 938 1,081 965 1,041 798 883 1,024 1,008 959 970 905 863 1,018 1,146 963 1,002 894 1,124 899 1,160 838 1,220 1,139 1,042 993 1,138 1,127 998 1,087 885 960 1,278 932 1,000 784 806 1,085 1,022 781 1,017 960 1,046 1,499 825 1,148 943 1,227 1,275 1,089 990 853 1,082 901 933 1,339 1,245 1,233 1,279 1,198 1,108 1,146 1,321 1,297 1,430 1,014 1,194 1,108 1,154 1,301 1,390 1,121 1,029 1,120 1,036 1,338 1,341 1,134 1,283 1,155 1,258 960 1,055 1,201 1,217 1,161 1,173 1,079 1,027 1,179 1,355 1,178 1,198 1,057 1,349 1,067 1,368 1,002 1,403 1,357 1,246 1,198 1,338 1,343 1,176 1,323 1,055 1,154 1,396 1,120 1,177 928 925 1,264 1,223 948 1,236 1,147 1,220 1,697 965 1,275 1,119 1,444 1,545 1,296 1,190 1,029 1,288 995 1,064 1,460 1,362 1,348 1,401 1,308 1,201 1,248 1,436 1,402 1,664 1,153 1,291 1,191 1,245 1,412 1,502 1,258 1,116 1,205 1,114 1,432 1,477 1,224 1,412 1,276 1,397 1,039 1,134 1,302 1,317 1,252 1,265 1,170 1,111 1,264 1,487 1,272 1,342 1,150 1,452 1,149 1,492 1,076 1,514 1,473 1,347 1,293 1,464 1,458 1,273 1,441 1,147 1,241 1,532 1,207 1,264 1,017 1,002 1,366 1,319 1,024 1,346 1,248 1,318 1,824 1,048 1,338 1,197 1,641 1,676 1,420 1,286 1,116 1,392 1,108 1,182 1,592 1,489 1,473 1,531 1,433 1,305 1,357 1,561 1,516 1,912 1,294 1,406 1,280 1,343 1,541 1,625 1,397 1,223 1,297 1,209 1,534 1,628 1,323 1,541 1,406 1,544 1,135 1,222 1,420 1,432 1,351 1,365 1,274 1,218 1,357 1,629 1,375 1,491 1,257 1,558 1,238 1,622 1,156 1,626 1,595 1,455 1,396 1,600 1,587 1,384 1,586 1,274 1,336 1,302 1,358 1,128 1,094 1,477 1,423 1,119 1,465 1,361 1,440 1,956 1,144 1,407 1,280 1,816 1,812 1,549 1,389 1,215 1,505
000s 5AC 5H7 5KA 5CK 5EK 5EL 5HV 5HT 5KC 5J8 5HX 5KD 5JK 5FT 5KP 5FD 5LN 5HK 5H9 5ML 5KQ 5E3 5LR 5MY 5H5 5E5 5EY 5E7 5LY 5D5 5H6 5C1 5AJ 5ER 5FR 5LX 5HE 5KF 5EC 5GT 5EX 5A8 5L5 5J1 5KH 5H1 5C9 5DC 5K6 5D9 5FJ 5A4 5MX 5CN 5CP 5F4 5HN 5AT 5JA 5MC 5HY 5LJ 5GF 5G7 5JQ 5DG 5K8 5K4 5LA 5A5 5J4 5LD 5KN 5HJ 5HM 5HH Daventry and South Northamptonshire Derbyshire Dales and South Derbyshire Derwentside Doncaster Central Doncaster East Doncaster West Dudley Beacon and Castle Dudley South Durham and Chester-le-Street Durham Dales Ealing Easington East Cambridgeshire and Fenland East Devon East Elmbridge and Mid Surrey East Hampshire East Kent Coastal East Leeds East Lincolnshire East StaVordshire East Surrey East Yorkshire Eastbourne Downs Eastern Birmingham Eastern Cheshire Eastern Hull Eastern Leicester Eastern Wakeeld Eastleigh and Test Valley South Eden Valley Ellesmere Port and Neston Eneld Epping Forest Erewash Exeter Fareham and Gosport Fylde Gateshead Gedling Great Yarmouth Greater Derby Greenwich Teaching Guildford and Waverley Halton Hambleton and Richmondshire Hammersmith and Fulham Haringey Teaching Harlow Harrow Hartlepool Hastings and St Leonards Havering Heart of Birmingham Teaching Herefordshire Hertsmere Heywood and Middleton High Peak and Dales Hillingdon Hinckley and Bosworth Horsham and Chanctonbury Hounslow Hudderseld Central Huntingdonshire Hyndburn and Ribble Valley Ipswich Isle of Wight Islington Kennet and North Wiltshire Kensington and Chelsea Kingston Knowsley Lambeth Langbaurgh Leeds North East Leeds North West Leeds West 69,686 66,667 83,917 96,660 83,575 101,126 94,573 167,210 130,800 85,723 321,825 99,041 117,133 105,908 221,176 161,988 234,126 151,983 241,038 96,655 130,496 120,353 177,667 237,400 161,386 115,807 143,636 171,930 110,356 58,439 77,814 242,179 92,149 86,562 109,053 150,845 63,955 202,615 80,083 84,369 122,927 238,961 197,477 122,778 91,187 192,779 244,127 76,440 178,844 93,563 92,771 213,977 273,739 141,283 77,454 73,694 88,551 219,844 72,366 69,697 216,776 121,658 108,182 103,859 125,609 131,654 248,319 150,973 202,056 142,871 163,276 325,353 95,954 135,571 145,162 104,159
000s 76,144 73,098 92,108 106,046 91,564 111,276 104,000 183,305 142,506 93,543 351,627 111,295 128,632 115,315 241,135 176,375 256,544 165,586 264,418 105,953 142,275 131,125 193,451 261,167 175,727 126,904 157,990 189,117 120,686 63,669 84,726 266,098 100,471 94,912 119,043 164,513 69,679 222,211 87,250 92,785 134,717 262,607 215,301 134,429 99,349 211,754 268,255 83,343 195,404 102,533 101,808 234,966 306,865 155,057 84,448 80,879 96,476 240,199 79,324 75,886 236,868 132,742 117,789 114,072 137,539 144,148 272,794 164,383 221,866 156,180 183,010 357,521 105,091 147,704 158,271 113,481
000s 83,164 79,841 100,637 115,849 99,975 123,654 114,380 200,193 154,770 101,809 383,489 124,606 140,862 125,106 262,444 191,768 280,660 179,743 288,857 115,715 154,866 142,336 210,321 288,817 190,654 138,573 173,834 208,492 131,900 69,113 91,920 291,976 109,463 103,665 129,608 179,353 75,636 242,719 94,710 103,249 147,114 287,940 234,345 146,687 107,843 232,053 294,350 90,727 213,109 111,962 111,450 257,728 342,777 169,421 91,928 88,338 104,725 261,958 86,632 82,510 258,422 144,457 128,073 124,674 150,092 157,648 298,986 178,727 243,036 170,396 204,420 391,975 114,727 160,333 172,126 123,183
000s 104,517 97,008 121,632 137,014 118,167 146,427 136,068 237,291 181,569 121,940 444,899 156,053 179,174 149,115 316,148 228,969 330,340 212,695 359,453 138,875 184,294 168,507 247,473 341,749 229,873 163,267 208,780 255,393 159,468 83,150 107,271 351,514 131,877 124,535 155,995 214,320 87,963 286,689 115,517 125,968 174,653 344,632 277,262 172,678 129,360 265,137 346,339 107,862 255,367 131,905 132,985 303,017 410,557 202,786 110,360 102,997 125,705 308,041 104,013 121,690 298,309 172,344 157,561 152,279 179,944 185,563 336,943 211,111 275,175 202,727 243,375 467,660 135,700 192,073 208,941 145,982
000s 117,732 108,877 132,996 149,813 129,166 160,124 149,002 258,036 197,584 132,397 481,157 178,427 203,900 163,974 341,902 247,659 362,480 230,027 403,888 153,314 199,319 184,379 267,652 378,149 248,604 176,746 230,135 283,337 175,361 90,291 116,811 384,190 142,642 134,698 171,150 236,273 95,208 313,317 124,937 140,833 191,612 372,379 299,865 187,634 139,918 286,377 375,205 116,667 276,176 144,243 145,551 331,028 454,255 226,439 119,363 113,338 135,960 333,169 115,920 133,792 322,634 186,412 173,789 166,452 196,959 204,994 363,928 231,784 297,613 219,238 268,697 505,097 147,409 207,743 228,463 157,882
000s 588 "1,750 "4,087 "3,750 "1,065 "9,380 "7,659 "3,942 3,103 1,199 17,534 "26,540 "7,926 3,398 25,048 4,287 "6,706 11,440 "8,635 "2,085 8,696 9,192 10,493 "20,796 16,049 "1,998 "11,884 "14,514 246 3,905 2,739 "2,155 2,074 "2,280 1,052 2,052 3,621 "6,589 2,373 "8,009 "2,050 13,321 17,593 "1,896 8,428 20,224 "2,409 2,051 10,768 "1,711 "5,231 "74 "34,688 "6,139 3,259 "4,409 5,682 12,167 "1,427 1,987 5,324 1,753 3,270 "6,079 "1,812 "1,884 22,522 6,311 30,305 13,677 "30,018 24,169 "755 7,311 2,611 5,699
000s 502 "1,800 "4,232 "3,875 "1,093 "9,697 "7,916 "4,059 2,714 1,013 17,528 "26,181 "8,181 3,171 26,274 3,854 "6,923 11,730 "8,904 "2,139 8,844 9,435 10,567 "21,486 16,733 "2,060 "12,261 "14,987 228 3,969 2,595 "2,173 1,793 "2,345 892 1,736 3,630 "6,809 2,180 "8,275 "2,098 13,345 18,236 "1,964 8,751 21,141 "2,435 1,849 10,861 "1,765 "5,405 "49 "30,777 "6,328 3,166 "4,693 5,758 12,181 "1,459 1,814 4,706 1,480 3,019 "6,280 "1,858 "1,940 23,368 6,127 32,128 14,226 "28,453 24,772 "779 7,295 2,218 5,695
000s 420 "1,905 "4,511 "4,123 "1,154 "8,379 "7,768 "4,301 2,196 818 17,067 "25,440 "8,700 2,782 27,258 3,168 "7,355 11,821 "9,455 "2,259 8,816 9,520 10,393 "19,679 17,227 "2,183 "11,983 "14,273 214 3,955 2,334 "2,254 1,454 "2,484 732 1,406 3,549 "7,240 1,862 "6,985 "2,210 13,032 18,637 "2,088 8,962 21,837 "2,532 1,528 10,708 "1,873 "5,752 "16 "25,735 "6,719 2,959 "4,547 5,712 11,884 "1,536 1,533 3,806 1,193 2,602 "6,681 "1,959 "2,053 23,912 5,719 33,769 14,604 "26,242 24,951 "821 7,087 1,805 5,543
000s "5,560 "5,459 "2,808 "3,236 "604 "4,519 "4,169 1,842 1,131 1,016 30,857 "13,950 "11,951 "81 27,386 4,860 "1,942 15,585 "19,121 "5,834 11,232 1,012 14,911 "17,503 17,915 325 "10,517 "12,864 "904 1,313 820 494 3,598 3,973 "929 296 1,991 "1,595 5,938 "6,808 "7,033 6,970 17,131 1,182 3,952 17,602 3,541 2,353 19,243 "3,880 "14 766 "20,150 "10,787 4,414 "4,111 5,338 13,282 "5,533 "4,003 15,063 3,646 "1,722 "468 "676 "7,152 29,945 "1,492 20,230 19,473 "12,259 54,750 813 7,071 "22 8,980
000s "4,270 "3,949 "3,079 "3,318 "527 "4,682 "3,932 1,244 406 472 30,259 "6,471 "7,395 37 26,348 2,553 "1,442 15,489 "14,649 "5,561 10,125 126 12,306 "13,715 17,014 283 "8,347 "10,276 "660 315 455 550 1,661 2,739 "826 1,210 757 "253 5,288 "5,108 "6,950 2,543 16,069 570 2,138 16,121 1,900 1,479 18,599 "4,182 73 578 "16,476 "8,213 3,767 "5.2 4,108 10,889 "4,204 "4,267 14,496 2,230 "1,708 "637 "236 "7,435 28,067 "1,378 13,992 18,414 "9,746 56,500 478 6,196 261 8,799
% 0.8 "2.4 "4.4 "3.5 "1.2 "8.0 "7.1 "2.2 2.3 1.3 5.4 "20.2 "6.0 3.1 11.8 2.5 "2.6 7.6 "3.2 "2.0 6.7 7.6 5.9 "7.6 10.3 "1.6 "7.1 "7.3 0.2 6.6 3.4 "0.8 2.2 "2.4 0.9 1.3 5.6 "3.0 2.8 "8.2 "1.5 5.5 9.0 "1.5 9.4 11.0 "0.9 2.6 6.0 "1.7 "5.1 "0.0 "10.6 "3.9 4.1 "4.9 6.4 5.5 "1.8 2.7 2.4 1.4 2.9 "5.2 "1.3 "1.3 9.4 4.1 16.5 9.8 "14.9ey 7.4 "0.7 5.3 1.7 5.4
% 0.6 "2.2 "4.2 "3.3 "1.1 "7.6 "6.7 "2.0 1.8 1.0 4.9 "18.2 "5.6 2.7 11.3 2.1 "2.5 7.1 "3.1 "1.8 6.2 7.2 5.5 "7.2 9.8 "1.5 "6.7 "6.9 0.2 6.2 3.0 "0.8 1.7 "2.3 0.7 1.0 5.1 "2.8 2.4 "7.8 "1.4 5.1 8.5 "1.4 8.9 10.5 "0.8 2.1 5.5 "1.6 "4.8 "0.0 "8.6 "3.7 3.6 "4.8 5.9 5.0 "1.7 2.3 1.9 1.1 2.4 "4.9 "1.3 "1.3 8.9 3.6 16.0 9.3 "12.9 7.0 "0.7 4.8 1.3 4.9
% 0.5 "2.2 "4.1 "3.2 "1.1 "6.0 "6.0 "2.0 1.3 0.8 4.4 "16.2 "5.5 2.1 10.7 1.6 "2.4 6.6 "3.0 "1.8 5.6 6.6 4.9 "6.0 9.2 "1.5 "6.0 "6.0 0.2 5.6 2.5 "0.7 1.3 "2.2 0.5 0.7 4.6 "2.7 1.9 "6.0 "1.4 4.5 8.0 "1.3 8.4 10.0 "0.8 1.6 5.0 "1.6 "4.7 "0.0 "6.6 "3.6 3.1 "4.2 5.3 4.5 "1.6 1.8 1.4 0.8 1.9 "4.8 "1.2 "1.2 8.3 3.1 15.4 8.7 "10.9 6.4 "0.7 4.3 1.0 4.4
% "5.1 "5.3 "2.3 "2.3 "0.5 "3.0 "3.0 0.8 0.6 0.8 7.5 "8.2 "6.3 "0.1 9.5 2.2 "0.6 7.9 "5.1 "4.0 6.5 0.6 6.4 "4.9 8.5 0.2 "4.8 "4.8 "0.6 1.6 0.8 0.1 2.8 3.3 "0.6 0.1 2.3 "0.6 5.4 "5.1 "3.9 2.1 6.6 0.7 3.2 7.1 1.0 2.2 8.1 "2.9 "0.0 0.3 "4.7 "5.1 4.2 "3.5 4.4 4.5 "5.1 "3.2 5.3 2.2 "1.1 "0.3 "0.4 "3.7 9.8 "0.7 7.9 10.6 "4.8 13.3 0.6 3.8 "0.0 6.6
% "3.5 "3.5 "2.3 "2.2 "0.4 "2.8 "2.6 0.5 0.2 0.4 6.7 "3.5 "3.5 0.0 8.3 1.0 "0.4 7.2 "3.5 "3.5 5.4 0.1 4.8 "3.5 7.3 0.2 "3.5 "3.5 "0.4 0.3 0.4 0.1 1.2 2.1 "0.5 0.5 0.8 "0.1 4.4 "3.5 "3.5 0.7 5.7 0.3 1.6 6.0 0.5 1.3 7.2 "2.8 0.0 0.2 "3.5 "3.5 3.3 879 3.1 3.4 "3.5 "3.1 4.7 1.2 "1.0 "0.4 "0.1 "3.5 8.4 "0.6 4.9 9.2 "3.5 12.6 0.3 3.1 0.1 5.9

Code PCT 200304 allocation 200405 allocation 200506 allocation 200607 allocation 200708 allocation 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 200405 200506 200607 allocation allocation allocation allocation per per per per weighted weighted weighted weighted head(1) head(1) head(1) head(1) 000s 000s 000s 000s 895 992 934 851 909 896 861 877 944 848 920 859 977 960 902 929 938 872 883 963 922 837 932 940 915 915 963 891 889 851 977 905 871 925 814 933 904 855 896 857 888 966 882 910 872 881 881 916 908 893 863 853 1,033 944 938 899 996 902 931 883 1,185 884 897 865 994 997 1,027 981 1,090 1,018 935 996 982 946 963 1,028 932 1,003 944 1,064 1,046 987 1,013 1,022 957 969 1,049 1,008 927 1,016 1,024 1,001 1,001 1,050 977 973 936 1,064 991 956 1,009 912 1,020 990 939 983 941 975 1,054 968 997 957 967 967 1,001 994 979 948 938 1,125 1,028 1,022 985 1,085 988 1,019 968 1,392 969 983 950 1,084 1,086 1,119 1,167 1,286 1,232 1,118 1,220 1,181 1,106 1,152 1,209 1,130 1,212 1,142 1,277 1,291 1,196 1,193 1,230 1,123 1,157 1,230 1,193 1,148 1,212 1,253 1,217 1,198 1,262 1,178 1,199 1,103 1,267 1,168 1,155 1,194 1,077 1,195 1,205 1,144 1,177 1,167 1,152 1,257 1,165 1,173 1,148 1,155 1,155 1,206 1,175 1,184 1,128 1,119 1,337 1,216 1,214 1,167 1,241 1,176 1,212 1,199 1,457 1,165 1,178 1,144 1,323 1,315 1,264 1,231 1,434 1,248 1,208 1,265 1,212 1,212 1,245 1,229 1,208 1,230 1,239 1,318 1,377 1,236 1,285 1,282 1,208 1,234 1,300 1,279 1,245 1,226 1,273 1,293 1,227 1,284 1,275 1,239 1,211 1,284 1,224 1,255 1,249 1,210 1,211 1,218 1,209 1,277 1,208 1,274 1,307 1,211 1,272 1,211 1,250 1,250 1,279 1,263 1,270 1,220 1,232 1,358 1,283 1,285 1,269 1,350 1,271 1,311 1,249 1,565 1,267 1,256 1,242 1,330 1,330 1,314 200708 200304 200405 200506 200607 200708 allocation allocation allocation allocation allocation allocation per per per per per per weighted unweighted unweighted unweighted unweighted unweighted head(1) head(2) head(2) head(2) head(2) head(2) 000s 000s 1,347 1,553 1,360 1,340 1,379 1,336 1,336 1,385 1,340 1,336 1,340 1,360 1,415 1,487 1,373 1,391 1,389 1,336 1,345 1,408 1,390 1,358 1,337 1,386 1,393 1,338 1,387 1,387 1,350 1,336 1,390 1,341 1,371 1,361 1,336 1,337 1,336 1,341 1,391 1,336 1,387 1,410 1,336 1,384 1,336 1,393 1,393 1,387 1,378 1,385 1,337 1,347 1,457 1,392 1,393 1,385 1,456 1,385 1,419 1,362 897 1,380 1,368 1,360 1,428 1,428 1,412 913 1,137 767 845 767 711 950 785 722 776 803 1,000 778 783 760 943 864 824 732 1,067 907 1,057 856 858 947 875 822 895 694 893 788 829 895 878 1,112 1,216 885 892 1,074 803 1,034 861 843 986 840 827 898 920 934 996 961 864 927 905 905 1,047 797 926 768 1,085 985 949 970 751 865 815 1,002 1,254 828 928 835 773 1,044 857 779 847 867 1,110 841 852 821 1,030 935 900 802 1,168 991 1,167 926 932 1,028 946 885 983 752 979 855 903 980 955 1,249 1,324 962 975 1,179 874 1,140 935 921 1,077 920 907 882 981 1,004 1,026 1,096 1,057 930 1,009 985 988 1,141 871 1,008 840 966 1,078 1,039 1,067 813 937 882 1,193 1,484 991 1,109 1,016 923 1,222 1,018 907 1,019 1,037 1,355 1,002 1,049 983 1,214 1,119 1,050 957 1,373 1,172 1,441 1,095 1,137 1,241 1,122 1,053 1,186 916 1,150 1,015 1,058 1,180 1,125 1,479 1,546 1,161 1,182 1,412 1,075 1,353 1,112 1,103 1,262 1,101 1,082 1,045 1,182 1,184 1,244 1,305 1,262 1,094 1,193 1,170 1,167 1,303 1,034 1,192 1,037 1,118 1,292 1,242 1,287 985 1,127 990 1,306 1,611 1,072 1,225 1,101 1,000 1,335 1,126 982 1,111 1,121 1,496 1,076 1,132 1,080 1,319 1,206 1,169 1,042 1,493 1,271 1,573 1,185 1,239 1,335 1,212 1,128 1,299 990 1,284 1,092 1,148 1,285 1,223 1,646 1,695 1,257 1,294 1,533 1,163 1,484 1,198 1,213 1,376 1,204 1,189 1,196 1,290 1,287 1,362 1,429 1,382 1,170 1,290 1,264 1,268 1,412 1,126 1,282 1,128 1,193 1,410 1,357 1,410 1,057 1,212 1,063 1,428 1,743 1,171 1,359 1,201 1,105 1,474 1,254 1,072 1,232 1,225 1,650 1,157 1,222 1,201 1,430 1,308 1,296 1,139 1,615 1,384 1,714 1,295 1,345 1,434 1,325 1,221 1,417 1,080 1,421 1,185 1,258 1,403 1,337 1,818 1,867 1,382 1,435 1,670 1,288 1,618 1,290 1,344 1,497 1,333 1,327 1,330 1,404 1,403 1,483 1,566 1,511 1,251 1,402 1,371 1,382 1,524 1,225 1,384 1,233 1,273 1,538 1,480 1,543 1,136 1,303 1,143
000s 5EJ 5LF 5D3 5GC 5L2 5GL 5AM 5L3 5EH 5FX 5FV 5KM 5E9 5FK 5CQ 5DD 5A1 5AP 5DK 5D7 5HW 5C5 5KR 5MW 5CH 5FQ 5CD 5AN 5DT 5EG 5DF 5GH 5J7 5EF 5G9 5CR 5JM 5AF 5EE 5M8 5ME 5L6 5E1 5D8 5MP 5LW 5LV TAC 5A2 5EM 5MG 5J5 5DW 5F1 5KV 5FE 5HD 5DL 5NA 5MR 5M6 5JY 5H8 5MH 5GK 5M9 5FC Leicester City West Lewisham Lincolnshire South West Teaching Luton Maidstone Weald Maldon and South Chelmsford Manseld District Medway Melton, Rutland and Harborough Mendip Mid-Devon Middlesbrough Mid-Hampshire Mid-Sussex Milton Keynes Morecambe Bay New Forest Newark and Sherwood Newbury and Community Newcastle Newcastle-under-Lyme Newham North and East Cornwall North Birmingham North Bradford North Devon North Dorset North East Lincolnshire North East Oxfordshire North Eastern Derbyshire North Hampshire North Hertfordshire and Stevenage North Kirklees North Lincolnshire North Liverpool North Manchester North Norfolk North Peterborough North SheYeld North Somerset North Stoke North Surrey North Tees North Tyneside North Warwickshire Northampton Northamptonshire Heartlands Northumberland Norwich Nottingham City Oldbury and Smethwick Oldham Oxford City Plymouth Teaching Poole Portsmouth City Teaching Preston Reading Redbridge Redditch and Bromsgrove Richmond and Twickenham Rochdale Rotherham Rowley Regis and Tipton Royston, Buntingford and Bishops Stortford Rugby RushcliVe 124,766 283,282 143,841 153,586 182,029 58,828 84,468 208,169 103,526 83,263 82,193 180,521 133,756 105,463 167,638 289,864 152,587 99,480 74,039 278,959 91,279 276,635 137,074 144,069 82,714 131,674 75,209 145,648 50,193 137,262 148,197 153,184 149,007 135,109 118,120 181,822 89,151 93,424 127,665 151,428 127,555 173,148 156,305 193,605 146,587 171,988 222,223 277,933 120,087 273,061 102,125 211,831 142,974 229,948 147,167 164,140 141,957 160,450 207,662 121,603 161,752 128,790 229,769 79,348 58,510 73,481 93,206
000s 136,753 311,262 156,714 168,759 199,462 64,507 92,848 228,675 112,791 91,525 89,630 198,380 145,639 114,831 183,498 316,293 166,139 109,217 81,251 303,926 99,791 306,368 149,437 156,963 90,471 143,972 81,940 159,677 54,983 150,907 161,363 167,889 163,617 147,470 132,316 198,849 97,635 102,626 139,989 166,342 139,950 188,779 171,480 212,131 160,954 188,656 244,043 303,660 131,488 299,343 112,210 232,879 155,681 250,372 160,339 179,791 154,662 175,771 227,399 133,314 176,773 141,263 251,949 87,167 63,791 80,057 101,548
000s 149,345 341,224 170,113 185,096 218,377 70,647 101,507 250,623 122,435 100,068 97,491 216,866 158,340 124,849 200,679 344,226 180,639 119,350 89,016 329,912 108,797 343,886 162,502 170,383 98,680 156,979 88,946 174,394 60,151 165,047 175,436 183,828 178,807 160,538 147,710 216,862 106,553 112,400 152,899 182,185 152,891 205,491 187,336 231,622 175,894 206,566 267,341 330,872 143,487 326,924 122,658 257,782 169,243 271,630 174,048 196,673 167,886 192,392 248,587 145,607 192,786 154,258 275,182 95,276 69,433 86,902 110,230
000s 178,167 397,785 206,969 223,068 266,650 84,733 118,580 304,301 144,746 121,820 118,248 262,583 188,807 153,158 247,043 404,393 216,676 143,401 105,959 386,439 128,041 415,179 194,498 209,972 119,364 188,199 106,648 210,372 73,953 199,161 207,794 215,870 215,698 190,441 173,387 256,356 129,633 137,445 182,084 225,201 180,726 243,611 228,058 273,205 211,596 248,117 336,254 399,055 169,496 396,017 146,167 304,145 200,136 320,442 206,103 232,225 191,684 228,304 292,512 180,206 224,520 185,706 330,233 114,925 84,170 104,879 123,996
000s 194,829 429,633 228,322 247,703 292,733 94,369 131,009 340,701 159,262 135,946 130,402 287,093 204,214 165,638 277,919 438,522 236,351 159,756 116,037 417,413 139,511 454,046 214,247 228,767 129,248 207,633 116,559 229,114 81,471 221,030 226,238 237,977 236,133 208,972 191,147 283,377 143,686 153,199 198,242 251,427 196,328 263,493 253,743 298,390 234,807 277,229 377,137 434,542 185,524 430,928 160,047 332,588 216,453 348,433 223,879 253,929 207,042 249,341 317,506 197,578 242,789 202,989 361,022 125,652 91,037 113,435 134,116
000s "2,496 20,766 4,864 "11,784 "58 "709 "6,208 "9,635 4,931 "5,906 1,181 "12,234 9,357 6,200 "1,023 4,101 5,463 "5,004 "1,917 14,067 527 "28,239 2,101 8,623 317 357 4,294 "3,507 "964 "10,332 11,041 "570 "7,936 1,750 "17,748 220 "1,558 "6,757 "3,727 "10,930 "5,123 9,652 "5,797 "3,053 "7,740 "5,747 "12,166 2,425 "1,660 "6,282 "6,643 "18,785 19,583 7,273 4,116 "3,306 10,961 205 5,463 "2,679 27,510 "5,958 "6,753 "4,870 5,738 6,998 11,247
000s "2,563 21,265 4,573 "12,152 "14 "717 "6,418 "9,928 4,857 "6,090 1,005 "12,633 9,550 6,241 "1,013 3,463 5,190 "5,164 "1,960 13,943 444 "28,365 1,778 8,688 269 314 4,309 "3,607 "982 "10,667 11,319 "549 "8,191 1,479 "16,322 179 "1,599 "6,969 "3,849 "11,275 "5,294 9,669 "5,977 "3,153 "7,991 "5,914 "12,548 2,056 "1,701 "6,460 "6,861 "19,412 20,697 6,771 3,737 "3,391 11,258 220 5,070 "2,739 29,272 "6,149 "6,977 "5,028 5,979 7,277 11,826
000s "2,708 21,393 4,062 "12,677 35 "746 "6,834 "10,540 4,633 "6,472 822 "13,440 9,565 6,136 "1,031 2,794 4,686 "5,488 "2,066 13,416 365 "23,219 1,440 8,551 231 281 4,217 "3,819 "1,031 "11,299 11,404 "541 "8,709 1,199 "14,423 156 "1,689 "7,409 "4,090 "11,985 "5,633 9,443 "6,346 "3,346 "8,497 "6,268 "13,334 1,693 "1,792 "6,838 "7,299 "17,413 21,672 5,915 3,128 "3,581 11,370 232 4,435 "2,886 30,903 "6,536 "7,417 "5,348 6,150 7,468 12,305
000s "5,993 42,833 "3,942 "12,055 "1,442 "4,146 "5,878 "16,187 "5,064 "6,480 "4,045 "6,962 6,667 11,730 "13,141 4,321 1,702 "7,628 "3,291 8,405 670 "13,903 "7,262 "12 1,893 "6,817 1,019 606 "1,973 "10,032 2,024 "8,681 "2,914 "3,539 "8,880 "12,913 "5,709 "7,311 687 "11,979 348 6,460 "11,488 69 "10,658 "13,198 "16,938 2,124 "1,138 "739 "6,321 "9,833 12,637 2,890 2,049 "496 11,126 "252 4,111 "3,279 28,473 "703 "4,072 "2,773 3,644 4,573 3,922
000s "5,510 43,806 "4,105 "8,984 "1,253 "3,423 "4,752 "12,357 "5,413 "4,931 "4,330 "5,327 4,417 11,368 "10,080 1,935 649 "5,794 "3,431 6,737 488 "15,156 "7,611 0 698 "7,316 169 346 "2,089 "8,017 904 "8,631 "2,466 "3,660 "6,933 "10,278 "5,211 "5,556 795 "9,119 291 4,611 "9,203 "114 "8,516 "10,055 "13,679 700 "894 0 "5,805 "9,371 10,716 1,695 1,241 0 10,115 0 1,917 "3,384 27,846 "685 "4,554 "2,335 2,600 3,442 2,537
% "1.8 7.4 3.2 "6.7 "0.0 "1.1 "6.5 "4.2 4.6 "6.2 1.4 "6.0 7.0 5.8 "0.6 1.3 3.4 "4.5 "2.3 5.0 0.5 "8.7 1.5 5.7 0.4 0.3 5.6 "2.2 "1.7 "6.6 7.4 "0.3 "4.7 1.2 "12.5 0.1 "1.6 "6.3 "2.7 "6.3 "3.6 5.5 "3.3 "1.5 "4.7 "3.0 "4.8 0.8 "1.3 "2.1 "5.7 "7.7 14.5 3.1 2.7 "1.9 7.9 0.1 2.5 "2.0 18.8 "4.2 "2.7 "5.4 10.0 9.7 12.7
% "1.7 6.9 2.8 "6.3 "0.0 "1.0 "6.1 "3.9 4.1 "5.8 1.1 "5.6 6.5 5.3 "0.5 1.0 3.0 "4.2 "2.2 4.5 0.4 "8.0 1.1 5.3 0.3 0.2 5.2 "2.1 "1.6 "6.2 7.0 "0.3 "4.5 0.9 "10.5 0.1 "1.5 "6.0 "2.5 "6.0 "3.4 5.0 "3.2 "1.4 "4.4 "2.8 "4.6 0.6 "1.2 "2.0 "5.4 "7.3 14.0 2.6 2.2 "1.7 7.4 0.1 2.1 "1.9 18.3 "3.9 "2.5 "5.1 9.5 9.2 12.2
% "1.7 6.4 2.3 "6.0 0.0 "1.0 "6.0 "3.8 3.6 "5.6 0.8 "5.5 6.0 4.8 "0.5 0.8 2.5 "4.1 "2.1 4.0 0.3 "6.0 0.8 4.8 0.2 0.2 4.6 "2.0 "1.6 "6.0 6.4 "0.3 "4.4 0.7 "8.5 0.1 "1.5 "5.8 "2.5 "5.8 "3.4 4.5 "3.1 "1.3 "4.3 "2.7 "4.4 0.5 "1.2 "1.9 "5.3 "6.0 13.4 2.1 1.7 "1.7 6.8 0.1 1.7 "1.8 17.7 "3.8 "2.5 "5.0 8.9 8.7 11.6
% "3.3 12.1 "1.9 "5.1 "0.5 "4.7 "4.7 "5.1 "3.4 "5.1 "3.3 "2.6 3.7 8.3 "5.1 1.1 0.8 "5.1 "3.0 2.2 0.5 "3.2 "3.6 "0.0 1.6 "3.5 1.0 0.3 "2.6 "4.8 1.0 "3.9 "1.3 "1.8 "4.9 "4.8 "4.2 "5.1 0.4 "5.1 0.2 2.7 "4.8 0.0 "4.8 "5.1 "4.8 0.5 "0.7 "0.2 "4.1 "3.1 6.7 0.9 1.0 "0.2 6.2 "0.1 1.4 "1.8 14.5 "0.4 "1.2 "2.4 4.5 4.6 3.3
% "2.8 11.4 "1.8 "3.5 "0.4 "3.5 "3.5 "3.5 "3.3 "3.5 "3.2 "1.8 2.2 7.4 "3.5 0.4 0.3 "3.5 "2.9 1.6 0.4 "3.2 "3.4 0.0 0.5 "3.4 0.1 0.2 "2.5 "3.5 0.4 "3.5 "1.0 "1.7 "3.5 "3.5 "3.5 "3.5 0.4 "3.5 0.1 1.8 "3.5 "0.0 "3.5 "3.5 "3.5 0.2 "0.5 0.0 "3.5 "2.7 5.2 0.5 0.6 0.0 5.1 0.0 0.6 "1.7 13.0 "0.3 "1.2 "1.8 2.9 3.1 1.9

Code PCT 200304 allocation 200405 allocation 200506 allocation 200607 allocation 200708 allocation 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 200405 200506 200607 200708 200304 200405 200506 200607 200708 allocation allocation allocation allocation allocation allocation allocation allocation allocation allocation per per per per per per per per per per weighted weighted weighted weighted weighted unweighted unweighted unweighted unweighted unweighted head(1) head(1) head(1) head(1) head(2) head(2) head(2) head(2) head(2) head(1) 000s 000s 000s 000s 000s 000s 923 893 898 925 1,025 900 917 912 861 935 845 929 938 982 852 902 959 911 992 950 925 936 904 891 908 903 944 881 882 948 907 933 913 938 958 886 879 934 889 962 931 1,011 854 942 940 938 938 908 989 919 971 865 909 905 897 942 831 788 839 879 829 939 1,029 1,010 979 985 1,008 1,117 985 1,003 998 946 1,019 929 1,012 1,022 1,069 937 987 1,045 997 1,081 1,035 1,010 1,020 990 977 992 990 1,029 967 968 1,033 993 1,017 997 1,022 1,043 972 964 1,021 974 1,047 1,024 1,102 939 1,027 1,024 1,021 1,021 995 1,078 1,003 1,061 951 994 991 983 1,026 915 884 925 965 938 1,023 1,120 1,190 1,167 1,177 1,209 1,337 1,178 1,186 1,200 1,183 1,204 1,121 1,208 1,213 1,308 1,145 1,204 1,219 1,214 1,282 1,254 1,197 1,202 1,162 1,170 1,213 1,164 1,227 1,145 1,134 1,245 1,172 1,214 1,202 1,227 1,290 1,174 1,155 1,223 1,170 1,244 1,222 1,271 1,124 1,214 1,207 1,230 1,230 1,186 1,270 1,205 1,271 1,118 1,232 1,165 1,193 1,226 1,123 1,078 1,128 1,148 1,147 1,208 1,326 1,291 1,245 1,262 1,275 1,475 1,268 1,269 1,260 1,271 1,261 1,208 1,263 1,269 1,294 1,217 1,258 1,320 1,260 1,331 1,333 1,288 1,232 1,228 1,207 1,245 1,265 1,280 1,251 1,246 1,234 1,241 1,280 1,267 1,281 1,346 1,255 1,242 1,324 1,207 1,353 1,321 1,327 1,228 1,284 1,286 1,260 1,260 1,280 1,318 1,265 1,345 1,214 1,282 1,266 1,236 1,273 1,208 1,208 1,240 1,208 1,243 1,251 1,363 1,398 1,358 1,375 1,386 1,597 1,385 1,384 1,373 1,386 1,379 1,336 1,377 1,384 1,394 1,337 1,372 1,429 1,374 1,429 1,439 1,396 1,342 1,346 1,337 1,359 1,383 1,387 1,370 1,365 1,345 1,352 1,389 1,382 1,389 1,445 1,368 1,356 1,429 1,336 1,461 1,429 1,427 1,342 1,391 1,394 1,374 1,374 1,389 1,419 1,380 1,450 1,371 1,389 1,381 1,347 1,388 1,336 1,336 1,384 1,336 1,357 1,368 1,474 1,124 890 1,008 797 979 807 976 813 872 843 827 897 981 742 735 750 1,102 737 892 790 968 751 1,110 996 777 1,030 843 951 1,045 767 887 787 733 775 823 791 873 948 765 986 1,182 817 980 896 892 831 831 1,047 801 811 901 821 823 980 819 895 778 961 798 941 1,156 963 908 1,235 974 1,105 863 1,067 881 1,057 888 961 919 902 972 1,064 798 803 816 1,202 801 967 858 1,057 813 1,221 1,086 841 1,132 912 1,049 1,153 826 965 855 797 844 891 863 955 1,034 829 1,075 1,303 883 1,081 974 974 899 813 1,150 871 879 980 893 895 1,073 887 966 852 1,068 873 1,023 1,294 1,047 987 1,460 1,159 1,320 1,029 1,276 1,052 1,236 1,065 1,204 1,086 1,080 1,154 1,257 964 975 989 1,403 967 1,142 1,036 1,253 951 1,436 1,293 1,019 1,335 1,080 1,248 1,357 984 1,130 1,017 956 1,014 1,094 1,037 1,141 1,236 985 1,278 1,558 1,009 1,299 1,150 1,151 1,076 971 1,373 1,022 1,049 1,166 1,038 1,103 1,260 1,063 1,145 1,041 1,289 1,056 1,207 1,565 1,234 1,166 1,587 1,262 1,442 1,112 1,379 1,143 1,333 1,159 1,314 1,185 1,214 1,253 1,368 1,030 1,058 1,073 1,517 1,047 1,229 1,116 1,354 1,031 1,574 1,486 1,102 1,459 1,163 1,370 1,492 1,063 1,225 1,099 1,038 1,099 1,175 1,125 1,241 1,333 1,064 1,383 1,689 1,081 1,426 1,240 1,248 1,166 1,051 1,500 1,102 1,137 1,254 1,185 1,189 1,378 1,147 1,238 1,155 1,455 1,207 1,323 1,695 1,343 1,258 1,717 1,379 1,576 1,209 1,490 1,246 1,453 1,268 1,433 1,297 1,345 1,364 1,489 1,110 1,163 1,170 1,641 1,143 1,323 1,203 1,466 1,124 1,725 1,639 1,204 1,600 1,262 1,504 1,639 1,158 1,338 1,194 1,133 1,198 1,263 1,229 1,353 1,437 1,180 1,497 1,825 1,160 1,563 1,347 1,356 1,275 1,156 1,632 1,187 1,240 1,347 1,338 1,288 1,504 1,250 1,351 1,282 1,610 1,347 1,464 1,843 1,467 1,358
000s 5F5 5KK 5KE 5E2 5EP 5EN 5LP 5M2 5DM 5D1 5FW 5FN 5M1 5JJ 5GJ 5DX 5EQ 5A3 5CV 5LK 5HL 5JD 5HC 5AA 5AG 5M5 5K1 5MF 5KG 5MQ 5FP 5FF 5DY 5MN 5DJ 5MT 5L1 5AK 5G1 5F9 5LE 5GX 5J3 5HR 5F7 5JR 5JW 5KL 5L7 5LT 5M7 5L4 5K3 5LH 5K2 5FY 5MK 5AH 5GQ 5CW 5C4 5F6 5CX Salford Scarborough, Whitby and Ryedale Sedgeeld Selby and York SheYeld South West SheYeld West Shepway Shropshire County Slough Solihull Somerset Coast South and East Dorset South Birmingham South Cambridgeshire South East Hertfordshire South East Oxfordshire South East SheYeld South Gloucestershire South Hams and West Devon South Hudderseld South Leeds South Leicestershire South Liverpool South Manchester South Peterborough South Sefton South Somerset South Stoke South Tyneside South Warwickshire South West Dorset South West Kent South West Oxfordshire South Western StaVordshire South Wiltshire South Worcestershire Southampton City Southend on Sea Southern Norfolk Southport and Formby Southwark St Albans and Harpenden St Helens StaVordshire Moorlands Stockport SuVolk Coastal SuVolk West Sunderland Teaching Surrey Heath and Woking Sussex Downs and Weald Sutton and Merton Swale Swindon Tameside and Glossop Taunton Deane Teignbridge Telford and Wrekin Tendring Thurrock Torbay Tower Hamlets TraVord North TraVord South 247,939 138,792 91,185 216,207 110,485 107,858 95,502 230,545 98,923 168,822 116,393 132,472 330,605 75,765 129,139 57,710 167,411 172,121 90,085 67,967 137,550 112,150 100,413 138,532 71,107 161,978 124,979 126,424 158,322 192,584 122,640 141,986 139,950 141,156 99,642 216,861 205,816 153,413 156,491 115,701 282,305 105,092 181,808 91,401 251,919 80,843 178,550 290,492 153,464 121,490 324,770 78,399 152,323 219,032 86,195 94,675 124,364 128,228 117,395 128,536 237,707 88,212 108,726
000s 271,411 152,118 99,979 235,557 120,373 118,130 104,546 252,424 108,728 183,931 127,991 144,375 360,194 82,496 142,052 63,163 182,394 188,320 98,089 74,050 150,173 122,187 110,029 151,887 77,654 177,546 136,164 138,774 173,831 209,820 134,315 154,808 152,859 153,789 108,493 237,779 225,716 167,594 171,508 125,978 310,472 114,576 199,906 99,581 274,293 88,023 194,956 318,336 167,316 132,691 355,056 86,218 166,721 240,013 94,443 103,084 136,914 143,975 129,330 141,006 269,000 96,076 118,389
000s 296,139 166,123 109,195 255,791 130,665 128,971 114,328 275,548 119,200 199,657 140,301 156,956 390,991 89,690 155,785 69,075 197,989 205,893 106,420 80,382 163,518 132,634 120,103 165,832 84,771 193,820 147,807 151,634 189,955 227,759 146,636 168,529 166,890 166,938 117,958 259,712 247,042 182,986 187,231 136,676 341,085 124,703 222,113 108,095 297,789 95,496 212,311 347,602 182,116 144,863 387,426 94,536 182,319 261,987 103,125 111,836 152,918 161,452 144,805 153,987 303,641 104,389 128,446
000s 346,814 198,010 130,630 307,131 155,696 154,032 134,799 331,198 148,236 236,950 175,041 188,073 467,293 109,152 189,518 84,031 230,000 250,189 125,824 97,051 192,333 157,191 141,193 210,058 103,668 227,817 176,117 179,689 222,991 275,947 173,083 200,604 201,112 200,301 145,066 313,484 295,218 217,056 224,883 161,841 401,542 142,879 262,020 127,271 349,861 115,682 256,665 413,283 213,279 173,834 459,723 116,872 223,813 308,593 125,141 134,213 187,621 200,202 181,711 185,688 360,074 123,843 151,599
000s 374,615 216,805 142,796 335,917 168,357 168,470 148,623 363,336 161,537 259,370 195,512 205,872 510,764 118,947 209,692 92,211 248,764 275,190 136,088 104,967 208,252 172,566 154,399 233,129 114,166 249,358 192,456 196,436 243,791 303,964 190,469 218,687 220,655 218,332 156,897 344,274 323,249 234,771 252,044 175,035 433,721 154,535 286,542 138,529 379,343 127,346 285,040 449,010 230,681 190,791 497,211 133,446 243,943 337,310 137,943 147,656 209,334 223,705 204,371 207,397 395,521 135,581 163,955
000s "2,835 "2,574 "2,551 5,291 12,429 "493 "1,049 "170 "5,336 5,606 "9,113 2,598 8,681 6,658 "8,875 "216 7,143 61 7,694 3,066 1,625 4,254 "2,922 "5,403 574 "5,770 4,856 "6,135 "8,558 9,634 "652 4,467 1,018 4,791 5,230 "5,569 "8,630 1,867 "4,671 4,080 5,475 12,269 "16,827 2,426 5,744 2,557 1,540 "5,408 12,716 893 21,385 "5,256 "882 "6,514 "1,111 2,609 "12,397 "23,947 "11,543 "6,233 "28,093 1,713 13,243
000s "2,933 "2,638 "2,636 4,663 13,029 "484 "1,079 "145 "5,488 5,256 "9,403 2,200 7,777 6,896 "9,143 "207 6,946 91 7,955 3,002 1,374 4,071 "3,018 "5,576 493 "5,970 4,663 "6,341 "8,855 9,541 "656 4,155 871 4,508 5,209 "5,720 "8,884 1,575 "4,801 3,867 4,644 12,887 "17,399 2,179 4,983 2,381 1,312 "5,592 13,125 761 21,715 "5,426 "882 "6,733 "1,134 2,366 "12,801 "22,731 "11,921 "6,429 "24,603 1,449 13,934
000s "3,112 "2,783 "2,802 3,786 13,507 "487 "1,140 "114 "5,819 4,646 "9,655 1,781 6,352 7,040 "9,708 "203 6,499 119 8,105 2,837 1,114 3,719 "3,207 "5,925 416 "6,356 4,282 "6,748 "9,434 9,170 "675 3,624 734 4,008 5,046 "6,050 "9,423 1,274 "5,082 3,479 3,772 13,391 "14,920 1,787 4,031 2,080 1,089 "5,942 13,341 636 21,603 "5,771 "904 "7,160 "1,190 1,975 "10,486 "21,006 "9,799 "6,832 "20,139 1,171 14,510
000s
000s
% "1.1 "1.7 "2.6 2.3 11.8 "0.4 "1.0 "0.1 "4.7 3.2 "6.8 1.9 2.5 8.8 "6.0 "0.3 4.2 0.0 8.7 4.4 1.1 3.6 "2.7 "3.6 0.7 "3.3 3.8 "4.4 "4.9 4.9 "0.5 3.0 0.7 3.3 5.1 "2.3 "3.8 1.2 "2.7 3.5 1.8 12.1 "8.1 2.6 2.2 3.0 0.8 "1.7 8.4 0.7 6.5 "5.9 "0.5 "2.8 "1.2 2.7 "8.5 "15.0 "8.4 "4.4 "10.0 1.9 12.8
% "1.0 "1.6 "2.4 1.9 11.3 "0.4 "1.0 "0.1 "4.5 2.7 "6.4 1.4 2.1 8.4 "5.6 "0.3 3.7 0.0 8.2 3.9 0.9 3.2 "2.5 "3.3 0.6 "3.1 3.3 "4.1 "4.6 4.4 "0.5 2.6 0.5 2.8 4.7 "2.2 "3.5 0.9 "2.5 3.0 1.4 11.6 "7.6 2.1 1.7 2.6 0.6 "1.6 7.9 0.5 6.1 "5.6 "0.5 "2.6 "1.1 2.2 "8.0 "13.0 "8.0 "4.1 "8.0 1.4 12.3
% "1.0 "1.5 "2.4 1.4 10.7 "0.3 "0.9 "0.0 "4.3 2.2 "6.0 1.1 1.5 7.8 "5.5 "0.3 3.2 0.1 7.6 3.4 0.6 2.7 "2.5 "3.3 0.5 "3.0 2.8 "4.0 "4.5 3.9 "0.4 2.0 0.4 2.3 4.2 "2.1 "3.4 0.7 "2.5 2.5 1.1 11.0 "6.0 1.6 1.3 2.1 0.5 "1.6 7.4 0.4 5.5 "5.4 "0.5 "2.5 "1.1 1.7 "6.0 "11.0 "6.0 "4.0 "6.0 1.1 11.8
% 1.5 "2.1 "0.8 0.3 16.0 "0.3 "0.2 "1.0 "0.1 "0.8 "5.1 "0.7 "0.3 1.6 "4.3 "1.1 3.7 "0.9 4.6 4.8 1.3 "3.2 "3.4 "5.1 "2.3 "0.6 0.7 "1.7 "2.1 "3.0 "2.4 0.6 "0.4 0.7 5.9 "1.3 "2.4 2.7 "5.1 6.4 3.9 4.3 "3.4 1.0 1.1 "0.9 "4.5 0.6 3.6 "0.5 5.8 "6.6 0.8 "0.4 "2.8 0.1 "5.1 "5.1 "5.4 "5.1 "3.6 "1.7 7.2
% 0.9 "1.9 "0.7 0.1 15.3 0.0 "0.1 "0.8 0.0 "0.4 "3.5 "0.5 "0.1 0.3 "3.5 "1.0 3.1 "0.8 3.2 3.9 0.8 "3.1 "2.8 "3.5 "2.2 "0.1 0.2 "1.0 "1.4 "2.9 "2.3 0.3 "0.2 0.3 4.3 "1.2 "2.1 1.6 "3.5 5.5 3.2 3.0 "3.1 0.4 0.7 "0.8 "3.5 0.3 2.5 "0.3 4.6 "3.5 0.3 "0.3 "2.7 0.2 "3.5 "3.5 "3.5 "3.5 "3.5 "1.2 6.4
5,098 3,414 "4,212 "4,291 "1,047 "987 767 324 21,432 22,328 "504 0 "332 "82 "3,194 "3,101 "180 65 "2,026 "1,145 "9,311 "7,091 "1,288 "1,136 "1,320 "506 1,728 404 "8,602 "7,605 "914 "901 8,308 7,581 "2,339 "2,267 5,571 4,237 4,418 3,904 2,455 1,603 "5,200 "5,536 "4,995 "4,449 "11,361 "8,455 "2,391 "2,514 "1,289 "284 1,184 297 "3,015 "2,080 "4,682 "3,575 "8,549 "9,109 "4,343 "4,581 1,265 689 "726 "546 1,401 705 8,023 6,530 "4,199 "4,235 "7,115 "6,885 5,748 3,730 "12,153 "9,141 9,728 9,108 14,965 13,398 5,912 4,525 "9,348 "9,157 1,199 580 3,849 2,567 "1,047 "1,011 "12,067 "10,338 2,618 1,410 7,383 5,528 "885 "608 25,005 22,086 "8,261 "4,840 1,856 799 "1,394 "935 "3,622 "3,851 90 360 "9,980 "7,592 "10,649 "8,114 "10,338 "7,412 "9,877 "7,522 "13,358 "14,345 "2,093 "1,669 10,136 9,928

Code PCT 200304 allocation 200405 allocation 200506 allocation 200607 allocation 200708 allocation 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 closing DFT 200405 closing DFT 200506 closing DFT 200607 closing DFT 200708 closing DFT 200304 200405 200506 200607 200708 200304 200405 200506 200607 200708 allocation allocation allocation allocation allocation allocation allocation allocation allocation allocation per per per per per per per per per per weighted weighted weighted weighted weighted unweighted unweighted unweighted unweighted unweighted head(1) head(1) head(1) head(1) head(1) head(2) head(2) head(2) head(2) head(2) 000s 000s 000s 000s 000s 000s 963 900 915 853 910 1,048 910 992 884 846 902 934 912 933 905 887 863 918 876 862 1,221 988 845 916 852 908 921 878 948 916 1,050 985 1,001 938 999 1,152 996 1,081 970 931 989 1,017 998 1,017 992 973 948 1,005 961 948 1,339 1,077 930 1,001 937 993 1,008 963 1,033 1,003 1,251 1,189 1,212 1,125 1,193 1,365 1,206 1,256 1,150 1,110 1,210 1,198 1,182 1,195 1,165 1,183 1,137 1,196 1,162 1,154 1,570 1,255 1,151 1,213 1,113 1,179 1,189 1,145 1,215 1,198 1,265 1,266 1,281 1,261 1,300 1,434 1,273 1,333 1,208 1,221 1,289 1,258 1,254 1,291 1,258 1,222 1,207 1,232 1,208 1,347 1,461 1,357 1,208 1,288 1,211 1,276 1,246 1,212 1,224 1,274 1,380 1,382 1,388 1,376 1,410 1,551 1,384 1,437 1,336 1,337 1,395 1,372 1,367 1,399 1,372 1,336 1,336 1,344 1,336 1,446 1,547 1,466 1,336 1,392 1,337 1,390 1,358 1,336 1,336 1,388 725 741 882 964 998 1,028 854 893 913 985 850 939 862 972 906 832 859 944 761 959 1,189 813 734 696 950 782 944 810 867 903 787 807 961 1,061 1,096 1,125 932 970 993 1,085 930 1,023 938 1,067 991 904 935 1,026 824 1,047 1,255 884 798 758 1,048 858 1,024 888 934 986 933 969 1,160 1,274 1,308 1,328 1,126 1,121 1,169 1,295 1,135 1,204 1,104 1,260 1,161 1,088 1,112 1,212 983 1,264 1,421 1,029 975 915 1,246 1,020 1,197 1,055 1,088 1,172 1,014 1,052 1,259 1,395 1,415 1,429 1,229 1,208 1,266 1,419 1,224 1,313 1,198 1,373 1,264 1,181 1,247 1,313 1,090 1,356 1,488 1,109 1,055 986 1,367 1,111 1,296 1,151 1,175 1,274 1,108 1,150 1,366 1,526 1,531 1,538 1,339 1,301 1,404 1,552 1,323 1,436 1,308 1,489 1,382 1,293 1,383 1,433 1,207 1,454 1,564 1,196 1,169 1,068 1,511 1,213 1,413 1,275 1,287 1,388
000s 5GN 5DP 5E8 5M3 5NC 5LG 5J2 5GV 5JV 5MJ 5GG 5D6 5KX 5E6 5F3 5D2 5CY 5FM 5DH 5L9 5LC 5G3 TAG 5DN 5MV 5G5 5HF 5DR 5E4 Uttlesford Vale of Aylesbury Wakeeld West Walsall Teaching Waltham Forest Wandsworth Warrington Watford and Three Rivers Waveney Wednesbury and West Bromwich Welwyn Hateld West Cumbria West Gloucestershire West Hull West Lancashire West Lincolnshire West Norfolk West of Cornwall West Wiltshire Western Sussex Westminster Windsor, Ascot and Maidenhead Witham, Braintree and Halstead Wokingham Wolverhampton City Wycombe Wyre Wyre Forest Yorkshire Wolds and Coast England 52,071 143,593 131,156 237,124 226,435 275,795 163,513 151,919 112,703 112,186 81,981 122,798 188,232 149,880 97,085 180,080 124,323 144,227 90,474 189,601 263,876 129,700 100,623 100,104 228,683 107,852 112,822 87,088 126,799
000s 56,772 157,179 143,375 260,693 248,565 303,063 178,963 165,631 123,614 123,427 89,915 133,788 206,016 163,420 106,387 197,501 136,533 157,833 99,238 206,444 289,491 141,407 110,770 109,406 251,451 117,956 123,458 95,519 138,148
000s 61,798 171,899 156,303 285,181 272,407 332,216 195,266 180,280 134,984 136,713 98,477 145,227 224,782 177,730 116,168 215,736 149,167 172,199 108,621 224,451 316,790 153,916 122,397 119,512 275,859 128,925 134,710 104,344 149,959
000s 73,835 207,078 189,155 342,196 320,806 388,415 237,103 208,055 160,058 161,162 119,016 171,945 266,091 208,035 136,355 262,818 185,337 204,952 134,671 244,733 367,029 178,091 150,157 143,394 326,781 152,351 158,954 123,968 177,232
000s
000s
000s
000s
000s
000s
% 6.7 "0.5 0.6 "6.6 "2.1 14.5 "0.5 9.0 "4.1 "7.7 "1.7 2.5 "0.5 1.7 "1.6 "2.8 "6.0 "0.4 "4.0 5.2 31.1 7.8 "7.2 1.0 "6.8 0.2 0.2 "2.8 3.7 0.0
% 6.3 "0.5 0.5 "6.2 "2.0 14.0 "0.5 8.5 "3.9 "7.3 "1.6 2.0 "0.5 1.3 "1.5 "2.7 "5.7 "0.4 "3.8 4.8 30.5 7.4 "6.8 0.8 "6.5 0.2 0.1 "2.6 3.3 0.0
% 5.7 "0.4 0.3 "6.0 "1.9 13.4 "0.4 7.9 "3.8 "6.0 "1.5 1.5 "0.5 1.0 "1.5 "2.6 "5.6 "0.3 "3.7 4.2 29.9 6.8 "6.0 0.6 "6.0 0.1 0.1 "2.5 2.7 0.0
% "0.5 "1.6 0.7 "0.9 1.3 12.7 0.1 4.8 "5.1 "4.0 1.3 "1.1 "1.4 1.5 "1.0 "3.9 "5.1 "3.1 "5.1 5.9 14.8 6.6 "5.1 1.2 "4.8 0.3 "2.0 "4.7 "3.7 0.0
% "0.4 "1.5 0.2 "0.7 0.8 11.9 "0.1 3.7 "3.5 "3.5 0.7 "0.9 "1.3 1.0 "0.9 "3.5 "3.5 "3.0 "3.5 4.4 11.6 5.8 "3.5 0.5 "3.5 0.3 "1.9 "3.5 "3.5 0.0
81,090 3,552 3,619 3,616 "392 "339 227,618 "840 "826 "835 "3,292 "3,372 205,849 825 699 582 1,371 417 374,066 "17,867 "18,451 "19,485 "3,088 "2,556 347,335 "4,995 "5,206 "5,589 4,239 2,689 420,027 37,401 39,504 41,334 43,886 44,808 259,050 "903 "904 "928 276 "159 225,025 13,416 13,900 14,196 9,476 8,129 178,920 "5,143 "5,307 "5,641 "8,514 "6,489 176,241 "10,020 "10,354 "9,299 "6,759 "6,392 129,022 "1,518 "1,557 "1,644 1,585 889 188,244 3,202 2,864 2,333 "1,827 "1,792 292,350 "1,084 "1,091 "1,126 "3,841 "3,903 224,710 2,623 2,215 1,787 3,089 2,207 149,392 "1,670 "1,723 "1,826 "1,437 "1,409 290,393 "5,645 "5,816 "6,170 "10,715 "10,532 207,305 "8,518 "8,792 "9,351 "10,016 "7,519 225,363 "586 "590 "605 "6,612 "6,859 150,935 "4,065 "4,187 "4,443 "7,164 "5,474 264,691 10,046 10,015 9,715 13,730 11,116 396,902 66,257 71,163 75,975 47,273 41,351 192,609 10,062 10,343 10,457 11,075 10,606 168,321 "8,412 "8,678 "8,345 "7,987 "6,105 155,932 1,065 909 752 1,759 751 360,656 "17,944 "18,536 "18,812 "16,460 "13,081 166,009 212 201 192 468 573 174,770 202 170 149 "3,264 "3,404 137,428 "2,670 "2,741 "2,900 "6,136 "4,984 195,825 4,870 4,669 4,277 "6,879 "7,102 "0 "0 0 0 0
45,027,181 49,328,244 53,924,975 64,309,595 70,354,697
Source: PCT data aggregated to SHA from 200304 to 200506 and 200607 and 200708 PCT revenue resource limits exposition books available at www.dh.gov.uk/allocations Footnotes: 1. 2002 ADS scaled to 2001 ONS sub-national population estimates 2. 2004 ADS scaled to 2003 based ONS sub-national population projections
4.2.2 What was the average percentage absolute adjustment made to crude Primary Care Trust populations for (a) age structure (b) additional need (c) market forces and (d) other in the 200708 weighted capitation formula? (Q50) Answer 1. There are separate components in the weighted capitation formula for the diVerent services for which PCTs receive funding: hospital and community health services (HCHS), prescribing, primary medical services and HIV/AIDS. Each component includes adjustments for age, additional need and market forces, with the exception of the prescribing component which does not have an adjustment for market forces. 2. Each adjustment generates a separate PCT index, comparing the PCT score on the adjustment to the national average. The indices are simultaneously applied to crude populations to produce weighted populations which are then normalised, or scaled, back to the national crude population. This produces PCT weighted populations for each component which are combined into PCT unied weighted populations using national expenditure weights. It is not possible to produce overall adjustments for age, additional need and market forces without giving a diVerent weighted population. 3. The index for each adjustment is centred on an average of 1, or 100% in percentage terms. PCTs with an index greater than 1 for the age, additional need or market forces adjustments will be above the national average and those PCTs with an index less than 1 will be below the national average. 4. Table 50a and Figure 50a show measures of dispersion and the average percentage absolute adjustment for each index in the HCHS Component in 200708. Table 50b and Table 50c show the range for each index in the prescribing and primary medical services components in 200708. 5. There are two other adjustments in the 200607 and 200708 weighted capitation formula: the English language diYculties adjustment (ELDA) and the growth area adjustment. These are adjustments to monetary targets rather than adjustments to crude populations. Table 50a RANGES FOR HCHS COMPONENT INDICES 200708 Adjustment Additional need Market forces factor 0.71 1.52 0.81 0.17 13.9% 0.90 1.21 0.32 0.06 5.4%
Age Minimum Maximum Range Standard deviation Average percentage absolute adjustment 0.84 1.25 0.41 0.06 4.7%
Emergency ambulance cost 0.99 1.01 0.02 0.00 0.2%
Table 50b RANGES FOR PRESCRIBING COMPONENT IN 200708 Adjustment Age Additional need Minimum Maximum Range Standard deviation Average percentage absolute adjustment Table 50c RANGES FOR PRIMARY MEDICAL SERVICES COMPONENT IN 200708 Adjustment Additional need 0.83 1.34 0.52 0.10 8.0% Market forces factor 0.95 1.17 0.22 0.04 2.7% 0.73 1.28 0.55 0.09 7.0% 0.83 1.44 0.60 0.11 9.0%
Age Minimum Maximum Range Standard deviation Average percentage absolute adjustment 0.83 1.23 0.40 0.06 4.7%
Figure 50a: RANGES FOR HCHS COMPONENT INDICES IN 2007-08

1.6
1.5
1.4
1.3
1.2
1.1
EACA index
1
MFF index
0.9
Age index
0.8
Additional need index

0.7
0.6
4.2.3 What percentage adjustments were made to crude populations for (a) age structure (b) additional need (c) market forces and (d) other for each Primary Care Trust in the 200708 weighted capitation formula? (Q51) Answer Table 51 shows the age, additional need and market forces adjustments expressed as indices centred around 1 for each PCT in the HCHS, prescribing and primary medical services components of the weighted capitation formula in 200708. It is not possible to produce overall adjustments for age, additional need and market forces without giving a diVerent weighted population.
Table 51 200708 WEIGHTED CAPITATION FORMULA ADJUSTMENTS HCHS component Additional Age need MFF adjustment adjustment adjustment 1.15 1.02 1.02 1.00 0.99 0.98 0.92 0.96 1.00 0.97 1.01 1.03 1.11 0.99 0.96 1.25 1.00 1.03 1.01 0.94 1.04 0.95 0.98 1.06 0.91 0.85 0.97 0.92 0.99 0.99 0.95 1.06 1.01 0.91 0.98 0.96 1.14 0.90 1.17 1.21 0.85 1.22 1.10 1.05 0.84 0.90 0.93 0.83 0.87 0.91 0.79 1.27 1.31 1.21 0.77 1.16 1.00 0.82 1.43 1.19 1.09 1.02 1.06 1.00 0.83 0.83 0.99 0.95 0.94 0.93 0.99 0.95 1.06 1.13 0.94 1.04 0.92 1.00 0.96 1.01 1.04 0.95 1.05 1.03 0.95 0.93 0.92 1.10 0.94 0.97 1.11 0.95 0.95 1.14 1.02 1.01 1.01 0.94 1.07 Prescribing component Additional EACA Age need adjustment adjustment adjustment 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.15 1.02 1.04 1.02 1.00 1.00 0.87 0.92 1.02 0.95 1.05 1.03 1.15 0.98 0.98 1.28 1.00 1.05 1.02 0.91 1.07 0.96 0.98 1.03 0.89 0.74 0.95 0.88 0.94 0.94 0.89 1.10 1.00 0.94 0.95 0.98 1.08 0.93 1.14 1.11 0.91 1.18 1.04 1.05 0.90 0.97 0.96 0.88 0.93 0.92 0.87 1.22 1.18 1.16 0.86 1.10 1.02 0.88 1.26 1.08 1.06 1.03 1.04 1.00 0.91 0.89 Primary medical services component Additional Age need MFF adjustment adjustment adjustment 1.13 1.03 1.02 1.00 1.00 0.98 0.93 0.96 1.00 0.97 1.01 1.02 1.11 0.98 0.97 1.23 1.00 1.03 1.02 0.95 1.04 0.97 0.98 1.04 0.92 0.86 0.98 0.92 0.96 0.98 0.93 1.06 1.01 0.95 0.97 0.99 1.09 0.92 1.11 1.08 0.91 1.12 1.04 1.05 0.90 0.96 0.96 0.90 0.92 0.95 0.87 1.18 1.16 1.18 0.87 1.10 0.99 0.90 1.22 1.11 1.03 1.04 1.04 1.01 0.90 0.91 0.98 0.97 0.96 0.97 0.98 0.98 1.04 1.06 0.98 1.02 0.97 0.99 0.98 1.00 1.00 0.97 1.02 1.00 0.99 0.98 0.97 1.03 0.98 0.98 1.05 1.01 0.99 1.07 1.02 1.01 1.01 0.95 1.03
Code 5L8 5AW 5ED 5FA 5LL 5HG 5C2 5A9 5JE 5GR 5ET 5FL 5F8 5GD 5GE 5FH TAK 5GP 5H2 5CC 5HP 5G6 5HQ 5CE 5G2 5CF 5CG 5K5 5LQ 5JF 5JG 5JL 5A7
PCT Adur, Arun and Worthing Airedale Amber Valley Asheld Ashford Ashton, Leigh and Wigan Barking and Dagenham Barnet Barnsley Basildon Bassetlaw Bath and North East Somerset Bebington and West Wirral Bedford Bedfordshire Heartlands Bexhill and Rother Bexley Care Trust Billericay, Brentwood and Wickford Birkenhead and Wallasey Blackburn with Darwen Blackpool Blackwater Valley and Hart Bolton Bournemouth Teaching Bracknell Forest Bradford City Teaching Bradford South and West Brent Teaching Brighton and Hove City Bristol North Bristol South and West Broadland Bromley
Table 51 (Continued) 200708 WEIGHTED CAPITATION FORMULA ADJUSTMENTS HCHS component Additional Age need MFF adjustment adjustment adjustment 1.03 0.99 0.98 0.98 0.99 0.95 0.88 0.98 1.04 1.04 1.04 1.00 1.09 0.96 0.95 0.88 1.06 0.99 1.00 1.04 0.99 1.04 1.04 1.02 0.99 0.86 1.00 1.05 0.98 1.06 0.97 0.93 0.95 1.20 0.94 1.06 1.05 0.78 1.11 1.02 0.91 1.02 0.87 0.95 0.96 1.14 1.49 1.45 0.81 0.90 0.81 0.85 0.83 0.93 1.06 0.72 0.96 1.37 0.87 0.81 1.12 0.83 0.88 0.94 0.95 0.93 0.96 0.96 0.95 1.06 1.21 0.94 0.98 0.94 0.99 0.96 0.90 0.94 0.96 0.99 0.98 0.96 1.00 0.98 1.03 0.98 0.93 1.08 0.94 1.17 0.99 0.99 1.01 0.95 1.06 1.09 Prescribing component Additional EACA Age need adjustment adjustment adjustment 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.05 0.99 1.02 0.98 1.00 0.88 0.81 1.00 1.04 1.07 1.09 1.02 1.13 0.94 0.92 0.79 1.10 1.00 1.01 1.03 1.01 1.07 1.06 1.05 1.01 0.79 1.01 1.09 0.95 1.10 0.94 0.91 0.97 1.13 0.95 1.05 1.01 0.90 1.11 1.00 0.95 1.02 0.90 0.98 0.98 1.10 1.39 1.29 0.87 0.93 0.88 0.91 0.87 0.97 1.05 0.83 0.99 1.20 0.95 0.87 1.07 0.89 0.91 0.95 Primary medical services component Additional Age need MFF adjustment adjustment adjustment 1.03 0.99 0.99 0.98 1.00 0.91 0.86 0.98 1.04 1.04 1.05 1.00 1.09 0.96 0.94 0.85 1.06 0.99 1.00 1.03 1.00 1.04 1.04 1.04 0.99 0.87 1.00 1.05 0.97 1.07 0.96 0.94 1.00 1.11 0.98 1.03 1.02 0.91 1.09 1.03 0.94 1.03 0.90 1.00 0.97 1.11 1.26 1.31 0.87 0.94 0.89 0.91 0.90 0.96 1.06 0.85 1.00 1.14 0.93 0.88 1.06 0.90 0.93 0.96 0.97 0.97 0.97 0.98 0.98 1.03 1.14 0.97 0.98 0.97 0.98 0.97 0.95 1.00 1.01 1.03 0.97 0.97 0.98 0.99 0.99 0.99 0.97 1.03 0.96 1.17 0.98 0.98 1.01 0.96 1.02 1.05
Code 5EV 5G8 5DQ 5JX 5J6 5JH 5K7 5MM 5LM 5D4 5JP 5H4 5KT 5AL 5HA 5CL 5JT 5JC 5JN 5KW 5DV 5H3 5EA 5G4 5F2 5C3 5GM 5KY 5MD 5KJ 5MA 5K9
PCT Broxtowe and Hucknall Burnley, Pendle and Rossendale Burntwood, Licheld and Tamworth Bury Calderdale Cambridge City Camden Cannock Chase Canterbury and Coastal Carlisle and District Castle Point and Rochford Central Cheshire Central Cornwall Central Derby Central Liverpool Central Manchester Central SuVolk Charnwood and North West Leicestershire Chelmsford Cheltenham and Tewkesbury Cherwell Vale Cheshire West Chestereld Chiltern and South Bucks Chorley and South Ribble City and Hackney Teaching Colchester Cotswold and Vale Coventry Teaching Craven, Harrogate and Rural District Crawley Croydon
Code 5GW 5J9 5CM 5AC 5H7 5KA 5CK 5EK 5EL 5HV 5HT 5KC 5J8 5HX 5KD 5JK 5FT 5KP 5FD 5LN 5HK 5H9 5ML 5KQ 5E3 5LR 5MY 5H5 5E5 5EY 5E7 5LY
PCT Dacorum Darlington Dartford, Gravesham and Swanley Daventry and South Northamptonshire Derbyshire Dales and South Derbyshire Derwentside Doncaster Central Doncaster East Doncaster West Dudley Beacon and Castle Dudley South Durham and Chester-le-Street Durham Dales Ealing Easington East Cambridgeshire and Fenland East Devon East Elmbridge and Mid Surrey East Hampshire East Kent Coastal East Leeds East Lincolnshire East StaVordshire East Surrey East Yorkshire Eastbourne Downs Eastern Birmingham Eastern Cheshire Eastern Hull Eastern Leicester Eastern Wakeeld Eastleigh and Test Valley South
Code 5D5 5H6 5C1 5AJ 5ER 5FR 5LX 5HE 5KF 5EC 5GT 5EX 5A8 5L5 5J1 5KH 5H1 5C9 5DC 5K6 5D9 5FJ 5A4 5MX 5CN 5CP 5F4 5HN 5AT 5JA 5MC 5HY
PCT Eden Valley Ellesmere Port and Neston Eneld Epping Forest Erewash Exeter Fareham and Gosport Fylde Gateshead Gedling Great Yarmouth Greater Derby Greenwich Teaching Guildford and Waverley Halton Hambleton and Richmondshire Hammersmith and Fulham Haringey Teaching Harlow Harrow Hartlepool Hastings and St Leonards Havering Heart of Birmingham Teaching Herefordshire Hertsmere Heywood and Middleton High Peak and Dales Hillingdon Hinckley and Bosworth Horsham and Chanctonbury Hounslow
Table 51 (Continued) 200708 WEIGHTED CAPITATION FORMULA ADJUSTMENTS HCHS component Additional Age need MFF adjustment adjustment adjustment 1.00 0.96 0.99 1.01 1.12 0.88 1.00 0.91 0.94 0.97 0.87 1.04 1.00 0.96 0.99 0.95 0.90 1.04 0.92 0.99 0.99 1.01 0.94 1.02 1.04 1.08 0.99 1.02 1.03 0.90 1.07 1.06 0.82 1.14 0.99 0.99 1.25 0.81 0.86 0.80 1.48 1.16 1.10 1.00 0.93 1.07 1.17 1.14 0.84 1.05 0.85 0.82 1.16 0.95 0.79 0.89 0.88 1.28 0.76 0.75 0.94 1.00 0.95 1.01 0.93 0.98 0.96 1.21 1.01 1.20 1.12 0.96 1.15 0.96 0.97 0.97 0.97 0.96 1.11 0.95 1.04 1.02 1.00 0.93 1.01 0.96 0.97 0.93 0.96 1.02 1.03 1.03 0.94 Prescribing component Additional EACA Age need adjustment adjustment adjustment 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.99 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.99 1.00 1.00 1.00 1.00 0.99 0.99 1.00 1.00 1.17 0.82 1.03 0.87 0.90 0.97 0.79 1.08 0.98 0.90 0.98 0.90 0.85 1.08 0.88 1.02 1.02 1.03 0.94 1.06 1.06 1.13 0.99 1.04 1.05 0.88 1.09 1.04 0.88 1.10 0.99 0.99 1.17 0.87 0.98 0.88 1.39 1.08 1.09 0.99 0.96 1.01 1.09 1.05 0.90 1.02 0.90 0.88 1.12 0.94 0.86 0.92 0.93 1.20 0.86 0.84 0.96 1.04 Primary medical services component Additional Age need MFF adjustment adjustment adjustment 1.00 0.98 1.00 1.00 1.12 0.87 1.02 0.90 0.93 0.98 0.85 1.05 1.00 0.93 0.99 0.95 0.90 1.04 0.92 1.00 1.00 1.01 0.95 1.03 1.04 1.08 0.99 1.03 1.04 0.91 1.06 1.04 0.89 1.07 0.95 0.97 1.13 0.89 0.94 0.91 1.22 1.10 1.06 1.01 0.98 1.04 1.08 1.06 0.92 1.02 0.90 0.87 1.11 0.98 0.88 0.92 0.90 1.20 0.88 0.85 0.95 1.02 0.98 0.99 0.96 0.99 0.98 1.13 0.99 1.16 1.05 1.01 1.10 0.99 0.99 0.99 0.99 1.00 1.06 0.96 1.01 0.99 0.97 0.97 0.99 0.97 0.98 0.96 1.00 1.00 1.00 1.01 0.97
Code 5LJ 5GF 5G7 5JQ 5DG 5K8 5K4 5LA 5A5 5J4 5LD 5KN 5HJ 5HM 5HH 5EJ 5LF 5D3 5GC 5L2 5GL 5AM 5L3 5EH 5FX 5FV 5KM 5E9 5FK 5CQ 5DD
PCT Hudderseld Central Huntingdonshire Hyndburn and Ribble Valley Ipswich Isle of Wight Islington Kennet and North Wiltshire Kensington and Chelsea Kingston Knowsley Lambeth Langbaurgh Leeds North East Leeds North West Leeds West Leicester City West Lewisham Lincolnshire South West Teaching Luton Maidstone Weald Maldon and South Chelmsford Manseld District Medway Melton, Rutland and Harborough Mendip Mid Devon Middlesbrough Mid-Hampshire Mid-Sussex Milton Keynes Morecambe Bay
Table 51 (Continued) 200708 WEIGHTED CAPITATION FORMULA ADJUSTMENTS HCHS component Additional Age need MFF adjustment adjustment adjustment 1.15 1.03 0.98 0.99 1.04 0.85 1.09 1.03 1.00 1.09 1.11 1.02 0.96 1.04 0.96 0.99 0.95 1.03 0.98 0.95 1.20 0.96 0.98 1.08 1.02 1.02 0.98 1.04 0.99 0.97 0.98 1.05 1.03 0.94 0.80 0.98 0.80 1.22 1.02 1.38 0.94 0.96 1.08 0.96 0.81 1.06 0.78 1.08 0.83 0.90 1.13 1.00 1.49 1.52 0.89 1.13 1.31 0.88 1.24 0.80 1.07 1.10 1.01 0.97 0.97 1.00 1.04 1.20 0.99 0.93 1.07 0.95 0.92 1.11 0.92 0.97 0.95 0.92 0.95 0.94 1.04 0.93 1.06 1.05 0.95 0.94 0.95 0.97 0.94 0.99 0.95 0.99 0.92 1.12 0.95 0.94 0.99 1.00 0.98 0.94 0.94 0.96 Prescribing component Additional EACA Age need adjustment adjustment adjustment 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.99 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.99 1.00 1.00 1.00 1.00 1.01 1.00 1.00 1.19 1.06 0.99 0.96 1.05 0.77 1.15 1.03 1.00 1.15 1.15 1.03 0.96 1.07 0.97 0.98 0.94 1.06 0.97 0.92 1.28 0.94 0.97 1.10 1.03 1.02 0.99 1.05 1.02 0.96 0.99 1.10 0.99 0.87 0.88 0.99 0.87 1.16 1.02 1.19 0.95 0.96 1.02 0.97 0.88 0.99 0.85 1.06 0.88 0.92 1.05 0.97 1.39 1.37 0.94 1.06 1.15 0.95 1.16 0.87 1.06 1.06 0.99 0.96 0.96 1.02 1.04 1.12 Primary medical services component Additional Age need MFF adjustment adjustment adjustment 1.14 1.03 0.98 0.98 1.03 0.86 1.09 1.03 1.01 1.09 1.11 1.02 0.97 1.04 0.97 0.99 0.97 1.03 0.99 0.95 1.19 0.96 0.99 1.07 1.01 1.02 0.98 1.04 1.00 0.97 0.99 1.05 1.00 0.92 0.87 1.01 0.88 1.14 1.03 1.15 0.96 0.98 1.04 0.96 0.88 1.04 0.87 1.06 0.90 0.93 1.05 1.01 1.22 1.34 0.94 1.06 1.14 0.93 1.16 0.89 1.06 1.05 1.01 0.99 0.98 1.02 1.02 1.14 0.98 0.97 1.01 0.99 0.96 1.07 0.95 0.99 0.98 0.96 0.97 0.98 1.00 0.97 1.02 1.00 0.98 0.97 1.01 1.03 0.96 1.00 0.99 0.98 0.97 1.04 0.98 0.97 0.99 1.00 0.98 0.97 0.98 1.00
Code 5A1 5AP 5DK 5D7 5HW 5C5 5KR 5MW 5CH 5FQ 5CD 5AN 5DT 5EG 5DF 5GH 5J7 5EF 5G9 5CR 5JM 5AF 5EE 5M8 5ME 5L6 5E1 5D8 5MP 5LW 5LV TAC 5A2 5EM
PCT New Forest Newark and Sherwood Newbury and Community Newcastle Newcastle-under-Lyme Newham North and East Cornwall North Birmingham North Bradford North Devon North Dorset North East Lincolnshire North East Oxfordshire North Eastern Derbyshire North Hampshire North Hertfordshire and Stevenage North Kirklees North Lincolnshire North Liverpool North Manchester North Norfolk North Peterborough North SheYeld North Somerset North Stoke North Surrey North Tees North Tyneside North Warwickshire Northampton Northamptonshire Heartlands Northumberland Care Trust Norwich Nottingham City
Table 51 (Continued) 200708 WEIGHTED CAPITATION FORMULA ADJUSTMENTS HCHS component Additional Age need MFF adjustment adjustment adjustment 0.99 0.96 0.95 1.01 1.12 0.98 0.98 0.93 0.95 0.99 0.93 0.95 1.00 1.00 0.96 1.01 1.02 0.98 1.12 1.01 1.02 1.06 0.95 1.08 1.06 0.92 1.03 1.10 1.20 0.97 1.00 0.98 1.04 1.23 1.23 0.85 1.05 0.88 1.03 1.12 0.87 0.97 0.92 0.76 1.23 1.15 1.20 0.76 0.89 0.80 1.29 0.94 1.19 0.87 0.91 1.00 0.97 0.90 1.03 0.90 0.94 0.83 1.12 0.74 0.83 0.75 0.98 0.95 1.04 0.94 0.98 1.00 0.94 1.09 1.06 0.97 1.13 0.95 0.93 0.96 1.06 1.01 0.96 0.97 0.94 0.94 0.96 0.95 0.95 0.99 0.94 1.10 1.00 0.95 0.97 1.00 1.05 1.07 1.07 Prescribing component Additional EACA Age need adjustment adjustment adjustment 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.99 1.00 1.00 1.00 0.97 0.95 0.88 1.02 1.13 0.96 0.98 0.89 0.92 1.01 0.90 0.95 1.01 1.00 0.97 1.02 1.03 0.96 1.17 1.04 1.02 1.07 0.89 1.11 1.10 0.87 1.04 1.15 1.24 0.93 1.02 0.99 1.07 1.08 1.13 0.92 1.05 0.92 0.99 1.09 0.91 0.98 0.93 0.86 1.16 1.08 1.05 0.85 0.91 0.88 1.21 0.95 1.16 0.92 0.94 0.99 0.99 0.93 0.97 0.94 0.96 0.89 1.06 0.84 0.89 0.83 Primary medical services component Additional Age need MFF adjustment adjustment adjustment 0.99 0.97 0.92 1.02 1.11 0.98 0.98 0.92 0.95 1.00 0.94 0.97 1.01 1.01 0.97 1.01 1.02 0.98 1.11 1.02 1.02 1.06 0.92 1.08 1.06 0.92 1.03 1.10 1.18 0.97 1.01 0.99 1.05 1.14 1.15 0.95 1.05 0.93 1.04 1.09 0.93 0.97 0.95 0.88 1.12 1.08 1.10 0.86 0.94 0.91 1.18 0.97 1.13 0.92 0.95 1.01 1.02 0.94 1.01 0.94 0.94 0.88 1.07 0.86 0.88 0.87 1.00 0.98 1.03 0.98 0.98 1.00 0.98 1.04 1.02 0.98 1.05 0.98 0.97 0.98 1.01 0.99 0.97 1.00 0.97 0.98 0.97 0.97 0.97 0.99 0.96 1.05 1.00 0.97 0.97 1.01 1.00 1.01 1.01
Code 5MG 5J5 5DW 5F1 5KV 5FE 5HD 5DL 5NA 5MR 5M6 5JY 5H8 5MH 5GK 5M9 5FC 5F5 5KK 5KE 5E2 5EP 5EN 5LP 5M2 5DM 5D1 5FW 5FN 5M1 5JJ 5GJ 5DX
PCT Oldbury and Smethwick Oldham Oxford City Plymouth Teaching Poole Portsmouth City Teaching Preston Reading Redbridge Redditch and Bromsgrove Richmond and Twickenham Rochdale Rotherham Rowley Regis and Tipton Royston, Buntingford and Bishops Stortford Rugby RushcliVe Salford Scarborough, Whitby and Ryedale Sedgeeld Selby and York SheYeld South West SheYeld West Shepway Shropshire County Slough Solihull Somerset Coast South and East Dorset South Birmingham South Cambridgeshire South East Hertfordshire South East Oxfordshire
Table 51 (Continued) 200708 WEIGHTED CAPITATION FORMULA ADJUSTMENTS HCHS component Additional Age need MFF adjustment adjustment adjustment 1.01 0.98 1.12 0.96 0.97 1.03 1.03 0.96 0.97 1.00 1.09 1.01 1.04 1.03 1.13 1.03 0.99 1.05 1.05 1.04 0.97 1.06 1.06 1.13 0.89 0.97 1.00 1.04 1.02 1.13 1.02 1.21 0.83 0.86 0.89 1.12 0.82 1.29 1.30 0.91 1.21 0.87 1.17 1.23 0.82 0.91 0.80 0.79 0.84 0.83 0.87 1.03 0.96 0.85 0.95 1.26 0.76 1.20 0.97 0.96 0.81 0.84 0.94 1.01 0.93 0.95 0.97 0.96 0.96 1.00 0.99 0.95 0.94 0.92 0.94 1.00 0.93 1.02 1.04 0.94 0.98 0.97 1.01 0.98 0.95 0.93 1.15 1.08 0.96 0.93 0.98 0.98 0.99 Prescribing component Additional EACA Age need adjustment adjustment adjustment 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.01 0.99 1.19 0.97 0.96 1.05 1.03 0.89 0.98 1.02 1.13 1.02 1.05 1.04 1.18 1.04 1.01 1.09 1.09 1.07 0.92 1.04 1.11 1.16 0.83 0.96 1.03 1.09 1.03 1.17 1.06 1.10 0.90 0.92 0.93 1.04 0.88 1.25 1.22 0.93 1.19 0.90 1.14 1.15 0.88 0.96 0.87 0.86 0.90 0.90 0.91 1.01 0.96 0.90 0.99 1.13 0.87 1.18 1.00 0.98 0.89 0.89 Primary medical services component Additional Age need MFF adjustment adjustment adjustment 1.01 0.98 1.12 0.97 0.97 1.03 1.04 0.94 0.98 1.01 1.09 1.01 1.03 1.03 1.13 1.03 1.00 1.05 1.07 1.04 0.95 1.05 1.07 1.12 0.89 0.98 1.01 1.04 1.02 1.12 1.04 1.09 0.88 0.89 0.94 1.07 0.89 1.14 1.17 0.94 1.11 0.91 1.11 1.12 0.90 0.94 0.88 0.87 0.94 0.90 0.92 1.03 0.99 0.91 1.01 1.10 0.87 1.12 1.01 0.98 0.91 0.91 0.98 0.99 0.95 0.96 1.00 0.97 1.01 1.02 0.98 0.98 0.96 0.97 0.98 0.99 0.96 1.00 1.00 0.96 0.98 0.97 1.01 0.98 0.96 0.95 1.12 1.02 0.99 0.96 0.99 0.97 0.98
Code 5EQ 5A3 5CV 5LK 5HL 5JD 5HC 5AA 5AG 5M5 5K1 5MF 5KG 5MQ 5FP 5FF 5DY 5MN 5DJ 5MT 5L1 5AK 5G1 5F9 5LE 5GX 5J3 5HR 5F7 5JR 5JW
PCT South East SheYeld South Gloucestershire South Hams and West Devon South Hudderseld South Leeds South Leicestershire South Liverpool South Manchester South Peterborough South Sefton South Somerset South Stoke South Tyneside South Warwickshire South West Dorset South West Kent South West Oxfordshire South Western StaVordshire South Wiltshire South Worcestershire Southampton City Southend on Sea Southern Norfolk Southport and Formby Southwark St Albans and Harpenden St Helens StaVordshire Moorlands Stockport SuVolk Coastal SuVolk West
Table 51 (Continued) 200708 WEIGHTED CAPITATION FORMULA ADJUSTMENTS HCHS component Additional Age need MFF adjustment adjustment adjustment 0.99 0.98 1.06 0.95 0.97 0.96 0.98 1.06 1.12 0.95 1.20 0.95 1.13 0.84 0.96 1.02 1.00 0.97 0.99 1.00 0.90 0.89 0.98 0.98 1.12 1.00 1.01 1.03 1.01 0.99 1.25 0.75 0.82 0.89 0.99 0.94 1.16 0.91 0.93 1.07 1.01 1.00 1.05 1.44 1.12 0.89 0.75 0.80 1.02 1.18 1.13 0.98 1.01 0.84 0.98 1.22 0.89 1.06 0.95 1.15 0.94 1.11 1.00 1.10 1.00 1.03 0.96 0.94 0.90 0.94 0.98 1.04 0.90 1.18 1.00 1.00 1.05 1.05 0.95 0.94 1.08 1.14 0.97 1.09 0.94 0.97 1.06 0.94 0.98 0.93 Prescribing component Additional EACA Age need adjustment adjustment adjustment 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.01 0.99 1.10 0.91 0.99 0.95 0.98 1.08 1.16 0.95 1.24 0.94 1.17 0.73 0.94 1.02 1.04 0.98 1.01 1.01 0.85 0.81 0.99 0.96 1.15 0.98 0.98 1.07 1.03 0.98 1.19 0.85 0.88 0.92 0.98 0.94 1.10 0.95 0.96 1.04 1.01 0.97 1.05 1.24 1.09 0.94 0.84 0.87 1.02 1.06 1.04 0.98 1.02 0.89 0.99 1.10 0.93 1.06 0.96 1.08 Primary medical services component Additional Age need MFF adjustment adjustment adjustment 1.00 0.99 1.07 0.95 0.99 0.96 0.98 1.06 1.12 0.96 1.18 0.95 1.12 0.83 0.97 1.02 1.01 0.98 0.99 1.01 0.90 0.88 0.98 0.98 1.11 1.00 1.00 1.03 1.02 0.98 1.15 0.87 0.88 0.94 1.01 0.96 1.11 0.93 0.94 1.03 1.01 0.98 1.00 1.16 1.09 0.94 0.86 0.88 1.05 1.09 1.05 0.99 1.01 0.92 0.98 1.11 0.93 1.04 0.97 1.11 0.98 1.04 0.99 1.05 0.99 1.01 0.98 0.96 0.95 0.97 0.98 1.01 0.95 1.13 1.00 1.00 0.99 1.01 0.98 0.98 1.04 1.08 0.98 1.03 0.97 0.99 1.02 0.97 0.98 0.99
Code 5KL 5L7 5LT 5M7 5L4 5K3 5LH 5K2 5FY 5MK 5AH 5GQ 5CW 5C4 5F6 5CX 5GN 5DP 5E8 5M3 5NC 5LG 5J2 5GV 5JV 5MJ 5GG 5D6 5KX 5E6
PCT Sunderland Teaching Surrey Heath and Woking Sussex Downs and Weald Sutton and Merton Swale Swindon Tameside and Glossop Taunton Deane Teignbridge Telford and Wrekin Tendring Thurrock Torbay Tower Hamlets TraVord North TraVord South Uttlesford Vale of Aylesbury Wakeeld West Walsall Teaching Waltham Forest Wandsworth Warrington Watford and Three Rivers Waveney Wednesbury and West Bromwich Welwyn Hateld West Cumbria West Gloucestershire West Hull
Table 51 (Continued) 200708 WEIGHTED CAPITATION FORMULA ADJUSTMENTS HCHS component Additional Age need MFF adjustment adjustment adjustment 1.00 1.03 1.11 1.08 1.03 1.16 0.90 0.98 0.99 0.95 1.01 0.97 1.12 1.05 1.08 1.05 0.99 0.95 1.07 0.87 0.84 0.91 0.74 0.87 0.71 1.17 0.83 0.98 0.92 0.92 0.93 0.93 0.95 0.90 1.00 1.00 1.21 1.11 1.00 1.10 0.95 1.07 0.92 0.96 0.94 Prescribing component Additional EACA Age need adjustment adjustment adjustment 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.03 1.05 1.18 1.14 1.05 1.20 0.83 0.98 1.00 0.97 1.00 0.97 1.16 1.10 1.15 1.05 0.99 0.96 1.04 0.91 0.90 1.00 0.83 0.91 0.83 1.09 0.88 1.00 0.95 0.95 Primary medical services component Additional Age need MFF adjustment adjustment adjustment 1.01 1.03 1.12 1.09 1.04 1.15 0.86 0.99 0.99 0.97 1.01 0.98 1.11 1.05 1.08 1.04 1.00 0.97 1.00 0.91 0.92 1.02 0.86 0.90 0.83 1.10 0.89 1.02 0.96 0.97 0.97 0.96 0.97 0.95 0.98 0.99 1.17 1.04 0.98 1.03 0.99 1.03 0.96 0.97 0.97
Code 5F3 5D2 5CY 5FM 5DH 5L9 5LC 5G3 TAG 5DN 5MV 5G5 5HF 5DR 5E4
PCT West Lancashire West Lincolnshire West Norfolk West of Cornwall West Wiltshire Western Sussex Westminster Windsor, Ascot and Maidenhead Witham, Braintree and Halstead Care Trust Wokingham Wolverhampton City Wycombe Wyre Wyre Forest Yorkshire Wolds and Coast
Source: 200607 and 200708 PCT revenue resource limits exposition book available at www.dh.gov.uk/allocations
4.3 Pharmaceutical Expenditure 4.3.1 What was pharmaceutical expenditure in each year from 199798 to 200506, by sector and generic/ branded drugs? (Q52) Answer 1. Total NHS net expenditure on medicines and listed appliances in England is given in Table 52a. In 200506, the total spent on prescriptions dispensed in the community was 7,215 millionthis is a provisional gure and has yet to be nalised. Resource gures are not available prior to 200102. 2. In cash terms, total NHS net expenditure on medicines and listed appliances relating to prescriptions dispensed in the community in England in 200506 was 7,232 million. Again, this is a provisional gure and has yet to be nalised. Table 52a NHS NET EXPENDITURE ON MEDICINES AND LISTED APPLIANCES, ENGLAND (RESOURCES) millions Total NHS net Total NHS net expenditure relating to expenditure relating prescriptions to medicines supplied dispensed in the in a secondary care community setting 5,707 6,342 6,961 7,370 7,215(1) 1,740 2,013 2,311 2,595 n/a(2) Total NHS net expnditure on medicines and listed appliances 7,447 8,355 9,272 9,965 n/a(2)
Year 200102 200203 200304 200405 200506
Footnotes: 1. Figure provisional and not yet nalised. 2. Figure not yet available. 3. Historical NHS Drug Bill expenditure gures (in cash terms), broken down by sector, for the nancial years 199798 to 200506 is provided in the Table 52b. Table 52b DRUGS BILL EXPENDITURE FIGURES (CASH) millions Total NHS net Total NHS net expenditure relating to expenditure relating prescriptions to medicines supplied dispensed in the in a secondary care community setting 4,085 4,339 4,833 5,161 5,552 6,209 6,799 7,340 7,232(1) 1,088 1,211 1,369 1,530 1,740 2,013 2,308 2,635 n/a(2) Total NHS net expnditure on medicines and listed appliances 5,173 5,550 6,202 6,691 7,292 8,222 9,107 9,975 n/a(2)
Year 199798 199899 19992000 200001 200102 200203 200304 200405 200506
Footnotes: 1. Figure provisional and not yet nalised. 2. Figure not yet available.
4. For prescriptions dispensed in the community in England, a breakdown between branded medicines, generic medicines, dressings and listed appliances for the nancial years 199798 to 200506 is provided in Table 52c. The table shows both the cost (expressed in terms of net ingredient cost) and the volume (number of prescription items) for each category. In 200506, branded drugs dispensed represent about 70% of the total net ingredient cost (inc. the cost of dressings and appliances). In 200506, the share of prescription items written generically was 80%, and the share of prescription items dispensed generically was 59%. Table 52c NUMBER AND NET INGREDIENT COST OF GENERIC AND PROPRIETARY PRESCRIPTION ITEMS DISPENSED IN THE COMMUNITY 199798 TO 200506 millions Drugs dispensed generically NIC Prescription items 651 703 1,049 1,077 1,079 1,397 1,799 2,054 2,042 230 240 254 284 300 325 359 392 427 Drugs dispensed as proprietary NIC Prescription items 3,574 3,845 4,116 4,283 4,886 5,275 5,488 5,633 5,523 260 261 265 261 275 282 282 281 286 Dressings and Appliance NIC Prescription items 240 251 270 291 316 346 378 407 449 15 15 15 16 17 17 18 19 20
Financial Year 199798 199899 19992000 200001 200102 200203 200304 200405 200506
Footnotes: 1. PCA, Prescription Pricing Division, England. Figures are for prescription items dispensed by chemists and appliance contractors and dispensing doctors including items personally administered in England, for nancial years (April to March). Note that in addition to prescriptions written by GPs in England, this includes those written by nurses, dentists, hospital doctors, (and, up to March 1994, armed services doctors and dentists) provided they were dispensed in the community. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England. The data do not cover drugs dispensed in hospital, mental health trusts or private prescriptions. Please note data for 200102 in the previous HSC was incorrect due to errors in Prescription Cost Analysis (PCA). The data has now been revised. 2. The net ingredient cost (NIC) is the basic cost of a drug. This cost does not take account of discounts, dispensing costs, fees or prescription charge income. All gures are expressed at outturn prices. 3. Generic dispensing covers drugs that are prescribed and available generically and the dispenser is reimbursed at the Drug TariV or generic price. It is possible in some circumstances for a branded drug or parallel import to be dispensed against the prescription. 4. The Department collects data on secondary care prescribing through NHS Trust and Health Authority nancial returns. On an annual basis, these high level aggregate returns enable it to monitor the pressure faced by local NHS organisations and the aggregate cost to the NHS as a whole. More detailed information is available to Trusts at a local level from hospital pharmacy IT systems. This is primarily used to monitor local spending on pharmaceuticals together with adherence to local policies aimed at ensuring the cost eVective use of medicines. 5. Pharmacy in the Future, the modernisation programme for pharmacy services in England made a commitment to secure better use of medicines in the NHS and the Audit Commission published their report A Spoonful of Sugar in December 2001 with recommendations. 6. Since then, the Department and the National Prescribing Centre (NPC) have been helping NHS organisations improve their medicines management services through the revised Medicines Management Framework and the National Collaborative Medicines Management Service Programme. The central aim is to ensure that clinicians, pharmacists and nancial planners work more closely together across local health economies to involve patients in decisions about their medicines so they know how to use them more eVectively to reduce avoidable ill health and waste. 7. The Medicines Management Services Collaborative (MMSC) has worked with 146 PCTs throughout England. The Hospital Medicines Management Collaborative (HMMC) has 44 Trusts currently participating in the programme, the Community Pharmacy Framework Collaborative (CPFC) has 28 host PCTs participating in the programme together with a number of associate PCTs and the Integrated Medicines Management Programme (IMMP) currently has 25 Trusts participating.
4.4 National Specialist Services (NSCAG) 4.4.1 Could the Department detail actual and planned expenditure on supra-regional and centrally commissioned services in each year from 200304 to 200708? (Q53) Answer 1. Actual expenditure between 200304 and 200506 is given in Table 53. Full details of planned expenditure for 200607 should be available by the end of September. 200708 information can be provided when nal budgets are conrmed and negotiations with Trusts are complete. We would expect this to be early in nancial year 200708.
Table 53 SUPRA REGIONAL SERVICES AND CENTRALLY COMMISSIONED SERVICES 200304, 200405 AND 200506
thousands Organisation code RAL RP4 RW3 RXT RNP RXV RKL RW1 RV5 RP4 RT3 RHQ RGM RM2 RTD RRK RHQ RQN RTH RP4 RQ3 RBS RQY 5E2 RQY 5HV RWE RTD RP4 RWE RRV RAN RRJ Total expenditure 200304 Provider Service funding funding 1,518 930(1) 362 4,302 3,513 3,867 1,518 1,292 Total expenditure 200405 Provider Service funding funding 1,770 972 400 3,437 3,817 4,234 327 284 539 3,192 11,420 1,171 6,863 3,714 4,579 2,814 649 1,420 1,811 1,656 1,697 1,202 1,579 250 87 142 2,813 675 1,480(1) 2,145 2,203 3,243 3,678 2,813 4,300 3,491 639 1,984 2,298 2,070 3,778 3,937 1,770 1,372 Service agreement 200506 Provider Service funding funding 2,019 1,025 424 5,582 4,966 3,869 1,117 1,262 12,638 1,758 514 3,593 11,889 1,180 7,120 4,015 4,989 33,753 687 2,069 1,967 6,366 1,579 1,741 1,878 1,342 1,369 263 119 135 3,731 638 1,900 2,396 6,928 1,369 19,068 2,019 1,449
NHS provider unit Royal Free Hospital, London Great Ormond Street Hospital, London Manchester Childrens Hospital Ardenleigh Unit, Birmingham Roycroft Unit, Newcastle upon Tyne Gardener Unit, Manchester Wells Unit, West London Hampshire Partnership NHS Trust South London & Maudsley NHS Trust St Andrews Hospital Great Ormond Street Hospital, London Royal Brompton & Hareeld, London Northern General Hospital, SheYeld Papworth Hospital, Cambridge Wythenshawe Hospital, Manchester Freeman Hospital, Newcastle upon Tyne Queen Elizabeth Hospital, Birmingham Weston Park Hospital, SheYeld Charing Cross Hospital, London John RadcliVe Hospital, Oxford Great Ormond Street Hospital, London Birmingham Childrens Hospital Alder Hey Childrens Hospital, Liverpool Springeld Hospital, London Selby & York PCT Springeld Hospital, London Dudley, Beacon & Castle PCT Gleneld Hospital, Leicester Freeman Hospital, Newcastle upon Tyne Great Ormond Street Hospital, London Gleneld Hospital, Leicester University College Hospital, London Royal National Orthopaedic Hospital, Stanmore Royal Orthopaedic Hospital, Birmingham
Service agreements Amyloidosis Bladder Exstrophy Mental Health Forensic Secure Service for Adolescents
11,682
Heart and Lung Transplantation
2,721(1) 10,541 1,600 6,410 3,250 4,336 2,459 640 1,361 1,759 1,460(1) 1,513 1,042 1,791
31,317 2,001
2,929 1,496
35,715 2,183
Choriocarcinoma Craniofacial Surgery
5,774 1,791
Inpatient Psychiatric Service for Deaf Children and Adolescents Deaf Telemental Health
479 3,491 4,921
517 3,731 4,934
ECMO (Adult) ECMO (Neonates and Infants)
ENDO (3)
9,124
9,785
Table 53 (continued) SUPRA REGIONAL SERVICES AND CENTRALLY COMMISSIONED SERVICES 200304, 200405 AND 200506 (continued)
thousands Organisation code RP4 RQ3 RJ1 RR1 RGT RP4 RW3 RAL RJ5 RQN RM3 RV8 RGT RJZ RRK RR8 RAL RTD RQ3 RJZ RR8 RQN RTD RTH RRV RQ6 RNJ RHQ RP4 RTD RJZ RQ3 RR8 RN5 RBV Total expenditure 200304 Provider Service funding funding 616 316 470 163 529 152(1) 80 320 365 268 6,120 3,966 4,837 8,185 8,665 4,918 3,049 2,897 2,994 3,181 2,367 336 544 148 164 936 433 1,172 557 556 5,042 1,939 1,923 2,996 1,409 932 633 Total expenditure 200405 Provider Service funding funding 682 423 492 271 552 167 93 371 588 322 6,639 4,128 4,950 8,718 9,226 5,352 3,218 3,232 3,348 3,387 2,973 461 602 181 294 1,098 505 1,339 601 600 5,631 2,112 2,075 3,402 2,144 1,105 763 Service agreement 200506 Provider Service funding funding 725 404 601 322 1,129 923
NHS provider unit Great Ormond Street Hospital, London Birmingham Childrens Hospital St Thomas Hospital, London Birmingham Heartlands Hospital Addenbrookes Hospital, Cambridge Great Ormond Street Hospital, London Manchester Childrens Hospital Royal Free Hospital, London St Marys Hospital, London Queen Charlottes Hospital, London Hope Hospital, Salford St Marks Hospital, London Addenbrookes Hospital, Cambridge Kings College Hospital, London Queen Elizabeth Hospital, Birmingham St Jamess University Hospital, Leeds Royal Free Hospital, London Freeman Hospital, Newcastle upon Tyne Birmingham Childrens Hospital Kings College Hospital, London St Jamess University Hospital, Leeds Hammersmith Hospital, London Royal Victoria Inrmary, Newcastle upon Tyne John RadcliVe Hospital, Oxford University College Hospital, London Royal Liverpool University Hospital St. Bartholomews Hospital, London Royal Hallamshire Hospital, SheYeld Great Ormond Street Hospital, London Freeman Hospital, Newcastle upon Tyne Kings College Hospital, London Birmingham Childrens Hospital St Jamess University Hospital, Leeds North Hampshire Hospital, Basingstoke The Christie Hospital, Manchester
Service agreements Epidermolysis Bullosa (Paediatric) Epidermolysis Bullosa (Adult) Gauchers (4)
1,081 365 268
1,183 588 322 331 7,173 5,108 5,522 8,957 9,644 5,532 3,392 3,481 3,375 3,687 2,668 524 693 199 433 1,166 537 1,294 634 635 6,298 2,250 2,837 4,705 1,743 331
HTLV (6) Reconstructive Surgery in Adolescents for Congenital Malformation of the Female Genital Tract Intestinal Failure Adult Liver Transplantation
10,086
10,767
12,281
32,551
34,696
36,528
Paediatric Liver Transplantation
8,542
9,708
9,730
Neuromuscular
1,192
1,538
1,849
Ocular Oncology
2,541 1,113
2,942 1,201
2,997 1,269
Paediatric Ventricular Assist Devices (Bridge to TransplantationVADS or ECMO) Paediatric Liver and Complex Hepatobiliary Pseudomyxoma Peritonei
8,904 4,405
9,818 5,546
11,385 6,448
thousands Total expenditure 200304 Provider Service funding funding 1,573 1,254 963 3,499 4,189(1) 2,301 1,891 2,019 964 477 163,355 1,511 0 120 51 Pancreas Transplants (2) 171 1,573 2,217 7,688 Total expenditure 200405 Provider Service funding funding 1,807 1,493 1,073 3,789 3,560 2,599 2,104 2,409 1,608 565 179,407 2,449 0 0 56 3,250 56 3,250 5,545 5,545 1,807 2,566 7,349 Service agreement 200506 Provider Service funding funding 2,339 1,496 1,042 4,366 4,172 2,649 2,256 2,537 1,734 185,374 3,044 112 2,339 2,538 8,538
Organisation code RGM RNJ RQ3 RTD RP4 RQY RXT RXV RQ3 RNJ
NHS provider unit Papworth Hospital, Cambridge St Bartholomews Hospital, London Birmingham Childrens Hospital Freeman Hospital, Newcastle upon Tyne Great Ormond Street Hospital, London Henderson Hospital, London Main House, Birmingham Webb House, Salford Birmingham Childrens Hospital Royal London Hospital
Service agreements Pulmonary Thrombo Endarterectomy Retinoblastoma SCIDS Personality Disorder
6,211 964 477 163,355 1,511 0
7,112 1,608 565 179,407 2,449 0
7,442 1,734 185,374 3,044 112
Small Bowel Transplantation (Paediatric) Total Anorectal Reconstruction (6) Sub Total Service Agreements OTHER
Papworth Hospital, Cambridge, Hareeld Hospital, Middlesex, and Freeman Hospital, Newcastle RGT RTD RP4 Addenbrookes Hospital, Cambridge Freeman Hospital, Newcastle upon Tyne Great Ormond Street Hospital, London Freeman Hospital, Newcastle upon Tyne/ Royal Liverpool University Hospital/ Manchester Royal Inrmary/ Addenbrookes Hospital, Cambridge/ St Marys Hospital, London/ Churchill Hospital, Oxford/ Guys Hospital, London
Adult Ventricular Assist Devices (2) Small Bowel Transplantation (Adult) (2) Paediatric Rheumatology Transplants (2) (5)
Sub Total Other Total Existing Service NEW SERVICES RTD RP4 RWE Freeman Hospital, Newcastle upon Tyne Great Ormond Street Hospital, London Gleneld Hospital, Leicester ECMO (Paediatrics)
171 165,037
171 165,037
5,755 185,162
5,755 185,162
8,701 194,075 323 665 1,330
8,701 194,075
2,318
thousands Organisation code RGT RP4 RW3 RAL RM3 RRV RW3 RQ6 RHQ RRV RAN RRJ RVJ RTD RL1 RBF Total expenditure 200304 Provider Service funding funding Total expenditure 200405 Provider Service funding funding Service agreement 200506 Provider Service funding funding 1,372 717 1,078 1,015 520 608 44,979 212 260 167 507 1,246 3,706 6,367 332 2,059 705 770 0 165,037 0 165,037 0 185,162 0 185,162 68,938 263,013
NHS provider unit Addenbrookes Hospital, Cambridge Great Ormond Street Hospital, London Manchester Childrens Hospital Royal Free Hospital, London Hope Hospital, Salford University College Hospital, London All LSD centres Central Manchester & Manchester Childrens Hospital Royal Liverpool University Hospital Royal Hallamshire Hospital, SheYeld Institute of Ophthalmology, London University College Hospital, London Royal National Orthopaedic Hospital, Stanmore Royal Orthopaedic Hospital, Birmingham Southmead Hospital, Bristol Freeman Hospital, Newcastle upon Tyne Robert Jones & Agnes Hunt Hospital, Oswestry NuYeld Orthopaedic Centre, Oxford
Service agreements Lysosomal Storage Disorders Service
5,310 44,979
Lysosomal Storage Disorders ERT Drugs Ophthalmic Pathology
1,146
Primary Malignant Bone Tumours
15,185 68,938 263,013
Sub Total New Serices TOTAL Source: Record of payments made to NHS providers of national specialist services. Footnotes: 1. Remapping between commissioners has taken place. 2. This service is funded on a cost per case basis. 3. From 200506 this service is funded as part of the Primary Malignant Bone Tumour Service. 4. From 200506 this service is funded as part of the Lysosomal Storage Disorder Service. 5. From 200506 this service is funded as part of the SCID Service. 6. This service has been returned to PCT commissioning from April 2005.
4.5 Community Care (Q54Q55) 4.5.1 What has net expenditure by central and local government on community care been in each year since 199798? Can the data be broken down by residential and on-residential care and include social security and housing expenditure contributing to community care objectives? (Q54) Answer 1. Table 54 provides details of central and local government net expenditure on services for community care in England between 199798 and provisionally, in most cases, 200506. All gures have been adjusted to 200405 prices using the latest Gross Domestic Product deator. 2. Community care expenditure is taken to mean expenditure on non-residential and residential care provided or arranged by local authorities for adults; community health services provided by the NHS for adults; certain social security benets which support community care objectives; and certain expenditure on housing. 3. Comparison of the data in Table 54 from 200405 onwards is aVected as a consequence of discontinued data collection in respect to community health expenditure. From 200405 the data required to calculate hospital and community health services expenditure by service sector ceased to be collected. Instead, the Department of Health initiated a replacement data collection to collect expenditure on a programme budgeting basis. 4. Furthermore, the publication of Local Authority domicilary care and residential care expenditure data at Lines A and C are not yet available. This is anticipated to be published in January 2007.
Table 54 NET EXPENDITURE BY CENTRAL AND LOCAL GOVERNMENT ON COMMUNITY CARE 199798 A. Local Authority Domiciliary Care (1) (2) (3) Assessment and Care Management Direct Payments Home Care Day Care for Older People Day Care for Other Adults Equipment and Adapatations Meals Other Services Community Health (4) Chiropody Family Planning Immunisation & Surveillance Screening Professional Advice & Support General Patient Care Community MI Nursing Community LD Nursing Community Maternity Health Promotion Community Dental Services to GPs Other CHS Total B Total A plus B 81 52 3 53 93 905 495 330 0 48 0 190 260 2,510 5,632 91 60 3 61 115 998 551 366 0 55 0 220 328 2,848 6,130 109 73 4 74 130 1,087 700 426 229 64 107 305 423 3,728 7,298 117 80 4 80 132 1,061 798 447 207 66 116 373 487 3,969 7,714 150 99 3 94 61 785 815 410 299 31 75 484 481 3,786 7,801 215 132 2 136 40 729 892 434 168 62 188 720 876 4,594 8,926 209 123 2 149 48 686 981 512 193 75 169 713 1,008 4,870 9,716 5,465 199899 19992000 200001 200102 200203 200304 200405 200506 (provisional)
Total A B.
779 1,207 171 497 73 47 468 3,122
810 10 1,258 184 532 65 46 497 3,282
881 41 1,351 196 572 71 51 570 3,570
942 49 1,406 235 608 108 58 340 3,745
1,043 56 1,484 259 640 122 58 353 4,015
1,170 82 1,585 272 693 126 57 348 4,332
1,337 123 1,777 285 749 145 58 372 4,846
1,536 187 1,993 302 763 163 57 463 5,465
Table 54 (Continued) NET EXPENDITURE BY CENTRAL AND LOCAL GOVERNMENT ON COMMUNITY CARE 199798 C. Local Authority Residental Care for (1), (2,) (3) Older People (Aged 65 or over) Adults aged under 65 with: A Physical Disablility or Sensory Impairment Learning Disabilites Mental Health Needs 199899 19992000 200001 200102 200203 200304 200405 200506 (provisional)
1,982 152 572 153 2,858 1,825
2,079 164 623 163 3,029 1,671
2,206 179 691 170 3,247 1,400
2,204 188 764 192 3,348 1,363
2,293 200 828 210 3,531 1,347
2,711 274 1,122 267 4,374 646
2,882 273 1,197 271 4,624 260
3,172 295 1,371 303 5,142
Income Support, Residential Care, Nurisng Homes and Residential Allowance Cases (5), (6), (7), (8) Total C plus D E. Other Social Security Benets (9), (10) Attendence Allowance Disability Allowance Invalid Care Allowance/Carers Allowance Independent Living Fund Social Fund Community Care Grants Total E
Total C D.
4,683
4,700
4,647
4,711
4,878
5,020
4,884
5,142
2,286 4,368 684 100 84 7,522
2,360 4,568 698 102 83 7,811
2,315 4,451 695 101 77 7,729
2,418 4,845 716 106 79 8,165
2,561 5,284 774 120 81 8,819
2,667 5,666 825 135 85 9,378
2,837 6,088 874 152 92 10,043
3,017 6,494 911 168 100 10,691
3,200 6,955 991 182 108 11,436
Table 54 (Continued) NET EXPENDITURE BY CENTRAL AND LOCAL GOVERNMENT ON COMMUNITY CARE 199798 F. Housing (11), (12), (13) Adaptations to all LA Dwellings for Older People and Disabled Adults (12) LA Grants; Disabled Facilities Grants (12) Housing Corporations Approved Development Programme (ADP) (11) LA Sponsored RSL (LASHG) (13) Total F Total E plus F Grand Total A to F 79 100 61 90 107 71 51 319 8,130 18,960 93 117 131 47 388 8,117 20,062 93 131 121 57 401 8,566 20,991 106 145 116 50 417 9,236 21,915 114 174 137 51 476 9,854 23,799 111 195 176 47 529 10,572 25,172 122 210 145 477 11,168 21,775 105 105 11,541 11,541 199899 19992000 200001 200102 200203 200304 200405 200506 (provisional)
45 285 7,807 18,122
Source: RO3 and PSS EX1 returns (A and C). Housing Investment Programme (HIP) Annual Plan return and Business Plan Statistical AppendixAnnual Monitoring (BPSA-AM) from 2001 onwards. Reported data only hence missing gures from non respond LAs. (F). Footnotes: 1. Local authority expenditure for 200001 and later years is obtained from the PSS EX1 return; individual service lines include overhead costs. For years prior to 200001 it is obtained from the RO3 current expenditure return but with a share of overhead costs allocated to service lines on a prorata basis. Figures for 200001 and later years are therefore not strictly comparable with those for earlier years. The RO3 return was redesigned in 199899 and equipment and adaptations and meals were made memorandum items leading to some underrecording and consequent ination of the other services expenditure; data for these items for 199899 and 19992000 are therefore not strictly comparable with those for earlier years. Expenditure on direct payments was only recorded from 199899 onwards. 2. Assessment and care management, although included under local authority nonresidential care in Part A, also includes expenditure which is relevant to residential care (Part C). 3. 200506 data will be available January 2007. 4. Data collection ended in 200405. 5. Expenditure is based on Preserved Rights Residential Care and Nursing Home cases and Residential Allowance cases for England. Expenditure has been updated since last years return and may not sum due to rounding to nearest million. From April 2002 claimants in Residential Care and Nursing Homes had preserved rights abolished and became the responsibility of local authorities. With the introduction of Pension Credit residential allowance rate of Income Support was withdrawn to all claimants in October 2003 and became the responsibilty of Local Authorities. Data excludes unemployed claimants who are provided for by Jobseekers Allowance. 6. Figures for 19992000 onwards are on a Resource Accounting and Budgeting basis. 200304 gures are based on latest actual data. Figures may not sdum due to rounding. 7. All gures are based on information received from DWP Information Directorate (IFD) for caseload and average weekly amounts which was used for the Country and Regional Analysis 2006, (apart from Social Fund which is based on nal grants). 8. Discontinued 200405. 9. Disability Living Allowance replaced Attendance Allowance (for people under 65) from 1992 onwards. 10. Invalid Carers Allowance was renamed Carers Allowance in April 2003. 11. Housing Corporation ADP approvals for schemes by Registered Social Landlords (mostly housing associations) in respect of homes for rent and sale to certain clinet groups (frail elderly, people with mental health problems, learning, or physical disabilities) and one general needs group (older people residential with warden support). This covers the Corporations own programme and joint schemes, but excludes local authoritysponsored schemes using LA Social Housing Grant (LASHG). Figures are approved and not actual expenditure. 12. 200506 datra will be available October 2006. 13. Discontinued 200405.
4.5.2 What was expenditure on NHS Continuing Care in each Strategic Health Authority in the latest available year, in absolute and per 100,000 population terms? Could the Department comment on these data? (Q55) Answer 1. The information requested on expenditure is not collected by the Department, and the Department is not aware of any other data collection relating to expenditure on continuing care. Information on the number of people receiving NHS Continuing Care, in each strategic health authority area, is collected on an annual basis. The information is shown in Table 55. 2. The variation between authorities is due to a number of factors. Currently the 28 SHAs each have eligibility criteria for continuing care, which are set and applied locally. The current consultation on a national framework for continuing care aims to bring these together in a single consistent approach to decision-making. Since eligibility for continuing care is based on a persons care needs, higher numbers would be expected in areas with larger populations of people likely to have long-term health needs. There is also some variation in how areas have recorded these numbers. Table 55 NUMBER OF PEOPLE RECEIVING CONTINUING CARE AT 31 MARCH 2006
SHA code SHA Population 18! Number of people receiving continuing care 559 428 423 2,030 768 889 599 655 695 1,224 583 1,129 382 689 965 1,176 1,929 723 2,142 1,134 552 237 351 1,609 655 539 1,350 593 25,008 Number of people receiving continuing care per 100,000 people 31.69 34.56 33.29 138.91 79.52 76.83 50.83 62.75 63.02 136.97 44.98 69.80 25.45 35.24 52.62 71.97 136.47 58.32 105.50 65.69 42.80 24.64 35.19 76.24 53.28 46.04 78.30 48.56 64.08
Q01 Q02 Q03 Q04 Q05 Q06 Q07 Q08 Q09 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 Q19 Q20 Q21 Q22 Q23 Q24 Q25 Q26 Q27 Q28
Norfolk, SuVolk and Cambridgeshire Bedfordshire and Hertfordshire Essex North West London North Central London North East London South East London South West London Northumberland, Tyne and Wear County Durham & Tees Valley North and East Yorkshire and Northern Lincolnshire West Yorkshire Cumbria & Lancashire Greater Manchester Cheshire & Merseyside Thames Valley Hampshire and Isle of Wight Kent and Medway Surrey and Sussex Avon, Gloucestershire & Wiltshire South West Peninsula Dorset & Somerset South Yorkshire Trent Leicestershire, Northamptonshire & Rutland Shropshire and StaVordshire Birmingham and the Black Country West Midlands South England
1,763,957 1,238,564 1,270,535 1,461,376 965,767 1,157,066 1,178,324 1,043,871 1,102,886 893,629 1,296,169 1,617,449 1,500,752 1,955,058 1,833,835 1,634,023 1,413,446 1,239,643 2,030,279 1,726,173 1,289,764 961,688 997,460 2,110,518 1,229,410 1,170,631 1,724,196 1,221,248 39,027,717
Source: LDPR Line 8228. Population, 2004 mid-year adult population by SHA area. Footnotes: 1. Continuing care is only available to people aged 18 or over. 4.6 Personal Social Services (PSS) 4.6.1 What was Personal Social Services expenditure on adults by client group and type of provision in (a) current prices and (b) real terms from 199798 to 200405? Could both client group and type of provision totals be included? (Q56) Answer 1. The information requested is given in Table 56a and Table 56b. Table 56a shows expenditure at current prices and Table 56b shows expenditure in real terms (current prices deated by the GDP deator at 200405 prices).
Table 56a PERSONAL SOCIAL SERVICES GROSS EXPENDITURE, CASH TERMS

millions Client group and type of provison Service strategy Older people (aged 65 or over) (1) (3) of which Assessment and care management Residential care (1) (2) Non-residential care (2) (3) Adults aged under 65 with a physical disability or sensory impairment (1) (3) of which Assessment and care management Residential care (1) (2) Non-residential care (2) (3) Adults aged under 65 with learning disabilities (1) (3) of which Assessment and care management Residential care (1) (2) Non-residential care (2) (3) Adults aged under 65 with mental health needs (1) (3) of which Assessment and care management Residential care (1) (2) Non-residential care (2) (3) Asylum seekers and other adults (2) Total (1) (2) (3) 199798 128.2 4,911.5 428.5 2,941.7 1,541.3 703.4 121.6 199.7 382.1 1,324.0 100.4 737.1 486.6 514.5 137.7 207.8 169.1 146.7 7,728.5 199899 148.5 5,216.2 431.9 3,179.7 1,604.6 749.8 130.0 218.0 401.8 1,494.9 101.8 838.1 555.1 564.1 154.3 223.7 186.1 208.4 8,382.0 19992000 161.4 5,643.7 471.1 3,453.3 1,719.3 832.7 135.9 242.4 454.3 1,633.1 105.6 922.0 605.4 632.8 177.8 241.5 213.5 337.7 9,241.3 200001 126.3 5,899.4 497.6 3,591.7 1,810.1 858.7 152.8 257.9 448.0 1,751.9 104.8 1,015.3 631.8 677.2 192.0 259.6 225.5 669.5 9,983.0 200102 112.7 6,173.2 555.1 3,727.2 1,890.9 926.5 159.4 275.6 491.6 1,904.0 116.7 1,111.0 676.4 721.4 215.8 280.0 225.5 641.3 10,479.0 200203 61.7 6,860.5 622.5 4,246.0 1,992.0 1,047.2 181.3 345.4 520.5 2,253.5 136.8 1,384.9 731.8 814.5 234.9 338.1 241.5 664.3 11,701.7 200304 61.9 7,375.8 737.0 4,258.9 2,380.0 1,143.8 199.9 330.4 613.5 2,609.4 152.7 1,400.7 1,056.1 944.0 254.8 324.0 365.2 702.8 12,837.9 200405 73.2 7,971.1 863.4 4,491.0 2,616.7 1,239.7 224.9 344.7 670.2 2,850.2 176.2 1,549.5 1,124.5 1,000.6 281.4 354.9 364.4 634.8 13,769.6
Source: RO3 and PSS EX1 returns. Footnotes: 1. From 200304 excludes the nursing care costs element as the NHS took over payment of this from 1 April 2003. 2. Local Authority Expenditure for 200001 and later years is obtained from the PSS EX1 return; individual service lines include overhead costs. For years prior to 200001 it is obtained from the RO3 current expenditure return but with a share of overhead cost allocated to service lines on a pro rata basis. Figures for 200001 and later years are therefore not comparable with those for earlier years. 3. Includes expenditure funded from the DCLG Supporting People grant introduced in 200304 and classied as social services expenditure.
Table 56b PERSONAL SOCIAL SERVICES GROSS EXPENDITURE, 200405 PRICES (4)
Client group and type of provison Service strategy Older people (aged 65 or over) (1) (3) of which Assessment and care management Residential care (1) (2) Non-residential care (2) (3) Adults aged under 65 with a physical disability or sensory impairment (1)(3) of which Assessment and care management Residential care (1) (2) Non-residential care (2) (3) Adults aged under 65 with learning disabilities (1) (3) of which Assessment and care management Residential care (1) (2) Non-residential care (2) (3) Adults aged under 65 with mental health needs (1) (3) of which Assessment and care management Residential care (1) (2) Non-residential care (2) (3) Asylum seekers and other adults (2) Total (1) (2) (3) 199798 151.9 5,817.0 507.5 3,484.0 1,825.4 833.1 144.0 236.5 452.6 1,568.1 118.9 872.9 576.3 609.4 163.0 246.1 200.2 173.8 9,153.2 199899 171.6 6,024.6 498.9 3,672.4 1,853.3 866.0 150.2 251.8 464.1 1,726.6 117.5 967.9 641.1 651.5 178.3 258.3 214.9 240.7 9,681.1 19992000 182.7 6,389.1 533.3 3,909.4 1,946.4 942.7 153.9 274.5 514.3 1,848.8 119.6 1,043.8 685.4 716.3 201.2 273.4 241.7 382.3 10,461.9 200001 141.0 6,586.0 555.5 4,009.7 2,020.8 958.6 170.5 287.9 500.2 1,955.8 117.0 1,133.5 705.4 756.0 214.4 289.8 251.8 747.4 11,144.9 200102 122.9 6,731.9 605.3 4,064.5 2,062.1 1,010.3 173.8 300.5 536.0 2,076.3 127.2 1,211.5 737.6 786.6 235.4 305.4 245.9 699.3 11,427.4 200203 65.2 7,256.9 658.4 4,491.3 2,107.1 1,107.7 191.8 365.4 550.6 2,383.7 144.7 1,464.9 774.1 861.6 248.5 357.7 255.5 702.7 12,377.8 200304 63.6 7,576.8 757.1 4,374.9 2,444.8 1,175.0 205.4 339.4 630.2 2,680.5 156.8 1,438.8 1,084.9 969.7 261.8 332.8 375.1 721.9 13,187.6 millions 200405 73.2 7,971.1 863.4 4,491.0 2,616.7 1,239.7 224.9 344.7 670.2 2,850.2 176.2 1,549.5 1,124.5 1,000.6 281.4 354.9 364.4 634.8 13,769.6
Source: RO3 and PSS EX1 returns Footnotes: 1. From 200304 excludes the nursing care costs element as the NHS took over payment of this from 1 April 2003. 2. Local Authority Expenditure for 200001 and later years is obtained from the PSS EX1 return; individual service lines include overhead costs. For years prior to 200001 it is obtained from the RO3 current expenditure return but with a share of overhead cost allocated to service lines on a pro-rata basis. Figures for 200001 and later years are therefore not comparable with those for earlier years. 3. Includes expenditure funded from the DCLG Supporting People grant introduced in 200304 and classied as social services expenditure. 4. Deated using the GDP deator at 200405 prices.
4.6.2 Could the Department detail trends in the unit costs of the main social services for adults each year since 19992000? How do costs vary between authorities? Could the Department comment on these gures? (Q57) Answer 1. The unit cost gures in Table 57 show in cash and real terms (deated by GDP at 200405 prices) the increases in selected unit costs for personal social services from 19992000 to 200405. The unit costs cover residential and nursing care for older people who are nancially supported by the local authorities and hourly costs for home care services. Between 200304 and 200405 the unit cost for local authority residential care increased by 9% in real terms whilst the unit costs of independent residential care and home care and nursing care increased by 4% in real terms. 2. The real terms weekly unit cost for supporting older people in nursing care placements rose between 19992000 and 200001 but fell between 200001 and 200102 before rising again in 200203. It is not possible to compare nursing care costs between 200203 and 200304 because of a change in the treatment of the nursing care element. Between 200304 and 200405 the unit costs have increased by 4% in real terms. The real terms unit costs of supporting older people in local authority staVed residential care homes and in independent residential care homes increased each year between 19992000 and 200405. Costs in the independent sector (private and voluntary residential homes and nursing homes) represent the costs to local authorities in purchasing care, whereas the costs for local authority homes represent the full cost of running such homes, which are declining in number as homes are transferred out of local authority control. The rise in unit costs of residential care for older people may have been associated with better or more intensive services (more space, higher staV/resident ratios) and changes in cost or eYciency. 3. The real terms hourly unit cost for home help/care rose from 12.70 in 19992000 to 12.90 in 200102 before falling back to 12.80 in 200203 and rising again to 13.60 in 200405. There has been an increase in home care provision over the same period, with an increase from 2.7 million contact hours reported in 19992000 to 3.4 million contact hours in 200405. Table 57 UNIT COSTS OF SELECTED PERSONAL SOCIAL SERVICES ENGLAND 19992000 to 200405 s Unit Cost Gross expenditure per week on supporting residents aged 65 and over in nursing care(1)(2)(3)(4) Gross expenditure per week on supporting residents aged 65 and over in local authority residential care(1)(2)(3)(5) Gross expenditure per week on supporting residents aged 65 and over in independent residential care(1)(2)(3)(5) Gross expenditure per hour of home care for all clients aged 18 or over(1)(6) Source: PSS EX1 return. Footnotes: 1. From 200001 total costs (ie total gross current expenditure ! capital costs) as reported on form PSS EX1 are used to calculate unit costs. Expenditure includes a full share of Social Services Management and Support Services (SSMSS) costs. For 19992000 gross current expenditure as reported on form RO3 has been used to calculate unit costs; an estimated share of SSMSS costs has been included. 2. From 200001 these unit costs have been calculated by taking total costs throughout the year for residential and nursing care placements as appropriate and dividing by the number of weeks older people were supported in such care during the year. A supported resident is one who is supported wholly or in part by the local authority. Residents in local authority homes who are assessed to pay the full costs and residents in other homes whose fees are paid in part or in full or through income support have been included where the relevant expenditure is included in the numerator. Cash terms Real terms(7) Cash terms Real terms(7) 19992000 200001 200102 200203 200304 200405 (est) 341 386 382 433 368 411 426 475 368 402 446 487 394 417 494 523 381 391 539 554 407 407 609 609
Cash terms Real terms(7)
271 307
279 311
286 312
313 331
338 347
361 361
Cash terms Real terms(7)
11.2 12.7
11.4 12.7
11.9 12.9
12.1 12.8
12.9 13.3
13.6 13.6
3. For 19992000 these unit costs have been calculated by taking gross current expenditure throughout the year on residential and nursing homes as appropriate and dividing it by the average number of supported residents in such homes reported at 31 March in consecutive years. Nursing homes includes nursing places in dual registered homes; residential homes includes residential places in dual registered homes. A supported resident is one who is supported wholly or in part by the local authority. Residents in local authority homes who are assessed to pay the full costs and residents in other homes whose fees are paid in part or through income support are not included. 4. From 200304 the costs of nursing care placements exclude the nursing costs which have been paid by the NHS from 1 April 2003. 5. The denition of local authority care excludes expenditure on people placed in the home of another local authority. This expenditure is included in the independent sector expenditure. 6. This unit cost is calculated by taking gross current expenditure throughout the year on home care services and dividing it by activity data collected during a sample week in September. 7. Deated using the GDP deator at 200405 prices. Variation Between Authorities 4. There is substantial variation between local authorities in these unit costs, as Figures 57a to 57d demonstrate. Variations between authorities in unit costs are to be expected as the demand for services varies, prices will be aVected by regional wage rates (for example higher prices in the South East), and supply factors such as the number of residential care homes will have a bearing. Variations between authorities in dependency of clients may also be relevant. However, such wide variability of individual authority gures also points to issues of data quality and there is a risk that misreporting of data by local authorities has had an eVect. In examining unit costs it is likely that extreme high or low values are the result of misreporting of expenditure data by local authorities. It is however notable that even if the more extreme gures are discounted signicant variation remains. 5. Figures 57a to 57d show the unit cost values calculated using expenditure data for 200405. Where a local authority has reported activity but no expenditure (an implied zero unit cost) they have been excluded from the charts. 6. Figure 57(a) shows the weekly unit cost for older people in nursing homes in 200405. The average weekly unit cost for England was 407 in 200405 ranging from under 250 a week in three authorities (Barnsley, Redcar and Cleveland and Wigan) to more than 1,000 a week in one authority (Lewisham). The middle 50% of the authorities had a unit cost between 353 and 472. 7. The weekly unit cost for residents aged 65 or over in local authority residential homes in 200405 is shown in Figure 57b. The average for England was 609, with the middle 50% of authorities having a unit cost between 529 and 847. One authority recorded a unit cost of under 100 (Somerset). Six authorities had a unit cost greater than 1,500 per week (Bradford, Hackney, Harrow, North East Lincolnshire, Oldham and Wiltshire). 8. The weekly cost for residents aged 65 or over in independent (private or voluntary) residential homes during 200405 for individual authorities is shown in Figure 56c. For individual authorities this unit cost varied from under 250 for four authorities (Harrow, Oldham, Redcar and Cleveland and Slough) to over 500 in seven authorities (Brent, Hillingdon, Islington, Kensington and Chelsea, Lewisham, Southwark and Waltham Forest). The average for England was 361, with the middle 50% of authorities having a unit cost between 325 and 396. 9. Figure 56(d) shows the hourly cost of home help/care for individual authorities in 200405. The hourly cost varied from 9 to 26. The average hourly unit cost for England was 13.60. The middle 50% of authorities had a unit cost between 12.40 and 15.70.
45 40 35
Figure 57a: GROSS WEEKLY COST PER PERSON OF NURSING CARE FOR OLDER PEOPLE, ENGLAND 2004-05
Number of Authorities
30 25 20 15 10 5 0 250 or less 251-300 301-350 351-400 401-450 451-500 501-550 551-600 601-650 650+
per week
Figure 57b: GROSS WEEKLY COST PER PERSON OF LOCAL AUTHORITY RESIDENTIAL CARE FOR OLDER PEOPLE, ENGLAND 2004-05
30 25 20 15 10 5 0
400 or less 401500 501600 601700 701800 801900 9011000 1001- 1101- 12011100 1200 1300 1301- 1401- 1501- 1600+ 1400 1500 1600
No. of authorities
per w eek
Figure 57c: GROSS WEEKLY COST PER PERSON OF RESIDENTIAL CARE IN INDEPENDENT RESIDENTIAL CARE HOMES FOR OLDER PEOPLE, ENGLAND 2004-05 70 60 50
No. of authorities
40
30 20 10 0 250 or less 251-300 301-350 351-400 401-450 451-500 501+ per week
Figure 57d: GROSS HOURLY COST OF HOME HELP/CARE FOR ALL CLIENTS, ENGLAND 2004-05 30 25 20 15 10 5 0 10 or less 10.0111 11.0112.00 12.0113.00 13.0114.00 14.0115.00 15.0116.00 16.0117.00 17.0118.00 18.0119.0 19+
Number of Local Authorities
per week
4.6.3 What grants were available for Personal Social Services in each year since 200304? Could the Department comment on these data? (Q58) Answer 1. Table 58 lists grants made available for Personal Social Services for adults since 200304. Provisional allocations are provided for 200708. This table has been further subdivided into revenue and capital allocations. 2. The table shows that in comparison to 2003-04, total Local Authority Specic Grant Resource allocations will, by 2007-08, have increased by 196.188 million.
3. However, specic revenue grant allocations for 200607 can be seen to have decreased when compared to 200506 for several reasons, namely: the transfer of 214 million of Residential Allowance funding into Formula Grant which was notied to and agreed with local authorities by way of a consultation exercise; the transfer of a proportion of Preserved Rights funding into Formula Grant reects the ongoing reduction in the number of people with the preserved rights covered by this funding. The treatment of the Preserved Rights Grant meets the Governments commitment to roll this funding into Formula Grant in stages, and was also agreed with local authorities as part of the 2004 consultation referred to above; and the fact that the 100 million increase to the Access and Systems Capacity Grant made in the previous two nancial years was not made recurrent. Table 58 PERSONAL SOCIAL SERVICES GRANT ALLOCATIONS 2003-04 TO 200708 millions 200304 Revenue Grants Access and Systems Capacity, including LRR(1) AIDS Support Carers Care Direct(2) CAMHS(3) Childrens Trusts(4) CSCI reimbursement grant Deferred Payments Delayed Discharges Human Resources Development Strategy(5) Individual Budget Pilots Mental Health National Training Strategy Performance Fund POPP Preserved Rights(6) Preventative Technology Residential Allowance(7) Training Support Programme(8) Young peoples substance misuse Planning(9) DH fundedallocated by OGD(10) Total Revenue Grants(11): Capital Grants SCE(R)Separate Programme element for AIDS/HIV Extra care housing grant Improving Information Management Grant Total Capital Grants Total Local Authority Specic Grant Resources 200405 200506 200607 200708 (provisional) 546.000 16.500 185.000 90.539 0.750 100.000 49.750 6.000 132.900 107.859 40.000 275.248 50.000
170.000 16.500 100.000 4.500 50.000 1.000 40.000 50.000 9.525 133.500 24.884 100.000 508.523 182.496 56.500 4.500
486.000 16.500 125.000 2.817 66.000 1.000 100.000 23.900 133.000 30.979 458.279 409.480 53.300 4.500 5.500 1,916.255 3.100 25.000 28.100 1,944.355
642.000 16.500 185.000 90.539 0.750 100.000 62.750 132.950 94.859 348.230 214.455
546.000 16.500 185.000 90.539 0.750 100.000 49.750 6.000 132.900 107.859 20.000 297.565 30.000
1,451.928 3.100 25.000 28.100 1,480.028
8.500 1,896.533 3.100 25.000 28.100 1,924.633
7.500 1,590.363 3.100 20.000 25.000 48.100 1,638.463
7.500 1,608.046 3.100 40.000 25.000 68.100 1,676.146
Source: Local Authority Service Letters 2005(5), 2004(26) and 2003(8). Footnotes: 1. An additional 100 million was added on a one oV basis to this grant for 200506. An additional 4 million has been added to this grant for 200607 and 200708 to allow local authorities to meet any liabilities arising from the repeal of the Liable Relative Rules. 2. Funding ended for these pilot sites 200405. 3. The whole of this grant is allocated by DH in relation to childrens PSS. The SR2004 settlement provided total funding of 93.539 million in each year. Of this, 90.539 million will be allocated by DH, and the remaining 3 million distributed by DfES through the Treatment Foster Care grant. 4. Transferred to Dfes 200506. 5. Funding reduced by 13 million because of transfer into NTS see Q.
6. The decline in Grant is rolled into baseline. 7. Rolled into baseline 200607. 8. Rolled into baseline 200607. 9. Transferred to Home OYce 200405. 10. Current examples include CAMHS3 million transfer to DfES for each of the years 200506, 200607 and 200708. Young Peoples Substance Misuse4.5 million transfer to Home OYce recurring in 200506, 200607 and 200708. 11. Carers, CAMHS, Human Resources Development Strategy, Improving Information Management and National Training Strategy all include an element of funding for Childrens services. 4.6.4 Could the Department detail trends in the Personal Social Services Pay and Price Index since 199798 and outline the assumptions behind the index? What are the expected nancial eVects of demographic pressures on PSS over the next ve years? (Q59) Answer The PSS ination index 1. The Personal Social Services (PSS) Pay and Prices Index is set out in Table 59a. 2. The interpretation of this table is that, for example, PSS pay and prices rose by approximately 4.3% between April 2004 and April 2005. The average increase between April 1996 and April 2005 of 4.21%. The nancial eVect of demographic changes 3. The Departments estimates of the notional nancial consequences of demographic changes on adult social services are set out in Table 59b. Only demographic pressures for adult social services are included, as childrens social services are the responsibility of the Department for Education and Skills. 4. The interpretation of this table is that, for example and on the basis of these estimations, resources for adult social services will need to increase by 1.0% between 200607 and 200708 in order to keep pace with changes in the age composition of the population, assuming that all other relevant factors remain constant. Table 59a PSS PAY AND PRICES INDEX Year April 1996 April 1997 April 1998 April 1999 April 2000 April 2001 April 2002 April 2003 April 2004 April 2005 Source: New Earnings Survey/Annual Survey of Hours and Earnings. Table 59b NOTIONAL FINANCIAL EFFECT ON PERSONAL SOCIAL SERVICES OF DEMOGRAPHIC PRESSURES Year 200708 200809 200910 201011 201112 Source: PSS EX1. Footnotes: 1. Estimates rounded to nearest decimal place. % increase over previous year (1) 1.0 0.9 0.9 1.1 1.0 % increase over previous year 3.2 4.4 4.1 4.8 3.3 4.4 4.4 5.0 4.2 4.3
4.6.5 Could the Department detail trends in sales and charges as a percentage of gross Personal Social Services expenditure on adults by type of service (a) nationally and (b) by local authority? (Q60) Answer 1. The information requested is given in Table 60a and Table 60b and in Figure 60a to Figure 60e. 2. The trend for charges for non-residential care has been to see a steady rise in the recoupment rate for all client groups from just under 7% in 199596 to around 12% from 19992000 until 200203 when it dropped to around 10% to 200405. 3. The drop to 10% in 200203 is likely to relate to the implementation of the Departments guidance on charging for non-residential care Fairer Charging Policies for Home Care and Other Non-residential Social Services Practices issued in August 2002, which was followed by statutory guidance in September 2003. As a result, councils will have reviewed their charging policies following consultation with local populations.
Table 60a SALES, FEES AND CHARGES AS A PERCENTAGE OF GROSS EXPENDITURE BY TYPE OF SERVICE
millions 200203 Sales Fees and Charges as a percentage of Gross current expenditure 36% 21% 19% 21% 200304 Sales Fees and Charges as a percentage of Gross current expenditure 32% 17% 14% 16% 200405 Sales Fees and Charges as a percentage of Gross current expenditure 29% 14% 11% 15%
Gross current expenditure Residential care for: Older people (aged 65 or over) Adults aged under 65 with: a physical disability or sensory impairment learning disabilities mental health needs Non residential care: of which Home care Day care Meals 4,246 345 1,385 338
Sales, Fees and Charges 1,531 71 263 71
Gross current expenditure 4,259 330 1,401 324
Gross current expenditure 4,491 345 1,550 355
1,820 1,003 99
211 38 43
12% 4% 43%
1,982 1,071 101
205 37 42
10% 3% 42%
2,220 1,107 99
227 42 42
10% 4% 43%
Source: PSS EX1 returns.
Table 60b SALES, FEES AND CHARGES AS A PERCENTAGE OF GROSS EXPENDITURE BY TYPE OF SERVICE, 200405
thousands Code Local authority NonResidential Care Home Care Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 227,135 231 773 1,105 496 489 1,585 3,043 713 575 1,095 878 369 1,948 805 1,504 487 2,276 1,741 833 1,026 3,525 352 4,550 89 3,193 1,216 1,721 4,411 445 1,330 185 3,338 628 2,219,954 10,549 12,078 10,557 6,301 14,680 8,043 40,965 7,637 6,613 11,778 5,704 3,430 17,542 10,157 13,287 15,909 12,728 18,894 8,395 8,637 25,401 12,851 40,342 981 21,080 19,098 12,723 22,002 3,408 9,805 41,840 26,633 10,294 10% 2% 6% 10% 8% 3% 20% 7% 9% 9% 9% 15% 11% 11% 8% 11% 3% 18% 9% 10% 12% 14% 3% 11% 9% 15% 6% 14% 20% 13% 14% 0% 13% 6% For Older People Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 1,318,971 3,573 7,221 7,686 4,291 6,486 6,003 23,781 4,153 5,237 5,105 4,439 1,429 16,577 4,481 8,803 10,577 7,704 10,285 5,161 6,859 9,600 4,072 19,243 208 13,191 7,857 6,615 19,643 4,046 7,647 23,779 27,537 11,596 4,490,998 16,240 27,258 25,318 15,106 26,767 16,976 102,345 15,112 17,818 20,492 18,437 5,979 49,925 16,043 26,600 40,918 22,883 31,156 17,263 17,499 37,713 23,099 64,284 825 44,291 25,436 24,417 56,367 10,497 22,153 66,232 89,847 27,383 29% 22% 26% 30% 28% 24% 35% 23% 27% 29% 25% 24% 24% 33% 28% 33% 26% 34% 33% 30% 39% 25% 18% 30% 25% 30% 31% 27% 35% 39% 35% 36% 31% 42% Residential Care For Adults with a Physical Disability For Adults with a Learning Disability Sales, Fees Sales, Fees and Charges and Charges as a as a percentage percentage Sales, Gross of Gross Sales, Gross of Gross Fees and Current Current Fees and Current Current Charges Expenditure Expenditure Charges Expenditure Expenditure 49,527 94 508 307 154 203 167 616 224 119 232 162 62 702 267 437 575 300 406 137 215 348 97 512 140 204 389 432 114 192 462 947 120 344,669 655 2,166 1,017 1,096 1,871 1,699 6,020 1,367 1,142 1,359 1,363 471 4,179 2,818 2,023 1,605 2,044 3,377 826 1,566 3,474 2,410 2,853 12 2,851 2,095 2,813 2,825 630 1,294 3,650 5,454 1,484 14% 14% 23% 30% 14% 11% 10% 10% 16% 10% 17% 12% 13% 17% 9% 22% 36% 15% 12% 17% 14% 10% 4% 18% 0% 5% 10% 14% 15% 18% 15% 13% 17% 8% 178,073 214 941 285 584 683 657 3,210 180 300 518 304 437 2,032 373 1,756 2,152 1,377 1,575 379 464 903 352 1,005 9 700 771 1,401 1,043 299 678 2,881 2,934 486 1,549,537 3,572 14,428 1,989 6,713 12,665 7,627 41,635 1,675 4,145 9,908 2,743 4,748 11,332 7,590 16,301 16,328 10,832 15,970 5,106 5,566 17,694 5,295 7,916 175 8,759 9,845 13,854 6,007 3,462 6,187 19,299 24,698 7,214 11% 6% 7% 14% 9% 5% 9% 8% 11% 7% 5% 11% 9% 18% 5% 11% 13% 13% 10% 7% 8% 5% 7% 13% 5% 8% 8% 10% 17% 9% 11% 15% 12% 7% For Adults with Mental Health needs Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 51,830 55 206 214 439 27 158 466 179 125 "424 120 342 1,284 1,900 339 1,356 242 268 242 59 148 219 326 27 103 390 1,247 147 30 132 271 433 177 354,865 524 2,670 1,066 1,662 791 1,560 4,709 929 1,824 2,660 928 950 3,553 4,854 2,810 3,657 2,161 1,870 1,085 1,348 2,324 3,418 3,298 799 1,196 2,263 6,359 1,245 341 1,343 2,578 4,908 447 15% 10% 8% 20% 26% 3% 10% 10% 19% 7% "16% 13% 36% 36% 39% 12% 37% 11% 14% 22% 4% 6% 6% 10% 3% 9% 17% 20% 12% 9% 10% 11% 9% 40%
R383 R384 R349 R602 R632 R385 R358 R659 R660 R334 R622 R642 R365 R386 R625 R603 R387 R633 R335 R366 R663 R371 R664 R370 R411 R359 R388 R412 R624 R621 R634 R665 R350
England Barking & Dagenham Barnet Barnsley Bath & North East Somerset UA Bedfordshire Bexley Birmingham Blackburn UA Blackpool UA Bolton Bournemouth UA Bracknell Forest UA Bradford Brent Brighton & Hove UA Bristol UA Bromley Buckinghamshire Bury Calderdale Cambridgeshire Camden Cheshire City of London Cornwall Coventry Croydon Cumbria Darlington UA Derby UA Derbyshire Devon Doncaster
Table 60b (Continued) SALES, FEES AND CHARGES AS A PERCENTAGE OF GROSS EXPENDITURE BY TYPE OF SERVICE, 200405
thousands Code Local authority NonResidential Care Home Care Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 2,303 1,317 5,452 1,307 1,892 1,195 1,431 5,724 1,201 2,702 1,127 476 410 548 3,823 995 1,439 572 1,087 540 2,561 1,045 876 1,184 4 1,228 479 7,930 1,032 548 2,056 380 1,575 4,211 12,889 12,602 23,258 11,255 11,455 17,254 13,997 70,988 11,709 26,603 12,845 11,350 5,747 11,076 56,534 10,284 11,353 2,739 10,409 6,294 50,674 10,433 8,934 5,510 31 14,153 8,566 53,223 6,848 4,990 20,127 8,299 10,468 62,626 18% 10% 23% 12% 17% 7% 10% 8% 10% 10% 9% 4% 7% 5% 7% 10% 13% 21% 10% 9% 5% 10% 10% 21% 13% 9% 6% 15% 15% 11% 10% 5% 15% 7% For Older People Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 9,904 6,636 14,683 7,993 12,490 15,371 7,235 37,727 7,129 9,031 5,187 3,280 3,346 2,971 25,113 3,948 348 4,729 5,336 4,055 28,300 3,672 3,504 5,346 80 5,522 2,013 33,764 9,217 3,201 10,148 3,189 4,928 31,396 35,772 24,133 56,904 21,028 35,387 55,105 18,534 121,659 24,549 44,338 20,886 14,704 10,836 14,045 89,615 15,022 10,024 11,242 16,379 15,277 88,946 17,266 14,930 19,515 322 20,282 10,628 121,395 31,729 11,507 36,159 11,207 20,323 113,637 28% 27% 26% 38% 35% 28% 39% 31% 29% 20% 25% 22% 31% 21% 28% 26% 3% 42% 33% 27% 32% 21% 23% 27% 25% 27% 19% 28% 29% 28% 28% 28% 24% 28% Residential Care For Adults with a Physical Disability For Adults with a Learning Disability Sales, Fees Sales, Fees and Charges and Charges as a as a percentage percentage Sales, Gross of Gross Sales, Gross of Gross Fees and Current Current Fees and Current Current Charges Expenditure Expenditure Charges Expenditure Expenditure 270 102 470 134 370 288 216 711 167 683 217 240 72 215 944 258 2 72 250 99 2,522 203 248 67 156 66 1,531 438 122 223 118 654 1,671 2,282 851 2,718 2,060 2,505 3,753 1,606 6,907 1,419 3,764 1,553 2,042 635 1,179 6,475 1,825 853 324 2,119 1,180 7,734 2,339 2,110 625 63 974 905 12,416 4,040 1,190 1,846 1,220 3,944 10,548 12% 12% 17% 7% 15% 8% 13% 10% 12% 18% 14% 12% 11% 18% 15% 14% 0% 22% 12% 8% 33% 9% 12% 11% 0% 16% 7% 12% 11% 10% 12% 10% 17% 16% 685 1,049 4,697 621 1,223 1,701 1,167 3,063 773 2,555 935 676 245 256 3,187 961 112 253 666 727 12,978 1,263 1,225 737 818 369 4,618 588 582 1,706 368 1,145 47 7,972 10,974 19,340 12,820 9,790 24,712 10,837 39,677 7,030 15,481 8,448 9,432 1,644 5,081 41,989 10,140 5,853 2,003 6,593 6,560 41,038 9,843 9,193 5,245 8,095 4,427 54,114 5,625 5,440 14,627 4,163 15,964 28,847 9% 10% 24% 5% 12% 7% 11% 8% 11% 17% 11% 7% 15% 5% 8% 9% 2% 13% 10% 11% 32% 13% 13% 14% 10% 8% 9% 10% 11% 12% 9% 7% 0% For Adults with Mental Health needs Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 63 229 488 328 402 781 2,049 657 112 "2 360 201 154 289 275 346 106 139 152 241 754 107 49 195 664 92 756 314 167 176 124 763 1,270 884 1,682 1,798 2,741 2,311 5,452 5,285 6,148 1,351 1,250 1,782 5,007 824 2,334 3,477 4,350 1,881 678 1,261 955 5,498 1,748 1,031 1,092 3,936 2,564 6,460 2,649 1,204 1,640 1,411 5,184 8,178 7% 14% 27% 12% 17% 14% 39% 11% 8% 0% 20% 4% 19% 12% 8% 8% 6% 21% 12% 25% 14% 6% 5% 18% 17% 4% 12% 12% 14% 11% 9% 15% 16%
R635 R360 R636 R389 R610 R637 R390 R666 R353 R419 R372 R373 R650 R374 R638 R391 R392 R606 R393 R656 R422 R394 R395 R601 R403 R375 R376 R667 R611 R396 R367 R344 R377 R668
Dorset Dudley Durham Ealing East Riding of Yorkshire UA East Sussex Eneld Essex Gateshead Gloucestershire Greenwich Hackney Halton UA Hammersmith & Fulham Hampshire Haringey Harrow Hartlepool UA Havering Herefordshire UA Hertfordshire Hillingdon Hounslow Isle of Wight UA Isles of Scilly Islington Kensington & Chelsea Kent Kingston Upon Hull UA Kingston Upon Thames Kirklees Knowsley Lambeth Lancashire
thousands Code Local authority NonResidential Care Home Care Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 1,737 798 2,111 1,211 1,908 3,048 745 2,674 1,543 842 980 1,200 1,072 139 7,679 804 820 883 1,467 2,259 917 2,233 841 4,402 4,294 1,086 485 926 1,147 541 984 574 34,252 10,270 23,277 15,165 20,954 31,048 7,705 26,591 10,247 7,455 5,715 7,224 19,574 10,770 36,326 5,711 5,313 6,931 7,087 23,243 20,646 15,863 11,595 26,550 12,217 29,129 6,805 8,816 5,721 9,582 5,699 11,139 5,611 5% 8% 9% 8% 9% 10% 10% 10% 15% 11% 17% 17% 5% 1% 21% 14% 15% 13% 21% 10% 4% 14% 7% 17% 0% 15% 16% 6% 16% 12% 9% 9% 10% For Older People Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 17,413 5,513 13,670 4,926 19,135 10,703 3,965 12,038 4,861 3,866 3,713 3,909 8,045 4,039 36,467 5,192 4,465 4,652 4,265 18,049 15,101 14,225 8,238 23,210 6,053 12,293 3,108 8,285 2,701 4,230 1,792 6,658 1,243 74,492 23,312 40,094 23,730 67,347 44,107 12,877 40,571 16,796 11,464 13,626 11,641 30,348 16,178 89,360 17,424 15,323 19,208 22,659 54,917 56,754 35,006 26,195 68,065 20,371 46,643 11,547 26,867 11,076 16,213 9,037 19,105 13,405 23% 24% 34% 21% 28% 24% 31% 30% 29% 34% 27% 34% 27% 25% 41% 30% 29% 24% 19% 33% 27% 41% 31% 34% 30% 26% 27% 31% 24% 26% 20% 35% 9% Residential Care For Adults with a Physical Disability For Adults with a Learning Disability Sales, Fees Sales, Fees and Charges and Charges as a as a percentage percentage Sales, Gross of Gross Sales, Gross of Gross Fees and Current Current Fees and Current Current Charges Expenditure Expenditure Charges Expenditure Expenditure 624 413 376 316 824 755 245 433 445 83 145 132 173 343 921 95 172 251 102 652 626 152 298 1,208 433 437 107 397 87 200 95 274 23 4,986 1,678 3,040 2,547 5,307 5,440 1,882 2,874 3,143 1,145 1,087 1,055 1,394 1,846 7,638 965 1,029 1,407 1,052 2,758 6,662 1,712 2,117 5,111 1,745 2,876 858 2,049 552 1,716 776 2,026 1,320 13% 25% 12% 12% 16% 14% 13% 15% 14% 7% 13% 13% 12% 19% 12% 10% 17% 18% 10% 24% 9% 9% 14% 24% 25% 15% 12% 19% 16% 12% 12% 14% 2% 3,948 2,637 1,744 627 1,493 4,611 277 1,353 561 409 458 568 380 697 5,443 557 419 980 246 1,477 1,488 1,183 943 4,011 2,207 1,255 380 1,075 145 483 651 413 333 20,617 10,251 14,643 10,402 15,452 16,680 4,957 4,892 7,404 5,865 3,399 3,192 4,912 8,350 28,601 2,829 3,308 7,833 4,821 14,573 23,535 7,528 7,418 24,232 5,803 13,571 3,805 10,266 1,866 5,187 6,539 6,771 3,315 19% 26% 12% 6% 10% 28% 6% "28% 8% 7% 13% 18% 8% 8% 19% 20% 13% 13% 5% 10% 6% 16% 13% 17% 38% 9% 10% 10% 8% 9% 10% 6% 10% For Adults with Mental Health needs Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 461 909 144 536 808 2,316 116 401 115 198 175 15 339 299 1,406 128 161 584 88 213 181 306 379 471 2,363 134 9 159 79 143 156 298 103 4,891 4,213 1,715 4,083 6,864 7,664 682 4,677 834 1,423 1,425 218 1,373 3,808 9,532 915 938 2,547 1,466 1,356 8,654 1,960 2,092 2,639 6,051 1,708 98 1,539 350 1,609 1,573 1,479 1,575 9% 22% 8% 13% 12% 30% 17% 9% 14% 14% 12% 7% 25% 8% 15% 14% 17% 23% 6% 16% 2% 16% 18% 18% 39% 8% 9% 10% 23% 9% 10% 20% 7%
R368 R628 R639 R378 R428 R345 R619 R336 R658 R397 R607 R620 R354 R398 R429 R612 R613 R605 R355 R618 R430 R431 R661 R669 R337 R434 R649 R652 R623 R626 R644 R399 R608
Leeds Leicester UA Leicestershire Lewisham Lincolnshire Liverpool Luton UA Manchester Medway Towns UA Merton Middlesbrough UA Milton Keynes UA Newcastle upon Tyne Newham Norfolk North East Lincolnshire UA North Lincolnshire UA North Somerset UA North Tyneside North Yorkshire Northamptonshire Northumberland Nottingham UA Nottinghamshire Oldham Oxfordshire Peterborough UA Plymouth UA Poole UA Portsmouth UA Reading UA Redbridge Redcar & Cleveland UA
thousands Code Local authority NonResidential Care Home Care Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 845 894 1,505 161 5,130 806 634 3,266 1,792 643 676 3,772 1,058 343 952 735 89 1,158 4,039 1,643 1,370 2,815 1,660 1,418 1,213 804 1,151 779 857 854 822 1,164 8,058 9,087 13,814 1,286 21,155 14,681 10,866 33,771 13,386 4,052 7,731 22,630 7,529 10,887 9,509 6,834 12,574 9,077 26,572 12,750 5,111 10,746 32,648 13,256 26,239 7,399 6,372 7,696 6,372 6,215 4,763 14,517 9,043 15,455 10% 10% 11% 12% 24% 5% 6% 10% 13% 16% 9% 17% 14% 3% 10% 11% 1% 13% 15% 13% 0% 13% 9% 13% 5% 16% 13% 15% 12% 14% 18% 0% 9% 8% For Older People Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 4,175 5,171 8,405 792 7,490 7,655 10,692 20,225 7,561 2,257 4,031 14,235 5,933 4,918 4,624 5,549 5,489 5,130 23,091 8,988 5,819 7,967 20,086 8,865 21,503 4,002 3,076 10,032 2,833 2,887 10,727 2,998 6,042 8,519 12,600 19,547 26,182 2,710 23,554 29,714 37,575 63,057 23,759 7,756 12,164 46,588 18,479 19,348 17,678 17,311 23,838 17,540 64,420 26,208 18,350 28,180 61,741 30,205 78,638 14,346 14,557 24,066 10,227 9,893 23,470 14,115 19,499 30,894 33% 26% 32% 29% 32% 26% 28% 32% 32% 29% 33% 31% 32% 25% 26% 32% 23% 29% 36% 34% 32% 28% 33% 29% 27% 28% 21% 42% 28% 29% 46% 21% 31% 28% Residential Care For Adults with a Physical Disability For Adults with a Learning Disability Sales, Fees Sales, Fees and Charges and Charges as a as a percentage percentage Sales, Gross of Gross Sales, Gross of Gross Fees and Current Current Fees and Current Current Charges Expenditure Expenditure Charges Expenditure Expenditure 150 322 184 1 299 309 734 1,007 257 161 141 403 447 "34 169 92 773 346 644 221 171 262 500 188 707 122 72 355 89 95 145 204 208 244 1,473 1,234 949 101 2,083 1,610 4,061 3,333 1,063 731 840 3,564 1,148 1,031 1,432 885 3,625 1,529 4,337 1,892 754 1,666 4,182 1,509 9,971 804 1,316 1,664 548 970 472 1,718 1,223 1,641 10% 26% 19% 1% 14% 19% 18% 30% 24% 22% 17% 11% 39% "3% 12% 10% 21% 23% 15% 12% 23% 16% 12% 12% 7% 15% 5% 21% 16% 10% 31% 12% 17% 15% 755 584 644 48 955 759 1,160 1,703 1,156 1,933 1,304 1,415 1,686 715 723 929 792 338 2,044 292 706 999 1,822 1,227 4,354 543 818 4,323 399 268 769 402 341 1,728 7,185 5,011 6,236 607 3,231 8,719 8,675 9,043 6,242 5,145 7,300 12,291 9,803 4,514 6,064 6,949 15,199 5,481 18,712 5,572 5,684 7,020 19,203 5,512 38,844 6,666 7,928 6,957 2,918 4,915 5,370 6,291 5,638 6,787 11% 12% 10% 8% 30% 9% 13% 19% 19% 38% 18% 12% 17% 16% 12% 13% 5% 6% 11% 5% 12% 14% 9% 22% 11% 8% 10% 62% 14% 5% 14% 6% 6% 25% For Adults with Mental Health needs Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 81 113 220 21 829 99 276 305 163 225 71 422 144 152 122 121 476 227 605 366 166 120 294 416 362 210 129 314 15 25 236 184 149 143 1,756 1,381 938 113 1,956 2,683 1,784 2,714 1,090 1,207 580 2,533 400 1,207 906 1,166 5,891 1,449 3,220 2,038 1,571 1,514 3,356 1,686 3,270 1,443 1,523 515 769 236 1,866 3,830 1,749 1,403 5% 8% 23% 19% 42% 4% 15% 11% 15% 19% 12% 17% 36% 13% 13% 10% 8% 16% 19% 18% 11% 8% 9% 25% 11% 15% 8% 61% 2% 11% 13% 5% 9% 10%
R400 R338 R351 R629 R339 R361 R347 R352 R670 R645 R362 R436 R604 R356 R627 R654 R379 R346 R640 R340 R609 R630 R438 R357 R439 R401 R631 R341 R662 R655 R653 R380 R342 R369
Richmond Upon Thames Rochdale Rotherham Rutland UA Salford Sandwell Sefton SheYeld Shropshire Slough UA Solihull Somerset South Gloucestershire UA South Tyneside Southampton UA Southend UA Southwark St Helens StaVordshire Stockport Stockton on Tees UA Stoke-on-Trent UA SuVolk Sunderland Surrey Sutton Swindon UA Tameside The Wrekin UA Thurrock UA Torbay UA Tower Hamlets TraVord Wakeeld
thousands Code Local authority NonResidential Care Home Care Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 1,746 989 1,285 810 2,428 739 1,663 1,141 2,602 771 791 1,938 549 1,390 2,251 1,039 11,479 10,306 9,724 8,235 19,258 5,336 23,412 13,217 20,515 18,671 6,882 18,101 4,291 13,310 17,121 7,916 15% 10% 13% 10% 13% 14% 7% 9% 13% 4% 11% 11% 13% 10% 13% 13% For Older People Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 7,144 3,887 7,791 5,499 10,427 2,062 22,400 3,527 7,268 8,067 2,345 10,397 1,907 7,833 10,087 4,863 28,241 16,455 23,602 18,391 35,846 7,879 72,610 17,499 24,311 25,206 8,790 34,219 6,957 26,633 40,358 14,070 25% 24% 33% 30% 29% 26% 31% 20% 30% 32% 27% 30% 27% 29% 25% 35% Residential Care For Adults with a Physical Disability For Adults with a Learning Disability Sales, Fees Sales, Fees and Charges and Charges as a as a percentage percentage Sales, Gross of Gross Sales, Gross of Gross Fees and Current Current Fees and Current Current Charges Expenditure Expenditure Charges Expenditure Expenditure 179 110 360 180 175 61 511 119 570 321 135 475 41 281 359 181 1,663 1,261 1,325 1,040 3,094 417 6,285 1,325 2,813 2,424 799 2,961 438 1,033 3,015 1,110 11% 9% 27% 17% 6% 15% 8% 9% 20% 13% 17% 16% 9% 27% 12% 16% 388 432 2,765 333 354 240 2,264 711 407 1,529 396 1,022 660 833 2,049 434 15,039 7,413 13,331 2,728 12,407 4,425 24,203 10,897 429 17,084 6,409 11,073 7,831 4,838 17,892 4,736 3% 6% 21% 12% 3% 5% 9% 7% 95% 9% 6% 9% 8% 17% 11% 9% For Adults with Mental Health needs Sales, Fees and Charges as a percentage Sales, Gross of Gross Fees and Current Current Charges Expenditure Expenditure 207 28 1,442 115 "260 17 658 467 363 268 97 666 6 653 780 282 1,932 1,356 4,451 1,102 1,833 389 4,182 6,460 2,166 3,250 702 3,126 422 1,780 2,825 1,017 11% 2% 32% 10% "14% 4% 16% 7% 17% 8% 14% 21% 1% 37% 28% 28%
R363 R402 R381 R651 R440 R643 R441 R382 R343 R641 R646 R348 R647 R364 R671 R617
Walsall Waltham Forest Wandsworth Warrington UA Warwickshire West Berkshire West Sussex Westminster Wigan Wiltshire Windsor & Maidenhead UA Wirral Wokingham UA Wolverhampton Worcestershire York UA
Source: PSS EX1 return.
14
FIGURE 60a: RECENT TRENDS IN SALES, FEES AND CHARGES RECOUPMENT RATES ON HOME CARE FOR ALL CLIENT GROUPS
12
10
recoupment rate (%)
0 1995-96 1996-97 1997-98 1998-99 1999-00 2000-01 2001-02 2002-03 2003-04 2004-05
45
FIGURE 60b: RECENT TRENDS IN SALES, FEES AND CHARGES RECOUPMENT RATES ON RESIDENTIAL ACCOMMODATION FOR OLDER PEOPLE
40
35
recoupment rate (%)
30
25
20
15
10
1995-96
1996-97
1997-98
1998-99
1999-00
2000-01
2001-02
2002-03
2003-04
2004-05
FIGURE 60c: SALES, FEES AND CHARGES RECOUPMENT RATES FOR ALL CLIENT GROUPS - HOME CARE, 2004-05
60 50 40
No. of LAs
30 20 10 0 4% or less 5 % - 8% 9% - 12% 13% - 16% 17% - 20% 21% - 24%
FIGURE 60d: SALES, FEES AND CHARGES RECOUPMENT RATES FOR ALL CLIENT GROUPS - MEALS, 2004-05
40 35 30
No. of LAs
25 20 15 10 5 0 15% or less 16 % - 30% 31% - 45% 46% - 60% 61% - 75% 76% - 90% 91% and over
FIGURE 60e: SALES, FEES AND CHARGES RECOUPMENT RATES, OLDER PEOPLE RESIDENTIAL ACCOMMODATION, 2004-05
100 90 80 70
No. of LAs
60 50 40 30 20 10 0 10% or less 11 % - 20% 21% - 30% 31% - 40% 41% - 50% 51% or over
4.6.6 What proportion of (a) contact hours of home help/care and (b) supported residential care was purchased by local authorities from the independent sectors, nationally, by region and by local authority, in the latest year for which data are available? Could the Department comment on these data? (Q61) Answer 1. Table 61 shows for each authority the percentage contribution of the independent sector in respect of two main elements of social services for adults (contact hours of home help/care and the percentage of local authority supported residents in independent sector residential care homes). Councils are continuing to make increased use of the independent sector. 2. For England as a whole, the independent sector provided 73% of the total contact hours of home help/ care in 2005, compared with 69% in 2004 and 2% in 1992, prior to the introduction of the Community Care Reforms in 1993. Use of the independent sector varies considerably between authorities and between services within authorities. 9% of authorities have less than 50% of their home help/care services provided by the independent sector and 3% of authorities have all their provision from the independent sector. The variations in the use of the independent sector may reect historical patterns of provision, local needs and local political priorities. 3. Local authorities place and nancially support signicant numbers (84% of all supported residents in residential care) of clients in independent sector residential care homes. This represents a slight increase on the 2004 gure of 83%. Over the last few years a substantial number of authorities have transferred some of their care homes to independent ownership. There is some variation in the use of the independent sector across local authorities. All councils have more than 50% of their supported residents in independent sector homes; of these 4 have all supported residents in such homes.
Table 61 PERCENTAGE OF SOCIAL SERVICES FOR ADULTS WHICH ARE PURCHASED BY THE LOCAL AUTHORITY FROM THE INDEPENDENT SECTOR: ENGLAND: 2005 (1) Government OYce region and local authority ENGLAND EASTERN Bedfordshire Cambridgeshire Essex Hertfordshire Luton Norfolk Peterborough Southend SuVolk Thurrock EAST MIDLANDS Derby Derbyshire Leicester Leicestershire Lincolnshire Northamptonshire Nottingham Nottinghamshire Rutland NORTH EAST Darlington Durham Gateshead Hartlepool Middlesbrough Newcastle upon Tyne North Tyneside Northumberland Redcar and Cleveland South Tyneside Stockton on Tees Sunderland NORTH WEST Blackburn with Darwen Blackpool Bolton Bury Cheshire Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St Helens Stockport Tameside TraVord Warrington Wigan Wirral Contact hours of home help/care % 73.4 83.0 75.2 89.2 91.8 100.0 62.2 47.6 91.6 88.8 74.0 81.1 65.4 52.7 41.7 81.1 84.8 72.7 73.1 75.4 71.6 46.0 65.7 63.8 76.4 34.6 78.7 76.2 81.8 37.2 63.3 71.1 66.2 73.8 47.7 70.7 63.8 59.8 51.1 64.2 51.0 58.3 84.2 78.8 94.0 76.9 74.5 39.0 74.3 73.5 81.5 81.7 47.9 59.7 53.0 80.6 45.1 81.3 Supported residents in residential care (2) (3) (4) % 84.3 89.3 96.8 99.9 95.1 99.6 58.8 82.1 61.6 92.2 77.1 75.7 79.7 65.8 71.0 79.2 78.6 91.9 76.7 83.8 81.6 77.7 87.9 99.8 89.5 86.1 99.0 85.3 87.9 93.1 90.5 74.2 87.5 84.0 80.9 84.5 76.8 90.4 74.0 78.0 88.9 61.8 85.5 98.6 86.7 93.8 97.3 77.0 90.5 93.1 93.7 68.3 98.5 84.1 63.0 85.3 92.8 72.6
Government OYce region and local authority LONDON Barking & Dagenham Barnet Bexley Brent Bromley Camden City of London Croydon Ealing Eneld Greenwich Hackney Hammersmith & Fulham Haringey Harrow Havering Hillingdon Hounslow Islington Kensington & Chelsea Kingston-upon-Thames Lambeth Lewisham Merton Newham Redbridge Richmond-upon-Thames Southwark Sutton Tower Hamlets Waltham Forest Wandsworth Westminster SOUTH EAST Bracknell Forest Brighton & Hove Buckinghamshire East Sussex Hampshire Isle of Wight Kent Medway Towns Milton Keynes Oxfordshire Portsmouth Reading Slough Southampton Surrey West Berkshire West Sussex Windsor & Maidenhead Wokingham SOUTH WEST Bath & N E Somerset Bournemouth Bristol Cornwall Devon Dorset Gloucestershire Isles of Scilly North Somerset Plymouth
Contact hours of home help/care % 82.8 78.5 100.0 99.4 100.0 61.8 80.9 40.0 82.3 81.6 80.5 88.6 52.1 76.6 71.9 97.6 82.0 81.2 77.8 88.7 85.3 70.3 100.0 86.7 78.8 83.6 92.2 80.4 100.0 77.1 72.1 59.5 76.1 98.9 80.5 78.3 90.1 72.0 88.8 81.9 64.6 81.5 94.9 62.7 70.1 85.7 60.3 62.0 83.3 68.2 83.0 65.4 69.4 77.1 68.6 62.0 76.5 39.6 70.2 70.1 58.0 79.0 74.4 72.4 87.1
Supported residents in residential care (2) (3) (4) % 86.9 77.4 96.6 99.9 75.3 .. 83.5 100.0 79.6 86.1 86.5 88.3 95.3 90.6 71.2 97.5 79.0 89.0 79.4 88.2 82.9 72.7 96.1 100.0 94.3 93.0 94.5 95.1 100.0 82.3 99.2 63.0 90.0 90.5 84.6 69.3 92.2 96.3 91.7 69.8 94.4 91.3 79.8 93.7 100.0 64.8 58.7 58.1 75.0 88.4 70.8 80.9 80.1 76.0 87.0 74.1 96.9 63.5 98.5 84.7 75.8 92.5 50.0 98.2 87.7
Government OYce region and local authority Poole Somerset South Gloucestershire Swindon Torbay Wiltshire WEST MIDLANDS Birmingham Coventry Dudley Herefordshire Sandwell Shropshire Solihull StaVordshire Stoke-on-Trent The Wrekin Walsall Warwickshire Wolverhampton Worcestershire YORKSHIRE & THE HUMBER Barnsley Bradford Calderdale Doncaster East Riding Kingston-upon-Hull Kirklees Leeds N E Lincolnshire North Lincolnshire North Yorkshire Rotherham SheYeld Wakeeld York
Contact hours of home help/care % 73.9 50.3 67.6 77.2 81.4 87.4 72.8 66.7 76.9 39.2 87.2 81.6 87.7 79.8 62.1 81.0 85.6 91.0 73.6 85.2 62.3 60.7 60.0 61.0 67.0 57.2 86.2 70.6 53.6 41.3 69.1 76.5 68.3 59.6 62.8 54.4 55.4
Supported residents in residential care (2) (3) (4) % 93.5 89.3 72.4 79.3 94.7 95.2 76.3 62.1 86.9 79.9 94.5 72.4 92.0 92.6 72.5 59.8 93.7 69.9 82.6 67.6 93.6 82.3 92.5 75.8 91.6 75.8 96.0 91.7 82.9 66.8 95.8 93.6 67.8 79.6 86.9 84.5 59.9
Source: HH1 return for homecare and the SR1 return for Supported Residents information. Footnotes: 1. Data collected on Information Centre (IC) annual returns HH1 (home help) for a survey week during September 2005, and SR1 (supported residents) as at 31 March 2005. 2. These gures do not include clients supported by local authorities in nursing care homes, which are all in the independent sector, or clients supported in any unstaVed homes. 3. Includes residents supported in other authorities. 4. Data includes clients formerly in receipt of preserved rights and Boyd Loophole residents. 4.6.7 Could the Department comment on the replacement of Formula Spending Shares for Personal Social Services with Relative Needs Formula calculations? (Q62) Answer 1. Responsibility for the administration of the general formula grant resides with the Department for Communities and Local Government. 2. As some elements of the previous grant distribution system were misinterpreted as targets for council spending and council tax levels, central government will use a new method of allocating Formula Grant from 200607. This new allocation model contains four funding blocks: the central allocation, relative needs amount, relative resource amount and oor damping blocks. 3. The new Grant Distribution formulae concentrates on the allocation of actual grant to local authorities, without the use of misleading assumptions about councils budget and council tax levels. 4. The Government have always been clear that the Grant Distribution System simply aims to distribute grant, not to pre-empt councils budgeting decisions. We have therefore made sure that authorities grant allocations have not changed simply as a result of the introduction of the new distribution system.
5. Activity, Performance and EYciency 5.1 In-Patient Activity and Waiting 5.1.1 How many admissions, removals and decisions to admit were there in each year since 198889? What was non-emergency and emergency activity in each year? What was the waiting list, and how many suspensions and self-deferrals were outstanding, at the end of each year? (Q63) Answer The information requested is given in Table 63a to Table 63c. Table 63a NUMBERS OF DECISIONS TO ADMIT, ADMISSIONS AND REMOVALS England 12 months to: March 1989 March 1990 March 1991 March 1992 March 1993 March 1994 March 1995 March 1996 March 1997 March 1998 March 1999 March 2000 March 2001 March 2002 March 2003 March 2004 March 2005 March 2006 Ordinary and Day Case Admissions Decision to Admit Admitted 2,783,298 2,943,658 2,964,836 3,257,615 3,480,268 3,501,715 3,765,407 3,968,825 4,111,511 4,192,037 4,189,323 4,159,078 3,935,930 3,781,437 3,778,390 3,802,744 3,787,713 4,031,519 2,632,085 2,768,482 2,761,005 2,993,532 3,111,627 3,110,477 3,376,016 3,500,353 3,549,074 3,543,634 3,826,507 3,682,180 3,467,338 3,244,185 3,330,981 3,391,644 3,390,694 3,577,104 Removed 200,677 260,503 306,899 387,980 412,299 451,559 521,320 547,863 551,999 558,242 672,432 622,787 613,931 581,534 601,353 621,345 612,004 613,626
Source: KH06 NHS Trust-based gures. Notes: 1. In the year 199798, information was collected annually only. Table 63b IN-PATIENT WAITING LIST AND NUMBER OF SELF DEFERRALS AND SUSPENSIONS England Number at: March 1989 March 1990 March 1991 March 1992 March 1993 March 1994 March 1995 March 1996 March 1997 March 1998 March 1999 March 2000 March 2001 March 2002 March 2003 March 2004 March 2005 March 2006 June 2006 No of patients waiting for admission 922,676 958,976 948,243 917,717 994,974 1,064,369 1,044,051 1,048,029 1,158,004 1,297,662 1,072,860 1,037,066 1,006,727 1,035,365 992,075 905,753 821,722 784,554 784,523 Self Deferrals 45,867 46,176 48,113 44,116 54,895 64,374 79,340 90,020 95,412 121,160 90,765 81,041 75,474 71,663 68,916 65,875 62,811 64,995 66,603 Suspensions not collected not collected not collected not collected not collected not collected not collected 52,544 66,832 77,635 81,086 74,993 76,734 71,030 72,823 78,813 73,359 71,897 75,277
Source: KH07A NHS Trust-based gures. Footnotes: 1. In the year 199798, information was collected annually only.
Table 63c EMERGENCY AND NON-EMERGENCY GENERAL & ACUTE ADMISSIONS(1), (2), (3) England Year 199697 199798 199899 19992000 200001 200102(5) 200203(5) 200304 200405 200506(6) Non-Elective Admissions (Emergency) 3,603,712 3,735,690 3,854,980 3,893,223 3,949,302 3,967,554 4,013,674 4,281,536 4,504,295 4,677,746 Elective Admissions(4) (Non-Emergency) 4,364,224 4,450,266 4,868,981 4,933,617 5,044,678 5,080,176 5,307,871 5,492,033 5,606,534 5,691,325
Source: Health Authority Quarterly Monitoring, Monthly Monitoring Returns. Footnotes: 1. These gures are for admissions purchased by the NHS (commissioner-based). 2. Figures for years prior to 200506 have been rebased to allow direct comparison. 3. General & Acute specialities do not include mental health, learning diYculties or maternity services. 4. Elective activity includes waiting list, booked and planned admissions. 5. Earlier gures are from Health Authorities. With the abolition of Health Authorities, gures for 200102 and 200203 are based on returns from NHS Trusts. 6. Figures are subject to revision when nal outturn gures are received. 5.1.2 What were (a) mean and (b) median waiting times for inpatient admission in each year since 198889? Could these data be shown in tabular and graphical form? (Q64) Answer 1. The information requested is given in Table 64 and Figure 64. Table 64 ESTIMATED MEAN AND MEDIAN INPATIENT WAITING TIMES (IN WEEKS) Qtr Ending March 1988 March 1989 March 1990 March 1991 March 1992 March 1993 March 1994 March 1995 March 1996 March 1997 March 1998 March 1999 March 2000 March 2001 March 2002 March 2003 March 2004 March 2005 March 2006 June 2006 Source: QF01 commissioner-based. Mean 40.0 40.4 37.4 32.8 22.2 19.6 20.0 17.4 15.9 18.1 20.0 18.6 18.7 18.1 17.4 15.6 12.4 10.6 8.7 8.6 Median 21.7 22.2 20.5 19.2 13.9 13.8 14.0 12.3 11.8 13.2 14.8 12.8 12.9 12.6 12.7 11.9 10.2 8.5 7.3 7.1
Figure 64: ESTIMATED INPATIENT AVERAGE WAITING TIMES
45 40 35 30
Weeks
25 20 15 10 5
September 88
September 89
September 90
September 91
September 92
September 93
September 94
September 95
September 96
September 97
March 88
March 89
March 90
March 91
March 92
March 93
March 94
March 95
March 96
March 97
March 98
Quarter ended Mean Median
5.1.3 Could the Department detail (a) numbers of First Finished Consultant Episodes (FFCEs), broken down into ordinary and day cases (b) admissions by type of admission and (c) episode/spell ratios by Strategic Health Authority in the past three years for which data are available? Could the Department comment on the use of FFCEs rather than Finished Consultant Episodes (FCEs)? (Q65) Answer 1. The available information is given in Table 65. 2. From 30 June 1998, the Departments admissions data has been collected as First Finished Consultant Episodes (FFCEs) rather than Finished Consultant Episodes (FCEs). The reason for this change is that FFCEs are a better indicator of new demand (ie patients entering the system for a new episode of care), as for every single FFCE there can be a number of FCEs, meaning FCEs generally overstate demand. 3. Furthermore, it can be noted that spell based activity counts are based on completed episodes of care (ie the sum of the completed FCEs equals one spell) and are thus similar in number to FFCE counts of activity. Essentially, spells are a count of discharges whereas FFCEs is a count of admissions, hence the two giving similar counts over any given period. 4. Note that the Departments data collections on ordinary and day-case admissions are not further subdivided by admission type. Also note that the Department does not collect data episode or spell which is available from the Information Centres HES return (though this is not directly comparable with the Departments information as supplied).
June 06
Mar 99
Mar 00
Mar 01
Mar 02
Mar 03
Mar 04
Sep 98
Sep 99
Sep 00
Sep 01
Sep 02
Sep 03
Sep 04
Mar 05
Table 65 ORDINARY & DAYCASE ELECTIVE ADMISSIONS

200304 Ordinary Admissions 74,976 54,224 50,216 54,031 36,642 42,918 46,650 35,015 57,754 43,482 63,912 78,591 76,768 111,953 92,601 65,234 65,264 52,380 88,018 73,702 80,086 47,990 49,752 92,107 49,241 52,131 78,403 48,973 200304 Daycase Admissions 173,282 109,267 118,410 114,478 71,181 110,099 108,992 81,090 150,989 95,192 144,037 161,013 152,196 191,285 143,928 135,699 117,300 95,127 168,839 167,184 128,901 124,770 127,248 219,746 118,857 126,063 176,299 97,967 200405 Ordinary Admissions 73,238 53,340 47,508 53,462 34,991 41,812 111,012 33,749 56,305 40,640 61,886 75,255 76,694 103,863 83,375 61,209 61,280 51,520 93,664 70,198 75,871 45,840 47,432 88,984 47,604 51,172 74,248 47,490 200405 Daycase Admissions 185,008 107,056 115,747 123,526 71,320 106,108 154,006 81,753 157,520 93,118 147,642 161,255 145,864 186,710 137,210 142,206 123,677 92,166 182,987 172,090 129,798 126,001 132,750 229,402 123,110 133,136 178,652 103,074 200506 Ordinary Admissions 74,310 55,692 50,782 49,914 33,977 43,529 43,927 32,140 56,291 40,800 66,120 74,851 73,932 105,020 84,709 59,527 59,721 49,412 77,505 69,062 74,038 46,619 49,878 88,460 51,252 51,638 74,660 48,979 200506 Daycase Admissions 203,086 111,466 120,075 125,040 77,505 108,835 121,804 85,343 161,554 98,091 156,444 171,138 152,478 198,315 143,511 154,009 130,874 87,649 184,358 181,878 138,238 132,049 139,265 254,648 137,156 137,378 183,294 109,099
Code Q01 Q02 Q03 Q04 Q05 Q06 Q07 Q08 Q09 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 Q19 Q20 Q21 Q22 Q23 Q24 Q25 Q26 Q27 Q28
Strategic Health Authority Norfolk, SuVolk And Cambridgeshire SHA Bedfordshire And Hertfordshire SHA Essex SHA North West London SHA North Central London SHA North East London SHA South East London SHA South West London SHA Northumberland, Tyne & Wear SHA County Durham And Tees Valley SHA North And East Yorkshire And Northern Lincolnshire SHA West Yorkshire SHA Cumbria And Lancashire SHA Greater Manchester SHA Cheshire & Merseyside SHA Thames Valley SHA Hampshire And Isle Of Wight SHA Kent And Medway SHA Surrey And Sussex SHA Avon, Gloucestershire And Wiltshire SHA South West Peninsula SHA Dorset And Somerset SHA South Yorkshire SHA Trent SHA Leicestershire, Northamptonshire And Rutland SHA Shropshire And StaVordshire SHA Birmingham And The Black Country SHA West Midlands South SHA
Source: Health Authority Quarterly Monitoring, Monthly Monitoring Returns. Footnotes: 1. These gures are for admissions purchased by the NHS (commissioner based). 2. Figures for years prior to 200506 have been rebased to allow direct comparison. 3. General & Acute specialities do not include mental health, learning diYculties or maternity services. 4. Elective activity includes waiting list, booked and planned admissions. 5. Earlier gures are from Health Authorities. With the abolition of Health Authorities, gures for 200102 and 200203 are based on returns from NHS Trusts. 6. Figures are subject to revision when nal outturn gures are received.
5.1.4 How many patients were waiting for inpatient treatment, by time waiting and Strategic Health Authority in commissioner-based form at the last available count? What were the mean and median waiting times in each case? (Q66) Answer The information requested is given in Table 66.
Table 66 IN-PATIENT WAITING LIST STATISTICS (ORDINARY AND DAY CASE ADMISSIONS) AT 30 JUNE 2006 (COMMISSIONER-BASED) TIME ON WAITING LIST
England by Strategic Health Authority Waiting Time (weeks) Total 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 18-19 19-20 20-21 21-22 22-23 23-24 24-25 25-26 26-27 27-28 28-29 29-30 30! Waiting week weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks weeks Mean Median 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 4 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 0 1 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 1 0 0 9 0 6 0 4 1 0 2 0 0 0 5 0 0 28 9.1 9.1 8.5 9.0 9.1 8.9 8.8 8.3 8.1 8.2 8.8 7.7 8.2 7.7 7.8 8.8 8.3 9.8 9.2 9.5 9.3 7.8 7.4 7.8 8.9 9.2 7.5 9.4 8.6 7.5 7.7 7.1 7.6 7.6 7.6 7.4 7.0 6.6 6.6 7.3 6.2 6.7 6.4 6.2 7.5 7.1 8.4 7.8 8.1 7.9 6.2 5.8 6.4 7.5 7.6 6.2 7.8 7.1
Strategic Health Authority
Norfolk, SuVolk and 39,272 2,470 3,166 3,059 2,966 2,041 2,470 2,265 2,235 1,738 1,717 1,386 1,159 1,397 1,356 1,316 1,326 1,137 1,138 959 798 810 781 555 463 319 245 Cambridgeshire Bedfordshire and Hertfordshire 27,705 1,716 2,019 2,172 2,017 1,492 1,728 1,665 1,485 1,233 1,340 973 980 1,133 967 866 930 820 787 693 539 544 476 358 320 261 190 Essex 27,014 2,140 2,118 2,077 1,984 1,483 1,784 1,734 1,406 1,257 1,423 979 761 978 985 891 806 824 718 571 484 494 468 265 207 118 59 North West London 26,356 2,030 1,991 1,900 1,850 1,290 1,689 1,475 1,469 1,017 1,347 888 846 1,004 1,024 822 924 808 683 738 584 577 474 383 280 180 83 North Central London 18,384 1,412 1,340 1,283 1,267 903 1,239 1,109 987 747 912 560 592 681 678 637 612 589 483 399 386 387 385 249 230 194 123 North East London 21,818 1,624 1,692 1,549 1,557 1,122 1,402 1,279 1,232 973 1,039 836 709 825 698 707 673 670 626 557 450 432 487 291 226 120 41 South East London 22,404 1,657 1,800 1,640 1,648 1,173 1,422 1,418 1,269 998 1,066 804 695 807 815 740 654 648 668 534 412 445 321 271 196 188 115 South West London 17,679 1,483 1,482 1,366 1,308 939 1,233 1,055 1,069 809 923 662 605 536 612 515 573 492 400 394 313 295 225 166 135 73 15 Northumberland, Tyne and Wear 20,989 1,594 2,022 1,774 1,688 1,101 1,446 1,427 1,241 910 929 699 659 770 638 572 475 564 512 317 375 330 317 215 170 154 90 County Durham & Tees Valley 14,905 1,013 1,335 1,241 1,372 762 1,061 1,036 843 661 695 436 438 504 525 438 366 367 347 251 297 270 210 137 135 95 70 North and East Yorkshire and 27,212 2,113 2,214 2,041 2,032 1,316 1,862 1,609 1,607 1,108 1,248 879 875 1,128 1,064 810 744 718 619 512 535 490 525 357 333 299 174 Northern Lincolnshire West Yorkshire 31,436 2,982 2,928 2,902 2,624 1,710 2,099 1,983 1,779 1,346 1,461 1,040 975 1,119 891 877 852 795 649 484 546 402 304 272 183 153 79 Cumbria & Lancashire 32,009 2,264 2,964 2,717 2,663 1,817 2,117 2,073 1,907 1,538 1,399 1,053 986 1,227 1,068 837 798 794 750 503 578 546 518 312 286 197 97 Greater Manchester 47,361 3,862 4,283 4,097 3,913 2,757 3,436 3,135 3,051 2,226 2,187 1,451 1,637 1,800 1,503 1,334 1,261 1,127 964 710 757 648 453 291 269 163 46 Cheshire & Merseyside 39,317 3,783 3,688 3,320 3,234 2,198 2,908 2,352 2,360 1,705 1,923 1,087 1,274 1,351 1,154 1,014 994 904 810 565 630 622 495 300 276 233 126 Thames Valley 27,483 2,175 1,994 1,950 2,079 1,351 1,714 1,637 1,739 1,243 1,341 898 875 1,194 942 933 789 863 730 675 517 537 475 319 244 182 87 Hampshire and Isle of Wight 26,703 1,711 2,014 2,147 2,069 1,420 1,977 1,859 1,745 1,329 1,550 965 980 995 942 883 780 651 598 535 361 360 275 227 168 105 48 Kent and Medway 23,686 1,290 1,618 1,609 1,679 1,117 1,474 1,389 1,304 970 1,127 860 711 964 743 756 813 730 792 690 562 705 574 428 393 278 110 Surrey and Sussex 36,910 2,401 2,557 2,737 2,468 1,967 2,320 2,233 2,139 1,685 1,779 1,414 1,148 1,395 1,241 1,271 1,178 1,167 1,102 1,006 758 840 699 523 384 320 173 Avon, Gloucestershire & 35,980 2,345 2,628 2,440 2,430 1,602 2,228 2,190 1,912 1,531 1,884 1,167 1,181 1,354 1,185 1,259 1,198 1,161 1,056 967 835 828 775 581 523 452 267 Wiltshire South West Peninsula 29,084 2,233 2,043 2,048 1,868 1,289 1,790 1,751 1,644 1,146 1,537 955 1,002 1,123 1,012 959 1,043 977 859 688 734 688 548 418 337 248 144 Somerset & Dorset 14,835 1,079 1,348 1,448 1,353 958 1,065 970 896 614 681 504 473 513 379 388 375 300 264 243 228 192 151 131 125 93 61 South Yorkshire 20,194 1,865 2,103 1,918 1,793 1,279 1,397 1,227 1,075 860 918 633 582 643 554 518 484 444 383 293 302 256 250 164 119 86 48 Trent 38,885 2,892 3,724 3,554 3,320 2,391 2,502 2,513 2,390 1,834 1,678 1,367 1,148 1,468 1,174 1,075 1,019 877 817 686 636 509 423 349 302 161 76 Leicestershire, Northamptonshire 25,312 1,755 2,097 1,939 1,837 1,192 1,731 1,383 1,495 1,071 1,156 820 898 941 881 883 820 764 710 668 528 545 420 315 225 175 63 & Rutland Shropshire and StaVordshire 21,733 1,498 1,651 1,609 1,485 1,091 1,387 1,407 1,256 954 1,023 611 708 900 712 674 653 653 565 561 447 481 466 278 248 224 182 Birmingham and the Black 29,194 2,302 2,875 2,722 2,527 1,693 2,156 2,043 1,773 1,321 1,385 970 925 1,049 822 706 716 610 566 468 390 347 355 187 129 101 56 Country West Midlands South 24,624 1,479 1,808 1,910 1,826 1,138 1,523 1,511 1,345 957 1,127 731 912 913 981 940 731 779 672 613 494 566 518 342 336 271 201 England 768,484 57,168 63,502 61,169 58,857 40,592 51,160 47,728 44,653 33,781 36,795 25,628 24,734 28,712 25,546 23,621 22,587 21,233 19,268 16,280 14,476 14,146 12,368 8,684 7,242 5,443 3,069 Source: QF01.
5.1.5 In latest quarter for which data are available, how many patients waited (a) over three months and (b) over six months for inpatient treatment by Strategic Health Authority of residence and specialty? (Q67) Answer 1. The information requested is given in Table 67a and Table 67b.
Table 67a NUMBER OF INPATIENTS NOT SEEN IN THE QUARTER ENDED 30 JUNE 2006 WHO WAITED OVER 13 WEEKS FOLLOWING A CONSULTANT DECISION TO ADMIT
England by Strategic Health Authority and Specialty Strategic Health Authority Norfolk, SuVolk and Cambridgeshire Bedfordshire and Hertfordshire Essex North West London North Central London North East London South East London South West London Northumberland, Tyne and Wear County Durham and Tees Valley North and East Yorkshire and Northern Lincolnshire West Yorkshire Cumbria and Lancashire Greater Manchester Cheshire and Merseyside Thames Valley Hampshire and Isle of Wight Kent and Medway Surrey and Sussex Avon, Gloucestershire and Wiltshire South West Peninsula Somerset and Dorset South Yorkshire Trent Leicestershire, Northamptonshire and Rutland Shropshire and StaVordshire Birmingham and the Black Country West Midlands South England Source: QF01 commissioner based. Footnotes: 1. Includes non-major specialties. General Surgery 1,985 947 1,057 1,566 890 807 1,223 643 496 470 1,713 1,231 1,687 1,671 1,445 799 760 1,069 1,929 1,697 1,460 368 687 1,454 1,058 865 922 1,296 32,195 Urology 995 432 566 463 512 390 381 151 375 501 460 630 507 709 594 459 370 568 601 748 458 114 240 541 504 212 163 354 12,998 Trauma and Orthopaedics 3,176 2,550 2,108 2,227 1,299 1,427 1,715 1,224 1,878 1,279 2,022 1,618 2,781 2,808 2,849 2,682 2,175 3,125 4,394 4,178 2,829 1,362 1,141 3,374 1,954 2,933 2,541 3,182 66,831 Ophthalmology ENT 968 816 658 1,015 638 1,090 528 448 540 138 554 550 508 799 1,173 581 714 758 1,076 1,254 957 254 364 494 598 579 340 722 19,114 454 325 236 418 419 578 411 584 126 132 200 228 249 410 393 255 163 277 426 404 214 48 233 225 222 199 170 179 8,178 SPECIALTY Oral Plastic Surgery Surgery 913 479 421 183 153 148 132 298 356 310 322 259 214 700 407 502 367 233 463 657 502 131 225 345 1,029 311 97 371 10,528 849 426 581 313 163 243 115 171 310 147 452 274 338 348 236 684 212 152 149 458 421 192 121 161 442 146 316 222 8,642 General Medicine 252 13 123 34 19 182 133 38 3 1 330 315 86 772 67 3 36 20 39 33 95 2 89 249 14 87 88 97 3,220 Dermatology 53 55 2 1 42 55 6 0 30 1 0 2 0 5 197 0 3 0 67 3 204 0 18 65 7 0 26 3 845 Gynaecology 809 639 633 636 592 518 770 311 172 313 467 634 360 416 248 783 607 779 915 1,012 845 301 217 596 709 488 269 546 15,585 All Specialties(1) 11,203 7,752 6,890 7,560 5,352 5,979 6,007 4,209 4,729 3,508 7,180 6,488 7,284 9,526 8,134 7,293 5,942 7,574 10,667 11,088 8,655 2,933 3,901 8,104 6,997 6,153 5,453 7,444 194,005
Table 67b PERCENTAGE OF INPATIENTS NOT SEEN IN THE QUARTER ENDED 30 JUNE 2006 WHO WAITED OVER 26 WEEKS FOLLOWING A CONSULTANT DECISION TO ADMIT
England by Strategic Health Authority and Specialty Strategic Health Authority Norfolk, SuVolk and Cambridgeshire Bedfordshire and Hertfordshire Essex North West London North Central London North East London South East London South West London Northumberland, Tyne and Wear County Durham and Tees Valley North and East Yorkshire and Northern Lincolnshire West Yorkshire Cumbria and Lancashire Greater Manchester Cheshire and Merseyside Thames Valley Hampshire and Isle of Wight Kent and Medway Surrey and Sussex Avon, Gloucestershire and Wiltshire South West Peninsula Somerset and Dorset South Yorkshire Trent Leicestershire, Northamptonshire and Rutland Shropshire and StaVordshire Birmingham and the Black Country West Midlands South England Source: QF00 commissioner based. Footnotes: 1. Includes non-major specialties General Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 1 0 1 0 0 0 5 0 0 10 Urology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 1 0 0 5 Trauma and Orthopaedics 0 1 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 0 0 6 Ophthalmology ENT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 2 SPECIALTY Oral Plastic Surgery Surgery 0 0 0 8 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 General Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Gynaecology All Specialties(1) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 1 0 0 11 0 9 0 5 1 0 3 0 0 0 9 0 0 42
5.2 Outpatient Activity and Waiting 5.2.1 How many (a) GP referrals for rst outpatient appointment (b) other rst outpatient referrals (c) rst attendances and (d) other attendances were there in each year since 198889? (Q68) Answer 1. The available information is given in Table 68. Table 68 REFERRALS AND OUTPATIENT APPOINTMENTS(1) GP and GDP(2) Referrals to 1st Outpatient Appointment (Consultant Led) Other Referrals to 1st Outpatient Appointment (Consultant Led) Subsequent Outpatient Appointments (Consultant Led) 28,332,392 27,728,475 27,785,860 27,609,744 27,952,184 28,184,758 28,519,690 28,942,923 29,128,357 29,578,700 30,105,837 30,376,617 30,904,294 31,103,107 31,062,363 30,886,026 31,689,082 31,397,428 31,499,332
Year 198788 198889 198990 199091 199192 199293 199394 199495 199596 199697 199798 199899 19992000 200001 200102 200203 200304 200405 200506
First Outpatient Appointments (Consultant Led) 8,513,705 8,389,356 8,519,361 8,501,760 8,941,526 9,342,280 9,680,593 10,362,877 10,989,334 11,294,069 11,529,432 11,777,780 12,136,405 12,466,233 12,612,615 12,878,799 13,430,530 13,370,173 13,727,249
7,996,019 8,547,633 8,692,158 8,991,722 9,139,785 9,141,425 9,362,770 9,470,342 9,655,874 9,802,237 9,776,914 9,807,847
1,680,927 2,322,463 2,877,519 3,328,204 3,361,251 3,460,904 3,717,471 4,016,558 4,299,402 4,643,662 4,960,972 5,254,313
Source: Department of Health, QM08, KH09, monthly monitoring. Footnotes: 1. This data is provider-based. 2. GDP % General Dental Practitioner.3. GP referrals rst collected in December 1993. 199495 is the rst full nancial year of data. 5.2.2 What were (a) mean and (b) median waiting times for outpatient appointments in each year since 198889? Could these data be shown in tabular and graphical form? (Q69) Answer 1. The available information is given in Table 69 and Figure 69. Outpatient waiting times gures were rst collected in 199495. No data are available before this date.
Table 69 AVERAGE WAITING TIMES AND NUMBERS FOR FIRST OUTPATIENT APPOINTMENTS Mean waiting time (weeks) 9.3 9.3 8.7 8.7 9.3 10.4 11.5 10.8 11.1 9.0 8.5 7.4 6.4 Median waiting time (weeks) 5.5 5.7 6.0 6.0 6.3 7.0 7.6 7.4 7.6 7.3 7.1 7.0 6.1
Quarter ending March 1994 March 1995 March 1996 March 1997 March 1998 March 1999 March 2000 March 2001 March 2002 March 2003 March 2004 March 2005 March 2006 Source: QM08 NHS Trust-based gures. Footnotes: 1. Figures not available prior to 199394.
FIGURE 69: OUTPATIENT AVERAGE WAITING TIMES (PATIENTS SEEN) 14
12
10
Weeks
March 94
March 95
March 96
March 97
March 98
March 99
March 00
March 01
March 02
March 03
March 04
March 05
Quarter ended Mean Median
5.2.3 How many new outpatient attendances were there by Strategic Health Authority in the past three years for which data are available? What are these data equivalent to per 1,000 population? (Q70) Answer The information requested is given in Table 70.
March 06
Table 70 FIRST OUTPATIENT ATTENDANCES (CONSULTANT LED)(1) Org Code Org Name 200304 200405 200506 200304 per 1,000 population 260 219 230 270 446 301 321 299 418 274 213 240 237 316 319 250 227 217 244 248 250 269 381 208 220 237 305 236 269 200405 per 1,000 population 263 220 240 285 435 306 329 296 334 275 215 229 240 309 319 254 230 226 242 253 247 267 370 210 229 241 309 229 268 200506 per 1,000 population 275 205 240 294 423 278 345 311 358 281 234 234 244 316 325 262 236 238 243 259 262 281 398 212 249 236 327 242 275
Norfolk, SuVolk And Cambridgeshire SHA Bedfordshire And Hertfordshire SHA Essex SHA North West London SHA North Central London SHA North East London SHA South East London SHA South West London SHA Northumberland, Tyne & Wear SHA County Durham And Tees Valley SHA North And East Yorkshire And Northern Lincolnshire SHA West Yorkshire SHA Cumbria And Lancashire SHA Greater Manchester SHA Cheshire & Merseyside SHA Thames Valley SHA Hampshire And Isle Of Wight SHA Kent And Medway SHA Surrey And Sussex SHA Avon, Gloucestershire And Wiltshire SHA South West Peninsula SHA Dorset And Somerset SHA South Yorkshire SHA Trent SHA Leicestershire, Northamptonshire And Rutland SHA Shropshire And StaVordshire SHA Birmingham And The Black Country SHA West Midlands South SHA England
571,772 358,341 371,588 498,995 546,843 464,216 484,717 392,241 582,230 315,228 346,758 508,450 454,262 814,389 754,838 538,363 402,215 349,308 620,168 543,076 400,480 321,799 488,668 552,593 332,253 349,698 701,282 365,759 13,430,530
580,166 360,942 387,496 526,254 534,029 470,983 496,205 388,223 464,759 316,328 349,767 483,902 458,946 795,465 755,062 545,721 407,583 362,704 616,755 554,117 395,894 320,072 474,743 557,515 346,510 354,629 710,418 354,985 13,370,173
606,199 336,268 387,339 542,757 519,566 427,890 520,705 408,016 499,139 322,586 381,977 496,095 467,961 812,415 768,861 562,610 418,252 381,968 617,724 568,136 419,069 336,369 509,859 563,433 376,176 348,294 751,379 376,206 13,727,249
Source: Department of Health, QM08, monthly monitoring. Population data, GP membership populations, The Information Centre for health and social care. Footnote: 1. This data is provider based.
5.2.4 Of patients not yet seen following written referral at the end of the latest quarter for which data are available, how many had been waiting (a) less than 13(b), 1317(c), 1721 and (d) more than 21 weeks, by Strategic Health Authority, in commissioner-based form? (Q71) Answer 1. The information requested is given in Table 71. It is not possible to show (c) and (d) separately. Table 71 PATIENTS NOT YET SEEN FOLLOWING GP WRITTEN REFERRAL, TIME WAITING FROM REFERRAL TO QUARTER ENDED 30 JUNE 2006 (COMMISSIONER-BASED) GP written referrals not yet seen at end of quarter who have been waiting (weeks) under 13 13 to under 17 17 ! 47,193 36,160 43,545 43,720 38,553 39,191 37,686 30,169 37,534 23,898 35,191 45,340 42,382 72,100 62,401 39,158 36,151 40,094 53,413 50,735 39,492 23,827 32,466 50,333 35,289 31,410 59,725 39,403 1,166,559 0 2 0 1 0 2 0 0 0 0 2 0 0 1 20 1 0 0 1 1 0 0 0 0 0 18 2 0 51 0 0 0 0 0 1 0 0 0 0 0 0 0 0 28 0 0 0 0 10 0 0 0 0 0 88 0 1 128
Strategic Health Authority Norfolk, SuVolk and Cambridgeshire Bedfordshire and Hertfordshire Essex North West London North Central London North East London South East London South West London Northumberland, Tyne and Wear County Durham & Tees Valley North and East Yorkshire and Northern Lincolnshire West Yorkshire Cumbria & Lancashire Greater Manchester Cheshire & Merseyside Thames Valley Hampshire and Isle of Wight Kent and Medway Surrey and Sussex Avon, Gloucestershire & Wiltshire South West Peninsula Somerset & Dorset South Yorkshire Trent Leicestershire, Northamptonshire & Rutland Shropshire and StaVordshire Birmingham and the Black Country West Midlands South England Source: QM08R. (Commissioner based).
5.2.5 Of patients seen following written referral in the latest quarter for which data are available, how many waited (a) less than 13 weeks and (b) more than 13 weeks, by Strategic Health Authority of residence and specialty? (Q72) Answer 1. The information requested is given in Table 72a and Table 72b.
Table 72a NUMBER OF PATIENTS SEEN IN THE QUARTER ENDED 31 MARCH 2006 WHO WAITED UNDER 13 WEEKS FOLLOWING GP WRITTEN REFERRAL
England by Strategic Health Authority & Specialty General Surgery 11,343 6,853 8,363 8,626 6,207 6,511 8,844 6,236 8,013 6,079 9,798 10,939 10,738 15,180 14,387 7,708 9,289 8,924 13,377 10,182 9,692 5,907 7,978 13,881 5,533 5,302 12,249 8,276 256,415 Urology 3,847 2,033 2,497 2,703 2,023 2,171 2,091 2,136 2,643 2,120 2,979 3,395 3,667 5,211 4,327 2,703 3,292 2,717 5,037 3,780 2,656 2,122 2,977 4,287 2,010 1,517 3,772 2,972 83,685 Trauma & Orthopaedics 6,960 5,697 6,186 6,095 3,196 4,296 6,128 4,380 5,495 3,426 5,622 4,447 8,511 10,336 9,751 8,524 5,925 5,600 10,628 8,383 5,791 4,274 5,446 10,061 5,195 2,349 9,677 7,336 179,715 ENT 7,925 4,531 6,460 5,429 4,205 4,962 3,725 3,864 6,390 4,628 5,682 6,404 7,101 10,673 8,885 5,794 5,394 6,194 9,341 6,758 5,645 3,211 4,836 8,964 4,121 2,235 8,661 5,123 167,141 SPECIALTY Ophthalmology Oral Surgery 7,555 4,930 5,895 7,673 3,612 4,698 3,449 4,418 4,717 3,247 5,922 5,860 6,523 8,958 8,622 6,616 6,450 4,712 10,236 7,100 5,234 3,570 4,860 8,381 3,187 2,096 10,168 5,860 164,549 4,027 2,464 3,410 2,592 2,160 989 1,556 2,149 1,567 1,450 1,854 2,158 3,081 5,572 3,594 3,870 3,489 2,398 4,585 3,505 2,158 1,942 2,282 4,201 2,391 706 2,474 2,391 75,015 Plastic Surgery 1,098 1,274 1,157 1,012 228 320 272 609 799 833 1,271 1,003 775 816 1,244 2,092 249 590 1,170 1,051 1,293 290 537 601 829 199 1,305 670 23,587 General Medicine 3,387 1,966 2,835 1,031 2,344 1,456 2,049 1,432 3,051 4,017 3,434 3,461 6,278 9,238 6,046 2,091 2,779 3,090 4,441 3,478 2,058 2,066 5,616 7,998 2,108 2,400 6,564 4,583 101,297 Dermatology 5,607 3,248 5,469 5,156 4,060 4,422 5,425 3,454 5,486 3,344 4,537 5,329 5,146 7,493 7,440 6,401 5,946 3,991 6,762 6,141 4,922 3,051 5,834 8,920 3,859 2,153 8,277 4,490 146,363 Gynaecology 7,011 4,722 5,364 6,711 5,770 5,177 9,745 6,956 6,755 4,282 5,644 8,068 8,003 13,742 11,576 6,005 7,422 5,644 8,038 8,002 6,425 3,574 5,035 10,127 4,494 3,050 9,846 4,489 191,677 All Specialties(1) 79,456 49,201 65,388 68,254 49,899 54,747 58,848 50,405 62,767 43,655 62,896 68,137 73,090 115,692 99,931 68,646 66,490 56,796 94,682 77,910 63,853 40,315 57,935 103,646 46,078 29,126 103,403 59,430 1,870,676
Strategic Health Authority Norfolk, SuVolk and Cambridgeshire Bedfordshire and Hertfordshire Essex North West London North Central London North East London South East London South West London Northumberland, Tyne and Wear County Durham & Tees Valley North and East Yorkshire and Northern Lincolnshire West Yorkshire Cumbria & Lancashire Greater Manchester Cheshire & Merseyside Thames Valley Hampshire and Isle of Wight Kent and Medway Surrey and Sussex Avon, Gloucestershire & Wiltshire South West Peninsula Somerset & Dorset South Yorkshire Trent Leicestershire, Northamptonshire and Rutland Shropshire and StaVordshire Birmingham and the Black Country West Midlands South England
Source: QM08R commissioner-based. Footnotes: 1. Includes non-major specialties.
Table 72b NUMBER OF PATIENTS SEEN IN THE QUARTER ENDED 31 MARCH 2006 WHO WAITED OVER 13 WEEKS FOLLOWING GP WRITTEN REFERRAL
England by Strategic Health Authority & Specialty General Surgery 469 373 68 622 277 3 100 1 111 155 327 56 598 195 351 21 86 0 5 209 159 534 27 91 84 1,975 58 153 7,108 Urology 128 187 18 344 166 1 115 0 79 75 135 113 178 148 250 19 51 15 3 59 45 323 11 29 11 778 21 138 3,440 Trauma & Orthopaedics 900 630 74 889 595 2 187 1 512 373 1,071 63 375 539 765 210 17 33 7 451 366 688 95 80 69 3,673 142 270 13,077 ENT 218 1,321 60 487 340 24 59 0 438 51 283 97 693 356 468 76 239 0 12 562 155 639 7 13 92 2,656 83 120 9,549 SPECIALTY Ophthalmology Oral Surgery 144 491 70 132 180 15 520 3 31 45 499 39 436 236 228 30 115 10 3 131 363 1,105 89 29 21 2,002 253 100 7,320 145 285 40 257 183 3 60 0 266 86 111 10 397 215 138 3 24 0 13 78 158 498 48 30 47 1,169 26 194 4,484 Plastic Surgery 108 124 30 28 53 1 8 0 27 80 215 53 65 25 11 54 0 0 2 75 20 22 9 15 9 224 56 41 1,355 General Medicine 153 152 14 39 155 0 47 0 47 107 219 39 537 271 129 8 69 2 1 93 8 326 12 30 67 1,656 32 53 4,266 Dermatology 153 305 65 613 483 4 126 3 81 137 145 16 948 428 260 70 62 0 0 299 65 766 16 32 18 1,364 62 110 6,631 Gynaecology 331 203 44 407 369 2 205 1 178 54 100 169 199 156 328 9 51 4 7 291 97 430 1 34 28 1,786 32 136 5,652 All Specialties(1) 3,518 5,064 683 5,324 3,901 127 1,984 11 2,403 1,653 4,206 972 5,348 3,256 3,319 586 840 75 76 2,942 1,729 6,952 359 494 631 21,879 987 1,794 81,113
Strategic Health Authority Norfolk, SuVolk and Cambridgeshire Bedfordshire and Hertfordshire Essex North West London North Central London North East London South East London South West London Northumberland, Tyne and Wear County Durham & Tees Valley North and East Yorkshire and Northern Lincolnshire West Yorkshire Cumbria & Lancashire Greater Manchester Cheshire & Merseyside Thames Valley Hampshire and Isle of Wight Kent and Medway Surrey and Sussex Avon, Gloucestershire & Wiltshire South West Peninsula Somerset & Dorset South Yorkshire Trent Leicestershire, Northamptonshire and Rutland Shropshire and StaVordshire Birmingham and the Black Country West Midlands South England
Source: QM08R commissioner-based. Footnote: 1. Includes non-major specialties.
5.2.6 Could the Department comment on the progress of the Outpatient Commissioning Dataset? How much has been spent on the project, by year? How much is planned to be spent, by year? When are data likely to be published and in what form? Could the Department comment on the quality of these data? Could the Department comment on the possibility of making diagnosis and procedure mandatory in data submission? (Q73) Answer 1. The Outpatient Commissioning Dataset (CDS) owed for the rst time midway through 200102. Therefore, the dataset is relatively new. Like all new datasets, data quality and coverage were initially patchy. The advent of Payment by Results and the 18-week wait programme have raised the importance of the dataset signicantly. Work is being undertaken to improve quality by: Publishing the data, so NHS organisations can view each others gures and compare quality; and The national data improvement programme (NDIP). This is led by the Information Centre (IC) with the aim of improving data quality and tness for purpose by working with NHS organisations and by inuencing future dataset developments to ensure that they facilitate the submission of good quality data from the NHS. 2. Table 73 shows the estimated historic and planning on selected projects around the outpatient CDS. 3. In July 2006, analysis of the record level information from the Outpatient Commissioning dataset was published for the rst time by the Information Centres Hospital Episode Statistics (HES) team. The published data covered 200405 and 200304 and were labelled as experimental. The experimental status is used within OYcial Statistics to cover data which contain a great deal of useful and usable material but which are indicative and are not yet suYciently robust to be denitive. 4. The publication can be downloaded from the IC website at the following address: http://www.ic.nhs.uk/pubs/hesoutpatients2003to2005/hespub/le 5. The quality of the data is discussed in section 4 of the publication referenced above. The main ndings on quality are: National attendance counts show close agreement between these data and existing DH aggregate returns and in many areas the data provide a good basis for national comparison; At local level the new data need to be treated with greater caution due to a few large local variations in completeness and recording practices; Data items that are well completed (above 90%) include age, referral source and personal information around the patient that is essential for tracking the patients journey through the NHS; and Data items that are poorly completed are mainly those that are not mandated, such as information on whether the patient did not attend as well as procedure and diagnosis information. 6. In addition to publishing the analysis, customers have the opportunity to request the raw data, so that they can perform further analysis of the data and provide the IC with comments around their quality. A specic outpatient data quality publication is planned for late autumn 2006, that will explore quality issues in more detail based on this user feedback. 7. The possibility of mandating procedure and diagnosis is currently being actively discussed and explored. Clearly there would be a large cost to the NHS in additional staV time and enhanced systems to enable this information to be consistently recorded. However, having these items mandatory would make the dataset much richer and facilitate both the monitoring of the 18 week wait target and the funding of outpatient procedures and diagnoses under Payment by Results (PbR). The current plan is that NHS providers will be paid for outpatient activity under Version 4 Healthcare Resource Groups under the PbR tariV from 200809. Procedure and, probably, diagnosis information will be needed to create these HRGs. Therefore, if NHS organisations do not start submitting the information at this point, they will not get paid, so this will produce a powerful incentive for this information to be submitted, regardless of whether its submission is mandated.
Table 73 ESTIMATED HISTORIC AND PLANNED SPEND ON SELECTED PROJECTS AROUND THE OUTPATIENT CDS
thousands 200102 Central system for receiving and processing providers data(2) Suppliers of Hospital Episode Statistics System (Northgate) Central Spend on Data Set Change Notices National Data Improvement Programme (NDIP) Producing Publication of Data from Outpatient CDS Source: Northgate Budgets, Information Centre Budgets, Connecting for Health Budgets. Footnotes: 1. There is not a single project developing the Outpatient CDS, rather there are several interconnected project and work areas developing various aspects of it. This table gives the central expenditure on areas for which this can be estimated. Expenditure that would occur even without the Outpatient CDS has been omitted. Local expenditure in collecting the data has also been omitted as it is assumed that this information would be collected for local purposes even if it were not submitted centrally. 2. The central system for receiving and processing data is NHS Wide Clearing Service (NWCS) up until Quarter 3 200607 and Secondary Uses Service (SUS) from Quarter 4 200607 onwards. Additional developmental costs around Secondary Uses Service (SUS) have been excluded from the estimate as these would have occurred regardless of the Outpatient CDS. The costs around SUS transmitting data have been estimated by extrapolating the NWCS gures. 380 0 40 0 0 200203 400 40 20 0 0 200304 430 382 60 0 0 200405 450 58 24 0 2 200506 470 58 28 69 26 200607 490 93 50 62 46 200708 520 93 60 68 75
5.3 Primary Care Activity 5.3.1 How many NHS GP consultations are estimated to have taken place in each year since 1989? (Q74) Answer 1. The data requested is given in Table 74. 2. The gures are estimated using results from the OYce for National Statistics (ONS) general household survey (GHS) and ONS population estimates. These estimates are rounded to the nearest million and are subject to a large margin of error. 3. For additional data on the subject see the tables in section 7 of the GHS (www.statistics.gov.uk/ghs) Table 74 ESTIMATED TOTAL NUMBER OF NHS GP AND PRACTICE NURSE CONSULTATIONS IN ENGLAND, PER YEAR Year 1989 1990 1991 1992 1993 1994 1995 1996 1997(2) 1998 1999(2) 2000 2001 2002 2003 2004 All GP consultations(1),(3),(4) 218,000,000 243,000,000 214,000,000 232,000,000 252,000,000 224,000,000 235,000,000 254,000,000 217,000,000 221,000,000 218,000,000 243,000,000 215,000,000 223,000,000
Practice Nurse consultations(3),(4),(5)
64,000,000 81,000,000 85,000,000 89,000,000 91,000,000
Source: OYce for National Statistics General Household Survey and Population Statistics Database. Footnotes: 1. GP consultations include home visits, telephone consultations and visits to the GP practice by the patient. 2. GP consultation estimates are not available for 1997 and 1999. 3. Population data used to calculate the estimated total numbers of consultations are revised 2001-based estimates from the ONS and may diVer slightly from previous estimates. 4. Figures are rounded to the nearest million. 5. Practice nurse consultation estimates are not available prior to 2000. 5.3.2 Could the Department provide evidence of any shift in activity from secondary to primary care settings? Could the Department comment on these data and the likely impact of such service reconguration? (Q75) Answer 1. The Department has been collecting data on total activity in primary care and outpatient settings though diYculties have been found in such data collections. These stem from data collection not being as well embedded in these areas as it is in secondary care, where data recording standards have been in place for decades. Hence, the recent Hospital Episode Statistics (HES) publication Reporting Outpatient Journeys: Hospital Outpatient Activity in 200304 and 200405 has been marked experimental. 2. Data showing total activity in primary care and outpatient settings is given in Table 75, though note the ranges used, reecting data quality issues. 3. Direct collection of data pertaining to shifts in activity from secondary to primary care is not yet possible. While the Department is seeking to develop work in collecting information relating to shifts in activity, particularly following the recent White Paper Our health, our care, our say there are issues in dening activity that has shifted. 4. The issues arise mainly from the diVerent models of provision across the country. For example where certain activity may be new to a particular primary care provider in one part of the country it can have already become regular work for providers in other areas. Distinctions between primary care settings and secondary care activity as separate entities are thus diYuclt to apply nationally.
5. A project is underway to generate evidence for shifting care in six speciality areasENT, orthopaedics, gynaecology, dermatology, urology and general surgery. The Care Closer to Home Demonstration project is evaluating services in 30 locations across England, where care has been shifted or made more convenient for patients. The evaluation will look at the cost implications of shifting care in these areas but will also consider the safety, workforce and clinical governance implications of shifting care. The project is being carried out in assocition with a number of the Royal Colleges and speciality associations as well as the Healthcare Commisison and the NHS Confederation. In addition the NHS Institutes Shifting Care demonstration sites are looking to develop a practical evidence base of the eVects of shifting to primary care, and lessons to be learnt in doing so. We are working with the NHS Institute to develop a joint implementation plan. 6. This work and wider learning will provide information on the eVects of shifting from secondary to primary care, and as such will help inform future decisions on the beneifts of, and how to make, the shift to primary care. Table 75 NHS-FUNDED OPERATIVE PROCEDURES IN DIFFERENT SETTINGS Thousands Year(2) (4) 200102 200203 200304 200405 200506 Procedures in Primary Care(1) Procedures in Outpatients(3) 1,111 1,729 2,045 2,067 2,153 to 2,175 527 631 656 to 681
Source: LDPR Collection. Footnotes: 1. Due to denitional issues, data prior to 200304 are not comparable. 2. Figures for years prior to 200506 have been rebased to allow direct comparison. 3. With the abolition of Health Authorities, gures for 200102 and 200203 are based on returns from NHS Trusts. 4. 200506 gures are subject to revision when nal outturn gures are received. 5.4 Action on Waiting Lists 5.4.1 Could the Department comment on recent relative trends in waiting lists and times and rates of NHS activity? Could these comparative trends be shown graphically where appropriate? (Q76) Answer 1. Figure 76a shows how waiting times have fallen since 1997. In particular, as at end June 2006, there were only 42 patients waiting over 26 weeks (six months), compared with 284,000 in March 1997. The gure shows how the number waiting over 15, 12, nine and six months have been reduced in order to meet PSA targets. 2. Similarly, Figure 76b shows that the number of patients on the total in-patient waiting list, rose from 826,000 in June 1987 to 1,158,000 in March 1997, and a peak of 1,313,000 in April 1998. It has subsequently fallen steadily to 785,000 in June 2006. 3. The number of decisions to admit for in-patient treatment per year rose from around 2.8 million in 1988 to 4.2 million 1998, before falling back to 4.0 million in 2005 (see Figure 76c). The number of admissions from the waiting list follow a very similar pattern, rising between 1988 and 1998, before falling back in the period up to 2005. 4. The gap between these two data series peaked in 199798, leading to the waiting list peaking in April 1998. The gap between the two series then reduced, allowing for the list to fall over the subsequent years. The recent fall in activity reects the fact that more patients are now treated in an outpatient setting, rather than being admitted as in-pateints. Hence, waiting times have fallen as less patients are added to the list.
Figure 76a : Inpatient waiting times by timeband (commissioner-based), 1997 - present

500000
Target: No one waiting more than 15 months at Mar 2002 Target: No one waiting more than 12 months at Mar 2003 Target: No one waiting more than 9 months at Mar 2004 Target: No one waiting more than 6 months by Dec 2005
450000
400000
350000
Number of patients
300000
250000
200000
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100000
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0 Mar 97
Mar 98
Mar 99
Mar 00
Mar 01
Mar 02
Mar 03
Mar 04
Mar 05
People waiting 6 months or more People waiting 12 months or more
People waiting 9 months or more People waiting 15 months or more
Figure 76b : In-patient waiting list (provider-based), 1987 - present

1400000
1200000
1000000
Number of patients
800000
600000
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Mar 1987 Mar 1988 Mar 1989 Mar 1990 Mar 1991 Mar 1992 Mar 1993 Mar 1994 Mar 1995 Mar 1996 Mar 1997 Mar 1998 Jul 1998 Nov 1998 Mar 1999 Jul 1999 Nov 1999 Mar 2000 Jul 2000 Nov 2000 Mar 2001 Jul 2001 Nov 2001 Mar 2002 Jul 2002 Nov 2002 Mar 2003 Jul 2003 Nov 2003 Mar 2004 Jul 2004 Nov 2004 Mar 2005 Jul 2005 Nov 2005 Mar 2006
Figure 76c : Admissions and decisions to admit - Provider based, England

4500000
4000000
3500000
3000000
2500000
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0 Mar 89 Mar 90 Mar 91 Mar 92 Mar 93 Mar 94 Mar 95 Mar 96 Mar 97 Mar 98 Mar 99 Mar 00 Mar 01 Mar 02 Mar 03 Mar 04 Mar 05 Mar 06 Admissions Decision to Admit
5.4.2 What progress has been made towards monitoring the target of no patients waiting more than 18 weeks from GP appointment to treatment? Have any pilot studies taken place? If so, what were the results? When does the Department expect National Statistics accredited data to be published? (Q77) Answer 1. The Department has been working with eight local health economies since early this year on developing simple and practical measurement systems to capture and record referral to treatment (RTT) times to support delivery of the 18 weeks target. These health economiesknown as pioneersmake use of one of a variety of existing patient administration systems; they reect a range of local health environments and are focussing on a number of diVerent specialties. The pioneers have developed practical approaches to RTT measurement that do not require signicant additional investment in IT systems and that are transferable to others with similar IT systems. Each of the pioneer sites submitted a full report on their tactical approach to RTT measurement and these are available on the 18 weeks website. In addition the RTT approaches developed by the pioneers have been shared with the rest of the NHS through a series of roadshows covering the whole country. 2. The learning from the pioneers was instrumental in the creation of the recent dataset change notice (DSCN 17/2006) which mandates national data collection (for pioneers and non-pioneers alike) from January 2007 and for all patients from April 2007. 3. This particular collection will report for the rst time on referral to treatment times and will be challenging for NHS organisations. However, as with other new collections the Department is committed to publishing and disseminating the RTT data once the requirements of national statistics (including coherence, completeness, timeliness and accuracy) have been met. It can take several months of data collection before this point is reached. Precise timing will depend on the quality of data submitted by the NHS. 5.4.3 What additional mechanisms are in progress to deal with waiting lists and times, and what is expenditure and projected expenditure on these additional mechanisms? (Q78) Answer 1. Following the successful achievement of targets for 13 weeks and 26 weeks for rst out-patient appointments and in-patient admissions respectively, the NHS is working towards a new waiting time target. By the end of 2008, patients will be treated within a maximum of 18 weeks from referral by their GP to the start of their treatment. For the rst time, this will include all the out-patient consultations and diagnostic tests needed before treatment can commence. 2. Modelling of the extra resources needed to progress against the 18 week target was part of the Spending Review and resources are in place until 2007.
3. The NHS has been set interim milestones and each PCT will submit quantitative plans for achieving the milestones and then the 18-week target overall. The plans will include the volumes of extra hospital activity that PCTs expect to need in order to reduce waiting times to 18 weeks. SHAs will monitor the delivery of those plans agains the agreed trajectories and the Recovery and Support Unit will work closely with SHAs to ensure rapid action and support where needed, including an intensive support team that will work in health economies where hands-on support is required. 4. Work is advanced in collecting data on waiting times that have not previously been measured. For diagnostics, national data collection began in January 2006. On a monthly basis, we are now collecting activity and waiting time band data for 15 key tests. This list was developed based on extensive piloting and extensive consultation with NHS clinicians and managers during 2005. To identify any other long waits, we have also introduced a bi-annual census of long waiting times for other diagnostic tests. The rst bi-annual census took place in February 2006. The estimated cost of the diagnostic data collection is 460,000. 5. Work is on-going with eight pioneer sites to: develop ways to use existing NHS computer systems to measure full referral to treatment waiting times; demonstrate that 18-week waits can be achieved in key specialties; and explain to others what they did in order to achieve the target. 6. Each pioneer will be paid 25,000 to cover their costsa total of 200,000. 7. Work is underway in diagnostics through national clinical leads to co-ordinate improvements in waiting times for three key areas of diagnostics: imaging, physiological measurement, endoscopy and pathology. 8. In order to provide extra capacity for key diagnostic tests, the Department of Health procured extra MRI scanning capacity from an independent sector provider, Alliance Medical. During 200506, this contract provided an additional 130,000 scans (an extra 15% on top of NHS capacity) and was procured at costs signicantly below NHS costs. The costs of the contract however, are commercially condential under the terms of the contract. 9. Choice of scan was introduced in late 2005 to incentivise reductions in waits for imaging tests such as MRI and CT. Patients who are waiting longer than 26 weeks are oVered the choice of having their scan done at another provider. This has provided Trusts with an incentive to reduce their waiting times because neither doctors nor hospital managers like to lose patients. To date, over 40,000 patients have received their scans more quickly as a result of choice of scan. At April 2006, the average waiting time for a scan was seven and a half weeks. The funds associated with diagnostic imaging tests follow the patient between providers and responsibility for funding transferred activity rests with Originating Providers. This has enabled Choice of Scan to be delivered without the need for additonal funding. 10. The Independent Sector Treatment Centre Programme represents an investment of 400 million per year over ve years (from 200304 to 200708 onwards). 5.5 Beds 5.5.1 By sector, in each year since 199798, (a) how many available beds were there (b) how many beds were occupied (c) what was the occupancy rate and (d) average length of stay? (Q79) Answer 1. The information requested is given in Table 79. Table 79 AVERAGE DAILY NUMBER OF AVAILABLE AND OCCUPIED BEDS AND AVERAGE LENGTH OF STAY BY SECTOR, ENGLAND, 199798 TO 200405
Year Number of available beds 199798 199899 19992000 200001 200102 200203 200304 200405 Average annual change Number of occupied beds 199798 199899 19992000 All specialties (exc day only) 193,625 190,006 186,290 186,091 184,871 183,826 184,019 181,784 "0.9% 156,549 156,669 154,137 General and acute 138,047 136,426 135,080 135,794 136,583 136,679 137,247 136,123 "0.2% 111,112 112,486 112,279 Acute 107,807 107,729 107,218 107,956 108,535 108,706 109,793 109,505 0.2% 85,038 86,991 87,409 Geriatric 30,240 28,697 27,862 27,838 28,047 27,973 27,454 26,619 "1.8% 26,074 25,495 24,869 Mental illness 36,601 35,692 34,173 34,214 32,783 32,753 32,252 31,667 "2.0% 31,647 31,219 29,775 Learning disability 8,197 7,491 6,834 6,316 5,694 5,038 5,212 4,899 "7.1% 7,221 6,447 5,834 Maternity 10,781 10,398 10,203 9,767 9,812 9,356 9,309 9,095 "2.4% 6,568 6,517 6,248 Day only 7,125 7,568 7,938 8,155 8,036 8,544 8,813 9,160 3.7% 5,812 6,390 6,619
Year 200001 200102 200203 200304 200405 Average annual change Occupancy rate 199798 199899 19992000 200001 200102 200203 200304 200405 Length of stay (days) 199798 199899 19992000 200001 200102 200203 200304 200405
All specialties (exc day only) 156,290 157,330 156,933 157,862 154,931 "0.1% 80.9% 82.5% 82.7% 84.0% 85.1% 85.4% 85.8% 85.2% 8.8 8.4 7.8 8.2 8.1 7.9 7.4 7.1
General and acute 114,982 117,437 118,278 119,296 117,227 0.8% 80.5% 82.5% 83.1% 84.7% 86.0% 86.5% 86.9% 86.1% 7.0 6.8 6.8 7.0 7.1 7.1 6.8 6.4
Acute 89,730 91,676 92,712 93,971 92,904 1.3% 78.9% 80.8% 81.5% 83.1% 84.5% 85.3% 85.6% 84.8% 5.5 5.4 5.4 5.6 5.7 5.7 5.5 5.3
Geriatric 25,252 25,761 25,565 25,325 24,323 "1.0% 86.2% 88.8% 89.3% 90.7% 91.8% 91.4% 92.2% 91.4% 22.6 22.2 21.9 23.4 23.4 23.1 21.7 20.1
Mental illness 29,918 29,045 28,654 28,285 27,832 "1.8% 86.5% 87.5% 87.1% 87.4% 88.6% 87.5% 87.7% 87.9% 60.3 59.4 52.2 58.2 52.7 52.2 54.4 55.7
Learning disability 5,504 4,942 4,315 4,385 4,134 "7.7% 88.1% 86.1% 85.4% 87.1% 86.8% 85.6% 84.1% 84.4% 176.9 175.4 97.5 133.0 116.1 101.4 52.4 74.1
Maternity 5,886 5,907 5,686 5,896 5,738 "1.9% 60.9% 62.7% 61.2% 60.3% 60.2% 60.8% 63.3% 63.1% 2.3 2.2 2.1 2.1 2.0 1.9 1.9 1.7
Day only 6,891 6,950 6,900 7,333 7,457 3.6% 81.6% 84.4% 83.4% 84.5% 86.5% 80.8% 83.2% 81.4% n/a n/a n/a n/a n/a n/a n/a n/a
Source: Department of Health form KH03, Hospital Episode Statistics (HES), Health and Social Care Information Centre. Footnotes: 1. General and acute is dened as acute plus geriatric (excluding well babies). 2. Average (mean) length of stay for ordinary admissions per available bed. Figures exclude well babies.
5.5.2 How many (a) general and acute and (b) total beds were available in each Strategic Health Authority in the latest year for which data are available? How many, and what proportion, were occupied? (Q80) Answer 1. The information requested is given in Table 80.
Table 80 AVERAGE DAILY NUMBER OF AVAILABLE AND OCCUPIED BEDS BY SECTOR STRATEGIC HEALTH AUTHORITIES ENGLAND, 200405
OrgID Name England Avon, Gloucestershire & Wiltshire HA Bedfordshire and Hertfordshire HA Birmingham and the Black Country HA Cheshire & Merseyside HA County Durham & Tees Valley HA Cumbria & Lancashire HA Dorset & Somerset HA Essex HA Greater Manchester HA Hampshire and Isle of Wight HA Kent and Medway HA Leicestershire, Northamptonshire & Rutland HA Norfolk, SuVolk and Cambridgeshire HA North and East Yorkshire and Northern Lincolnshire HA North Central London HA North East London HA North West London HA Northumberland, Tyne and Wear HA Shropshire and StaVordshire HA South East London HA South West London HA South West Peninsula HA South Yorkshire HA Surrey and Sussex HA Thames Valley HA Trent HA West Midlands South HA West Yorkshire HA Total (Available) 181,784 8,033 4,280 9,135 10,236 4,719 7,082 4,678 4,828 10,404 5,852 4,742 5,200 8,276 5,202 5,768 5,960 6,719 6,854 4,892 5,807 4,760 6,010 5,922 8,312 5,995 9,120 4,800 8,199 General & Acute (Available) 136,123 6,440 3,061 7,067 7,784 3,423 5,267 3,579 3,562 8,230 4,406 3,742 3,621 6,318 4,208 4,205 4,381 4,867 4,868 3,744 3,987 3,473 4,779 4,613 6,101 4,645 6,303 3,530 5,920 Total (Occupied) 154,931 6,737 3,558 7,931 8,798 3,854 5,898 3,975 4,290 8,680 4,964 4,255 4,343 7,051 4,089 5,104 5,478 6,008 5,589 4,242 5,069 4,070 4,971 4,824 7,266 5,176 7,722 4,284 6,706 General & Acute (Occupied) 117,227 5,525 2,490 6,261 6,681 2,786 4,456 3,080 3,193 6,953 3,842 3,399 3,099 5,489 3,368 3,673 4,017 4,391 4,009 3,317 3,403 3,023 4,007 3,823 5,413 4,040 5,342 3,197 4,950 Total (% Occupancy) 85.2% 83.9% 83.1% 86.8% 85.9% 81.7% 83.3% 85.0% 88.8% 83.4% 84.8% 89.7% 83.5% 85.2% 78.6% 88.5% 91.9% 89.4% 81.5% 86.7% 87.3% 85.5% 82.7% 81.5% 87.4% 86.3% 84.7% 89.3% 81.8% General & Acute (% Occupancy) 86.1% 85.8% 81.3% 88.6% 85.8% 81.4% 84.6% 86.1% 89.6% 84.5% 87.2% 90.8% 85.6% 86.9% 80.0% 87.3% 91.7% 90.2% 82.4% 88.6% 85.3% 87.1% 83.8% 82.9% 88.7% 87.0% 84.8% 90.6% 83.6%
Source: Department of Health form KH03. Footnotes: 1. General and acute is dened as acute plus geriatric (excluding well babies).
5.6 Delayed Discharge 5.6.1 How many delayed discharges from acute hospital beds were there in the last year, by Strategic Health Authority and broad reason for delay? What proportion of available beds are occupied by patients subject to delayed discharge by Strategic Health Authority? (Q81) Answer 1. The information requested is given in Table 81a to Table 81c.
Table 81a ACUTE DELAYED TRANSFERS OF PATIENTS OF ALL AGES, 200304

Delays by reason Housing patients not Delayed covered by Discharge Care Community Patient or NHS and Rate (per package in Equipment/ family Community available own home adaptions choice Disputes Care Act Total bed) 184 11 4 36 14 2 0 2 9 9 3 4 12 3 10 2 1 0 1 9 1 1 1 8 16 5 9 6 5 98 4 6 5 5 4 0 8 3 6 3 7 5 3 3 3 0 0 2 2 2 4 4 2 9 3 4 0 1 451 19 8 11 62 1 11 19 11 13 28 10 16 26 30 5 11 24 7 5 12 14 9 13 20 22 26 15 3 111 1 0 5 1 0 0 1 3 5 1 0 2 1 0 8 1 0 34 0 2 3 0 1 20 3 15 0 4 17 2,895 0 103 0 79 4 168 2 138 0 20 0 51 0 94 0 101 2 164 0 69 0 76 1 137 0 68 1 101 2 74 0 122 0 47 0 129 1 134 1 45 0 122 0 111 0 66 1 242 0 156 0 117 2 124 0 37 2.5% 2.0% 3.1% 2.6% 1.9% 0.7% 1.1% 3.2% 1.5% 4.7% 2.2% 2.6% 2.6% 1.7% 2.7% 2.1% 3.1% 1.0% 3.9% 5.3% 1.2% 4.4% 3.1% 1.8% 4.8% 4.1% 2.1% 4.2% 0.7%
Org code Org name Q20 Q02 Q27 Q15 Q10 Q13 Q03 Q14 Q17 Q18 Q25 Q01 Q11 Q05 Q06 Q04 Q09 Q26 Q22 Q07 Q08 Q21 Q23 Q19 Q16 Q24 Q28 Q12
Completion of Public assessment Funding 587 13 9 28 17 2 11 35 25 64 7 23 29 8 8 18 18 3 38 20 7 39 11 32 48 18 18 35 3 78 1 0 1 1 1 2 5 1 1 0 4 4 1 0 3 0 0 0 1 1 12 1 4 28 4 0 1 1
Care Home Care Home Further placement placement non-acute Residential Nursing NHS care Home Home 801 26 38 24 23 7 4 9 38 41 7 20 34 13 29 19 52 17 41 80 3 24 83 1 29 52 35 43 9 214 12 6 22 2 2 7 9 8 7 4 0 16 7 9 7 22 1 2 8 3 3 2 2 19 10 7 11 6 354 16 8 32 11 1 16 6 3 16 16 8 18 6 11 7 17 2 4 8 13 22 0 3 52 39 3 11 5
England Avon, Gloucestershire & Wiltshire Bedfordshire & Hertfordshire Birmingham & the Black Country Cheshire & Merseyside County Durham & Tees Valley Cumbria & Lancashire Essex Greater Manchester Hampshire & the Isle of Wight Kent and Medway Leicestershire, Northamptonshire & Rutland Norfolk, SuVolk & Cambridgeshire North & East Yorkshire & Northern Lincolnshire North Central London North East London North West London Northumberland, Tyne & Wear Shropshire & StaVordshire Somerset & Dorset South East London South West London South West Peninsula South Yorkshire Surrey & Sussex Thames Valley Trent West Midlands South West Yorkshire
Source: Situation Reports.
Table 81b ACUTE DELAYED TRANSFERS OF PATIENTS OF ALL AGES, 200405

Delays by reason Housing patients not Delayed covered by Discharge Care Community Patient or NHS and Rate (per package in Equipment/ family Community available own home adaptions choice Disputes Care Act Total bed) 195 16 3 29 16 0 4 5 8 9 3 7 26 0 3 3 2 11 2 7 1 3 1 5 8 3 7 7 6 63 1 0 3 5 1 3 7 0 2 4 6 3 1 2 0 3 2 3 0 1 2 1 1 3 1 2 3 3 380 9 19 12 40 0 15 14 20 7 12 7 14 19 14 5 20 14 19 6 3 13 3 12 29 12 18 13 11 58 0 0 1 0 0 0 0 2 1 1 0 0 4 0 2 1 0 0 0 0 1 0 0 22 4 3 2 14 44 2,521 1 98 0 53 6 155 2 115 0 16 1 65 0 84 0 81 5 153 2 106 0 116 3 159 1 46 2 54 2 55 4 110 0 39 2 99 0 101 2 47 5 94 0 46 1 53 3 199 1 101 1 124 0 75 0 77 2.1% 1.8% 2.1% 2.4% 1.6% 0.5% 1.5% 3.0% 1.2% 4.7% 1.8% 3.9% 3.0% 1.2% 1.4% 1.5% 2.9% 0.9% 3.1% 4.1% 1.2% 3.2% 1.3% 1.4% 4.0% 2.7% 2.3% 2.5% 1.5%
Org code Org name Q20 Q02 Q27 Q15 Q10 Q13 Q03 Q14 Q17 Q18 Q25 Q01 Q11 Q05 Q06 Q04 Q09 Q26 Q22 Q07 Q08 Q21 Q23 Q19 Q16 Q24 Q28 Q12
Completion of Public assessment Funding 511 19 3 26 15 3 5 32 13 47 30 29 27 7 1 19 24 3 38 23 1 28 7 16 31 3 21 26 14 135 8 2 17 0 0 5 4 0 4 7 7 6 0 1 3 10 0 0 0 0 10 0 1 38 5 3 1 3
Care Home Care Home Further placement placement non-acute Residential Nursing NHS care Home Home 654 20 8 23 20 12 14 9 27 43 15 50 38 5 12 11 24 5 29 58 13 20 32 17 31 32 60 13 13 198 11 11 14 5 0 7 9 5 10 15 6 23 4 10 4 8 0 0 4 14 0 2 0 12 12 4 2 6 283 13 7 24 12 0 11 4 6 25 17 4 19 5 9 6 14 4 6 3 12 12 0 0 22 28 5 8 7
England Avon, Gloucestershire & Wiltshire Bedfordshire & Hertfordshire Birmingham & the Black Country Cheshire & Merseyside County Durham & Tees Valley Cumbria & Lancashire Essex Greater Manchester Hampshire & the Isle of Wight Kent and Medway Leicestershire, Northamptonshire & Rutland Norfolk, SuVolk & Cambridgeshire North & East Yorkshire & Northern Lincolnshire North Central London North East London North West London Northumberland, Tyne & Wear Shropshire & StaVordshire Somerset & Dorset South East London South West London South West Peninsula South Yorkshire Surrey & Sussex Thames Valley Trent West Midlands South West Yorkshire
Table 81c ACUTE DELAYED TRANSFERS OF PATIENTS OF ALL AGES, 200506

Delays by reason Housing patients not covered by NHS and Community Care Act 44 1 2 6 2 0 1 0 1 2 1 0 3 0 4 1 2 1 0 2 0 0 1 0 12 2 0 0 0 Delayed Discharge Rate (per available bed) 2.1% 3.2% 4.2% 2.8% 1.8% 0.7% 1.6% 2.0% 1.3% 2.7% 3.2% 2.3% 2.5% 1.4% 2.5% 1.8% 2.6% 0.5% 3.3% 2.6% 1.1% 2.7% 2.7% 1.8% 2.8% 3.2% 1.7% 1.4% 1.1%
Org code
Org name England
Completion of assessment 455 20 25 42 21 1 12 5 19 19 21 15 18 5 5 22 21 2 33 5 3 19 19 16 29 15 20 7 16
Public Funding 109 28 1 9 1 0 0 3 0 2 8 7 1 0 2 2 9 0 2 0 0 6 2 2 22 0 2 0 0
Further non-acute NHS care 574 19 13 27 22 10 12 11 15 12 16 22 28 12 20 6 28 7 32 38 6 19 56 30 17 38 30 15 13
Care Home placement Residential Home 215 18 19 18 7 1 5 11 10 9 7 4 24 5 11 6 9 0 3 2 9 8 3 1 5 5 5 4 6
Care Home placement Nursing Home 272 37 18 16 5 3 14 2 2 19 19 5 15 3 15 5 15 2 1 9 11 9 3 1 16 16 2 5 4
Care package in own home 188 15 4 34 21 0 2 8 10 3 4 1 13 4 14 1 4 2 7 2 0 1 0 9 10 10 2 4 3
Community Patient Equipment/ or family adaptions choice 75 6 4 1 3 5 0 1 6 5 6 10 3 0 2 4 3 0 0 0 1 0 0 1 5 5 2 0 2 381 21 13 22 38 1 18 13 20 9 11 6 21 23 12 17 7 9 18 5 6 10 6 3 16 19 13 8 16
Disputes 53 0 0 2 1 0 2 2 4 2 3 0 1 0 0 1 2 0 2 0 4 2 0 0 7 4 14 0 0
Total 2,366 165 99 177 121 21 66 56 87 82 96 70 127 52 85 65 100 23 98 63 40 74 90 63 139 114 90 43 60
Avon, Gloucestershire & Wiltshire Bedfordshire & Hertfordshire Birmingham & the Black Country Cheshire & Merseyside County Durham & Tees Valley Cumbria & Lancashire Essex Greater Manchester Hampshire & the Isle of Wight Kent and Medway Leicestershire, Northamptonshire & Rutland Norfolk, SuVolk & Cambridgeshire North & East Yorkshire & Northern Lincolnshire North Central London North East London North West London Northumberland, Tyne & Wear Shropshire & StaVordshire Somerset & Dorset South East London South West London South West Peninsula South Yorkshire Surrey & Sussex Thames Valley Trent West Midlands South West Yorkshire
5.7 Mental Health 5.7.1 How many consultant episodes of patients with mental illness and how many per 1,000 population were there amongst residents of each (a) strategic Health Authority and (b) Primary care Trust area in 200304 and 200405? (Q82) Answer 1. The information requested is given in Table 82a and Table 82b. Table 82a NUMBER OF CONSULTANT PATIENT EPISODES OF PATIENTS WITH MENTAL ILLNESS PER 1,000 POPULATION, BY STRATEGIC HEALTH AUTHORITY IN 2003-04 AND 200405 Code Strategic Health Authority England Avon, Gloucestershire & Wiltshire Bedford & Hertfordshire Birmingham & The Black Country Cheshire & Merseyside County Durham & Tees Valley Cumbria & Lancashire Essex Greater Manchester Hampshire & Isle Of Wight Kent & Medway Leicestershire, Northamptonshire & Rutland Norfolk, SuVolk & Cambridgeshire North & East Yorkshire & Northern Lincolnshire North Central London North East London North West London Northumberland, Tyne & Wear Shropshire & StaVordshire Somerset & Dorset South East London South West London South West Peninsula South Yorkshire Surrey & Sussex Thames Valley Trent West Midlands South West Yorkshire Total 217,730 9,630 6,300 6,370 7,600 6,680 8,290 6,930 6,420 4,990 5,530 10,750 8,440 11,340 10,340 7,490 9,270 4,490 10,780 8,120 7,740 7,230 6,120 6,140 10,410 9,380 6,390 8,760 5,830 200304 Rate per 1,000 population 4.36 4.39 3.90 2.80 3.23 5.82 4.32 4.25 2.54 2.78 3.46 6.80 3.80 6.91 8.48 4.89 5.11 3.22 7.20 6.73 5.12 5.51 3.82 4.83 4.05 4.44 2.39 5.65 2.78 Total 205,800 7,140 4,920 8,200 9,930 4,580 8,310 8,110 10,920 9,640 4,850 7,260 8,750 5,210 7,240 8,210 7,070 6,060 5,570 5,850 8,620 6,310 7,150 5,320 10,150 6,540 9,330 5,590 8,990 200405 Rate per 1,000 population 4.11 3.22 3.01 3.60 4.22 4.00 4.31 4.93 4.30 5.32 2.99 4.54 3.88 3.16 5.85 5.31 3.83 4.37 3.71 4.78 5.68 4.74 4.40 4.17 3.91 3.07 3.46 3.57 4.26
Source: HES. Footnotes: 1. Rounded gures may not add up to the total rounded gure as they are rounded separately
Table 82b NUMBER OF CONSULTANT PATIENT EPISODES OF PATIENTS WITH MENTAL ILLNESS PER 1,000 POPULATION, BY PRIMARY CARE TRUST IN 200304 AND 200405
200405 Rate per 1,000 Population 4.11 200304 Total Rate per 1,000 Population 217,730 4.36
England
Total
PCT NORTHUMBERLAND, TYNE & WEAR 5D7 5D8 5KF 5KG 5KL TAC NEWCASTLE PCT NORTH TYNESIDE PCT GATESHEAD PCT SOUTH TYNESIDE PCT SUNDERLAND TEACHING PCT NORTHUMBERLAND CARE TRUST
205,800
1,270 720 920 860 1,060 1,240 250 470 440 610 460 680 310 460 580 320 780 480 190 550 1,550 720 420 540 1,160 740 250 320 620 680 900 640 350 250 1,090 330 1,390 1,120 1,420 780 580 520 1,030 300 560 630 850 450 360
4.69 3.78 4.79 5.68 3.76 3.98 2.80 2.52 5.09 6.15 5.37 4.69 3.35 5.25 3.25 3.22 5.56 4.10 2.69 4.11 5.00 3.47 3.86 4.24 4.78 5.19 3.32 2.88 4.32 4.80 5.62 4.72 2.84 3.42 5.06 3.63 4.91 3.67 5.36 3.57 3.19 3.91 4.18 2.49 4.80 6.15 4.45 2.93 1.40
1,310 690 1,100 910 1,080 1,340 320 560 430 570 460 750 370 460 720 350 670 520 200 660 1,780 540 490 470 1,220 600 260 340 680 630 780 630 350 320 1,040 320 1,490 1,200 1,790 680 690 570 980 310 420 600 880 520 700
4.93 3.60 5.74 5.99 3.81 4.32 3.58 3.02 4.98 5.79 5.42 5.25 4.03 5.27 3.99 3.51 4.81 4.53 2.89 5.04 5.77 2.60 4.48 3.71 5.02 4.26 3.45 3.14 4.75 4.40 4.99 4.74 2.91 4.29 4.80 3.49 5.26 3.96 6.80 3.11 3.80 4.30 3.98 2.56 3.62 5.79 4.57 3.40 2.72
COUNTY DURHAM & TEES VALLEY 5D9 HARTLEPOOL PCT 5E1 NORTH TEES PCT 5J8 DURHAM DALES PCT 5J9 DARLINGTON PCT 5KA DERWENTSIDE PCT 5KC DURHAM AND CHESTER-LE-STREET PCT 5KD EASINGTON PCT 5KE SEDGEFIELD PCT 5KM MIDDLESBROUGH PCT 5KN LANGBAURGH PCT CUMBRIA & LANCASHIRE 5CC BLACKBURN WITH DARWEN PCT 5D4 CARLISLE AND DISTRICT PCT 5D5 EDEN VALLEY PCT 5D6 WEST CUMBRIA PCT 5DD MORECAMBE BAY PCT 5F2 CHORLEY AND SOUTH RIBBLE PCT 5F3 WEST LANCASHIRE PCT 5G7 HYNDBURN AND RIBBLE VALLEY PCT 5G8 BURNLEY, PENDLE AND ROSSENDALE PCT 5HD PRESTON PCT 5HE FYLDE PCT 5HF WYRE PCT 5HP BLACKPOOL PCT GREATER MANCHESTER 5AA SOUTH MANCHESTER PCT 5CL CENTRAL MANCHESTER PCT 5CR NORTH MANCHESTER PCT 5CX TRAFFORD SOUTH PCT 5F4 HEYWOOD AND MIDDLETON PCT 5F5 SALFORD PCT 5F6 TRAFFORD NORTH PCT 5F7 STOCKPORT PCT 5HG ASHTON, LEIGH AND WIGAN PCT 5HQ BOLTON PCT 5J5 OLDHAM PCT 5JX BURY PCT 5JY ROCHDALE PCT 5LH TAMESIDE AND GLOSSOP PCT CHESHIRE & MERSEYSIDE 5F8 BEBINGTON AND WEST WIRRAL PCT 5F9 SOUTHPORT AND FORMBY PCT 5G9 NORTH LIVERPOOL PCT 5H2 BIRKENHEAD AND WALLASEY PCT 5H3 CHESHIRE WEST PCT 5H4 CENTRAL CHESHIRE PCT
England
Total
200405 Rate per 1,000 Population 3.95 2.94 5.98 4.33 4.73 4.87 4.48 5.25 5.01 3.57 4.27 2.00 1.63 2.01 3.32 3.60 2.71 4.45 2.47 4.71 5.60 3.20 3.15 4.36 5.05 5.49 4.98 4.82 5.91 5.58 2.60 1.97 3.53 3.23 5.91 4.03 3.07 2.87 4.51 3.35 3.45 4.22 5.49 4.90 5.07 2.94 3.44 2.04 4.32 2.49 3.27 3.38 5.10 2.25 3.74 2.29 3.68 4.89
200304 Total Rate per 1,000 Population 930 270 1,310 360 610 930 800 870 820 440 1,180 350 260 240 440 510 320 1,280 520 770 450 300 230 960 920 710 710 980 1,120 1,270 730 550 790 270 580 500 560 430 530 560 640 980 1,380 460 550 450 810 410 460 300 440 700 1,440 390 380 360 700 510 4.97 3.35 5.53 3.57 5.18 4.80 4.54 5.80 4.97 2.75 4.29 2.02 1.75 2.02 3.41 3.36 2.67 6.19 3.27 6.27 3.56 2.13 2.55 5.55 6.33 6.42 6.47 6.12 7.44 6.91 3.78 3.16 5.84 3.20 8.27 4.37 4.94 4.10 4.83 4.42 3.91 3.89 6.25 7.21 5.62 4.11 3.59 2.40 4.63 2.70 3.71 4.11 5.27 3.57 3.48 2.60 4.15 6.14
5H5 5H6 5HA 5HC 5J1 5J2 5J3 5J4 5M5
EASTERN CHESHIRE PCT ELLESMERE PORT AND NESTON PCT CENTRAL LIVERPOOL PCT SOUTH LIVERPOOL PCT HALTON PCT WARRINGTON PCT ST HELENS PCT KNOWSLEY PCT SOUTH SEFTON PCT
740 240 1,440 440 560 940 790 790 830
NORTH & EAST YORKSHIRE & NORTHERN LINCOLNSHIRE 5AN NORTH EAST LINCOLNSHIRE PCT 570 5E2 SELBY AND YORK PCT 1,180 5E3 EAST YORKSHIRE PCT 350 5E4 YORKSHIRE WOLDS AND COAST PCT 250 5E5 EASTERN HULL PCT 240 5E6 WEST HULL PCT 430 5EF NORTH LINCOLNSHIRE PCT 550 5KH HAMBLETON AND RICHMONDSHIRE PCT 330 5KJ CRAVEN, HARROGATE AND RURAL 930 DISTRICT PCT 5KK SCARBOROUGH, WHITBY AND RYEDALE PCT 390 WEST YORKSHIRE 5AW AIREDALE PCT 5CF BRADFORD CITY PCT 5CG BRADFORD SOUTH AND WEST PCT 5CH NORTH BRADFORD PCT 5E7 EASTERN WAKEFIELD PCT 5E8 WAKEFIELD WEST PCT 5HH LEEDS WEST PCT 5HJ LEEDS NORTH EAST PCT 5HK EAST LEEDS PCT 5HL SOUTH LEEDS PCT 5HM LEEDS NORTH WEST PCT 5J6 CALDERDALE PCT 5J7 NORTH KIRKLEES PCT 5LJ HUDDERSFIELD CENTRAL PCT 5LK SOUTH HUDDERSFIELD PCT SOUTH YORKSHIRE 5CK DONCASTER CENTRAL PCT 5EE NORTH SHEFFIELD PCT 5EK DONCASTER EAST PCT 5EL DONCASTER WEST PCT 5EN SHEFFIELD WEST PCT 5EP SHEFFIELD SOUTH WEST PCT 5EQ SOUTH EAST SHEFFIELD PCT 5H8 ROTHERHAM PCT 5JE BARNSLEY PCT TRENT 5AL CENTRAL DERBY PCT 5AM MANSFIELD DISTRICT PCT 5AP NEWARK AND SHERWOOD PCT 5D2 WEST LINCOLNSHIRE PCT 5D3 LINCOLNSHIRE SOUTH WEST TEACHING PCT 5EA CHESTERFIELD PCT 5EC GEDLING PCT 5ED AMBER VALLEY PCT 5EG NORTH EASTERN DERBYSHIRE PCT 5EM NOTTINGHAM CITY PCT 5ER EREWASH PCT 5ET BASSETLAW PCT 5EV BROXTOWE AND HUCKNALL PCT 5EX GREATER DERBY PCT 5FA ASHFIELD PCT 590 710 450 280 760 730 610 550 770 890 1,050 510 340 480 270 410 480 350 300 570 360 570 1,070 1,210 320 500 320 790 350 430 280 390 580 1,400 250 410 320 620 410
England
Total
200405 Rate per 1,000 Population 3.09 2.66 2.89 3.78 3.01 3.31 7.71 6.27 4.00 4.48 4.28 3.48 5.70 2.65 3.18 5.20 3.70 6.70 5.64 3.91 2.96 2.40 2.14 2.61 3.21 4.50 6.19 2.92 3.90 3.18 2.89 2.70 1.86 3.95 3.11 3.60 4.30 2.65 4.21 2.09 3.58 4.27 3.50 5.44 6.32 3.31 3.46 2.40 3.66 3.30 9.33 4.83 4.86
200304 Total Rate per 1,000 Population 330 340 780 470 320 660 1,100 1,430 660 1,470 940 1,320 1,330 480 470 530 1,180 980 760 740 460 290 500 640 650 530 2,390 780 370 300 350 710 290 1,030 730 720 600 160 1,420 210 880 740 1,110 720 510 330 770 580 2,390 390 540 380 490 3.10 3.00 2.88 4.66 3.04 4.61 9.86 8.30 5.64 6.29 5.85 4.81 6.31 3.16 4.38 5.14 4.12 8.01 6.20 4.63 3.98 2.24 2.52 3.17 3.38 4.68 6.52 3.09 4.21 3.21 3.37 2.96 1.79 4.09 3.48 4.06 5.86 1.79 4.64 1.14 3.55 4.47 3.95 5.86 5.22 3.08 4.78 2.75 16.41 4.20 4.66 2.85 3.37
5FC 5H7 5H9 5HN
RUSHCLIFFE PCT DERBYSHIRE DALES AND SOUTH DERBYSHIRE PCT EAST LINCOLNSHIRE PCT HIGH PEAK AND DALES PCT
330 300 790 380
LEICESTERSHIRE, NORTHAMPTONSHIRE & RUTLAND 5AC DAVENTRY AND SOUTH 320 NORTHAMPTONSHIRE PCT 5EH MELTON, RUTLAND AND HARBOROUGH PCT 480 5EJ LEICESTER CITY WEST PCT 870 5EY EASTERN LEICESTER PCT 1,080 5JA HINCKLEY AND BOSWORTH PCT 470 5JC CHARNWOOD AND NORTH WEST 1,060 LEICESTERSHIRE PCT 5JD SOUTH LEICESTERSHIRE PCT 690 5LV NORTHAMPTONSHIRE HEARTLANDS PCT 970 5LW NORTHAMPTON PCT 1,200 SHROPSHIRE & STAFFORDSHIRE 5DQ BURNTWOOD, LICHFIELD AND TAMWORTH PCT 5HR STAFFORDSHIRE MOORLANDS PCT 5HW NEWCASTLE-UNDER-LYME PCT 5M2 SHROPSHIRE COUNTY PCT 5ME NORTH STOKE PCT 5MF SOUTH STOKE PCT 5MK TELFORD AND WREKIN PCT 5ML EAST STAFFORDSHIRE PCT 5MM CANNOCK CHASE PCT 5MN SOUTH WESTERN STAFFORDSHIRE PCT BIRMINGHAM & THE BLACK COUNTRY 5D1 SOLIHULL PCT 5HT DUDLEY SOUTH PCT 5HV DUDLEY BEACON AND CASTLE PCT 5M1 SOUTH BIRMINGHAM PCT 5M3 WALSALL PCT 5MG OLDBURY AND SMETHWICK PCT 5MH ROWLEY REGIS AND TIPTON PCT 5MJ WEDNESBURY AND WEST BROMWICH PCT 5MV WOLVERHAMPTON CITY PCT 5MW NORTH BIRMINGHAM PCT 5MX HEART OF BIRMINGHAM TEACHING PCT 5MY EASTERN BIRMINGHAM PCT WEST MIDLANDS SOUTH 5CN HEREFORDSHIRE PCT 5DR WYRE FOREST PCT 5M9 RUGBY PCT 5MD COVENTRY PCT 5MP NORTH WARWICKSHIRE PCT 5MQ SOUTH WARWICKSHIRE PCT 5MR REDDITCH AND BROMSGROVE PCT 5MT SOUTH WORCESTERSHIRE PCT NORFOLK, SUFFOLK & CAMBRIDGESHIRE 5A2 NORWICH PCT 5AF NORTH PETERBOROUGH PCT 5AG SOUTH PETERBOROUGH PCT 5CY WEST NORFOLK PCT 5G1 SOUTHERN NORFOLK PCT 5GF HUNTINGDONSHIRE PCT 5GT GREAT YARMOUTH TEACHING PCT 5JH CAMBRIDGE CITY PCT 5JJ SOUTH CAMBRIDGESHIRE PCT 5JK EAST CAMBRIDGESHIRE AND FENLAND PCT 400 340 540 1,070 820 690 630 340 310 430 520 620 510 2,270 740 340 300 300 650 310 1,000 650 640 440 240 1,280 380 910 710 990 680 610 360 560 510 540 310 1,110 650 710
England
Total
200405 Rate per 1,000 Population 2.71 2.89 5.35 2.95 1.90 3.19 2.24 1.68 4.08 4.41 2.65 2.73 3.92 3.08 2.08 2.65 2.88 1.88 4.58 3.18 9.69 5.57 3.37 4.34 3.60 5.22 4.00 6.09 4.89 4.83 3.73
200304 Total Rate per 1,000 Population 370 310 560 250 200 430 460 210 890 640 690 410 1,220 630 160 490 480 490 550 340 1,010 400 270 650 180 580 480 460 510 510 430 3.09 3.16 3.94 2.47 2.02 3.53 2.10 2.22 4.82 4.24 2.87 4.19 6.74 3.84 2.25 2.98 3.46 3.72 3.93 2.82 6.32 5.15 3.11 4.03 2.44 4.30 3.30 4.53 4.07 3.06 3.15
5JL 5JM 5JQ 5JR 5JT 5JV 5JW
BROADLAND PCT NORTH NORFOLK PCT IPSWICH PCT SUFFOLK COASTAL PCT CENTRAL SUFFOLK PCT WAVENEY PCT SUFFOLK WEST PCT
330 290 770 300 190 400 500 160 750 670 640 270 710 500 150 430 400 250 640 390 1,550 430 300 710 260 710 580 620 620 800 520
BEDFORD & HERTFORDSHIRE 5CP HERTSMERE PCT 5GC LUTON PCT 5GD BEDFORD PCT 5GE BEDFORDSHIRE HEARTLANDS PCT 5GG WELWYN HATFIELD PCT 5GH NORTH HERTFORDSHIRE AND STEVENAGE PCT 5GJ SOUTH EAST HERTFORDSHIRE PCT 5GK ROYSTON, BUNTINGFORD AND BISHOPS STORTFORD PCT 5GV WATFORD AND THREE RIVERS PCT 5GW DACORUM PCT 5GX ST ALBANS AND HARPENDEN PCT ESSEX 5AH TENDRING PCT 5AJ EPPING FOREST PCT 5AK SOUTHEND ON SEA PCT 5DC HARLOW PCT 5GL MALDON AND SOUTH CHELMSFORD PCT 5GM COLCHESTER PCT 5GN UTTLESFORD PCT 5GP BILLERICAY, BRENTWOOD AND WICKFORD PCT 5GQ THURROCK PCT 5GR BASILDON PCT 5JN CHELMSFORD PCT 5JP CASTLE POINT AND ROCHFORD PCT TAG WITHAM, BRAINTREE & HALSTEAD CARE TRUST NORTH WEST LONDON 5AT HILLINGDON PCT 5H1 HAMMERSMITH AND FULHAM PCT 5HX EALING PCT 5HY HOUNSLOW PCT 5K5 BRENT PCT 5K6 HARROW PCT 5LA KENSINGTON AND CHELSEA PCT 5LC WESTMINSTER PCT NORTH CENTRAL LONDON 5A9 BARNET PCT 5C1 ENFIELD PCT 5C9 HARINGEY TEACHING PCT 5K7 CAMDEN PCT 5K8 ISLINGTON PCT NORTH EAST LONDON 5A4 HAVERING PCT 5C2 BARKING AND DAGENHAM PCT 5C3 CITY AND HACKNEY PCT 5C4 TOWER HAMLETS PCT 5C5 NEWHAM PCT 5NA REDBRIDGE PCT 5NC WALTHAM FOREST PCT 5A7 BROMLEY PCT 5A8 GREENWICH PCT
740 850 1,400 1,030 1,060 120 710 1,170 810 1,490 1,200 2,040 1,700 830 700 1,670 1,060 1,390 1,040 1,530 1,140 1,470
2.96 4.79 4.62 4.85 3.95 0.56 3.85 5.10 2.48 5.31 5.36 9.39 9.46 3.67 4.27 7.72 5.06 5.61 4.21 6.91 3.81 6.50
960 1,140 1,700 1,130 900 90 590 1,100 880 1,590 1,260 1,560 1,390 830 740 1,390 1,060 1,360 1,270 1,640 1,280 1,600
3.88 6.52 5.59 5.31 3.35 0.41 3.39 4.94 2.72 5.67 5.59 7.41 7.71 3.71 4.47 6.42 5.12 5.42 5.17 7.42 4.29 7.14
England
Total
200405 Rate per 1,000 Population 8.24 6.24 5.59 3.81 5.48 4.03 5.82 4.95 4.29 2.41 2.17 2.99 3.54 1.38 4.72 2.25 2.76 5.07 2.44 2.70 2.77 3.14 2.95 3.47 5.43 3.98 5.68 4.34 6.91 8.02 2.67 6.24 6.42 3.62 3.38 1.03 4.05 3.43 4.32 2.14 2.43 3.15 2.48 3.33 6.52 4.55 3.62 3.27 3.66 2.80 3.21 4.01 4.55 4.97 6.08 2.76 2.99 3.17
200304 Total Rate per 1,000 Population 1,830 1,580 730 1,100 880 1,330 1,800 990 1,930 610 310 750 460 330 1,060 140 400 920 200 550 380 550 500 470 950 830 820 910 850 970 460 1,910 910 660 460 150 780 630 340 340 510 900 370 350 590 440 1,110 600 910 360 560 1,030 1,050 1,640 990 510 280 330 6.82 6.21 2.95 5.01 5.82 3.94 6.58 5.54 5.21 2.78 3.34 3.83 3.90 2.17 5.33 1.92 3.25 5.66 2.71 2.79 3.42 3.75 3.08 3.46 5.54 3.95 6.03 5.21 4.97 5.11 2.63 8.66 4.87 4.05 2.08 0.84 3.29 2.40 3.55 3.20 3.08 3.84 3.84 4.02 6.88 3.35 4.18 3.78 4.07 1.82 2.69 4.77 5.01 6.54 5.87 3.30 2.77 3.23
5LD 5LE 5LF TAK 5A5 5K9 5LG 5M6 5M7
LAMBETH PCT SOUTHWARK PCT LEWISHAM PCT BEXLEY CARE TRUST KINGSTON PCT CROYDON PCT WANDSWORTH PCT RICHMOND AND TWICKENHAM PCT SUTTON AND MERTON PCT
2,210 1,590 1,380 840 830 1,370 1,610 910 1,590 530 210 580 420 210 940 160 340 840 180 530 310 470 480 470 930 840 790 770 1,180 1,510 470 1,380 1,190 590 760 190 970 900 420 230 410 740 240 290 550 600 970 520 820 560 660 870 970 1,250 1,020 430 300 330
THAMES VALLEY 5CQ MILTON KEYNES PCT 5DK NEWBURY AND COMMUNITY PCT 5DL READING PCT 5DM SLOUGH PCT 5DN WOKINGHAM PCT 5DP VALE OF AYLESBURY PCT 5DT NORTH EAST OXFORDSHIRE PCT 5DV CHERWELL VALE PCT 5DW OXFORD CITY PCT 5DX SOUTH EAST OXFORDSHIRE PCT 5DY SOUTH WEST OXFORDSHIRE PCT 5G2 BRACKNELL FOREST PCT 5G3 WINDSOR, ASCOT AND MAIDENHEAD PCT 5G4 CHILTERN AND SOUTH BUCKS PCT 5G5 WYCOMBE PCT HAMPSHIRE & ISLE OF WIGHT 5A1 NEW FOREST PCT 5DF NORTH HAMPSHIRE PCT 5DG ISLE OF WIGHT PCT 5E9 MID-HAMPSHIRE PCT 5FD EAST HAMPSHIRE PCT 5FE PORTSMOUTH CITY PCT 5G6 BLACKWATER VALLEY AND HART PCT 5L1 SOUTHAMPTON CITY PCT 5LX FAREHAM AND GOSPORT PCT 5LY EASTLEIGH AND TEST VALLEY SOUTH PCT KENT & MEDWAY 5CM DARTFORD, GRAVESHAM AND SWANLEY PCT 5FF SOUTH WEST KENT PCT 5L2 MAIDSTONE WEALD PCT 5L3 MEDWAY PCT 5L4 SWALE PCT 5LL ASHFORD PCT 5LM CANTERBURY AND COASTAL PCT 5LN EAST KENT COASTAL PCT 5LP SHEPWAY PCT SURREY & SUSSEX 5FH BEXHILL AND ROTHER PCT 5FJ HASTINGS AND ST LEONARDS PCT 5FK MID-SUSSEX PCT 5KP EAST ELMBRIDGE AND MID SURREY PCT 5KQ EAST SURREY PCT 5L5 GUILDFORD AND WAVERLEY PCT 5L6 NORTH SURREY PCT 5L7 SURREY HEATH AND WOKING PCT 5L8 ADUR, ARUN AND WORTHING PCT 5L9 WESTERN SUSSEX PCT 5LQ BRIGHTON AND HOVE CITY PCT 5LR EASTBOURNE DOWNS PCT 5LT SUSSEX DOWNS AND WEALD PCT 5MA CRAWLEY PCT 5MC HORSHAM AND CHANCTONBURY PCT
England
Total
200405 Rate per 1,000 Population
200304 Total Rate per 1,000 Population
AVON, GLOUCESTERSHIRE & WILTSHIRE 5A3 SOUTH GLOUCESTERSHIRE PCT 5DH WEST WILTSHIRE PCT 5DJ SOUTH WILTSHIRE PCT 5FL BATH AND NORTH EAST SOMERSET PCT 5JF BRISTOL NORTH PCT 5JG BRISTOL SOUTH AND WEST PCT 5K3 SWINDON PCT 5K4 KENNET AND NORTH WILTSHIRE PCT 5KW CHELTENHAM AND TEWKESBURY PCT 5KX WEST GLOUCESTERSHIRE PCT 5KY COTSWOLD AND VALE PCT 5M8 NORTH SOMERSET PCT SOUTH WEST PENINSULA 5CV SOUTH HAMS AND WEST DEVON PCT 5CW TORBAY Care Trust 5F1 PLYMOUTH PCT 5FM WEST OF CORNWALL PCT 5FQ NORTH DEVON PCT 5FR EXETER PCT 5FT EAST DEVON PCT 5FV MID DEVON PCT 5FY TEIGNBRIDGE PCT 5KR NORTH AND EAST CORNWALL PCT 5KT CENTRAL CORNWALL PCT SOMERSET & DORSET 5CD NORTH DORSET PCT 5CE BOURNEMOUTH PCT 5FN SOUTH AND EAST DORSET PCT 5FP SOUTH WEST DORSET PCT 5FW SOMERSET COAST PCT 5FX MENDIP PCT 5K1 SOUTH SOMERSET PCT 5K2 TAUNTON DEANE PCT 5KV POOLE PCT Source: HES. Footnotes: 1. PCTs grouped in Government OYce Regions (GOR). 2. Population gures used: 2004 % 50,093,130 2003 % 49,885,740. 3. No data available for Torbay Primary Care Trust.
520 300 490 550 960 710 440 510 720 800 570 600 450 0 1,090 680 640 670 690 450 460 670 680 330 870 530 560 650 540 820 730 830
2.08 2.39 4.12 3.18 4.47 3.97 2.34 2.50 4.53 3.60 2.96 3.11 3.96 0.00 4.47 4.21 4.19 4.96 5.67 4.65 4.26 4.08 3.55 3.63 5.95 3.53 4.11 4.46 4.91 5.39 6.87 4.67
540 350 550 580 1,170 850 340 550 710 880 580 650 520 0 1,170 620 690 610 720 430 400 720 700 360 1,050 640 590 640 420 700 740 990
2.18 2.90 4.65 3.39 5.47 4.77 1.81 2.75 4.47 3.99 3.06 3.40 4.66 0.00 4.83 3.84 4.63 4.62 5.99 4.56 3.75 4.43 3.67 3.96 7.16 4.27 4.38 4.42 3.89 4.63 7.00 5.59
5.7.2 Could the Department update the information given in Tables 3.4.1, on patients under the care of a learning disability or mental illness consultant, including (a) numbers of patients (b) discharges by length of stay, age and destination and (c) beds and residential places available? How many repeat admissions of such patients were there? (Q83) Answer 1. The available information is given in Table 83a to Table 83g. Care of Patients Under Learning Disability and Mental Illness specialities 2. The estimated number of in-patients under the care of the learning disability specialty, at the end of each year, fell to 3,139 in 200405 from 12,522 in 199495Table 83a. This is mainly due to the fall in the number of very long stay patients, from 8,002 to 1,590 over the period. This is matched by a decrease in the number of inpatients under the care of the mental illness specialty, at the end of the year, to 25,752 in 200405 from 37,143 in 199495Table 83b. This reects a reduction in dependence on long stay hospital beds and growth in provision of alternative forms of supported residential and home based services and community teams.
3. There has been an increase in the proportion of patients with learning disability discharged from hospital after a short stay. Table 83c shows that 76% of patients in 200405 had been in hosptial for less than a week. This compares with 73% of those in 199394. 4. Table 83d shows a decrease in the number of in-patient episodes of mental illness care lasting less than one month. There were 99,170 discharges in 200405 after short stay episodesless than one month (59% of all discharges) compared with 133,343 in 199495 (65% of all discharges). 5. Table 83e shows that most learning disability patients under-65 discharged after a length of stay of less than a year return to their usual place of residence (98% in 200405). This compares with an estimated 87% for mental illness patients in the same year, Table 83f. 6. In the case of learning disability patients aged 65 or over, 68% returned to their usual place of residence in 200405, with a further 24% transferred to other NHS providers. This compares to 65% and 17% respectively for mental illness patients. 7. Of the learning disability patients under 65 discharged after a stay of a year or more (an estimated 310 in 200405), 3% returned to their usual place of residence, 41% transferred to another NHS provider and 50% to local authority homes or other non-NHS institutions. For discharged mental illness patients under 65 (an estimated 2,870 in 200405), 52% returned to their usual place of residence, 19% transferred to another NHS provider and 16% to local authority homes or other non-NHS institutions. 8. Only an estimated 90 learning disability patients aged 65 or over were discharged after a stay of a year or more in 200405, compared with 960 for mental illness patients; the estimates of destination on discharge are based on small numbers and are unlikely to be reliable. 9. Table 83g shows which sets out the maximum number of registered places for each client group with learning disability or mental disorder, broken down by age group (children, adults and the over sixty-ves) and provider category type (NHS, Independent, Voluntary, Local Authority and other). 10. It is diYcult to aggregate capacity gures for diVerent client groups, because a home may have places that are registered for more than one client group. For example, a home might have a total number of 23 places all registered for mental disorder, but some of the places might also be registered for learning disability. At the end of March 2006, there were over 8,500 registered places in NHS and Local Authority facilities and over 83,200 registered places in Independent and Voluntary facilities. For children with learning disabilities and/or mental disorders there are nearly 5,000 registered placesalthough there are no places registered for children with mental disorders within NHS facilities. 11. Detailed data on private hospitals and clinics is not available in a comparable form, due to service denitional issues. Data on Care Homes are not available at present, as discussions have not been concluded between the Adult Social Services Team in the Health and Social Care Information Centre (HSCIC) and the Commission for Social Care Inspection (CSCI). Number of Repeat Discharges 12. Data on the number of times individual patients are discharged over a period of time after completing their spell in hospital is not yet reliable because coverage of patients in receipt of this care is patchy across the NHS. 13. The Departmentment does however have available two indicators, compiled by the Healthcare Commission, reecting the number of emergency psychiatric re-admissions. One, psychiatric re-admissions (adults), for patients aged 17-64 re-admitted as an emergency to the care of psychiatric specialist within 28 days of discharge, relates to Mental Health National Service Framework standard 4. The other, psychiatric readmissions (older people), is for people aged over 65 the psychiatric re-admissions (adults) indicator covers patients under a consultant whose speciality is Mental Illness or Old Age Psychiatry and is based on HES data. However, it excludes any patients with a primary diagnosis of substance abuse or eating disorder (ICD 10 codes: F10 to F19, F50, Z50.2 and Z50.3). For these excluded conditions, re-admission is often considered a necessary part of the care. It should also be noted that any planned re-admissions are excluded from the count of readmissions. 14. It is very important to note that the denition and coverage of this indicator diVers from that applied to psychiatric discharges in Table 83c and Table 83d. 15. The Healthcare Commission has recently released England re-admission rates for the calendar years 2003 and 2004. There have been changes to the denition, so it is not comparable with inormation available for previous years. The changes have made the indicator more relevant by excluding re-admissions that are not related to psychiatric conditions. 16. 10.32% of adult patients were re-admitted in 2004, compared with 10.70% in 2003. For older people, the 2004 gure was 5.33%, compared with a 2003 gure of 5.65%. Each of these values is estimated to an accuracy of !/"0.25%.
Table 83a PATIENTS UNDER THE CARE OF A LEARNING DISABILITIES CONSULTANT AT 31 MARCH BY DURATION OF STAY, ENGLAND: 1994-95 AND 2004-05
Numbers of Patients All durations under 1 year 1-2 years 2-3 years 3-5 years over 5 Rates per 100,000 population All durations under 1 year 1-2 years 2-3 years 3-5 years over 5 Source: HES. 1994-95 12,522 1,562 1,057 811 1,090 8,002 26 3 2 2 2 17 2004-05 3,139 377 305 261 606 1,590 6 1 1 1 1 3
Table 83b PATIENTS UNDER THE CARE OF A MENTAL ILLNESS CONSULTANT AT 31 MARCH BY DURATION OF STAY, ENGLAND 1994-95 AND 2004-05 Numbers of Patients All durations under 1 year 1-2 years 2-3 years 3-5 years over 5 Rates per 100,000 population All Durations under 1 year 1-2 years 2-3 years 3-5 years over 5 Source: HES. Table 83c ESTIMATED DISCHARGES OF LEARNING DISABILITIES PATIENTS FROM NHS FACILITIES BY DURATION OF STAY, ENGLAND 1994-95 AND 2004-05 Duration of Stay All durations under 1 week 1 week-1 month 1 month-3 months 3-months to 1 year 1 year-2 years 2 years-5 years 5 years-10 years over 10 years Duration unknown Percentages under 1 week 1994-95 47,306 34,617 9,000 887 750 361 357 211 1,123 0 73% 2004-05 25,088 19,056 4,520 489 466 121 197 100 139 0 76% 1994-95 37,143 19,730 4,310 2,781 3,852 6,470 77 41 9 6 8 13 2004-05 25,752 13,761 4,084 2,537 3,182 2,188 51 27 8 5 6 4
Numbers of Patients All durations under 1 year 1-2 years 2-3 years 3-5 years over 5 Rates per 100,000 population All durations under 1 year 1-2 years 2-3 years 3-5 years over 5
1994-95 12,522 1,562 1,057 811 1,090 8,002 26 3 2 2 2 17
2004-05 3,139 377 305 261 606 1,590 6 1 1 1 1 3
1 week-1 month 1 month-3 months 3-months to 1 year 1 year-2 years 2 years-5 years 5 years-10 years over 10 years Duration unknown Source: HES.
19% 2% 2% 1% 1% 0% 2% 0%
18% 2% 2% 0% 1% 0% 1% 0%
Footnotes: 1. Percentages have been calculated using unrounded gures. 2. Data for 1 week to 1 month is for 7 to 29 days and data for 1 month begins on 30 days to ensure there is no double counting. 3. The currency of this table is the total number of discharge episodes.
Table 83d ESTIMATED DISCHARGES OF MENTAL ILLNESS PATIENTS FROM NHS FACILITIES BY DURATION OF STAY, ENGLAND 199495 AND 200405 Duration of Stay All durations under 1 week 1 week-1 month 1 month-3 months 3-months-1 year 1 year-2 years 2 years-5 years 5 years-10 years over 10 years Duration unknown Percentages under 1 week 1 week-1 month 1 month-3 months 3-months-1 year 1 year-2 years 2 years-5 years 5 years-10 years over 10 years Duration unknown Source: HES. Footnotes: 1. Percentages have been calculated using unrounded gures. 2. Currency of this table is the total number of discharge episodes. 3. Data for 1 week to 1 month is for 7 to 29 days and data for 1 month begins on 30 days to ensure there is no double counting. 199495 202,701 43,237 90,106 48,907 16,134 1,760 1,304 588 665 0 21% 44% 24% 8% 1% 1% 0% 0% 0% 200405 166,710 37,069 62,101 42,072 21,177 2,182 1,416 307 143 243 22% 37% 25% 13% 1% 1% 0% 0% 0%
Table 83e ESTIMATED DISCHARGES OF LEARNING DISABILITY PATIENTS FROM NHS FACILITIES BY AGE, LENGTH OF STAY AND DESTINATION 1998-99 AND 2004-05 England Number and Percentages Intended Discharge Destination 1998-99 length of stay length of stay less than one of one year year or more 35,940 (2) 98% 0% 1% 0% 0% 0% 280 73% 1% 12% 0% 4% 9% 1,060 21% 2% 36% 8% 21% 13% 100 16% 2% 33% 2% 19% 28% 2004-05 length of stay length of stay less than one of one year year or more 24,360 98% 0% 1% 0% 0% 0% 170 68% 2% 24% 0% 1% 5% 310 3% 1% 41% 11% 39% 5% 90 13% 0% 36% 0% 51% 0%
Aged under 65 Number of discharges Percentage Usual Residence Temporary Residence Other NHS Provider LA Residential Non NHS Instituation Other and not known Aged 65 and over Number of discharges Percentage Usual Residence Temporary Residence Other NHS Provider LA Residential Non NHS Instituation Other and not known
Source: HES. Footnotes: 1. The currency of this table is the total number of discharge episodes. 2. The 1998-99 gures are almost 20,000 less than the previous year (not shown). Table 83f ESTIMATED DISCHARGES OF MENTAL ILLNESS PATIENTS FROM NHS FACILITIES BY AGE, LENGTH OF STAY AND DESTINATION, 1998-99 AND 2004-05 England Number and Percentages Intended Discharge Destination 1998-99 length of stay length of stay less than one of one year year or more 134,920 88% 3% 6% 0% 1% 2% 62,230 71% 2% 10% 2% 10% 5% 2,340 45% 6% 29% 3% 9% 8% 1,540 12% 2% 23% 2% 8% 53% 2004-05 length of stay length of stay less than one of one year year or more 116,650 87% 4% 7% 0% 1% 1% 44,320 65% 2% 17% 2% 11% 2% 2,870 52% 9% 19% 3% 13% 4% 960 26% 4% 37% 4% 25% 5%
Aged under 65 Number of discharges Percentage Usual Residence Temporary Residence Other NHS Provider LA Residential Non NHS Instituation Other and not known Aged 65 and over Number of discharges Percentage Usual Residence Temporary Residence Other NHS Provider LA Residential Non NHS Instituation Other and not known
Source: HES. Footnotes: 1. The 1998-99 gures are over 10,000 less than the previous year (not shown) and the most recent data shows a drop in the number of discharges for length of stay over 1 year.
Table 83g MAXIMUM CAPACITY FOR SERVICES PROVIDING CARE FOR PEOPLE WITH LEARNING DISABILITIES AND MENTAL DISORDERS AS AT 31 MARCH 2006
Maximum No of registered places for: LD(E) MD Children MD Mental Learning mental Disorder disability disorder adults over 65 152 3,465 2,442 670 87 6,816 0 130 35 164 0 329 123 17,754 4,028 532 195 22,632
Max No of registered places in the home 1,333 93,280 26,488 11,263 1,826 134,190
Ownership Type
LD Children learning disabilities
LD Learning disability adults
MD(E) Mental Disorder over 65 32 20,015 2,093 990 234 23,364
Max No of registered places for learning disability & mental disorders 1,294 62,255 20,954 7,219 1,472 93,194
NHS Independent Voluntary Local Authority Other Totals
18 1,923 955 1,575 57 4,528
1,054 27,694 14,542 4,032 1,011 48,333
Source: CSCI R&J Extract, August 2006. Footnotes: Data Source: R&I Extract 1 August 20061. A home may have places which are dual registered, ie for more than one client group.
5.7.3 How many people were admitted to (a) NHS facilities and (b) independent hospitals under the 1983 Mental Health Act in 200405, by Trust and type of section? (Q84)
Answer Number of People Sectioned by Trust and the Type of Section 1. Table 84a presents information on the number of admissions to NHS facilities (Trusts, Care Trusts and Primary Care Trusts) where the patient was detained under the 1983 Mental Health Act at admission, and on the number of occasions a patient already in hospital as an informal patient was placed under detention. Table 84b shows similar information for independent hospitals, as dened by the Care Standards Act 2000, in each SHA area (these data were forwarded to the Department directly from the independent hospitals). There were a total of 25,100 formal admissions to NHS facilities in 200405 with a further 1,600 formal admissions to independent hospitals. Another 23,400 changes from informal to formal detentions were recorded (23,000 in the NHS and 400 in independent hospitals). There may be double counting of patients where a patient has been detained more than once in the year.
Number of People Sectioned in Proportion to SHA Population 2. It is not possible to produce reliable gures on the numbers of people sectioned by SHA area of residence. The data provided on the aggregate return is provider-based and does not include geographic information on the area of residence. The Hospital Episode Statistics (HES) system does have some information on patients treated by area of residence, but the quality of data is poor on admissions of formally detained patients. 3. It is possible to look at the variation in the rate of psychiatric activity by Strategic Health Authority area of residence. Table 84c shows 200405 rate of consultant episodes varied from 2.99 to 5.85 per 1,000 population, with an average of 4.09 per 1,000 population. This does not imply similar variations in the rates for those sectioned.
Number of People Sectioned in Proportion to Admissions 4. In England, in 200405, there were 26,700 formal admissions to hospital (including high security hospitals and independent hospitals) under the Act and a further 23,400 changes from informal status to detention where patients were already in hospital. A patient subject to more than one period of detention under the Act during the year will be counted in these gures each time they are admitted to hospital under detention or have a change from informal status while in hospital. It is therefore not possible to determine the number of people sectioned. Around 14.2% of all admissions (estimated as 188,400) under psychiatric specialities in NHS hospitals in 200405 were formal admissions (26,700).
Appeals 5. The Mental Health Review Tribunal is an independent judicial body that hears applications and references by and on behalf of patients detained under the Mental Health Act 1983 as amended by the Mental Health (Patients in the Community) Act 1995. This includes patients admitted for assessment and/ or treatment, hospital orders, guardianship, after-care under supervision, and restricted patients who have come through the courts or transferred to hospital from prison. In some cases the nearest relative can also apply for the patients detention to be reviewed. Most hearings are a result of applications by the patient or the patients legal representative. 6. The act places a duty on Hospital Managers to refer a case to the tribunal at the end of specied periods where a patient has not had a hearing during that time. The Home Secretary in restricted cases is also obliged to refer cases to the Tribunal periodically and has a discretion to refer a patients case at any time. 7. In the nancial year 200506, there were 20,510 applications and references for appeals. During the same period 10,090 cases were aborted mostly because the patient was discharged by the hospital or the application was withdrawn before the hearing. There were 10,420 decided cases resulting in 1,570 discharges (absolute, conditional, deferred or delayed).
Table 84a ADMISSIONS TO NHS FACILITIES UNDER THE MHA 1983 AND CHANGES FROM INFORMAL TO DETAINED STATUS WHILE IN HOSPITAL, ENGLAND: 200405(1)
Numbers Admitted to hospital under Section England North East County Durham and Darlington Priority Services Gateshead Health Newcastle Upon Tyne Hospitals Newcastle, North Tyneside and Northumberland Mental Health Northgate and Prudhoe Northumbria Health Care South Of Tyne and Wearside Mental Health Tees and North East Yorkshire North West Five Borough Partnership Bolton Salford and TraVord Mental Health Calderstones Central Manchester and Manchester Childrens University Hospitals Cheshire and Wirral Partnership Lancashire Care Manchester Mental Health and Social Care Trust Mersey Care Morecambe Bay PCT North Cumbria Acute Hospitals North Cumbria Mental Health and Learning Disabilities North West Surrey Mental Health NHS Partnership Trust Pennine Care Salford PCT Southport and Ormskirk Hospital Yorkshire and Humber Barnsley PCT Bradford District Health and Social Care Trust Craven Harrogate & Rural District PCT Doncaster and South Humber Healthcare Hambleton and Richmondshire PCT arrogate Health Care Humber Mental Health Teaching Leeds Mental Health Teaching Leeds Teaching Hospitals Rotherham PCT Selby and York PCT SheYeld Care Trust SheYeld Childrens South West Yorkshire Mental Health York Health Services East Midlands Chestereld PCT Derbyshire Mental Health Services High Peak and Dales PCT Leicestershire Partnership Lincolnshire Partnership North Eastern Derbyshire PCT Northampton General Hospital Northamptonshire Healthcare Nottinghamshire Healthcare West Midlands Birmingham and Solihull Mental Health Birmingham Childrens Hospital Coventry Teaching PCT Dudley Beacon and Castle PCT Dudley South PCT Heart Of England NHS Foundation Trust Herefordshire PCT North StaVordshire Combined Healthcare 25,113 1,170 253 9 5 340 53 16 220 274 3,226 283 465 14 0 342 591 523 254 135 2 99 76 439 0 3 1,925 76 265 49 237 32 1 195 332 0 0 103 227 1 406 1 1,903 24 340 7 302 204 9 1 384 632 2,848 760 20 208 95 2 0 59 226 Subject to Section after admission(1) 22,957 862 87 14 4 238 17 39 283 180 4,078 423 428 5 0 552 550 433 535 221 4 113 203 608 0 3 2,051 102 231 35 400 37 1 166 311 31 1 71 152 0 510 3 1,567 5 456 6 384 134 10 5 141 426 1,828 593 5 149 66 0 4 85 188 Total detentions in hospital 48,070 2,032 340 23 9 578 70 55 503 454 7,304 706 893 19 0 894 1,141 956 789 356 6 212 279 1,047 0 6 3,976 178 496 84 637 69 2 361 643 31 1 174 379 1 916 4 3,470 29 796 13 686 338 19 6 525 1,058 4,676 1,353 25 357 161 2 4 144 414
Numbers Admitted to hospital under Section North Warwickshire PCT Sandwell Mental Health NHS Social Care Trust Shrewsbury and Telford Hospitals Shropshire County PCT Solihull PCT South Birmingham PCT South StaVordshire Healthcare South Warwickshire PCT Walsall Teaching PCT Walsall Hospitals Wolverhampton City PCT Worcestershire Mental Health Partnership East of England Bedfordshire and Luton Community Cambridgeshire and Peterborough Mental Health Partnership Colchester PCT Hertfordshire Partnership Norfolk and Waveney Mental Health Partnership Norfolk and Norwich University Hospital North Essex Mental Health Partnership Norwich PCT South Essex Partnership SuVolk Mental Health Partnership West Norfolk PCT London Barnet, Eneld and Haringey Mental Health Barts and The London Brent Teaching PCT Camden and Islington Mental Health and Social Care Trust Central and North West London Mental Health East London and The City Mental Health Eneld PCT Hillingdon PCT Kings College Hospital Kingston Hospital North East London Mental Health Oxleas South London and Maudsley South West London and St Georges Mental Health University College London Hospitals NHS Foundation Trust West London Mental Health Westminster PCT South East Berkshire Healthcare Buckinghamshire Hospitals Buckinghamshire Mental Health East Hampshire PCT East Kent NHS and Social Care Partnership Trust East Sussex County Fareham and Gosport PCT Hampshire Partnership Isle Of Wight Healthcare Milton Keynes PCT Oxford RadcliVe Hospital Oxfordshire Learning Disability Oxfordshire Mental Healthcare Portsmouth City Teaching PCT South Downs Health Southampton University Hospitals Surrey Hampshire Borders Surrey Oaklands West Kent NHS and Social Care Trust West Sussex Health and Social Care Winchester and Eastleigh Healthcare South West Avon and Wiltshire Mental Health Partnership Bath and North East Somerset PCT 114 164 15 356 0 0 214 101 168 2 126 218 2,263 299 294 14 307 402 0 388 6 268 239 46 5,598 681 5 2 548 656 542 63 95 2 0 427 258 1,143 525 0 651 0 3,943 459 1 172 59 251 251 1 478 128 112 3 4 365 129 255 0 120 182 525 447 1 2,237 790 1 Subject to Section after admission(1) 57 75 2 130 0 0 202 44 51 6 74 97 1,868 177 225 0 240 189 28 497 1 216 245 50 5,555 509 23 2 146 1,111 722 8 157 6 18 534 255 996 502 4 558 4 3,209 203 7 123 31 379 189 1 366 31 77 5 2 195 66 151 26 236 222 604 291 4 1,939 385 5 Total detentions in hospital 171 239 17 486 0 0 416 145 219 8 200 315 4,131 476 519 14 547 591 28 885 7 484 484 96 11,153 1,190 28 4 694 1,767 1,264 71 252 8 18 961 513 2,139 1,027 4 1,209 4 7,152 662 8 295 90 630 440 2 844 159 189 8 6 560 195 406 26 356 404 1,129 738 5 4,176 1,175 6
Numbers Admitted to hospital under Section Cornwall Partnership Devon Partnership Dorset Health Care Gloucestershire Partnership North Bristol North Dorset PCT Plymouth Hospitals Plymouth PCT Royal Cornwall Hospitals Salisbury Health Care Somerset Partnership NHS and Social Care Trust Swindon and Marlborough Source: KP90. Footnotes: 1. Includes all changes from informal status to detention under the Act, and detentions where the patient was initially brought to hospital under Section 136 (Place of Safety Order). 2 The high security psychiatric hospitals are now the responsibilities of NHS Trusts. 3 Following transition of data from the Department of Health to the NHS Information Centre for health & social care, including subsequent data refresh, there is an apparent discrepancy of 23 cases out of a total of 26,752. This represents 0.08% of the total cases. 247 330 212 244 0 58 11 115 0 4 224 1 Subject to Section after admission(1) 185 305 456 146 9 132 19 161 16 4 110 6 Total detentions in hospital 432 635 668 390 9 190 30 276 16 8 334 7
Table 84b ADMISSIONS TO INDEPENDENT HOSPITALS UNDER THE MHS 1983 AND CHANGES FROM INFORMAL TO DETAINED STATUS WHILE IN HOSPITAL, ENGLAND: 200405(1) numbers Admitted to Subject to hospital under Section after Section admission(1) Independent Hospitals by GOR and SHA area England North East County Durham and Tees Valley SHA Northumberland, Tyne and Wear SHA North West Cheshire and Merseyside SHA Cumbria and Lancashire SHA Greater Manchester SHA Yorkshire & Humber North and East Yorkshire and Northern Lincolnshire SHA South Yorkshire SHA West Yorkshire SHA East Midlands Leicestershire, Northamptonshire and Rutland SHA Trent SHA West Midlands Birmingham and the Black Country SHA Shropshire and StaVordshire SHA West Midland South East of England Bedfordshire and Hertfordshire SHA Essex SHA Norfolk, SuVolk and Cambridge SHA London North Central London SHA North East London SHA North West London SHA South East London SHA South West London SHA South East Hampshire and Isle of Wight SHA Kent and Medway SHA Surrey and Sussex SHA Thames Valley SHA South West Avon, Gloucestershire and Wiltshire SHA Dorset and Somerset SHA South West Peninsula SHA Source: KP90. Footnotes: 1. Includes all changes from informal status to detention under the Act, and detentions where the patient was initially brought to hospital under Section 136 (Place of Safety Order). 2. Due to the transition of data from Department of Health to the Information Centre for health and social care and following data refresh there is a discrepancy of 23 cases out of a total of 26,752. This represents a 0.08% of the total number of cases. 1,616 19 18 1 216 13 26 177 116 81 1 34 168 105 63 67 21 43 3 84 0 22 62 711 34 286 255 104 32 199 48 6 47 98 36 26 2 8 400 5 4 1 57 1 10 46 17 17 0 0 17 17 0 7 1 4 2 16 0 14 2 189 30 66 48 35 10 80 26 6 39 9 12 12 0 0 2,016 24 22 2 273 14 36 223 133 98 1 34 185 122 63 74 22 47 5 100 0 36 64 900 64 352 303 139 42 279 74 12 86 107 48 38 2 8 Total detentions in hospital
Table 84c ALL CONSULTANT EPISODES(1) OF PATIENTS WITH MENTAL ILLNESS BY STRATEGIC HEALTH AUTHORITY(2) OF RESIDENCE, 200405(3) Total Q20 Q02 Q27 Q15 Q10 Q13 Q22 Q03 Q14 Q17 Q18 Q25 Q01 Q11 Q05 Q06 Q04 Q09 Q26 Q07 Q08 Q21 Q23 Q19 Q16 Q24 Q28 Q12 Avon, Gloucestershire and Wiltshire Strategic HA Bedfordshire and Hertfordshire Strategic HA Birmingham and the Black Country Strategic HA Cheshire and Merseyside Strategic HA County Durham and Tees Valley Strategic HA Cumbria and Lancashire Strategic HA Dorset and Somerset Strategic HA Essex Strategic HA Greater Manchester Strategic HA Hampshire and Isle of Wight Strategic HA Kent and Medway Strategic HA Leicestershire, Northamptonshire and Rutland Strategic HA Norfolk, SuVolk and Cambridgeshire Strategic HA North and East Yorkshire and Northern Lincolnshire Strategic HA North Central London Strategic HA North East London Strategic HA North West London Strategic HA Northumberland, Tyne & Wear Strategic HA Shropshire and StaVordshire Strategic HA South East London Strategic HA South West London Strategic HA South West Peninsula Strategic HA South Yorkshire Strategic HA Surrey and Sussex Strategic HA Thames Valley Strategic HA Trent Strategic HA West Midlands South Strategic HA West Yorkshire Strategic HA 205,803 7,144 4,919 8,196 9,926 4,575 8,314 5,848 8,114 10,918 9,641 4,853 7,262 8,752 5,211 7,240 8,213 7,071 6,061 5,566 8,623 6,306 7,146 5,317 10,147 6,540 9,328 5,587 8,985 Rate per 1,000 population(4) 4.09 3.22 3.01 3.60 4.22 4.00 4.31 4.78 4.93 4.30 5.32 2.99 4.54 3.88 3.16 5.85 5.31 3.83 4.37 3.71 5.68 4.74 4.40 4.17 3.91 3.07 3.46 3.57 4.26
Source: HES. Appeals 5. The Mental Health Review Tribunal is an independent judicial body that hears applications and references by and on behalf of patients detained under the Mental Health Act 1983 as amended by the Mental Health (Patients in the Community) Act 1995. This includes patients admitted for assessment and/ or treatment, hospital orders, guardianship, after-care under supervision, and restricted patients who have come through the courts or transferred to hospital from prison. In some cases the nearest relative can also apply for the patients detention to be reviewed. Most hearings are a result of applications by the patient or the patients legal representative. 6. The act places a duty on Hospital Managers to refer a case to the tribunal at the end of specied periods where a patient has not had a hearing during that time. The Home Secretary in restricted cases is also obliged to refer cases to the Tribunal periodically and has a discretion to refer a patients case at any time. 7. In the nancial year 200506, there were 20,510 applications and references for appeals. During the same period 10,090 cases were aborted mostly because the patient was discharged by the hospital or the application was withdrawn before the hearing. There were 10,420 decided cases resulting in 1,570 discharges (absolute, conditional, deferred or delayed).
5.7.4 How many patients with (a) mental illness and (b) learning diYculties have been resident in each high secure hospital in each year since 1997? Are any data available for medium security hospitals and prisons? (Q85) Answer 1. Table 85a and Table 85b show the total number of patients in the high security psychiatric hospitals at 31 December in each of the last nine years from 1997 to 2005, and the number of patients who were classied as having a learning disability (within the Mental Health Act 1983 categories of mental impairment or severe mental impairment) for the same period. The gures embrace mental illness, psychopathic disorder, mental impairment and severe mental impairment. The learning disabilities gures in the second part of the table are also included in the rst part of the table and embrace the Mental Health Act 1983 classications of mental impairment and severe mental impairment. Table 85a TOTAL NUMBER OF PATIENTS RESIDENT IN HIGH SECURE HOSPITALS As at 31.12.97 31.12.98 31.12.99 31.12.00 31.12.01 31.12.02 31.12.03 31.12.04 31.12.05 Ashworth 456 426 416 410 405 367 289 270 272 Broadmoor 440 426 429 410 382 331 314 286 272 Rampton 454 457 447 429 392 375 372 357 360 Total 1,350 1,309 1,292 1,249 1,179 1,073 975 913 904
Source: High Security Hospitals. Footnotes: 1. The gures embrace mental illness, psychopathic disorder, mental impairment and severe mental impairment. Table 85b TOTAL NUMBER OF PATIENTS WITH LEARNING DISABILITIES IN HIGH SECURE HOSPITALS As at 31.12.97 31.12.98 31.12.99 31.12.00 31.12.01 31.12.02 31.12.03 31.12.04 31.12.05 Ashworth 18 9 0 3 3 4 2 0 0 Broadmoor 0 0 0 0 0 1 0 0 0 Rampton 111 104 95 87 87 75 63 55 48 Total 129 113 965 90 90 80 65 55 48
Source: High Security Hospitals. Footnotes: 1. These gures are included in the rst part of the table embracing the Mental Health Act 1983 classications of mental impairment and severe mental impairment. 2. The trend for a number of years has been for the high security psychiatric hospital patient population to reduce as secure psychiatric services more widely, particularly at a medium secure level, have been developed. This is in line with the Government policy that people should be treated in the least restrictive environment consistent with the need to protect themselves and the public, and as close to home as possible. 3. A high degree of priority has been given to moving inappropriately placed women patients out of the high security psychiatric hospitals. It is intended that a high security psychiatric womens service will only be provided at Rampton Hospital in the longer term. The womens service at Ashworth Hospital has already closed. There are currently 34 patients in the womens service at Broadmoor Hospital, with a target date of September 2007 for the closure of the service.
4. The ultimate impact of mental health prison in-reach teams on high security psychiatric hospital admissions remains uncertain. While these teams are preventing some psychiatric hospital admissions by improving the standard of community-type care available in prison, they are also improving the identication of prisoners who require transfer to psychiatric hospitals for treatment of mental health problems. Some of these individuals require a high security setting, although the eVect on hospital facilities providing medium and other levels of security is more signicant. 5. Broadmoor and Rampton Hospitals are involved in pilot projects for the assessment and treatment of people with dangerous and severe personality disorder (DSPD). Broadmoor Hospital is currently accommodating 23 patients in their DSPD Unit, while Rampton Hospital has 37 patients in their DSPD service. When both pilots are fully up and running Broadmoor and Rampton Hospitals will each provide 70 beds for DSPD patients. 6. There are also DSPD pilot projects in Whitemoor and Frankland Prisons. The impact on high security psychiatric hospital patient numbers in the longer term arising from the development of DSPD services will become clearer as the pilot projects are evaluated and decisions are taken about the type of settings in which this group of people should most appropriately be accommodated. 7. Each of the high security psychiatric hospitals remains the responsibility of an NHS TrustAshworth: Mersey Care NHS Trust, Broadmoor: West London Mental Health NHS Trust, Rampton: Nottinghamshire Healthcare NHS Trust. The three Trusts are performance managed by the relevant Strategic Health Authorities. 8. The High Security Psychiatric Services National Oversight Group has responsibility for co-ordinating the planning and delivery of high security psychiatric services and for ensuring that the Secretary of States specic duties under Section 4 of the National Health Service Act 1977 to provide high security psychiatric care are properly discharged. 9. Table 85a indicates a continuing downward trend in the total number of high security psychiatric hospital patients and in the number of patients with a classication of mental impairment/severe mental impairment at 31 December 2005. All gures exclude patients on trial leave of absence. Number of People with Mental Health Problems in Medium Secure Psychiatric Units 10. The position remains, as in previous years, that we are unable to supply data over the last four years for the number of people with mental health problems and with learning disabilities who have been in medium secure psychiatric units. We know, however, that there has historically been pressure on medium secure and other secure psychiatric beds. Therefore, steps have been taken to increase the number of secure psychiatric beds over the last few years. 11. The increase in bed numbers has signicantly improved the prospects of patients requiring psychiatric care and treatment in secure conditions being placed in the most appropriate settings to meet their needs. 12. More generally, the development and modernisation of mental health services, which is one of the Governments core national priorities, has placed a focus on the local development of services to meet the needs of the local population. This has provided a more focused mechanism for identifying the needs of local populations and the development of integrated local services. 13. High and medium secure psychiatric services are commissioned by Primary Care Trusts but in a collaborative manner around Cluster Group arrangements. The Cluster Groups are charged with taking forward the development of appropriate secure psychiatric services. 14. A review of the forensic mental health system that will provide information to inform the future planning of secure psychiatric services is currently being arranged. Prevalence of Mental Health Problems in the Prison Population 15. It is not possible to state with any precision how many prisoners have mental health problems at any one time. That is not a question of the application of objective criteria but is essentially a matter for the clinical judgement of the psychiatrists responsible for each persons care and treatment. However, a survey of mental ill health in the prison population undertaken in 1997 by the OYce for National Statistics estimated that around 90% of prisoners had at least one of the ve disorders (personality disorder, psychosis, neurosis, alcohol misuse, and drug dependence) considered in the survey. Co-morbidity levels are also high. [Psychiatric Morbidity among Prisoners in England and Wales ONS 1998]. 16. The NHS Plan included rm commitments that, by 2004, 300 additional staV would be involved in providing mental health services to prisoners and 5,000 prisoners at any one time would be receiving more comprehensive mental health services in prison. All prisoners with severe mental illness would be in receipt of treatment, and no prisoner with serious mental illness would leave prison without a care plan and a care co-ordinator. 17. These commitments have been met through the prison mental health in-reach project, under which the NHS has funded the introduction into prisons of multi-disciplinary mental health in-reach teams. The project began at 18 establishments in England and the four in Wales in 200102, and was extended to
another 26 during 200203 and a further 46 in 200304. Mental health in-reach teams are now operating at 102 establishments and since April 2006 all prisoners have access to them. The commitment in the NHS plan that 300 additional staV would be in post by the end of 2004 has been exceeded. 18. In December 2001, the then Prison Health Policy Unit and Task Force published, Changing the Outlook, a Strategy for Developing and Modernising Mental Health Services in Prisons. This set out the vision of where prison mental health services should be by 2006 and identied the steps that would have to be taken if it were to be realised. Every prison was expected to look critically, with its local NHS partner (Primary Care Trust) at its existing provision to establish whether it met the needs identied in the establishments joint health needs assessment and conformed to the principles and standards set out in both the Department of Healths National Service Framework for Mental Health and Changing the Outlook. 19. The basic principle underpinning the Strategy is that mental health services for prisoners should, as far as possible, be provided in the same way as they would be in the wider community. Prisoners who, were they not in prison, would be treated in their own homes under the care of Community Mental Health Teams, should be treated on the wings, their prison home. Those needing more specialist care should be able to receive it in the prison health care centre, and there should be quick and eVective mechanisms to transfer prisoners who need in-patient treatment for mental disorder to hospital. 20. Prisoners who are already receiving treatment for mental disorder in the community under, for example, the Care Programme Approach should continue to have access to that level of service while they are in prison and, if appropriate, on release. A more eVective screening tool has been introduced at all establishments to identify those who have immediate and/or signicant health needs, particularly mental health needs. 21. At the end of 2003, the National Institute for Mental Health in England (NIMHE) was commissioned to implement a national prison mental health programme to form part of a wider range of innovative NIMHE projects and work-streams. This work continues to be implemented by the Care Services Improvement Partnership (CSIP) of which the former NIMHE is a part. This mainstreaming of prison mental health is designed to ensure that front-line clinical staV and service users in prison are linked into a range of new developments, learning is shared and good practice disseminated. A nationally developed care pathway for prison mental health was published in January 2005 that provides detailed guidance to staV and service commissioners alike. By following the prisoner from arrest through custody and on to release, it underpins the concept of end to end oVender management. 22. The number of prisoners transferred to hospital as restricted patients under sections 47 (sentenced) and 48 (unsentenced) of the Mental Health Act 1983 rose by 76% between 1991 and 1994 but thereafter remained relatively stable at an average of 745 each year until 1999. In 2005, the last year for which statistics have been published, 896 prisoners were transferred as restricted patients under those sections, a rise of 19% on the revised 2002 gure of 644. 23. Many prisoners, particularly those in the acute stage of a mental illness, are transferred to hospital within a reasonable timescale but problems of apparently excessive delay can still occur in some individual cases. Although considerable eVorts have been made to reduce such delays, at any one time around 40 or so prisoners will have been waiting longer than three months for a hospital place following acceptance by the NHS. Tighter regular monitoring has already been introduced to identify any prisoners who have been waiting unacceptably long periods for transfer to hospital. A protocol issued in 2003 set out what must be done when a prisoner has been waiting for a hospital place for more than three months following acceptance by the NHS. As indicated by the rise in the number of transfers since 2003, both appear to have brought about an improvement. 24. However, there remains some lack of clarity around the arrangements for transferring prisoners with mental health problems to hospital. The Prison Service, Prison Health, the National Institute for Mental Health in England (NIMHE), and the commissioners and providers of NHS hospital services are now working collaboratively on a two year project that began in April 2005. Its principal objective is to establish a national waiting time standard for transfers between custodial settings and hospitals that is equivalent to the waiting time for referrals between mainstream NHS providers and hospital and which is maintained for all prisoners requiring transfer. In January 2006, it produced procedures for the transfer of prisoners under Sections 47 and 48 of the Mental Health Act 1983. This aimed to reduce unacceptable delays in the transfer of prisoners by providing clarication and a clear description of the transfer process. 5.7.5 Is there any evidence of increasing emphasis on talking therapies in NHS mental health treatment? (Q86) Answer 1. There is robust clinical evidence of the eVectiveness of talking treatments for various mental health problems such as depression, anxiety and schizophrenia which have been carefully considered by the National Institute for Health and Clinical Excellence during the development of clinical guidelines for such conditions. 2. More talking therapies are being provided over the NHS in recent years (as evidenced by the increasing investment in psychological therapies from 125 million in 200102 to 142 million in 200405 (The 200506 National Survey of Investment in Mental Health Services, Mental Health Strategies, http://www.dh.gov.uk/
assetRoot/04/13/50/11/04135011.pdf) and the signicant increases in the number of clinical psychologists and qualied psychotherapists employed in the NHS (NHS StaV 19952005, The Information Centre for health and social care, http://www.ic.nhs.uk/pubs/nhsstaV)). Our evidence shows, however, that services are not keeping pace with increasing demand from service users and that provision is not evenly spread across the country. To a large extent, psychological therapies can be seen as a victim of their own success. 3. The OYce for National Statistics Psychiatric Morbidity Survey 2000 found that 24% of people assessed as having a neurotic disorder were receiving treatment of some kind for a mental or emotional problem. Of those receiving treatment, only 9% were having talking therapies and a further 4% were receiving both medication and talking treatments (Surveys of Psychiatric Morbidity among Adults in Great Britain, OYce for National Statistics, http://www.dh.gov.uk/assetRoot/04/06/81/88/04068188.pdf). 4. The NHS Patient Survey 2005 also reported that while 40% of the respondents received talking therapies in the previous year, one in three (33%) of those who had not had talking therapy said that they would have liked it (Survey of Mental Health Service Users 2005, Healthcare Commission, http://www.healthcarecommission.org.uk/ db/ documents/04019829.pdf). In the previous years Patient Survey, 59% of service users said they would have liked talking therapy (Survey of Mental Health Service Users 2005, Healthcare Commission, http://www.healthcarecommission.org.uk/ db/ documents/ 04008183.pdf). The Departments consultation on patient choice also showed that the single most common request from people with mental health problems is for quick access to eVective talking treatments (Building on the Best Mental Health Taskforce Report, December 2003, http://www.dh.gov.uk/assetRoot/04/07/86/ 54/04078654.PDF). There is also anecdotal evidence from primary care professionals that waiting times for talking therapies are too long (GP frustration over depression therapies, 10 September 2005, Pulse-i, http://www.pulse-i.co.uk/articles/fulldetails.asp?aid%7759). 5. Approximately 2.75 million people visit GP surgeries each year with mental health problems that could be treated eVectively with psychological interventions. Only a minority of these people (8%) receive any form of talking therapy. So, despite the big increases in psychologists in recent years, the key challenge remains in making further stepped increases in the psychological therapy workforce and targeting and improving access for people that would benet from this service. 6. There is evidence to suggest that the demand for psychological therapies has increased in recent years as more services have become available. For example, the Building on the Best Consultation exercise identied improved accress to talking therapies as the top priority for mental health service users in extending the scope and range of choices available to thema point reinforced in the more recent SCMH study. 7. The Departments improving Access to Psychological Therapies Programme will make the case for investing in this additional psychological therapy workforce. As well as seeking to conrm clinical eVectiveness, and to capture health and social benets to service users, the programme will collect evidence to demonstrate the overall nancial benet to the economy that will be derived from investing in psychological therapy services by reduing the number of people with mental health problems on Incapacity (and other) Benets and reducing sickness rates in the workplace (as part of the Treasurys cross-cutting review of Mental Health and Employment announced in Budget 2005). 8. The IAPT programme will dene: the numbers of new staV required to deliver comprehensive, evidence based psychological interventions; training requirements and opportunities for retraining of existing staV; the provision of Computerised self-help; and, reform of care pathways based on the NICE recommendation for the provision of a stepped care model by which patients receive treatment according to the severity of their condition and their initial treatment response.
Background 9. There has been a signicant political and societal interest in the need for improved access to psychological interventions for individuals accessing health care (Turpin, G, Hope, R, DuVy, R, Fossey, M and Seward, J (2006) Improving Access to Psychological Therapies: Implications for the Mental Health Workforce (due for publication shortly). There has also been a recent move to demonstrate the eVectiveness of introducing a stepped care approach to the delivery of psychological therapies (Department of Health (2006) Our Health, Our Care, Our Say: A new direction for community services. White paper. Department of Health, London) and to examine the cost of service provision and the economic impact. Professor Lord Layard and his team at the London School of Economics have been commissioned by the DH to undertake this evaluation, initial ndings expected early in 2007. In order to test diVerent modalities of psychological therapy provision robustly, the Government have invested 3.7 million in two demonstration sites and, supported by Care Services Improvement Partnership and work in its eight regional centres, a national improving access to psychological therapies network has been developed.
10. Recent high prole reports have also highlighted the cost benets (Layard et al, 2006 Centre for Economic Performance (2006). The Depression Report: A New Deal for Depression and Anxiety Disorders. London School of Economics) and the clinical eVectiveness (Gillespie, K DuVy, M, Hackmann, A and Clark, DM (2002) Community based cognitive therapy in the treatment of posttraumatic stress disorder following the Omagh bomb, Behaviour Research and Therapy 40, 345357) of appropriately delivered evidence-based psychological interventions. The National Institute for Health and Clinical Excellence (NICE) has developed guidelines that strongly endorse the use of psychological interventions for the treatment of a range of mental health disorders (eg Depression: National Institute for Health and Clinical Excellence (2004) Depression: Management of Depression in primary and secondary care. NICE, London.). 5.8 Performance Ratings 5.8.1 Could the Department comment on trends in (a) NHS star ratings and (b) social services star ratings performance? How many NHS organisations and councils saw a drop in their rating in each year for which data are available? Can the Department comment on any common factors between organisations with a ratings drop? (Q87) Answer 1. Star Ratings and the number of NHS trusts whose rating has risen/fallen on the previous year are set out in the Table 87a to Table 87d. Because of changes to organisational conguration and the assessment process, data between years is not directly comparable. 2. Star ratings and the number of councils whose rating has risen/fallen on the previous year are shown in Table 87e. Table 87a ACUTE AND SPECIALIST TRUSTS(1) (2) Star rating *** ** * Zero Number risen on previous year Number fallen on previous year 200001 35 103 23 12 200102 52 88 36 10 46 40 200203 63 68 31 14 51 35 200304 76 58 29 10 50 41 200405 73 53 38 9 34 42
Source: 200001 to 200203 risen/fallen value is the Department of Health. 200304 to 200405 risen/fallen value is the Healthcare Commission. Footnotes: 1. Due to mergers of NHS organisations it is not always possible to compare an organisations star rating to the previous year. 2. For 200001, only acute trusts were performance rated. Table 87b AMBULANCE TRUSTS(1) (2) Star rating *** ** * Zero Number risen on previous year Number fallen on previous year 200001 200102 12 16 4 0 200203 10 7 9 5 2 14 200304 10 11 6 4 9 7 200405 13 6 9 3 8 7
Source: 200001 to 200203 risen/fallen value is the Department of Health. 200304 to 200405 risen/fallen value is the Healthcare Commission. Footnotes: 1. Due to mergers of NHS organisations it is not always possible to compare an organisations star rating to the previous year. 2. For 200001, only acute trusts were performance rated.
Table 87c MENTAL HEALTH TRUSTS(1) (2) Star rating *** ** * Zero Number risen on previous year Number fallen on previous year 200001 200102 4 67 13 2 200203 13 42 26 3 12 16 200304 15 38 23 7 21 25 200405 21 45 12 5 30 15
Source: 200001 to 200203 risen/fallen value is the Department of Health. 200304 to 200405 risen/fallen value is the Healthcare Commission. Footnotes: 1. Due to mergers of NHS organisations it is not always possible to compare an organisations star rating to the previous year. 2. For 200001, only acute trusts were performance rated. Table 87d PRIMARY CARE TRUSTS(1) (2) Star rating *** ** * Zero Number risen on previous year Number fallen on previous year 200001 200102 200203 45 139 98 22 200304 45 181 63 14 104 69 200405 58 158 80 7 82 77
Source: 200001 to 200203 risen/fallen value is the Department of Health. 200304 to 200405 risen/fallen value is the Healthcare Commission. Footnotes: 1. Due to mergers of NHS organisations it is not always possible to compare an organisations star rating to the previous year. 2. For 200001, only acute trusts were performance rated. Table 87e COUNCILS Star rating *** ** * Zero Number risen on previous year Number fallen on previous year 200001 200102 11 52 75 12 200203 16 74 52 8 41 6 200304 20 82 40 8 27 11 200405 26 86 33 5 37 18
Source: 200001 to 200203 risen/fallen value is the Department of Health. 200304 to 200405 risen/fallen value is the Healthcare Commission. Footnotes: 3. A high-level analysis of the areas where performance has been poor for 200405 is in Table 87f. 4. The table shows areas of poor performance for Trusts with a zero star rating. The gures reect the number of zero star Trusts where more than one Trust has scored Signicantly Underachieved pn a particular Key Target, or Low on a particular Balance Scorecare indicator. The gures in brackets shows the total number of zero star Trusts by type. 5. A rules based approach was used to determine the overall rating, where penalty points are given for failure against Key Targets and the Balanced Scorecare indicators. The rating was then awarded according to the total amount of penalty points received, with particular weighting towards achieving Key Targets. Zero star trusts are therefore likely to have failed one or more key targets. 6. A high-level breakdown of all ratings is available in NHS performance ratings 2004/2005 available on the Healthcare Commissions website.
Table 87f TRUSTS Acute & Specialist Trusts (9 zero stars) Key Targets Elective patients waiting longer than the standard Financial Management Outpatients waiting longer than the standard Total time in A&E: four hours of less Category B Calls meeting 14/19 minute target Crisis resolution team implementation Balanced Scorecare Clinical focus Patient focus Capacity and capacity focus Improving health Service provision 6 8 3 3 3 Mental Health Trusts (5 zero stars) Primary Care Trusts (7 zero stars) 2 7 Ambulance Trusts (3 zero stars)
2 2 2
3 3
3 4 2 4
7. A high-level analysis of the areas where performance has been poor for 20405 is in Table 87g. 8. The table shows areas of poor performance for Councils with a zero star rating. The gures reect the number of zero star Councils where more than one Council has scored no or poor on a particular Judgement. The number in brackets shows the total number of zero star Councils. 9. A high-level breakdown of all ratings is available in Performance Ratings for Social Services in England, December 2005 available on the Commission for Social Care Inspections website. Table 87g COUNCILS 200405 Judgements Childrens social care services Serving People Well? Childrens social care services Service Provision Healthcare 10. The publication of NHS Performance Ratings takes forward the Governments commitment to provide both patients and the general public with comprehensive, easily understandable information on the performance of their local health services, and is seen as an important step towards delivering a more open and accountable NHS. 11. The performance ratings system provides a high-level overview of NHS organisations performance across a wide range of measures. The rating awarded is based on the trusts performance against a number of key targets and a wider set of balanced scorecard performance indicators. 12. Since 200203, the Healthcare Commission has had responsibility for production of performance ratings. Prior to 200203, the Department of Health published performance ratings. 13. The indicators for rating performance were based on priorities and guidance set by the Department of Health. These indicators may change from year to year. They also reect, for some priorities, the incremental changes made to targets to achieve year-on-year improvements to the service patients will receive. 14. Where organisations under perform, resource is available locally to support modernisation and improvement. In addition, DHs Recovery and Support Unit work closely with SHAs to improve performance through supporting implementation and management. Councils (5 zero stars) 4 3
15. From 200506, the Healthcare Commission will take forward a new approach to annually assessing each NHS organisations performance. The new annual health check will provide a richer and more comprehensive picture of the performance of the NHS. It will also establish a baseline of performance from which organisations can improve. Social Care 16. The publication of Performance Ratings for Social Services in England is in response to the 1998 social services white paper Modernising Social Services, in which the Government committed to put in place eVective systems to monitor and manage performance. 17. The performance ratings system provides a high-level overview of Social Services organisations performance across adult and childrens services. The rating awarded is based on the councils performance against information from a number of sources including performance data, evaluation through inspection/ reviews and monitoring by the Commission for Social Care Inspection Business Relationship Managers. 18. Prior to 200304, the Social Services Inspectorate published performance ratings. Since 200304, the independent regulator the Commission for Social Care Inspection has had responsibility for production of performance ratings. 19. External support, such as Performance Action Teams, assist council staV in developing their capacity and systems to deliver improved social services. This support is provided to councils obtaining zero stars to improve their capacity and systems, and to one star trusts to prevent them slipping to zero stars. Also, attention is now being directed to councils whose performance judgements have remained static (coasting) over a period of three years. 20. The information for 200405 shown in table 5 includes the ratings for Childrens social care. From 200506, the Childrens Services ratings will be separate and Commission for Social Care Inspection will only publish Adult Social Care Ratings.
5.9 Management Costs 5.9.1 What were management costs by type of NHS organisation and as a share of total NHS expenditure in each year since 199798? (Q88) Answer 1. The information requested is given in Table 88. Table 88 MANAGEMENT COSTS 199798 to 200405 (ENGLAND)
millions 199798 199899 19992000 200001 200102 200203 200304 200405 Actual Actual Actual Actual Actual Actual Actual Actual HA/SHA 432 PCT NHS trust 1,296 GP Fundholding(1) Total 1,728 34,664 Total NHS Expenditure(2) (3) Management costs as % of NHS Spend 5.0% 414 1,290 1,704 36,608 4.7% 497 1,287 1,784 40,201 4.4% 536 24 1,307 1,867 43,932 4.3% 463 224 1,306 1,993 49,021 4.1% 97 723 1,311 2,131 54,042 3.9% 115 847 1,425 2,387 63,001 3.8% 133 986 1,457 2,576 69,706 3.7%
Source: Audited health authority annual accounts 199798 to 199899. Audited (strategic) health authority summarisation forms 19992000 to 200405. Audited NHS Trust summarisation schedules 199798 to 200405. Audited primary care trust summarisation schedules 200001 to 200405. Footnotes: 1. Figures not available. 2. The large rise in expenditure between 200203 and 200304 is due to a change in accounting basis from stage 1 resource based budgeting in 200203 to stage 2 resource based budgeting in 200304. This involved a transfer of non cash items into the DEL. On a stage 2 basis, the value for the total expenditure in 200203 is 56,503 million. 3. Total Net NHS Expenditure (England), 200405 is estimated outturn expenditure. 4. Percentages and totals may not be precise owing to the rounding of gures to m. 5. The Department of Health does not collect data from NHS Foundation Trusts therefore the table does not include management costs of NHS Foundation Trusts. 6. Management cost information is collected in audited returns, which provides external scrutiny on the gures. The Department does not have concerns over the quality of the data.
5.9.2 Could the Department detail expenditure on management consultants as part of turnaround teams, nationally and by organisation? Could the Department comment on the availability of more general data concerning NHS expenditure on external consultants? (Q89) Answer 1. The information requested on turnaround teams is given in Table 89. 2. Organisations within the turnaround cohort were asked to outline the estimated costs of turnaround support at a local level ie turnaround director/advisor support. Some organisations have included ancillary/ indirect costs to turnaround eg external legal, communications, training and benchmarking support. 3. More generally, the Department does not collect information from the NHS on this type of expenditure. Primary Care Trusts and NHS Trusts operate within the framework of Department of Health policy; they are held to account for this by SHAs, not directly by the Department. NHS organisations account separately for their nancial performance, publishing their own set of annual nancial accounts. Table 89 ESTIMATED COST OF TURNAROUND SUPPORT FOR COHORT ORGANISATIONS millions External Turnaround Support Fees (January 2006 March 2007) 0.1 0.6 0.0 0.6 0.8 1.5 0.4 0.4 0.4 1.2 0.6 0.2 0.4 0.9 0.8 0.6 0.2 0.7 0.8 1.0 0.2 0.2 0.2 0.2 0.0 0.3 0.3 0.3 0.3 0.1 0.3 0.5 0.0 0.4 0.3 0.5 0.3 0.0 0.3 0.5 0.5
Organisation George Eliot Hospital NHS Trust Shrewsbury and Telford Hospital NHS Trust South Warwickshire NHS Trust North Cumbria PCT The Royal West Sussex NHS Trust Surrey and Sussex Healthcare NHS Trust University Hospital of North StaVordshire NHS Trust Mayday Hospital NHS Trust Barnet & Chase Farm Hospitals NHS Trust Mid Yorkshire Hospitals NHS Trust Selby and York PCT Dacorum PCT Royal Cornwall Hospitals NHS Trust Hammersmith Hospitals NHS Trust Brighton & Sussex Univ Hospitals NHS Trust North Cumbria NHS Trust (combined with North Cumbria PCT) SheYeld PCTs Weston Area Health NHS Trust United Lincs Hospitals NHS Trust Hillingdon PCT Cheshire West PCT (5H3) Kennet and North Wiltshire PCT West Wiltshire PCT (5DH) Royal Wolverhampton Hospital NHS Trust Sandwell and West Birmingham Hospitals NHS Trust North Stoke PCT (5ME) Cambridge City PCT North Middlesex Univ Hospital NHS Trust Queen Marys Sidcup NHS Trust Queen Elizabeth Hospital Kings Lynn NHS Trust Oxford RadcliVe Hospital NHS Trust St Georges Healthcare NHS Trust West Hertfordshire Hospitals NHS Trust Royal Free NHS Trust Scarborough, Whitby and Ryedale PCT Yorkshire Wolds and Coast PCT West Middlesex University NHS Trust Guildford and Waverley PCT The Mid Cheshire Hospitals NHS Trust Kensington and Chelsea PCT East and North Hertfordshire NHS Trust East Elmbridge and Mid Surrey PCT
Category 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
millions External Turnaround Support Fees (January 2006 March 2007) 0.0 0.5 0.1 0.1 0.2 0.3 0.2 0.1 0.1 0.3 0.6 0.0 0.1 0.3 0.2 0.0 0.0 0.3 0.0 0.0 0.1 0.0 0.0 0.1 0.3 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.0 0.0 0.0 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 22.1
Organisation East Cheshire NHS Trust Hounslow PCT (5HY) North West London Hospitals NHS Trust Southport and Ormskirk Hospital NHS Trust Maidstone and Tunbridge Wells NHS Trust Southampton University Hospitals NHS Trust Bexley PCT Colchester PCT Maidstone Weald PCT High Peak and Dales PCT Kingston PCT East Hampshire PCT South Cambridgeshire PCT (combined with Cambridge City PCT) Blackwater Valley and Hart PCT SW Kent PCT (combined with Maidstone Weald PCT) Fareham and Gosport PCT (combined with East Hampshire PCT) Cotswold and Vale PCT North Somerset PCT Good Hope Hospital NHS Trust North Tees and Hartlepool NHS Trust Ashford and St Peters NHS Trust Bedford Hospitals NHS Trust Sedgeeld PCT Essex Rivers NHS Trust South Tees Hospitals NHS Trust Bedfordshire Heartlands PCT Princess Alex Harlow NHS Trust West SuVolk Hospitals NHS Trust Queen Elizabeth Hospital NHS Trust The Lewisham Hospital NHS Trust Morecambe Bay NHS Trust Isle of Wight NHS Trust (combined with Isle of Wight PCT) RUH Bath NHS Trust SuVolk Coastal PCT North Devon Healthcare NHS Trust Chelmsford PCT Witham, Braintree & Halstead Care PCT Broadlands PCT (5JL) North Norfolk PCT Southern Norfolk PCT (5GI) SuVolk West PCT Waveney PCT Lewisham PCT Wandsworth PCT (5LG) Morecambe Bay PCT Ipswich PCT (combined with SuVolk Coastal PCT) Isle of Wight PCT N Hants PCT New Forest PCT (5A1) South Wiltshire PCT (5DJ) Bromley Hospitals NHS Trust Bromley PCT North Hampshire Hospitals NHS Trust Tendring PCT Barnsley PCT TOTAL
Category 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 4 4 4 4 4
Footnotes: 1. For category 1 and 2 organisations (as at May 2006), the estimated expenditure for external support on turnaround between January 2006March 2006 was 4,769k. The projected costs for turnaround for the nancial year 200607 is estimated to be 15,830k. These costs include DH contributions of 93k towards the cost of the rst three months of turnaround support for the category 1 organisations.
2. For category 3 and 4 organisations (as at June 2006), the estimated expenditure for external support on turnaround between January 2006March 2006 was 173k. The projected costs for turnaround for the nancial year 200607 is estimated to be 1,306k. 5.10 Financial Balance 5.10.1 What has the NHS nancial balance been in each year since 199798? (Q90) Answer 1. The information requested is given in Table 90. 2. For all years, except 200506 the gures are from the audited summarisation schedules and are therefore denitive. The 200506 gures are from the Month 12 Financial Monitoring Returns with the exception of the foundation trust gures, which are from Monitor. These gures must therefore be treated as provisional until they are signed oV by the NAO/Chief Executive. Table 90 NHS SURPLUS/(DEFICIT) 199798 TO 200506 millions Financial year 199798 199899 19992000 200001 200102(1) 200203 200304 200405 200506(2) HAs/PCTs (18) 17 (52) 56 111 189 210 100 48 NHS Trusts (104) (36) (77) 56 (40) (94) (138) (322) (560) Foundation Trusts Total NHS position (121) (18) (129) 112 71 96 73 (258) (536)
(37) (24)
Source: 199798 to 200405 Audited Summarisation Schedules. 200506 Month 12 Financial Monitoring Returns. Footnotes: 1. The total for NHS trusts in 200102 does not sum to the total of the individual organisations due to a central adjustment relating to a prior period adjustment being made in the underlying accounts following a change in the interpretation of FRS11. 2. Provisional. 5.10.2 What have decits and surpluses been in each (a) NHS Trust (b) Primary Care Trust and (c) Strategic Health Authority been in each year since 199798 for which data are available, in s and as a percentage of turnover? (Q91) Answer 1. The information requested is given in Table 91a to Table 91d. 2. Figures for 200506 are subject to audit and remain provisional.
Table 91a NHS TRUSTS SURPLUS/(DEFICIT) FOR THE FINANCIAL YEARS 199798 TO 200506
Code NHS trust 199798 000s 0 (846) 8 60 (490) 339 200 30 9 78 (303) 5 190 (1,230) 300 (628) 471 (2,660) (460) (883) 52 3 163 142 26 38 14 2 114 77 70 51 163 (104) (762) 70 88 (1,557) 1,368 (217) 124 14 12 70 (570) (2,683) (114) 11 6 199 36 354 (938) 97 637 (729) 8 9 11 28 199899 000s 0 (4,721) (1,238) 64 3 305 (554) 36 6 352 6 46 159 (2,964) (274) (987) (539) 561 161 (3,748) 76 (154) 0 12 54 14 5 46 2 97 52 (27) 15 136 3 (461) 273 762 0 42 3 680 869 17 (113) 2 25 4 34 (1,119) 488 (595) 5 20 9 350 19992000 000s 114 243 (111) (784) 81 (323) 3 95 11 58 75 (4,613) (184) (3,291) (3,999) (426) Surplus/ (decit) 200001 200102 000s 000s 6 1,559 (35) 3 41 (1,150) 11 0 10 40 105 1,866 11 6,206 3 26 (2) (450) 1,225 45 (7,659) 6 0 (3,563) (190) 11 (9,281) 16 0 (1,549) (1,514) 4 80 95 0 262 (5,154) 3 52 81 276 (6,989) 2 3,285 77 0.2% 0.0% 0.1% "0.3% 0.0% 0.2% "11.5% 0.4% "0.4% 1.2% "4.4% "0.6% "1.4% 0.1% 0.0% 0.2% 0.1% 0.2% 0.6% 0.1% 0.0% 0.4% 0.5% 0.5% 0.1% 2.0% "0.2% "2.5% 0.4% 0.5% "5.4% 1.9% "0.2% 0.1% 0.1% 0.0% 0.1% "0.9% "1.6% "0.2% 0.1% 0.0% 0.4% 0.1% 0.7% "1.4% 0.3% 2.2% "1.2% 0.0% 0.0% 0.0% 0.0% 200203 000s 200304 000s 200405 000s 200506 000s 199798 % of turnover(1) 199899 19992000 200001 200102 200203 200304 200405 200506
RA0 RA1 RA2 RA3 RA4 RA5 RA7 RA8 RA9 RAB RAE RAF RAG RAH RAJ RAL RAN RAP RAQ RAS RAT RAU RAW RAX RAZ RB1 RB2 RB4 RB5 RB6 RB7 RB8 RBA RBB RBD RBF RBG RBH RBJ RBK RBL RBN RBP RBQ RBS RBT RBU RBV RBW RBX RBZ RC1 RC3 RC4 RC5 RC8 RC9 RCA RCB RCC RCD
CROYDON & SURREY DOWNS COMMUNITY NHS TRUST EPSOM HEALTH CARE NHS TRUST ROYAL SURREY COUNTY HOSPITAL NHS TRUST WESTON AREA HEALTH NHS TRUST EAST SOMERSET NHS TRUST EAST GLOUCESTERSHIRE NHS TRUST UNITED BRISTOL HEALTHCARE NHS TRUST TRECARE NHS TRUST SOUTH DEVON HEALTH CARE NHS TRUST THE FREEMAN GROUP OF HOSPS NHS TRUST BRADFORD TEACHING HOSPS NHS FOUND TRUST NORTHERN GENERAL HOSPITAL NHS TRUST DONCASTER ROYAL INFIRM AND MONTAGU TRUST ANGLIAN HARBOURS NHS TRUST SOUTHEND HOSPITAL NHS TRUST ROYAL FREE HAMPSTEAD NHS TRUST ROYAL NAT ORTHOPAEDIC HOSP NHS TRUST NORTH MIDDLESEX UNIVERSITY HOSP NHS TRUST NORTH HERTFORDSHIRE NHS TRUST THE HILLINGDON HOSPITAL NHS TRUST NORTH EAST LONDON MENTAL HEALTH NHS TRUST CENTRAL MIDDLESEX HOSPITAL NHS TRUST LIFECARE NHS TRUST KINGSTON HOSPITAL NHS TRUST ST HELIER NHS TRUST AVON AMBULANCE SERVICE NHS TRUST CLEVELAND AMBULANCE NHS TRUST ESSEX AMBULANCE SERVICE NHS TRUST GLOUCESTERSHIRE AMBULANCE SERVICES NHST MERSEY REGIONAL AMBULANCE SERVICE TRUST STAFFORDSHIRE AMBULANCE SERVICE TRUST SOUTH YORKSHIRE AMBULANCE SERVICE NHS TR TAUNTON AND SOMERSET NHS TRUST ROYAL NAT HOSP RHEUM DISEASE NHS FOUN TRUST WEST DORSET GENERAL HOSPITALS NHS TRUST NUFFIELD ORTHOPAEDIC CENTRE NHS TRUST FIRST COMMUNITY NHS TRUST THE FOUNDATION NHS TRUST RUGBY NHS TRUST WALSALL HOSPITALS NHS TRUST WIRRAL HOSPITAL NHS TRUST ST HELENS AND KNOWSLEY HOSPITALS NHS TRUST CHESTER AND HALTON COMMUNITY NHS TRUST THE CARDIOTHORACIC CNTR LIVERPOOL NHST ROYAL LIVERPOOL CHILDRENS NHS TRUST THE MID CHESHIRE HOSPITALS NHS TRUST CENTRAL MANCHESTER HEALTHCARE NHS TRUST CHRISTIE HOSPITAL NHS TRUST NORTHUMBRIA AMBULANCE SERVICE NHS TRUST LINCOLNSHIRE AMBULANCE NHS TRUST NORTHERN DEVON HEALTHCARE NHS TRUST BEDFORD HOSPITAL NHS TRUST EALING HOSPITAL NHS TRUST EAST HERTFORDSHIRE NHS TRUST HAREFIELD HOSPITAL NHS TRUST HORIZON NHS TRUST LUTON AND DUNSTABLE HOSPITAL NHS TRUST NORTHALLERTON HEALTH SERVICES NHS TRUST YORK HOSPITALS NHS TRUST SCARBOROUGH AND NE YORKS NHS TRUST HARROGATE AND DISTRICT NHS FOUND TRUST
0.0% "1.5% 0.0% 0.2% "1.2% 0.3%
0.0% "8.1% "1.7% 0.2% 0.0% 0.3% "0.3% 0.3% 0.0% 0.3% 0.0% 0.1% 0.2% "1.4% "0.7% "1.5% "0.7% 0.8% 0.3% "14.4% 0.1% "0.1% 0.0% 0.2% 0.2% 0.2% 0.0% 0.3% 0.0% 0.1% 0.6% 0.0% 0.0% 0.6% 0.0% "0.6% 0.2% 0.7% 0.0% 0.1% 0.0% 1.0% 0.4% 0.0% "0.5% 0.0% 0.0% 0.0% 0.0% "1.2% 2.1% "0.9% 0.0% 0.0% 0.0% 0.4%
0.5% 0.3% "0.3% "1.6% 0.1% "0.2% 0.0% 0.1% 0.0% 0.1% 0.1% "1.9% "0.4% "4.6% "4.6% "0.4%
0.0% 1.8% "0.1% 0.0% 0.0% "0.5% 0.0% 0.0% 0.0% 0.0% 0.1% 0.7% 0.0% 7.2% 0.0%
0.1% 0.0% "1.0% 2.0% 0.0% "2.9% 0.0% 0.0% "3.3% "0.4% 0.0% "3.5% 0.0% 0.0% "1.3% "2.7% 0.0% 0.0% 0.1% 0.0% 0.2% "8.0% 0.0% 0.0% 0.1% 0.2% "10.2% 0.0% 0.9% 0.0%
17 5,216 0 0 22 7 13 4 10 (14) 8 0 3 7 2 2 (7)
4 (847) 0 0 20 84 35 3 (58) 345 5 0 37 5 13 2 3,744
57 (961) 0 (989) (963) 91 5 241 22 14 6 0 7 5 8 3 (309)
17 (10,217) (3,793) (4,106) 23 151 503 5 134 107 15 0 5 3 15 (448) 82
524 (4,845) 6 (8,166) 2,212 352 14 (947) 1,445 (488) 5 0 611 16 (998) 229
0.0% 2.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% "0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% "0.3% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% "0.1% 3.2% 0.0% 0.0% 0.2% 0.0% 0.1% 0.0% 6.6%
0.0% "0.3% 0.0% "0.9% "0.8% 0.1% 0.0% 1.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% "0.6%
0.0% "3.0% "6.2% "3.3% 0.0% 0.2% 0.3% 0.0% 0.3% 0.7% 0.0% 0.0% 0.0% 0.0% 0.1% "0.4% 0.1%
0.3% "1.3% 0.0% "6.4% 1.5% 0.3% 0.0% "3.7% 2.3% "2.6% 0.0% 0.0% 1.7% 0.0% "0.9% 0.4%
(1,030) 5 92 (318) 11 3 61 (495) 2 137 161 (203) 27 18 64 283 50 22 (334) 576 (4,659) (249) 0 126 5 (1,328) (5,167) (265) 128 (805) 23 (150) 401
9 1 5 123 11 13 9 1 2 7 (3,549) 2 0 3 17 5 52 9 0 180 857 0 4 (1) 10 47 10 101 12 6 10 6
"1.0% 0.0% 0.4% "4.0% 0.0% 0.0% 0.4% "0.4% 0.0% 0.2% 0.4% "0.9% 0.1% 0.0% 0.0% 0.3% 0.2% 0.1% "0.5% 0.8% "2.3% "0.4% 0.0% 0.2% 0.0% "1.7% "5.4% "1.1% 0.2% "1.7% 0.0% "0.2% 0.4%
0.0% 0.0% 0.0% 1.4% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0% "7.9% 0.0% 0.0% 0.0% 0.0% 0.0% 0.2% 0.0% 0.0% 0.2% 0.4% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0%
41 13 3 9 1 0 99 1 0 1 (3,149) 98
8 19 2 0 1 23 6 2 0 2,741 (183)
(1,057) 16 93 0 3 3 0 2 372 120 7
(1,845) 25 9 0 10 31 5 3 (991) (8,480) 1
1,926 20 106 0 1 32 10 3 (7,961) (11,887) 1,059
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% "4.1% 0.1%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 2.9% "0.2%
"0.9% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.5% 0.1% 0.0%
"1.5% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% "1.3% "8.4% 0.0%
1.4% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% "10.3% "11.7% 1.0%
52 22 7 41 34
99 9 32 51
852 4 62 7
171 1 (4,506) 4
396 3 (7,292)
0.1% 0.0% 0.0% 0.0% 0.0%
0.1% 0.0% 0.0% 0.1%
0.8% 0.0% 0.1% 0.0%
0.1% 0.0% "5.0% 0.0%
0.3% 0.0% "7.7%
Table 91a (Continued) NHS TRUSTS SURPLUS/(DEFICIT) FOR THE FINANCIAL YEARS 199798 TO 200506
Code NHS trust 199798 000s 1,246 61 39 (141) (2,347) 13 50 33 116 85 56 28 9 66 62 (164) (1,003) (11) (578) 1 (1,249) 75 94 78 (182) (101) 167 13 34 (6,549) 246 (2,384) (5,296) 3 138 523 (124) 13 69 6 (154) (698) 345 (41) (1,110) 4 (19) (112) 3 7 72 (176) 15 31 51 (1,244) 63 52 216 3 251 27 199899 000s 167 29 1 151 (515) 61 30 512 33 258 65 65 4,307 23 (133) (1,179) (190) 48 1,032 5 27 47 508 (201) 0 27 68 (1,859) 492 (2,897) (2,282) 21 188 231 (118) 187 62 9 309 (128) 61 2 19 106 (6) 35 0 18 305 12 13 71 1 2 5 30 0 48 959 10 (404) 0 10 9 0 12 16 4 0 3 (4,225) (5,210) (5,845) 13,581 (15,687) 11 13 2 6 502 28 15 66 24 19992000 000s 495 (86) (63) 46 28 5 51 40 54 (788) (4,927) 25 (138) 140 (92) 51 54 6 (637) 3 5 164 (2,705) (4,811) (152) 251 (329) 242 (671) 2 (66) (343) (4) (430) Surplus/ (decit) 200001 200102 000s 000s 80 110 21 17 46 14 53 30 30 736 (2,358) (336) (208) 79 (523) 35 7 126 (21) 139 150 8,505 (2,790) 124 (105) 0 (87) 4 (76) 104 4 103 70 27 37 33 200203 000s 200304 000s 200405 000s 200506 000s 199798 % of turnover(1) 199899 19992000 200001 200102 200203 200304 200405 200506
RCE RCF RCH RCJ RCK RCL RCN RCP RCQ RCR RCS RCT RCU RCV RCW RCX RCY RCZ RD1 RD2 RD3 RD4 RD5 RD6 RD7 RD8 RD9 RDA RDB RDC RDD RDE RDF RDH RDJ RDK RDL RDM RDP RDQ RDR RDS RDT RDU RDV RDX RDY RDZ RE2 RE3 RE4 RE5 RE6 RE7 RE8 RE9 REA REB REC RED REE REF
BRADFORD COMMUNITY HEALTH NHS TRUST AIREDALE NHS TRUST NORTH TEES HEALTH NHS TRUST SOUTH TEES HOSPITALS NHS TRUST THE ROYAL VICTORIA INFIRMARY TRUST ALLINGTON NHS TRUST BARNSLEY COMM AND PRIORITY SERV NHS TRUST BASSETLAW HOSP AND COMM HEALTH SERV TRUST DONCASTER HEALTHCARE NHS TRUST MULBERRY NHS TRUST NOTTINGHAM CITY HOSPITAL NHS TRUST NOTTINGHAM COMMUNITY HEALTH NHS TRUST SHEFFIELD CHILDRENS NHS TRUST CENTRAL SHEFFIELD UNIV HOSPS NHS TRUST WESTON PARK HOSPITAL NHS TRUST THE QUEEN ELIZ HOSP KINGS LYNN NHS TRUST ASHFORD HOSPITAL NHS TRUST BARNET COMMUNITY HEALTHCARE NHS TRUST ROYAL UNITED HOSPITAL BATH NHS TRUST BATH AND WEST COMMUNITY NHS TRUST POOLE HOSPITAL NHS TRUST WILTSHIRE HEALTH CARE NHS TRUST AYLESBURY VALE COMM HEALTHCARE NHS TRUST EAST BERKSHIRE NHS TRUST HEATHERWOOD AND WEXHAM PARK HOSPS TRUST MILTON KEYNES GENERAL HOSPITAL NHS TRUST MILTON KEYNES COMMUNITY HEALTH NHS TRUST PARKSIDE NHS TRUST SOUTH BEDFORDSHIRE COMM HC NHS TRUST WELLHOUSE NHS TRUST BASILDON & THURROCK UNI HOSP NHS FDTN TRUST ESSEX RIVERS HEALTHCARE NHS TRUST FOREST HEALTHCARE NHS TRUST NEW POSSIBILITIES NHS TRUST NORTH EAST ESSEX MENTAL HEALTH NHS TRUST SOUTHEND COMMUNITY CARE SERV NHS TRUST EASTBOURNE HOSPITALS NHS TRUST HASTINGS AND ROTHER NHS TRUST OPTIMUM HEALTH SERVICES NHS TRUST RAVENSBOURNE NHS TRUST SOUTH DOWNS HEALTH NHS TRUST THAMESLINK HEALTHCARE SERVICES NHS TRUST LAMBETH HEALTHCARE NHS TRUST FRIMLEY PARK HOSPITAL NHS FOUND TRUST ST PETERS HOSPITAL NHS TRUST BATH MENTAL HEALTH CARE NHS TRUST DORSET HEALTHCARE NHS TRUST ROYAL BRNMTH AND CHRISTCRCH FOUN TRUST GATESHEAD HOSPITALS NHS TRUST SOUTH CUMBRIA COMMUNITY AND MH NHS TRUST SOUTH TEES COMMUNITY AND MH NHS TRUST WESTMORLAND HOSPITAL NHS TRUST CUMBRIA AMBULANCE SERVICE NHS TRUST WEST CUMBRIA HEALTH CARE NHS TRUST NORTHUMBERLAND MENTAL HEALTH NHS TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST EXETER AND DIST COMMTY HLTH SERV NHS TRUST FRENCHAY HEALTHCARE NHS TRUST PHOENIX NHS TRUST PLYMOUTH COMMUNITY SERVICES NHS TRUST SOUTHMEAD HEALTH SERVICES NHS TRUST ROYAL CORNWALL HOSPITALS NHS TRUST
(1,448)
(3,288)
4,267
83 113 0 2,079 0
34 23 1 (24,784) 0
44 11 (5,358) (1,968) 35
31 39 (8,499) (946) 0
126 1,379 (10,986) (7,338) 0
8 776 0 12 30 (4) 0 17 214 (330) (4) 62
11 (1,394)
36 (3,172)
(4,186) 943
(3,691) 374
4,765 22 (2,300)
12 (5,843)
293
(1,439)
216 (1,904) 4 25
124 (524) 15 38
69 93 5 (250)
2,457
1,453
2.5% 0.1% 0.1% "0.1% "1.3% 0.0% 0.2% 0.1% 0.3% 0.8% 0.0% 0.1% 0.0% 0.0% 0.4% "0.3% "2.8% 0.0% "0.8% 0.0% "1.8% 0.2% 0.3% 0.6% "0.2% "0.2% 0.7% 0.0% 0.1% "9.1% 0.3% "2.8% "4.4% 0.0% 0.5% 1.3% "0.2% 0.0% 0.2% 0.0% "0.2% "2.4% 0.6% "0.1% "2.1% 0.0% 0.0% "0.1% 0.0% 0.0% 0.2% "1.0% 0.2% 0.1% 0.2% "2.0% 0.1% 0.0% 0.6% 0.0% 0.2% 0.0%
0.3% 0.0% 0.0% 0.1% "1.5% 0.2% 0.1% 1.1% 0.3% 0.2% 0.2% 0.2% 2.7% 0.1% "0.2% "2.0% "0.2% 0.2% 1.4% 0.0% 0.1% 0.3% 0.4% "0.4% 0.0% 0.0% 0.2% "2.5% 0.6% "2.7% "1.6% 0.1% 0.7% 0.5% "0.1% 0.2% 0.2% 0.0% 0.5% "0.2% 0.1% 0.0% 0.0% 0.1% 0.0% 0.4% 0.0% 0.1% 0.5% 0.0% 0.0% 0.2% 0.0% 0.0% 0.0%
0.8% "0.1% 0.0% 0.1% 0.1% 0.0% 0.1% 0.1% 0.0% "1.0% "7.0% 0.0% "0.5% 0.2% "0.5% 0.1% 0.3% 0.0% "1.1% 0.0% 0.0% 0.2% "2.2% "3.0% "0.5% 0.8% "0.7% 0.2% "0.7% 0.0% "0.1% "0.4% 0.0% "0.5%
0.1% 0.1% 0.0% 0.0% 0.1% 0.0% 0.1% 0.1% 0.0% 1.0% "2.5% "0.3% "0.4% 0.1% "1.3% 0.2% 0.0% 0.2% "0.1% 0.2% 0.1% 6.4% "1.9% 0.3% "0.3% 0.0% "0.1% 0.0% "0.1% 0.1% 0.0% 0.1%
0.1% 0.0% 0.0% 0.1%
0.0%
"1.8%
"3.8%
4.4%
0.0% 0.2% 0.0% 1.6% 0.0%
0.0% 0.0% 0.0% "20.5% 0.0%
0.0% 0.0% "6.1% "1.3% 0.0%
0.0% 0.1% "8.9% "0.6% 0.0%
0.0% 1.7% "11.1% "4.4% 0.0%
0.0% 1.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.3% "0.3% 0.0% 0.1%
0.0% "1.7%
0.0% "3.5%
"2.6% 0.9%
"2.2% 0.3%
3.7% 0.0% "8.2%
0.0% "4.7%
0.2%
"0.9%
0.2% "1.7% 0.0% 0.0%
0.1% "0.4% 0.0% 0.0%
0.1% 0.1% 0.0% "0.2%
1.8%
2.1%
0.3% 0.0% 0.2% 1.3% 0.0% "1.3% 0.0% 0.0%
0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.1% 0.0%
0.0% 0.0%
3.9% 0.0%
0.1% 0.1%
0.1%
"2.7%
"3.0%
"3.1%
5.9%
"6.6%
Code NHS trust 199798 000s (150) 13 259 21 175 (562) 13 636 49 52 (131) (605) 36 89 28 6 38 0 (1,421) (1,068) 61 21 15 782 94 531 144 36 126 25 151 (3,060) 194 1 39 86 (176) 385 (662) 118 312 43 (70) 341 (2,572) (270) 42 (924) (1,641) (981) 167 407 (100) 482 205 (1,674) 52 2 26 (122) 199899 000s (219) 456 74 236 14 56 210 10 918 76 47 6 40 7 0 338 223 55 23 5 415 65 734 161 45 15 15 5 56 42 8 9 340 457 365 88 25 (700) 36 321 (1,400) 46 1,319 (154) 72 (28) 45 314 0 2 211 (2,332) (1,393) 111 (826) 92 19992000 000s (299) 486 1 31 34 477 12 40 202 45 1,650 30 0 237 40 35 90 13 0 14 159 144 152 127 (125) 0 4 24 0 134 54 Surplus/ (decit) 200001 200102 000s 000s 2 62 8 27 18 244 16 37 33 9 5 5 3 0 0 40 15 49 5 2 6 22 0 5 4 5 (16,009) 0.0% "2.2% "1.9% 0.3% 0.2% 0.2% 1.0% 0.7% 0.4% 0.3% 0.1% 0.3% 0.1% 0.3% "2.1% 0.3% 0.0% 0.1% 0.3% "0.3% 0.6% "2.1% 0.7% 0.5% 0.1% "0.2% 0.7% "2.7% "0.4% 0.0% "1.2% "1.7% "1.3% 0.2% 0.9% "0.2% 0.6% 0.2% "1.8% 0.1% 0.0% 0.1% "0.3% 0.0% 0.5% 0.4% 0.3% 0.2% 0.1% 0.5% 0.4% 0.5% 0.3% 0.1% 0.0% 0.0% 0.0% 0.0% 0.1% 0.1% 0.0% 0.5% 0.7% 1.0% 0.5% 0.0% "1.2% 0.1% 0.6% "1.4% 0.1% 1.4% "0.1% 0.1% 0.0% 0.0% 0.5% 0.0% 0.0% 0.2% "2.5% "1.6% 0.3% "3.1% 0.2% 0.3% 0.1% 0.5% 0.1% 0.0% 0.0% 0.0% 0.4% 0.4% 0.2% 0.1% "0.2% 0.0% 0.0% 0.1% 0.0% 0.2% 0.0% 0.0% 0.0% 5 6 9 5 22 7 7 32 7 6 170 200203 000s 200304 000s 200405 000s 200506 000s 199798 % of turnover(1) 199899 19992000 200001 200102 200203 200304 200405 200506
REH REK REM REN REP REQ RER RES RET REU REV REW REX REY REZ RF2 RF3 RF4 RF5 RF6 RF7 RF8 RF9 RFA RFB RFC RFD RFE RFF RFG RFH RFJ RFK RFL RFM RFP RFQ RFR RFS RFT RFU RFV RFW RFX RFY RFZ RG1 RG2 RG3 RG4 RG6 RG7 RG8 RG9 RGA RGB RGC RGD RGF RGH RGJ RGK
HEREFORDSHIRE COMMUNITY HEALTH NHS TRUST SOUTH WARWICKSHIRE HEALTH CARE NHS TRUST AINTREE HOSPITALS NHS TRUST CLATTERBRIDGE CENTRE FOR ONCOLOGY TRUST LIVERPOOL WOMENS NHS FOUND TRUST SOUTHPORT AND FORMBY HOSP SERVS NHS TRUST ST HELENS AND KNOWSLEY COMM HEALTH TRUST NORTH MERSEY COMMUNITY NHS TRUST WALTON NEUROLOGY CENTRE NHS TRUST BURNLEY HEALTH CARE NHS TRUST LANCASTER ACUTE HOSPITALS NHS TRUST LANCASTER PRIORITY SERVICES NHS TRUST OLDHAM NHS TRUST WRIGHTINGTON HOSPITAL NHS TRUST ROCHDALE HEALTHCARE NHS TRUST ROYAL HULL HOSPITALS NHS TRUST EAST YORKSHIRE HOSPITALS NHS TRUST BARKING, HAVERING AND REDBRIDGE HOSP NHS TRUST HUMBERSIDE AMBULANCE SERVICE NHS TRUST NORTH EAST LINCOLNSHIRE NHS TRUST SCUNTHORPE AND GOOLE HOSPITALS NHS TRUST SCUNTHORPE COMMUNITY HEALTH CARE NHS TRUST NORTH YORKSHIRE AMBULANCE SERVICE TRUST DURHAM COUNTY AMBULANCE NHS TRUST LEICESTER GENERAL HOSPITAL NHS TRUST NOTTINGHAMSHIRE AMBULANCE SERV NHS TRUST LEICESTER ROYAL INFIRMARY NHS TRUST CHS SOUTHERN DERBYSHIRE NHS TRUST BARNSLEY HOSPITAL NHS FOUNDATION TRUST ROTHERHAM PRIORITY HEALTH SERVICES TRUST SOUTHERN DERBYSHIRE MENTAL HEALTH TRUST CENTRAL NOTTINGHAMSHIRE NHS TRUST QUEENS MEDICAL NOTTS UNI HOSP NHS TRUST GLENFIELD HOSPITAL NHS TRUST THE WEST LINDSEY NHS TRUST DERBY CITY GENERAL HOSPITAL NHS TRUST SOUTH LINCOLNSHIRE COMM AND MH SERV TRUST THE ROTHERHAM NHS FOUNDATION TRUST CHESTERFIELD ROYAL HOSPITAL NHS FOUND TRUST BEDFORD AND SHIRES HEALTH AND CARE NHS TRUST BEDS AND HERTS AMBULANCE AND PARAMEDIC TRUST WEST LONDON HEALTHCARE NHS TRUST WEST MIDDLESEX UNIVERSITY HOSP NHS TRUST HOUNSLOW AND SPELTHORNE COMM AND MH TRUST RIVERSIDE MENTAL HEALTH NHS TRUST NORTHWICK PARK AND ST MARKS NHS TRUST MID KENT HEALTHCARE NHS TRUST QUEEN ELIZABETH HOSPITAL NHS TRUST BROMLEY HOSPITALS NHS TRUST REDBRIDGE HEALTH CARE NHS TRUST BHB COMMUNITY HEALTH CARE NHS TRUST HAVERING HOSPITALS NHS TRUST THAMESIDE COMMUNITY HEALTHCARE NHS TRUST CHASE FARM HOSPITALS NHS TRUST CALDERDALE HEALTHCARE NHS TRUST HUDDERSFIELD HEALTH CARE SRVS NHS TRUST WHIPPS CROSS UNIVERSITY HOSP NHS TRUST LEEDS MENTAL HEALTH TEACHING NHS TRUST WAKEFIELD AND PONTEFRACT COMM HEALTH TRUST WEST YORKSHIRE AMBULANCE SERVICE TRUST EAST SUFFOLK LOCAL SERVICES NHS TRUST NORTH WEST ANGLIA HEALTH CARE NHS TRUST
15 (626)
10
10
10
"0.7% 0.1% 0.2% 0.1% 0.6% "1.3% 0.1% 1.0% 0.3% 0.1% "0.3% "2.0% 0.0% 0.6% 0.0% 0.0% 0.1%
"0.9% 0.4% 0.4% 0.7% 0.0% 0.3% 0.2% 0.0% 0.9% 0.1% 0.3% 0.0% 0.0% 0.0%
"1.1% 0.4% 0.0% 0.1% 0.2% 0.5% 0.1% 0.0% 0.2% 0.2% 1.9% 0.0% 0.0%
0.0% 0.0% 0.0% 0.1% 0.1% 0.2% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% "4.8% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.1% 0.0% 0.0% 0.4%
0.0% "0.6%
0.0%
0.0%
0.0%
7 7 73
0.0% 0.0% 0.0%
0.0%
0.0%
0.0%
61
41
52
29
0.0%
0.0%
0.0%
0.0%
235 9 25 166 28 (595) (7,909) 1,128 (396) (266) 24 49 0 1,091 80 (1,910) 0 21
15 15 25 178 5
49 19 3 3 (382)
22 20 19 (779)
39 21 14 137
13 27 13 (3,991)
23 147 (9,024)
0.3% 0.0% 0.1% 0.2% 0.1% "0.7% "7.8% 0.8% "0.3% "0.3% 0.0% 0.1% 0.0% 1.1% 0.1% "2.0% 0.0% 0.0%
0.0% 0.0% 0.1% 0.2% 0.0%
0.1% 0.0% 0.0% 0.0% "0.6%
0.0% 0.0% 0.1% "0.8%
0.0% 0.0% 0.0% 0.1%
0.0% 0.0% 0.0% "3.7%
0.1% 0.3% "8.8%
(1,583) 5 19 18 5 45 24 29 56 1 19
288 (1,392)
7,213 507
917 0
(9,186) 10,755
(19,199) (15,765)
"1.3% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.1%
0.3% "1.3%
5.7% 0.4%
0.7% 0.0%
"7.1% 6.5%
"14.4% "10.3%
51 20 3 1 (2)
2 30 1
3 36 0
7 24 20
(15,602) 1,549 (279)
0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0%
0.0% 0.0% 0.0%
0.0% 0.0% 0.0%
"8.9% 1.5% "0.4%
Code NHS trust 199798 000s 5 63 (1,271) 277 64 (32) 18 (564) (1,456) 3 42 (78) (383) 17 0 (749) (856) 462 (60) 0 71 119 91 10 (160) (1,235) 134 (2,787) (1,059) (31) 404 (43) (224) (176) 6 51 97 221 (629) 32 4 614 1,111 (107) 303 (5,967) 107 (1,223) 125 29 (549) 97 (721) (1,199) 13 (1,574) 165 30 680 199899 000s (446) 24 (652) 14 (769) 28 85 30 1,821 (998) (304) 16 11 49 (133) 59 (8) (163) 18 134 94 30 (600) (342) (9,734) (198) 53 34 224 72 4 108 450 38 666 6 0 259 466 (146) 812 (4,935) 31 (1,466) 2 7 748 36 (73) (1,246) 212 469 0 51 55 66 163 (918) 71 7 1 (721) (121) (2,500) 11 4 131 1,706 (311) (3,427) (300) (5,753) 3 0 60 (133) 309 1,279 (326) (139) 1,463 76 13 (231) 24 2 8 516 22 2,750 15 2 110 558 3 12,901 0 0 3 8 0 28 1,225 79 48 1 (180) (591) (50) 1 2 1 (344) (755) 0 28 15 (1,216) 191 4 2 4 613 (1,149) 5 87 14 18 9 53 4 0 3 160 1 91 4 20 (786) 3 2 124 5 2 4 4,280 550 7 19 8 4 20 (839) 0 10 (5,418) 0 214 4 85 5,486 8 3 94 8 (503) (163) (650) 471 403 2 (509) 3 (179) (5,014) 0 19 (11,579) 0 40 9 882 2 64 184 2,872 (7,505) (3,219) 252 (21,656) 481 35 (8,783) (2,158) 41 (2,507) (3,576) 0 24 (12,927) 250 125 1,096 26 88 413 (8,805) 3,094 (5,847) (33,569) 21 32 (13,827) 478 (14,985) 100 (5,972) 0 12 0.1% 1.0% 0.0% 0.1% 3.8% 0.1% 0.0% "0.2% 19992000 000s Surplus/ (decit) 200001 200102 000s 000s 200203 000s 200304 000s 200405 000s 200506 000s 199798 % of turnover(1) 199899 19992000 200001 200102 200203 200304 200405 200506
RGL RGM RGN RGP RGQ RGR RGS RGT RGU RGV RGW RGX RGY RGZ RH1 RH2 RH3 RH4 RH5 RH6 RH7 RH8 RHA RHB RHC RHD RHE RHF RHG RHH RHJ RHK RHM RHN RHP RHQ RHR RHS RHU RHV RHW RHX RHY RHZ RJ1 RJ2 RJ3 RJ5 RJ6 RJ7 RJ8 RJ9 RJB RJC RJD RJE RJF RJH RJK RJL RJM RJN
MID ANGLIA COMMUNITY HEALTH NHS TRUST PAPWORTH HOSPITAL NHS FOUNDATION TRUST PBORO & STAMFORD HOSPS NHS FOUND TRUST JAMES PAGET HEALTHCARE NHS TRUST IPSWICH HOSPITAL NHS TRUST WEST SUFFOLK HOSPITALS NHS TRUST LIFESPAN HEALTH CARE CAMBRIDGE NHS TRUST CAMBRIDGE UNI HOSPITAL NHS FOUND TRUST BRIGHTON HEALTH CARE NHS TRUST THANET HEALTH CARE NHS TRUST KENT AND CANTERBURY HOSPITALS NHS TRUST EASTBOURNE AND COUNTY HEALTHCARE NHS TRUST CANTERBURY AND THANET COMMUNITY NHS TRUST QUEEN MARYS SIDCUP NHS TRUST ROYAL BERKSHIRE AMBULANCE SERVICE TRUST SOUTH BUCKINGHAMSHIRE NHS TRUST HORTON GENERAL HOSPITAL NHS TRUST W BERKSHIRE PRIORITY CARE SERV NHS TRUST SOMERSET PARTNERSHIP NHS AND SOC CARE TRUST GLOUCESTERSHIRE ROYAL NHS TRUST SEVERN NHS TRUST ROYAL DEVON & EXETER NHS FOUND TRUST NOTTINGHAMSHIRE HEALTHCARE NHS TRUST CAMDEN AND ISLINGTON COMM HEALTH NHS TRUST ENFIELD COMMUNITY CARE NHS TRUST ROYAL LONDON HOMOEOPATHIC HOSP NHS TRUST CRAWLEY HORSHAM NHS TRUST MERTON AND SUTTON COMMUNITY NHS TRUST RICHMOND, TWICKENHAM AND ROEHAMPTON TRUST EAST SURREY HOSPITAL AND CHC NHS TRUST WORTHING PRIORITY CARE SERVICES TRUST N HAMPSHIRE, LODDON COMMUNITY NHS TRUST SOUTHAMPTON UNIVERSITY HOSPS NHS TRUST ANDOVER DISTRICT COMM HEALTH CARE TRUST DORSET AMBULANCE NHS TRUST SHEFFIELD TEACHING HOSPITALS NHS TRUST WILTSHIRE AMBULANCE SERVICE NHS TRUST SOUTHAMPTON COMMUNITY HEALTH SERV TRUST PORTSMOUTH HOSPITALS NHS TRUST THE RADCLIFFE INFIRMARY NHS TRUST ROYAL BERKSHIRE AND BATTLE HOSPS NHS TRUST OXFORD LEARNING DISABILITY NHS TRUST TWO SHIRES AMBULANCE NHS TRUST EAST BERKSHIRE COMMUNITY HEALTH TRUST GUYS AND ST THOMAS NHS FOUND TRUST THE LEWISHAM HOSPITAL NHS TRUST NW LONDON MENTAL HEALTH NHS TRUST ST MARYS NHS TRUST MAYDAY HEALTHCARE NHS TRUST ST GEORGES HEALTHCARE NHS TRUST CORNWALL PARTNERSHIP NHS TRUST WESTCOUNTRY AMBULANCE SERVICES NHS TRUST KIDDERMINSTER HEALTHCARE NHS TRUST SOUTH WARWICKSHIRE GEN HOSPS NHS TRUST MID STAFFORDSHIRE GEN HOSPITALS TRUST UNIV HOSP NORTH STAFFORDSHIRE NHS TRUST BURTON HOSPITALS NHS TRUST GOOD HOPE HOSPITAL NHS TRUST SHROPSHIRES MENTAL HEALTH NHS TRUST NORTH LINCOLNSHIRE AND GOOLE HOSPS NHS TRUST WALSALL COMMUNITY HEALTH NHS TRUST EAST CHESHIRE NHS TRUST
16 97 20 87 (286) 12 (1,339) (1,721) (139) (255) 1 (567) 91 (273) (33) 15 11 44 20
17 22 13 620 290 6 4 1,676 3 5 11 1,248 8 0 (27) 16 34 76 5
14 23 8 (992) (936) 0 0 946 0 23 (29) 125 (1,774) 24 46 272 35 62
3 22 11 992 947 1,904
(252) (969) 5 (1,404) (2,501) (921)
7 14 (6,443) (7,638) (995) 1,527 (11,905) (11,833)
(1,954) 7 (2,974) 2,555 37 5
41 17
(4,608) 17
(19,692) 64
2 44 614
0.0% 0.2% "1.8% 0.5% 0.1% "0.1% 0.0% "0.3% "1.5% 0.0% 0.1% "0.2% "0.8% 0.0% 0.0% "0.9% "3.7% 0.8% "0.3% 0.0% 0.1% 0.1% 0.1% 0.0% "4.5% "2.4% 0.4% "3.4% "1.9% "0.1% 1.0% 0.0% "2.5% "1.7% 0.1% 0.1% 0.1% 0.5% "0.6% 0.2% 0.0% 1.6% 0.3% "0.1% 0.9% "4.6% 0.1% "0.7% 0.2% 0.1% "1.4% 0.2% "1.1% "0.8% 0.0% "2.8% 0.8%
"1.7% 0.1% "0.9% 0.0% "0.9% 0.0% 0.2% 0.0% 1.7% "2.2% "0.4% 0.0% 0.0% 0.4% "0.2% 0.1% 0.0% "0.2% 0.0% 0.1% 0.1% 0.1% "16.8% "0.9% "20.6% "0.6% 0.1% 0.0% 2.2% 0.7% 0.0% 0.1% 0.3% 0.1% 0.6% 0.0% 0.0% 0.7% 0.1% "0.2% 2.3% "3.5% 0.0% "0.8% 0.0% 0.0% 1.8% 0.1% "0.1% "0.8% 0.4% 0.8%
0.0% 0.1% 0.0% 0.1% "0.5% 0.0% "0.7% "1.1% "0.3% "0.4% 0.0% "0.6% 0.1% "0.9% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.6% 0.4% 0.0% 0.0% 1.2% 0.0% 0.0% 0.1% 1.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0%
0.0% 0.0% 0.0% "0.8% "1.2% 0.0% 0.0% 0.6% 0.0% 0.0% "0.2% 0.1% "4.6% 0.0% 0.1% 0.2% 0.0% 0.1%
0.0% 0.0% 0.0% 0.7% 1.1% 0.8%
"0.4% "0.7% 0.0% "1.0% "2.6% "0.3%
0.0% 0.0% "3.9% "7.4% "1.2% 1.2% "7.1% "12.1%
"2.5% 0.0% "3.1% 5.4% 0.0% 0.0%
0.0% 0.1%
"4.9% 0.1%
"22.0% 0.3%
0.0% 0.0% 0.3%
0.0%
0.0%
140
2,044
0.1%
0.8%
0.2% 0.1% 0.1% "8.6% 0.6% 0.1% 0.0% "0.4% "1.6% "2.0% 0.1% 0.0% 0.3% 0.4% "0.3% "2.2% "0.3% "2.5% 0.0% 0.0% 0.1% "0.2% 0.4% 0.7% "0.5% "0.2%
0.0% "0.5% 0.0% 0.0% 0.1% 0.5% 0.0% 2.0% 0.1% 0.0% 0.3% 0.1% 0.0% 6.9% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.6% 0.1% 0.1%
"1.4% 0.0% 0.0% 0.0% 0.0% "3.6% "0.3% 0.0% 0.1% 0.1% "4.7% 0.0% 0.0% 0.0% 0.0% 0.2% "1.2% 0.0% 0.1% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% "0.5% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 1.5% 0.8% 0.0% 0.0% 0.0% 0.0% 0.0% "0.9% 0.0% 0.0% "1.7% 0.0% 0.0% 0.0% 0.0% 3.0% 0.0% 0.0% 0.0% 0.0% "0.2% "0.1% "0.2% 0.6% 0.7% 0.0% "0.5% 0.0% "0.2% "5.4% 0.0% 0.0% "3.2% 0.0% 0.0% 0.1% 0.3% 0.0% 0.2% 0.7% 2.0% "5.1% "1.2% 0.2% "6.5% 0.6% 0.1% "10.6% "1.9% 0.0% "2.5% "3.4% 0.0% 0.0% "3.5% 0.9% 0.8% 0.3% 0.0% 0.3% 1.4% "5.9% 1.1% "3.6% "10.0% 0.0% 0.0% "16.3% 0.4% "5.0% 0.1% "5.3% 0.0% 0.0%
Code NHS trust 199798 000s 70 38 (1,195) 80 170 8 20 1,102 (10) (1,792) 682 10 68 90 709 246 121 1 (196) (476) (524) 73 (1,062) 153 51 (531) 36 (3) 144 (49) (612) 44 (111) 8 237 67 15 16 140 38 243 49 20 53 61 16 90 40 378 (352) 9 258 (9) 21 579 (6,399) (346) 45 (98) 918 (396) 199899 000s 13 185 1,405 106 114 31 (449) 99 11 47 324 27 18 43 614 69 1 138 11 489 4 (485) 30 (1) 73 15 3 39 599 20 11 19992000 000s Surplus/ (decit) 200001 200102 000s 000s 200203 000s 200304 000s 200405 000s 200506 000s 199798 % of turnover(1) 199899 19992000 200001 200102 200203 200304 200405 200506
RJP RJQ RJR RJS RJT RJU RJV RJX RJY RJZ RK1 RK2 RK4 RK5 RK6 RK7 RK8 RK9 RKA RKB RKC RKD RKE RKF RKL RKW RKX RKY RL1 RL2 RL3 RL4 RL5 RL6 RLA RLB RLC RLD RLE RLF RLG RLH RLK RLM RLN RLQ RLR RLS RLT RLU RLV RLW RLX RLY RLZ RM1 RM2 RM3 RM4 RM5 RM6 RM7
SOUTHPORT AND FORMBY COMM HS NHS TRUST WARRINGTON COMMUNITY HC NHS TRUST COUNTESS OF CHESTER HOSP NHS FOUND TRUST HALTON GENERAL HOSPITAL NHS TRUST CHESHIRE COMMUNITY HEALTHCARE NHS TRUST CHORLEY AND SOUTH RIBBLE NHS TRUST WEST LANCASHIRE NHS TRUST CALDERSTONES NHS TRUST WIGAN AND LEIGH HEALTH SERVICES NHS TRUST KINGS COLLEGE HOSPITAL NHS TRUST PILGRIM HEALTH NHS TRUST LEICESTERSHIRE MENTAL HLTH SERVICE TRUST LINCOLN DISTRICT HEALTHCARE NHS TRUST SHERWOOD FOREST HOSPITALS NHS TRUST NOTTINGHAM HEALTHCARE NHS TRUST COMMUNITY HEALTH SHEFFIELD NHS TRUST DERBYSHIRE ROYAL INFIRMARY NHS TRUST PLYMOUTH HOSPITALS NHS TRUST WEST MIDLANDS AMBULANCE SERVICE NHS TRUST UNIV HOSPS COVENTRY & WARWICKSHIRE NHS TRUST WARRINGTON HOSPTIAL NHS TRUST HAMPSHIRE AMBULANCE SERVICE NHS TRUST THE WHITTINGTON HOSPITAL NHS TRUST THE PRINCESS ROYAL HOSPITAL NHS TRUST WEST LONDON MENTAL HEALTH NHS TRUST LEICESTERSHIRE AMB AND PARAMEDIC NHS TRUST COMM HC SERV (NORTH DERBYSHIRE) NHS TRUST DERBYSHIRE AMBULANCE SERVICE NHS TRUST ROB JONES AND A HUNT ORTHOPAEDIC NHS TRUST SHROPSHIRES COMMUNITY HEALTH SERV TRUST SOLIHULL HEALTHCARE NHS TRUST ROYAL WOLVERHAMPTON HOSPITAL NHS TRUST HEREFORD AND WORCESTER AMBULANCE NHS TRUST COVENTRY & WARWICKSHIRE AMBULANCE NHS TRUST BISHOP AUCKLAND HOSPITALS NHS TRUST DARLINGTON MEMORIAL HOSPITAL NHS TRUST NORTH TYNESIDE HEALTH CARE NHS TRUST COMMUNITY HEALTH CARE: N DURHAM NHS TRUST NORTH DURHAM ACUTE HOSPITALS NHS TRUST NORTH LAKELAND HEALTHCARE NHS TRUST CARLISLE HOSPITALS NHS TRUST PRIORITY HEALTHCARE WEARSIDE NHS TRUST CHEVIOT AND WANSBECK NHS TRUST NORTHUMBERLAND COMMUNITY HLTH NHS TRUST CITY HOSPITALS SUNDERLAND NHS FOUND TRUST HEREFORD HOSPITALS NHS TRUST WORCESTER ROYAL INFIRMARY NHS TRUST SOUTH WARWICKSHIRE MNTL HLTH SERV TRUST GEORGE ELIOT HOSPITAL NHS TRUST BIRMINGHAM WOMENS HEALTH CARE NHS TRUST SOUTHERN BIRMINGHAM COMM HLTH NHS TRUST CITY HOSPITAL NHS TRUST N BIRMINGHAM COMMUNITY HEALTH NHS TRUST NORTH STAFFS COMBINED HC NHS TRUST ROYAL SHREWSBURY HOSPITALS NHS TRUST NORFOLK AND NORWICH UNI HOSP NHS TRUST SOUTH MANCHESTER UNIV HOSP NHS TRUST SALFORD ROYAL HOSPITALS NHS TRUST TRAFFORD HEALTHCARE NHS TRUST MANCUNIAN COMMUNITY HEALTH NHS TRUST NORTHGATE AND PRUDHOE NHS TRUST GATESHEAD HEALTHCARE NHS TRUST
3 3 73 59 21 9 (65) (1,450) (66) 42 80 270 13 0 (752) (1,516) 49 (30) (1,433) (826) (86) 0 2 (1,285) (12) (27)
13 4 11 3 16 54 (84) 25 17 88 68 7 0 186 20 21 1 0 260 105 0 13 48 1 1
13 3 4 14 31 176
45 35
35 182
59 (2,734)
83 122
2 4 0 11 5 1 8 (545) 3 0 9 56 0 126
1 3 0 88 6 2 (988) (1,188) 3
(7,753) 231 5 (1,727) (3,400) (1,369)
(8,317) (203) 131 (2,537) 1,998 10
(1,932) (2,860) 20 127 20 782
0.4% 0.1% "2.0% 0.3% 0.8% 0.0% 0.0% 3.4% 0.0% "1.0% 1.2% 0.0% 0.2% 0.1% 1.3% 0.3% 0.2% 0.0% "0.7% "0.4% "0.9% 0.5% "1.5% 0.5% 0.5% "0.9% 0.3% 0.0% 0.4% "0.2% "0.6% 0.4% "1.9% 0.0% 0.5% 0.1% 0.0% 0.0% 0.5% 0.1% 0.7% 0.1% 0.1% 0.0% 0.1% 0.0% 0.6% 0.1% 1.1% "0.6% 0.0% 0.7% 0.0% 0.0% 0.5% "4.0% "0.4% 0.1% "0.2% 2.4% "1.3%
0.1% 0.6% 2.1% 0.4% 0.5% 0.1% "1.0% 0.3% 0.0% 0.0% 0.5% 0.0% 0.0% 0.1% 1.0% 0.1% 0.0% 0.4% 0.0% 0.8% 0.0% "0.6% 0.1% 0.0% 0.1% 0.1% 0.0% 0.1% 0.6% 0.2% 0.1%
0.0% 0.0% 0.2% 0.3% 0.0% 0.0% "0.1% "0.7% "0.1% 0.1% 0.1% 0.4% 0.0% 0.0% "2.1% "0.8% 0.1% "0.2% "1.8% "2.1% "0.1% 0.0% 0.0% "1.0% "0.1% "0.3%
0.0% 0.0% 0.0% 0.0% 0.0% 0.2% "0.1% 0.0% 0.0% 0.1% 0.1% 0.0% 0.0% 0.5% 0.0% 0.0% 0.0% 0.0% 0.6% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.1% 0.1%
0.0%
0.0%
0.1% 0.0%
0.1% 0.1%
0.2% "0.8%
0.2% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% "1.1% 0.0% 0.0% 0.0% 0.0% 0.0% 1.2%
0.0% 0.0% 0.0% 0.2% 0.0% 0.0% "0.9% "2.2% 0.0%
0.0%
0.0%
0.0%
"3.2% 0.4% 0.0% "4.3% "3.1% "0.8%
"3.2% "0.3% 0.0% "8.8% 1.6% 0.0%
"0.7% "4.3% 0.0% 0.4% 0.0% 0.4%
(792) 457 0 0
(2,314) (7,612) 67 0
0 (9,016) 0 0
253 (9,423) 0 0
"2.1% 0.3% 0.0% 0.0%
"5.5% "4.3% 0.5% 0.0%
0.0% "4.5% 0.0% 0.0%
0.4% "4.2% 0.0% 0.0%
35 25 150 (64) 98 37 (182) (697) 301 (337) 25 (93) 24 33 3,545 712 (200) 100 1,495
75 22 103 92 114 (1,821) (1,312) (668) (1,617) (328) (1,003) 13 (646) 126 16 1,638 (316) 341 2,082
0 9 1 61 22 349 48 295 8 607 26 9 29 959 0 478
6 47 13 7 372 10 38 (494) 82 14 26 5 7 11 (1,889) 32 (6,980) 230 2 27 62 88 32 231 (744) 8 215 92 59 450 (3,490) 43 557 145 7,460 449 2,270 32 63 17 909 282 51 (18) 8 4 132 20 (786) (264)
0.1% 0.0% 0.4% "0.1% 0.2% 0.1% "0.4% "1.9% 0.5% "0.3% 0.1% "0.1% 0.0% 0.0% 2.1% 0.7% "0.2% 0.2% 3.1%
0.2% 0.0% 0.2% 0.1% 0.2% "2.3% "2.5% "1.6% "2.3% "0.3% "1.6% 0.0% "0.8% 0.1% 0.0% 1.4% "0.3% 0.7% 2.9%
0.0% 0.0% 0.0% 0.0% 0.0% 0.6% 0.1% 0.3% 0.0% 0.8% 0.0% 0.0% 0.0% 1.0% 0.0% 0.7%
0.0% 0.0% 0.0% 0.0% 0.7% 0.0% 0.0% "0.5% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% "1.9% 0.0% "3.6% 0.1% 0.0% 0.0% 0.1% 0.0% 0.0% 0.1% "0.9% 0.0% 0.2% 0.0% 0.0% 0.2% "4.3% 0.1% 0.6% 0.0% 3.0% 0.2% 2.5% 0.0% 0.0% 0.0% 1.3% 0.5% 0.0% 0.0% 0.0% 0.0% 0.2% 0.0% "0.9% "0.4%
0 (7,294) 50
0.0% "8.8% 0.1%
Code NHS trust 199798 000s (2,410) (893) (174) (396) (472) 267 54 (474) 71 10 34 122 502 (156) 2 423 21 (284) 338 (245) 55 5 933 89 192 (137) 0 124 (3,789) 40 2 0 1,557 (1,228) 40 325 55 (261) 150 235 (45) 35 (1,499) (4,283) 29 1,386 220 (124) (1,636) (562) (3,311) 504 (1,171) (2,510) 36 413 511 6 199899 000s 19992000 000s Surplus/ (decit) 200001 200102 000s 000s 200203 000s 200304 000s 200405 000s 200506 000s 199798 % of turnover(1) 199899 19992000 200001 200102 200203 200304 200405 200506
RM8 RM9 RMA RMB RMC RMD RME RMF RMG RMH RMJ RMK RML RMM RMN RMP RMQ RMR RMS RMT RMU RMV RMW RMX RMY RMZ RN1 RN2 RN3 RN4 RN5 RN6 RN7 RN8 RN9 RNA RNB RNC RND RNE RNF RNG RNH RNJ RNK RNL RNM RNN RNP RNQ RNR RNS RNT RNU RNV RNW RNX RNY RNZ RP1 RP2 RP3
FURNESS HOSPITALS NHS TRUST ALEXANDRA HEALTH CARE NHS TRUST GREATER MANCHESTER AMBULANCE NHS TRUST BBURN, HBURN & RBLE VALLEY NHS TRUST BOLTON HOSPITALS NHS TRUST LANCASHIRE AMBULANCE SERVICE NHS TRUST COMMUNICARE NHS TRUST PRESTON ACUTE HOSPITALS NHS TRUST GUILD COMMUNITY HEALTHCARE NHS TRUST MENTAL HEALTH SERV OF SALFORD NHS TRUST SALFORD COMMUNITY HEALTH CARE NHS TRUST NORTH MANCHESTER HEALTHCARE NHS TRUST BLACKPOOL, WYRE AND FYLDE COMMUNITY TRUST COMMUNITY HEALTHCARE BOLTON NHS TRUST BURY HEALTH CARE NHS TRUST TAMESIDE AND GLOSSOP ACUTE SERVS NHS TRUST TAMESIDE AND GLOSSOP COMMUNITY NHS TRUST BLACKPOOL VICTORIA HOSPITAL NHS TRUST STOCKPORT ACUTE SERVICES NHS TRUST STOCKPORT HEALTHCARE NHS TRUST EAST YORKSHIRE COMM HEALTHCARE NHS TRUST HULL AND HOLDERNESS COMMUNITY HEALTH TRUST DEWSBURY HEALTH CARE NHS TRUST NORWICH COMM HEALTH PARTNERSHIP NHS TRUST NORFOLK & WAVENEY MH PARTNERSHIP NHS TRUST EAST ANGLIAN AMBULANCE NHS TRUST WINCHESTER AND EASTLEIGH HLTHCRE NHS TRUST EAST WILTSHIRE HEALTHCARE NHS TRUST SWINDON AND MARLBOROUGH NHS TRUST PORTSMOUTH HEALTH CARE NHS TRUST NORTH HAMPSHIRE HOSPITALS NHS TRUST DORSET COMMUNITY NHS TRUST DARTFORD AND GRAVESHAM NHS TRUST SOUTH KENT COMMUN HEALTHCARE NHS TRUST LEWISHAM AND GUYS MENTAL HEALTH NHS TRUST DUDLEY GROUP OF HOSPITALS NHS TRUST COVENTRY HEALTHCARE NHS TRUST DUDLEY PRIORITY HEALTH NHS TRUST SOUTH BIRMINGHAM MENTAL HEALTH NHS TRUST SANDWELL HEALTHCARE NHS TRUST NORTHERN BIRMINGHAM MENTAL HEALTH TRUST PREMIER HEALTH NHS TRUST NEWHAM UNIVERSITY HOSPITAL NHS TRUST BARTS AND THE LONDON NHS TRUST TAVISTOCK AND PORTMAN NHS TRUST NORTH CUMBRIA ACUTE HOSPITALS NHS TRUST NEWCASTLE CITY HEALTH NHS TRUST NTH CUMBRIA MH AND LEARNING DISAB NHS TRUST NEWC, N TYNESIDE AND NTHUMBERLND MH NHS TRUST KETTERING GENERAL HOSPITAL NHS TRUST ROCKINGHAM FOREST NHS TRUST NORTHAMPTON GENERAL HOSPITAL NHS TRUST STOKE MANDEVILLE HOSPITAL NHS TRUST OXFORDSHIRE MENTAL HEALTHCARE NHS TRUST OXFORDSHIRE COMMUNITY HEALTH NHS TRUST NORTHAMPTON COMM HEALTHCARE NHS TRUST OXFORD RADCLIFFE HOSPITAL NHS TRUST OXFORDSHIRE AMBULANCE NHS TRUST SALISBURY HEALTH CARE NHS TRUST NORTHAMPTONSHIRE HEALTHCARE NHS TRUST HARINGEY HEALTH CARE NHS TRUST MID ESSEX COMM AND MENTAL HEALTH NHS TRUST
0 388 630 1 68 84 18 114 1,017 162 248 420 25 19 97 36 (358) 485 21 20 12 710 (161) 227 47 (1) 235 813 85 (46) 0 793 (50) 41 29 (117) 185 169 (94) 154 (1,411) (4,149) 19 8 92 28 (516) (64) (1,855) 26 (279) (65) 0 15 (263)
(2,038) (151) 42 2 5 46 32 17 192 11 29 (63) 9 16 837 1,189 535 440 (1,156) 5 0 928 73 (172) (499) (1,400) (214) 1,268 (234) (221) 0 (152) (320) 6 15 (488) 102 (218) 566 (861) (2,979) 5 67 (800) (314) (2,420) (866) (2,153) 86 53 (647) 0 11 (27)
(109) 11 0 1 3 27 40 28 8 13 4 54 17 7 3 55
19 14 0 10 4 21 29 0 2 32 7 4 1 4 39
8 3 0 10
91 3 12
20 (2,706) 10
780 3,278 99
11
13
55
43 (100) 81 4 1 1,496 57 (35) 0 (704) 0 8 0 0 40 8 1 3,517 10,149 1 (1,217) 1,374 (354) 5,883 559 7,343 987 1,402 47 0 (17) (414)
0 1 39 0 16 (1,154) (625) (1,798) 3 7 1 0 7 88 11 38 0 6 1 3 (107) (280) (253) 8 0 473 1,000 13 314 (2,710) 4 0 (2,245) 0 24 0 (1,803) 0 (1,941) (6) 6 (2,404) 1 20 43 0 (4,133) 0 261 (1,197) (4,922) 2 3 21 0 13 0 1,724 (1,721) 46 2 13 3,414 373 56 69 527 40 (2,907) 3 192 747 0 11 37 61 848 527 1,103 76 4 94 (1,146) 1,741 1,119 550 (3,045) (835) 26 (3,470) 1,753
"6.9% "2.4% "0.6% "0.5% "0.5% 1.4% 0.2% "0.5% 0.2% 0.0% 0.2% 0.1% 0.9% "0.9% 0.0% 0.9% 0.1% "0.3% 0.5% "0.4% 0.2% 0.0% 1.6% 0.2% 0.4% "0.5% 0.0% 0.4% "5.3% 0.0% 0.0% 0.0% 2.7% "3.5% 0.1% 0.3% 0.2% "0.8% 0.3% 0.3% "0.1% 0.1% "2.6% "1.6% 0.3% 1.6% 0.4% "0.3% "2.1% "1.0% "7.3% 1.3% "2.8% "1.5% 0.5% 0.5% 1.0% 0.0%
0.0% 1.3% 0.7% 0.0% 0.3% 0.3% 0.0% 0.4% 2.6% 0.9% 0.2% 0.7% 0.1% 0.0% 0.2% 0.1% "0.3% 0.7% 0.0% 0.1% 0.0% 1.1% "0.3% 0.3% 0.2% 0.0% 0.8% 1.0% 0.1% "0.1% 0.0% 1.3% "0.1% 0.0% 0.1% "0.3% 0.3% 0.2% "0.2% 0.4% "2.3% "1.5% 0.2% 0.0% 0.1% 0.1% "0.6% "0.1% "3.8% 0.1% "0.6% "0.8% 0.0% 0.0% "1.0%
"4.7% "0.5% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.5% 0.1% 0.0% "0.1% 0.0% 0.0% 1.4% 2.5% 0.3% 0.6% "1.6% 0.0% 0.0% 1.3% 0.1% "0.2% "1.6% "1.7% "1.3% 1.3% "0.2% "0.3% 0.0% "0.2% "0.2% 0.0% 0.0% "1.0% 0.1% "0.5% 1.2% "1.3% "0.9% 0.0% 0.1% "0.9% "0.8% "2.6% "1.3% "3.9% 0.2% 0.1% "7.0% 0.0% 0.0% "0.1%
"0.3% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0% 0.2% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0%
0.2% 0.0% 0.0%
0.0% "1.9% 0.0%
1.2% 2.0% 0.2%
0.0%
0.0%
0.0%
0.0%
0.1%
0.1% "0.1% 0.1% 0.0% 0.0% 1.6% 0.0% 0.0% 0.0% "1.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 4.4% 3.1% 0.0% "1.2% 1.5% "0.8% 5.4% 0.8% 10.9% 2.1% 3.0% 0.5% 0.0% 0.0% "1.3%
0.0% 0.0% 0.1% 0.0% 0.0% "1.1% "0.8% "2.3% 0.0% 0.0% 0.0% 0.0% 0.0% 0.2% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% "0.1% "0.3% "0.3% 0.0% 0.0% 1.1% 1.0% 0.0% 0.3% "3.2% 0.0% 0.0% "3.5% 0.0% 0.0% 0.0% "1.2% 0.0% "1.9% 0.0% 0.0% "2.6% 0.0% 0.0% 0.0% 0.0% "3.0% 0.0% 0.2% "1.2% "3.7% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 1.4% "1.6% 0.0% 0.0% 0.0% 0.5% 1.8% 0.0% 0.2% 0.4% 0.0% "1.8% 0.0% 0.3% 1.4% 0.0% 0.0% 0.0% 0.1% 0.6% 0.7% 1.5% 0.1% 0.0% 0.1% "1.2% 1.1% 1.2% 0.7% "2.5% "0.5% 0.0% "3.4% 0.9%
45 0 32
590 0 101
1 0 51
50 0 153
281 0 28
0.4% 0.0% 0.0%
4.8% 0.0% 0.1%
0.0% 0.0% 0.1%
0.3% 0.0% 0.2%
1.6% 0.0% 0.0%
Code NHS trust 199798 000s 801 752 (53) (223) 0 8 8 34 0 53 (1,817) (902) 90 2 1 40 (236) (2,444) (99) 9 (299) 180 323 (471) (6) 202 (8) 83 333 75 106 989 255 (486) (4,527) (1,100) (1,421) (372) (2,393) (4,878) 33 (176) (61) (930) 6 43 248 264 (859) 185 (1,002) 9 199899 000s 695 0 (107) 143 27 (655) 17 0 (323) 1,812 (300) 51 2 32 (599) 30 (1,330) 514 28 (849) (55) (8) 215 19 (801) (280) 164 176 (2,503) (4,688) (77) 206 40 16 (150) (1,485) 64 25 (25) 628 7 283 15 117 48 (5,800) 25 19992000 000s (334) 0 (550) (21) (487) 810 (80) 62 (4,147) (231) 1 (526) (1,552) 23 (2,755) 337 (1) (859) (34) (64) (483) 41 (4,232) 47 352 (1,286) 459 (1,947) (295) Surplus/ (decit) 200001 200102 000s 000s 33 20 (1,504) 3 5 80 (1,271) (2,734) (873) 3 0 (807) 56 777 0 35 0 18 12 4 1,374 48 26 285 134 6 0 (1,722) (2,683) (110) 49 0 11 3 8 8 71 2 401 119 (220) 88 82 221 (1,880) 19 5 105 (17,819) (1,566) 2,204 (18,484) (6,535) 68 2 996 11 (67) 0 1,062 36 (229) 9 0 513 298 12 0 (2,299) 129 1,618 18 1,003 4 (1,349) 6 (3,572) 2 (15,483) 257 (13,394) 10 4 1 4 766 0 2 0 (2,316) 14 200203 000s 1,122 5 0 4 (967) 68 37 57 6,292 200304 000s 1 18 0 9 2,372 39 11 0 (27) 200405 000s (557) 11 (279) 216 378 34 51 1,500 444 (10,623) 200506 000s 1,983 3 210 199798 % of turnover(1) 199899 19992000 200001 200102 200203 200304 200405 200506
RP4 RP5 RP6 RP7 RPA RPB RPC RPD RPF RPG RPH RPK RPL RPM RPN RPP RPQ RPR RPS RPT RPU RPV RPW RPX RPY RQ1 RQ2 RQ3 RQ4 RQ5 RQ6 RQ7 RQ8 RQ9 RQJ RQK RQL RQM RQN RQQ RQR RQS RQT RQU RQV RQW RQX RQY RQZ RR1 RR2 RR3 RR4 RR5 RR7 RR8 RR9 RRD RRE RRF RRG RRH
GREAT ORMOND ST HOSP FOR CHILDREN NHS TRUST DONCASTER AND BASSETLAW HOSPITALS NHS TRUST MOORFIELDS EYE HOSPITAL NHS FOUND TRUST LINCOLNSHIRE PARTNERSHIP NHS TRUST MEDWAY NHS TRUST NORTH KENT HEALTHCARE NHS TRUST QUEEN VICTORIA HOSPITAL NHS FOUND TRUST KENT AND SUSSEX WEALD NHS TRUST SOUTH KENT HOSPITALS NHS TRUST OXLEAS NHS TRUST KENT AMBULANCE NHS TRUST SUSSEX WEALD AND DOWNS NHS TRUST WORTHING AND SOUTHLANDS HOSPITALS TRUST NORTH DOWNS COMMUNITY HEALTH NHS TRUST KINGSTON AND DISTRICT COMMUNITY NHS TRUST WANDSWORTH COMMUNITY HEALTH NHS TRUST SURREY AMBULANCE SERVICE NHS TRUST ROYAL WEST SUSSEX NHS TRUST MID SUSSEX NHS TRUST HEATHLANDS MENTAL HEALTH SERVICES TRUST EAST SURREY PRIORITY CARE NHS TRUST RIVERSIDE COMMUNITY HEALTHCARE NHS TRUST ST ALBANS AND HEMEL HEMPSTEAD NHS TRUST ROYAL BROMPTON HOSPITAL NHS TRUST THE ROYAL MARSDEN NHS FOUNDATION TRUST SURREY HEARTLANDS NHS TRUST SUSSEX AMBULANCE SERVICE NHS TRUST BIRMINGHAM CHILDRENS HOSPITAL NHS TRUST BLACK COUNTRY MENTAL HEALTH NHS TRUST WOLVERHAMPTON HEALTH CARE NHS TRUST ROYAL LIVERPOOL BROADGREEN UNIV HOSP TRUST MANCHESTER CHILDRENS HOSPITALS NHS TRUST MID ESSEX HOSPITAL SERVICES NHS TRUST THE BETHLEM AND MAUDSLEY NHS TRUST WEST HERTS COMMUNITY HEALTH NHS TRUST HARROW AND HILLINGDON HEALTHCARE NHS TRUST MOUNT VERNON AND WATFORD HOSPITALS TRUST CHELSEA AND WESTMINSTER HEALTHCARE TRUST HAMMERSMITH HOSPITALS NHS TRUST HINCHINGBROOKE HEALTH CARE NHS TRUST ST JAMESS AND SEACROFT UNIV HOSP TRUST UNITED LEEDS TEACHINGS HOSPITALS TRUST FOSSE HEALTH, LEICESTERSHIRE COMM TRUST GRANTHAM AND DISTRICT HOSPITAL NHS TRUST ESSEX AND HERTFORDSHIRE COMM NHS TRUST PRINCESS ALEXANDRA HOSPITAL NHS TRUST HOMERTON UNIV HOSPITAL NHS FOUND TRUST SW LONDON AND ST GEORGES MENTAL HLTH TRUST BOURNEWOOD COMMUNITY AND MH NHS TRUST HEART OF ENGLAND NHS FOUNDATION TRUST ISLE OF WIGHT HEALTHCARE NHS TRUST INVICTA COMMUNITY CARE NHS TRUST PINDERFIELDS AND PONTEFRACT HOSP NHS TRUST WIRRAL AND WEST CHESHIRE COMM NHS TRUST GATESHEAD HEALTH NHS FOUNDATION TRUST LEEDS TEACHING HOSPITALS NHS TRUST NORTH DURHAM HEALTH CARE NHS TRUST NORTH ESSEX MENTAL HEALTH PARTNERSHIP NHS TRUST SOUTH STAFFORDSHIRE HEALTHCARE NHS TRUST WRIGHTINGTON, WIGAN AND LEIGH NHS TRUST TOWER HAMLETS HEALTHCARE NHS TRUST NEWHAM COMMUNITY HEALTH SERVS NHS TRUST
0.7% 2.0% "0.1% "0.5% 0.0% 0.0% 0.0% 0.1% 0.0% 0.1% "2.8% "2.1% 0.3% 0.0% 0.0% 0.1% "0.5% "8.9% "0.4% 0.0% "0.5% 0.3% 0.5% "1.1% 0.0% 0.3% 0.0% 0.2% 0.2% 0.1% 0.1% 1.1% 0.5% "1.2% "5.2% "0.9% "0.6% "0.8% "1.3% "2.2% 0.0% "0.7% "0.1% "1.6% 0.0% 0.1% 0.6% 0.2% "1.4% 0.4% "0.9% 0.0%
0.6% 0.0% "0.1% 0.7% 0.0% "0.7% 0.0% 0.0% "0.7% 2.4% "0.6% 0.2% 0.0% 0.1% "1.2% 0.1% "2.3% 0.7% 0.1% "1.2% "0.3% 0.0% 0.1% 0.0% "0.8% "0.3% 0.3% 0.4% "2.8% "3.2% 0.0% 0.4% 0.0% 0.1% "0.3% "2.4% 0.1% 0.0% "0.1% 0.4% 0.0% 0.6% 0.0% 0.2% 0.0% "1.3% 0.0%
"0.3% 0.0% "0.6% "0.1% "0.8% 1.1% "0.4% 0.1% "5.1% "0.4% 0.0% "0.9% "2.7% 0.1% "3.6% 0.4% 0.0% "1.0% "0.1% "0.2% "0.3% 0.1% "4.0% 0.1% 0.8% "1.4% 0.3% "0.7% "0.5%
0.0% 0.0% "1.6% 0.0% 0.0% 0.4% "2.4% "3.2% "1.5% 0.0% 0.0% "1.3% 0.1% 0.9% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 1.1% 0.1% 0.1% 0.1% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.7% 0.0% 0.0% 0.0% "4.3% 0.0%
0.7% 0.0% 0.0% 0.0% "0.8% 0.2% 0.0% 0.2% 5.1%
0.0% 0.0% 0.0% 0.0% 1.9% 0.1% 0.0% 0.0% 0.0%
"0.3% 0.0% "0.2% 2.4% 0.3% 0.1% 0.0%
0.9% 0.0% 0.1%
1.2% 1.2% "7.6%
0.0% "2.4% "4.0% "0.2% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.2% 0.0% "0.3%
0.0% "1.6%
0.0% "4.3%
0.0% "17.1%
0.7% "13.6%
0.1% 0.0% 0.9% 0.0% "0.4% 0.0% 0.8%
0.0% "0.6% 0.0% 0.0% 0.3% 0.7% 0.0% 0.0% "1.3% 0.2% 1.1% 0.0% 0.6%
0.0% 0.0% 0.4%
"1.0% 0.0% 0.0%
0.1% "4.4% "2.2%
1.0% "4.3% "8.8%
163 (228) (1,567) 497 35 (32) (989) 36 79 (2,391) 10 10 (4,132) 50
(981) 1,412 33 75 1 5 5 9 5 16 19 36 4
(880) 41 24 6 (1) (431) 15 2,548 2 8 0 30 (1,502) 0 2
(3,714) 32 73 0 (3,704)
(495) 2 12 0 23
156 114 0 12
(5,857) 1,534 9
10 3,473 5 0 2
6 (309) 694 0 254
6 178 616 4 (743)
309 2,474 1 1,697 "1.8% 1.1%
0.6% "0.4% "2.3% 0.5% 0.0% "0.1% "0.5% 0.0% 0.1% "1.7% 0.0% 0.0% "0.9% 0.1%
"2.5% 1.6% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
"0.9% 0.0% 0.0% 0.0% 0.0% "0.5% 0.0% 1.6% 0.0% 0.0% 0.0% 0.0% "2.0% 0.0% 0.0%
"3.8% 0.0% 0.1% 0.0% "3.8%
"0.5% 0.0% 0.0% 0.0% 0.0%
0.1% 0.1% 0.0% 0.0%
"4.7% 1.0% 0.0%
0.0% 0.6% 0.0% 0.0% 0.0%
0.0% 0.0% 0.9% 0.0% 0.1%
0.0% 0.0% 0.7% 0.0% "0.4%
0.0% 2.5% 0.0% 0.9%
(1,097) 375
(514) 123
(483) 114
0 156
"0.8% 0.3%
"0.7% 0.2%
0.0% 0.4%
Code NHS trust 199798 000s 267 10 30 0 24 (163) (649) (2,997) 437 237 (145) 199899 000s 259 17 (27) 0 (102) 485 (3,846) 241 2 0 297 67 35 128 205 399 (1,638) 29 82 6 458 143 510 (152) 111 175 3 19992000 000s 207 23 34 0 90 (1,073) (4,992) (636) (784) 50 5 24 15 19 146 208 10 (2,664) 17 (1,613) 20 (319) (274) (5,021) 0 249 (498) (131) 19 29 23 152 (480) 21 26 (668) 1 90 7 (2,376) (314) 5 13 363 (271) 17 (1,197) 2 63 (377) 148 6 58 8 29 17 3 5 6,819 16 (4,846) (377) 280 (94) (4,573) 0 1 8 3 0 13 35 49 22 5 (360) 21 24 44 5 (2,996) 491 3 19 1 0 4 601 5 19 3 50 4 20 49 13 53 6 2 5 (920) (1,409) 0 562 3 (193) (826) 30 5 11 28 15 1 0 4 (1,221) 17 0 (6,232) 17 0 35 (2,298) 0 46 22 600 4 12 17 (12) 0 18 0 7 1 0 1,561 16 8 (44,620) 304 (2,145) (994) (2,193) (11,371) 23 19 7 24 15 19 0 16 38 1 102 (3,099) 27 20 28 (4,398) 99 94 65 6 5 1 1 38 (1,548) 0 70 39 1 545 (11,744) 1 2,402 46 0 43 588 453 66 120 (1,189) 3 342 (6,357) 0 1,258 719 311 1,250 (24,064) 3 1,480 554 (8,994) (2,789) 229 (2,606) (12,812) 315 0 9 0.2% 0.2% 0.0% 0.4% "0.4% "0.2% 0.1% 0.0% 0.0% 0.2% "0.2% 0.0% 0.0% "0.4% 0.0% 0.0% 0.0% "1.6% "0.3% 0.0% 0.0% 0.9% "0.1% 0.0% "0.5% 0.0% 0.1% "0.4% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% "0.4% 0.0% 0.0% 0.0% 0.0% "2.0% 0.5% 0.0% 0.1% 0.0% 0.0% 0.0% 0.2% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% "1.8% 0.0% 0.0% "2.3% 0.0% 0.0% 0.0% "1.9% 0.0% 0.0% 0.2% 0.2% 0.0% 0.0% 0.0% 0.0% 0.0% 1,371 0 20 9 9 51 130 37 55 9 (179) 46 (1,328) (310) 216 6,657 1 74 1,649 0 6 9 (489) 6 63 40 26 4 200 476 5 (225) 292 (4,149) 5 (1,712) (348) 7 (3,217) 11 1,004 22 192 25 10 10 1,580 33 61 289 116 (30,657) 109 (8,898) 92 82 3,240 18 177 259 234 40 (19,409) (7,560) 400 (40,834) (1,319) (21,395) Surplus/ (decit) 200001 200102 000s 000s 229 30 2 0 0 101 3 219 39 0 4 41 46 6,762 200203 000s 37 33 (686) 94 47 200304 000s 303 38 (924) 89 9,394 200405 000s 608 3 849 332 (4,930) 200506 000s 514 199798 % of turnover(1) 199899 19992000 200001 200102 200203 200304 200405 200506
RRJ RRK RRL RRM RRP RRQ RRR RRU RRV RRW RRX RRY RRZ RT1 RT2 RT3 RT5 RT6 RTA RTC RTD RTE RTF RTG RTH RTJ RTK RTL RTM RTN RTP RTQ RTR RTT RTV RTW RTX RTY RV1 RV2 RV3 RV4 RV5 RV6 RV7 RV8 RV9 RVJ RVK RVL RVM RVN RVP RVQ RVR RVT RVV RVW RVX RVY RW1 RW2
ROYAL ORTHOPAEDIC HOSPITAL NHS TRUST UNI HOSPITAL BIRMINGHAM NHS FOUND TRUST CITY AND HACKNEY COMM SERVICES NHS TRUST NORTH WARWICKSHIRE NHS TRUST BARNET, ENFIELD AND HARINGEY MH NHS TRUST CAMDEN AND ISLINGTON MENTAL HEALTH NHS TRUST TEDDINGTON MEMORIAL HOSP AND COMM NHS TRUST LONDON AMBULANCE SERVICE NHS TRUST UNI COLL LONDON HOSP NHS FOUND TRUST SOUTH DURHAM NHS TRUST LINCOLN AND LOUTH NHS TRUST HARTLEPOOL AND EAST DURHAM NHS TRUST WORCESTERSHIRE COMM HEALTHCARE NHS TRUST CAMBS & PETERBOROUGH MH PARTNERSHIP TRUST PENNINE CARE NHS TRUST ROYAL BROMPTON AND HAREFIELD NHS TRUST LEICESTERSHIRE & RUTLAND HLTH NHS TRUST LOCAL HEALTH PARTNERSHIPS NHS TRUST SOUTH DURHAM HEALTH CARE NHS TRUST COUNTY DURHAM AND DARLINGTON PRIOR SRV TRUST NEWCASTLE UPON TYNE HOSPITALS NHS TRUST GLOUCESTERSHIRE HOSPITALS NHS FOUND TRUST NORTHUMBRIA HEALTH CARE NHS TRUST DERBY HOSPITALS NHS FOUNDATION TRUST OXFORD RADCLIFFE HOSPITALS NHS TRUST SURREY HAMPSHIRE BORDERS NHS TRUST ASHFORD AND ST PETERS HOSPITALS NHS TRUST THAMES GATEWAY NHS TRUST EAST KENT NHS AND SC PARTNERSHIP TRUST SURREY OAKLANDS NHS TRUST SURREY AND SUSSEX HEALTHCARE NHS TRUST GLOUCESTERSHIRE PARTNERSHIP NHS TRUST SOUTH TEES HOSPITALS NHS TRUST SOUTH WARWICKSHIRE COMBINED NHS TRUST 5 BOROUGHS PARTNERSHIP NHS TRUST SHROPSHIRES COMMUNITY AND MENTAL HS NHS TRUST MORECAMBE BAY HOSPITALS NHS TRUST BAY COMMUNITY NHS TRUST TEES EAST & NTH YORKSHRE AMB SERV NHS TRUST EALING, HAMMERSMITH & FULHAM MH NHS TRUST BRENT KENSTON CHELSEA & WESTMER MH TRUST COMMUNITY HEALTH SOUTH LONDON NHS TRUST SOUTH LONDON AND MAUDSLEY NHS TRUST EAST MIDLANDS AMBULANCE SERVCE NHS TRUST BEDFORDSHIRE & LUTON COMMUNITY NHS TRUST NORTH WEST LONDON HOSPITALS NHS TRUST HULL & EAST RIDING COMM HEALTH NHS TRUST NORTH BRISTOL NHS TRUST NORTH EAST AMBULANCE SERVICE NHS TRUST BARNET & CHASE FARM HOSPITALS NHS TRUST SOUTH WEST LONDON COMMUNITY NHS TRUST AVON & WESTERN WILTSHIRE MHC NHS TRUST SOUTH LINCOLNSHIRE HEALTHCARE NHS TRUST WILTSHIRE & SWINDON HEALTHCARE NHS TRUST EPSOM & ST HELIER NHS TRUST N SEFTON & W LANCASHIRE COMM NHS TRUST EAST KENT HOSPITALS NHS TRUST NORTH TEES & HARTLEPOOL NHS TRUST TEES & NORTH EAST YORKSHIRE NHS TRUST SOUTHPORT & ORMSKIRK HOSPITAL NHS TRUST WEST HAMPSHIRE NHS TRUST SOUTHERN DERBYSHIRE COMM AND MH SRVS NHS TRUST
1.3% 0.0% 0.1% 0.0% 0.9% "0.2% "0.3% "7.1% 0.6% 0.4% "0.3%
1.1% 0.0% "0.1% 0.0% "3.9% 0.4% "1.5% 0.3% 0.0% 0.0% 0.3% 0.1% 0.1% 0.0% 0.1% 0.3% "0.8% 0.0% 0.1% 0.0% 0.6% 0.2% 0.5% "0.4%
0.7% 0.0% 0.1% 0.0% 1.4% "0.9% "1.8% "0.7% "1.2% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% "0.9% 0.0% "1.5% 0.0% "0.4% "0.2% "4.6% 0.0%
0.8% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0%
0.7% 0.0% 0.0% 0.0% 0.0% 0.0% 2.2%
0.1% 0.0% "0.5% 0.1% 0.0%
0.8% 0.0% "0.6% 0.1% 2.4%
1.4% 0.0% 0.5% 0.2% "4.6%
1.0%
53 1,273
0.0% 0.6%
0.1% 0.0% 0.1% 0.0% 0.1% 0.0% 0.0% 0.0% 2.3% 0.0% "4.4% "0.5% 0.3% "0.1% "4.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% "0.9% "1.1% 0.0% 0.6% 0.0% "0.1% "1.8%
1.4% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% "1.0% "0.5% 0.2% 4.5% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 2.3% 0.0% 0.0% "16.1% 0.6% "1.1% "0.8% "1.1% "4.1% 0.0% 0.0% 0.0% 0.0%
1.6% 0.0% 0.0% 0.0% "0.7% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.8% 0.0% "0.4% 0.3% "2.9% 0.0% "0.6% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.2% "1.2% 0.0% 0.0% 0.1% "2.1% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
"0.3% 0.0% "1.8% 0.0% 1.3% 0.0% 0.0% 0.0% 0.0% 0.0% 0.3% 0.1% 0.0% 0.5% 0.1% "19.9% 0.1% "2.7% 0.0% "0.8% 0.0% 0.0% 0.0% 0.0% 0.7% "4.4% 0.0% 0.7% 0.1% 0.0% 0.0% 0.2% 0.1% 0.0% 0.1% "1.0% 0.0%
0.1% 0.1% 1.7% 0.0% 0.2% 0.3% 0.0% 0.0% "4.1% "4.5% 0.7% "25.5% "1.6% "6.7% 0.4% "3.2% 0.0% 0.8% 0.2% 0.4% 1.6% "8.8% 0.0% 0.4% 1.0% "3.6% "1.7% 0.1% "0.7% "7.2% 0.3% 0.0% 0.0%
Code NHS trust 199798 000s 199899 000s 19992000 000s Surplus/ (decit) 200001 200102 000s 000s 3 37 200203 000s 19 2,428 9 10 (2) (324) 25 18 38 79 18 (4,040) 11,668 2,495 176 48 365 (9,926) 0 77 (916) 12 8 (4,357) 13 3 (1,450) (747) 3 18 2,695 16 5 62 0 33 508 200304 000s 128 0 8 226 (1,261) 757 7 17 121 66 52 (8,968) (519) 19 38 37 116 (12,801) 0 48 (1,689) 93 25 (851) 16 33 (1,787) (1,025) (18,637) 21 (7,912) 24 (1,593) (929) 0 4 179 (5,237) (3,934) 0 367 (791) 347 0 1,883 2 1 200405 000s (7,727) 9 14 1,398 7 34 2 (5,461) (4,913) 64 87 (9,978) (8,557) 32 217 2 243 821 (1,049) (535) 84 1 7 13 (4,983) 9 456 (19,876) 129 (10,035) 28 (7,806) 84 0 (2,882) 338 2,518 (4,025) 0 163 (10,115) 0 89 494 72 6 200506 000s 6,472 12 20 56 2,089 29 (12,268) (15,145) 60 113 (28,284) (22,380) 3,553 1,377 (4,975) (1,585) 55 (461) (1,720) 83 5,102 166 38 (4,864) 1,330 349 (14,589) 172 (11,290) (210) (5,737) 23 0 114 28 153 0 271 (12,142) 70 1,992 66 2,449 570 30 199798 % of turnover(1) 199899 19992000 200001 200102 200203 200304 200405 200506
RW3 RW4 RW5 RW6 RW7 RW8 RW9 RWA RWC RWD RWE RWF RWG RWH RWJ RWK RWL RWN RWP RWQ RWR RWT RWV RWW RWX RWY RXA RXC RXD RXE RXF RXG RXH RXJ RXK RXL RXM RXN RXP RXQ RXR RXT RXV RXW RXX TAD TAE TAF TAH TAJ
CENT MANCHESTER/ MANCHESTER CHILD NHS TRUST MERSEY CARE NHS TRUST LANCASHIRE CARE NHS TRUST PENNINE ACUTE HOSPITALS NHS TRUST NORTH WEST SURREY MH NHS PARTNERSHIP TRUST WEST SUSSEX HEALTH AND SOCIAL CARE NHS TRUST SOUTH OF TYNE AND WEARSIDE MH NHS TRUST HULL & EAST YORKSHIRE HOSPITALS NHS TRUST DONCASTER & SOUTH HUMBER HLTHCARE NHS TRUST UNITED LINCOLNSHIRE HOSPITALS NHS TRUST UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST MAIDSTONE AND TUNBRIDGE WELLS NHS TRUST WEST HERTFORDSHIRE HOSPITALS NHS TRUST EAST AND NORTH HERTFORDSHIRE NHS TRUST STOCKPORT NHS TRUST EAST LONDON AND THE CITY MH NHS TRUST BIRMINGHAM SPECIALIST COMM HEALTH NHS TRUST S ESSEX MENTAL HEALTH AND COMM CARE NHS TRUST WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST WORCESTERSHIRE COMM AND MENTAL HEALTH TRUST HERTFORDSHIRE PARTNERSHIP NHS TRUST BUCKINGHAMSHIRE MENTAL HEALTH NHS TRUST DEVON PARTNERSHIP NHS TRUST NORTH CHESHIRE HOSPITALS NHS TRUST BERKSHIRE HEALTHCARE NHS TRUST CALDERDALE AND HUDDERSFIELD NHS TRUST CHESHIRE AND WIRRAL PARTNERSHIP NHS TRUST EAST SUSSEX HOSPITALS NHS TRUST EAST SUSSEX COUNTY HEALTHCARE NHS TRUST DONCASTER & SOUTH HUMBER HCARE NHS TRUST MID YORKSHIRE HOSPITALS NHS TRUST SOUTH WEST YORKSHIRE MENTAL HEALTH NHS TRUST BRIGHTON AND SUSSEX UNIV HOSPS NHS TRUST WEST KENT NHS AND SOCIAL CARE TRUST SANDWELL & WEST BIRMINGHAM HOSPS NHS TRUST BLACKPOOL, FYLDE AND WYRE HOSPS NHS TRUST DERBYSHIRE MENTAL HEALTH SERVICES NHS TRUST LANCASHIRE TEACHING HOSPITALS NHS TRUST CO DURHAM & DARLINGTON ACUTE HOSP NHS TRUST BUCKINGHAMSHIRE HOSPITALS NHS TRUST EAST LANCASHIRE HOSPITALS NHS TRUST BIRMINGHAM AND SOLIHULL MENTAL HEALTH NHSTRUST BOLTON, SALFORD AND TRAFFORD MENTAL HEALTH NHS TRUST SHREWSBURY AND TELFORD HOSPITAL NHS TRUST SURREY AND BORDERS PARTNERSHIP NHS TRUST BRADFORD DISTRICT CARE TRUST MANCHESTER MENTAL HLTH & SOCIAL CARE TRUST CAMDEN & ISLINGTON MH & SOCIAL CARE TRUST SHEFFIELD CARE NHS TRUST SANDWELL MH SOCIAL CARE NHS TRUST
0.0% 0.1%
85 343
28 61 9 47 104 17 (3,297) 33 67 85 45 9 0
4 38 3 13 (4,153) (11,487) 62 115 51 4 2 6 0 296 8 0 8 96 6
0.1% 0.5%
0.0% 0.1% 0.0% 0.0% 0.1% 0.0% "1.7% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0%
0.0% 0.1% 0.0% 0.0% "2.6% "6.6% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0% 0.0% 0.3% 0.0% 0.0% 0.0% 0.1% 0.0%
0.0% 1.6% 0.0% 0.0% 0.0% "0.4% 0.0% 0.0% 0.0% 0.0% 0.0% "2.3% 5.5% 1.4% 0.1% 0.0% 0.5% "5.4% 0.0% 0.1% "2.2% 0.0% 0.0% "4.6% 0.0% 0.0% "0.8% "1.4% 0.0% 0.0% 1.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.2%
0.0% 0.0% 0.0% 0.1% "4.6% 1.0% 0.0% 0.0% 0.1% 0.0% 0.0% "4.6% "0.2% 0.0% 0.0% 0.0% 0.1% "6.7% 0.0% 0.0% "3.5% 0.1% 0.0% "0.9% 0.0% 0.0% "0.9% "1.6% "7.5% 0.0% "3.1% 0.0% "0.6% "0.5% 0.0% 0.0% 0.1% "2.6% "1.7% 0.0% 0.4% "0.5% 0.4% 0.0% 1.9% 0.0% 0.0%
"1.8% 0.0% 0.0% 0.3% 0.0% 0.0% 0.0% "1.8% "1.8% 0.0% 0.0% "4.2% "4.1% 0.0% 0.2% 0.0% 0.4% 0.5% "2.1% "0.6% 0.1% 0.0% 0.0% 0.0% "2.4% 0.0% 0.5% "7.4% 0.1% "3.5% 0.0% "2.8% 0.0% 0.0% "1.2% 0.1% 1.1% "1.6% 0.0% 0.2% "5.7% 0.0% 0.1% 0.4% 0.1% 0.0%
1.3% 0.0% 0.0% 0.0% 2.3% 0.0% "3.7% "5.2% 0.0% 0.0% "13.6% "9.1% 2.3% 1.4% "2.0% "2.8% 0.0% "0.9% "1.9% 0.1% 4.8% 0.1% 0.0% "2.2% 1.8% 0.4% "4.9% 0.2% "3.6% "0.2% "1.8% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.2% "6.4% 0.0% 1.7% 0.1% 1.9% 0.6% 0.1%
38 0 29
0.0% 0.0% 0.0%
Source: Audited NHS Trust Summarisation Schedules 199798 to 200405, and 200506 Month 12 Financial Monitoring Returns. Footnotes: 1. Turnover is Total Operating Income.
Table 91b HEALTH AUTHORITIES SURPLUS/(DEFICIT) FOR THE FINANCIAL YEARS 199798 TO 200102
Code QD8 QAP QAQ QEW QCG QA6 QA7 QAA QEY QD9 QDD QAR QAC QA8 QCT QDT QA9 QER QAT QDV QDE QEA QAD QCK QDW QEC QAV QEP QAE QCX QAW QCA QDF QAK QAM QA4 QDG Strategic health authority AVON HA BARKING & HAVERING HA BARNET HA BARNET, ENFIELD AND HARINGEY HA BARNSLEY HA BEDFORDSHIRE HA BERKSHIRE HA BEXLEY & GREENWICH HA BEXLEY, BROMLEY AND GREENWICH HA BIRMINGHAM HA BRADFORD HA BRENT & HARROW HA BROMLEY HA BUCKINGHAMSHIRE HA BURY & ROCHDALE HA CALDERDALE & KIRKLEES HA CAMBRIDGE & HUNTINGDON HA CAMBRIDGESHIRE HA CAMDEN & ISLINGTON HA CORNWALL & ISLES OF SCILLY HA COUNTY DURHAM HA COVENTRY HA CROYDON HA DONCASTER HA DORSET HA DUDLEY HA EALING, HAMMERSMITH & HOUNSLOW HA EAST & NORTH HERTFORDSHIRE HA EAST KENT HA EAST LANCASHIRE HA EAST LONDON & THE CITY HA EAST NORFOLK HA EAST RIDING HA EAST SURREY HA EAST SUSSEX, BRIGHTON & HOVE HA ENFIELD & HARINGEY HA GATESHEAD & SOUTH TYNESIDE HA 199798 000s 581 100 (2,719) 342 891 1,398 9 (1.1,462) (1,385) 397 1,455 261 1,256 1,688 1,007 3,400 (1,457) 1,604 (391) (1,537) (1,221) 4,625 (2,778) (10,144) (2,605) (1,384) 2,398 3,647 (681) (713) (2,365) 1,285 4,593 (682) Surplus/(decit) 199899 19992000 200001 000s 000s 000s (2,337) 570 829 (896) 775 2,495 1,650 2,466 1,773 1,800 2,255 2,196 (455) 2,114 1,112 2,554 (1,843) 2,141 (566) (1,780) 1,358 4,136 107 .698 (3,749) 2,244 (1,657) 395 (1,482) 47 (1,264) 559 5,309 2,490 (592) (155) (4,452) (7) 916 778 (3,608) (1,899) 827 1,914 (1,352) 993 2,226 203 (1,007) (198) (1,530) 5,332 (5,230) (394) (1,680) 1,804 (51) 5,624 (2,121) 134 905 (615) (1,300) (309) 146 3,078 (323) 545 18 67 500 0 1,036 140 766 802 626 15 187 0 0 15 122 5 49 2,263 2,036 1,250 3,157 585 26 22 1,000 0 500 130 0 663 759 1,216 200102 000s 55 3 19 495 76 1,101 8 7,377 594 63 864 0 100 8,852 36 0 455 2,339 12 2,173 236 834 0 119 15 44 200 1,369 402 18 199798 0.1% 0.0% "1.3% 0.3% 0.3% 0.3% 0.0% "1.7% "0.5% 0.1% 0.8% 0.1% 0.5% 0.5% 0.4% 1.0% "0.5% 0.4% "0.2% "0.8% "0.7% 1.1% "1.7% "2.2% "0.9% "0.4% 0.7% 0.7% "0.2% "0.2% "0.9% 0.3% 1.5% "0.3% % of turnover(1) 199899 19992000 200001 "0.4% 0.2% 0.4% "0.6% 0.2% 0.6% 0.5% 0.3% 0.6% 0.5% 1.0% 0.6% "0.2% 0.6% 0.4% 0.6% "0.6% 0.5% "0.3% "0.8% 0.6% 0.9% 0.1% "1.3% 0.6% "0.5% 0.1% "0.4% 0.0% "0.4% 0.1% 1.6% 1.0% "0.1% "0.1% "1.8% 0.0% 0.2% 0.2% "1.0% "0.2% 0.2% 0.5% "0.5% 0.2% 0.8% 0.0% "0.2% 0.0% "0.4% 1.1% "2.2% "0.2% "0.7% 0.3% 0.0% 0.9% "0.6% 0.0% 0.2% "0.1% "0.3% "0.1% 0.0% 0.8% "0.1% 0.1% 0.0% 0.0% 0.3% 0.0% 0.2% 0.0% 0.1% 0.4% 0.2% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.9% 0.8% 0.6% 1.0% 0.3% 0.0% 0.0% 0.2% 0.0% 0.1 % 0.0% 0.0% 0.1% 0.2% 0.4% 200102 0.0% 0.0% 0.0% 0.3% 0.2% 0.6% 0.0% 0.9% 0.5% 0.0% 0.4% 0.0% 0.0% 3.8% 0.0% 0.0% 0.1% 0.9% 0.0% 3.0% 0.3% 0.4% 0.0% 0.0% 0.0% 0.0% 0.4% 0.3% 0.1% 0.0%
Table 91b (Continued) HEALTH AUTHORITIES SURPLUS/(DEFICIT) FOR THE FINANCIAL YEARS 199798 TO 200102
Code QDY QED QEX QA2 QD4 QEV QA3 QAG QAH QDH QCL QCM QC2 QC3 QAJ QC4 QDJ QET QDX QD1 QCV QDK QCH QAX QCN QEH QCD. QCY QDR QCC QDM QCP QCE QD2 QA5 QCQ QC6 Strategic health authority GLOUCESTERSHIRE HA HEREFORDSHIRE HA HERTFORDSHIRE HA HILLINGDON HA ISLE OF WIGHT HA ISLE OF WIGHT, PORTSMOUTH & SE HANTS HA KENSINGTON, CHELSEA & WESTMINSTER HA KINGSTON & RICHMOND HA LAMBETH, SOUTHWARK & LEWISHAM HA LEEDS HA LEICESTERSHIRE HA LINCOLNSHIRE HA LIVERPOOL HA MANCHESTER HA MERTON, SUTTON & WANDSWORTH HA MORECAMBE BAY HA NEWCASTLE & NORTH TYNESIDE HA NORFOLK HA NORTH & EAST DEVON HA NORTH & MID HAMPSHIRE HA NORTH CHESHIRE HA NORTH CUMBRIA HA NORTH DERBYSHIRE HA NORTH ESSEX HA NORTH NOTTINGHAMSHIRE HA NORTH STAFFORDSHIRE HA NORTH WEST ANGLIA HA NORTH WEST LANCASHIRE HA NORTH YORKSHIRE HA NORTHAMPTONSHIRE HA NORTHUMBERLAND HA NOTTINGHAM HA OXFORDSHIRE HA PORTSMOUTH & SOUTH EAST HAMPSHIRE HA REDBRIDGE & WALTHAM FOREST HA ROTHERHAM HA SALFORD & TRAFFORD HA 199798 000s 297 (464) (730) 556 5,784 (776) 788 (330) (4,924) (2,134) 3,226 (651) 404 (218) 7 751 (2,636) (423) 0 1,807 1,103 57 1,418 1,502 632 198 (1,308) (466) (99) 1,704 1,645 (1,772) (58) 1,108 Surplus/(decit) 199899 19992000 200001 000s 000s 000s 2,583 893 (476) (10) 1,129 (2,841) 86 3,674 1,793 1,280 (714) (3,638) 2,135 (2,590) (31) 1,104 (173) 260 1,140 (160) (1,969) (136) 945 (1,231) 35 1,921 (2,291) 706 4,276 3,062 113 (1,956) 882 (9) (3,596) 822 1,641 (328) (5,091) (5,509) 10 2,979 1,201 1,270 (2,219) 353 (2,037) (1,926) 106 1 374 472 (1,974) (1,932) (1,518) (703) (5,294) (625) (1,703) (2,130) 130 (96) 3,257 (2,481) 1,980 2,533 851 1,874 0 220 7 76 1,480 0 520 0 250 320 0. 1 0 0 500 0 99 0 601 849 202 0 0 0 5,113 701 0 0 1,693 450 0 2,713 900 3 200102 000s 74 193 9,102 3 3,331 3,101 70 4,522 2,242 639 1,542 586 0 4 0 385 1,812 144 2,872 2 24 611 30 532 1,151 93 816 1,060 363 4,815 4,548 0 1,088 10 199798 0.1% "0.5% "0.5% 0.6% 1.8% "0.4% 0.1% "0.1% "1.0% "0.6% 1.0% "0.2% 0.1% "0.1% 0.0% 0.3% "0.9% "0.2% 0.0% 0.8% 0.2% 0.0% 0.5% 0.6% 0.2% 0.0% "0.4% "0.2% 0.0% 0.5% 0.6% "0.6% 0.0% 0.4% % of turnover(1) 199899 19992000 200001 0.8% 0.9% "0.3% 0.0% 0.3% "1.2% 0.0% 0.7% 0.3% 0.3% "0.2% "1.0% 0.5% "1.0% 0.0% 0.4% "0.1% 0.1% 0.6% "0.1% "0.4% "0.1% 0.3% "0.5% 0.0% 0.4% "0.6% 0.3% 1.0% 0.9% 0.0% "0.6% 0.6% 0.0% "0.9% 0.6% 0.9% "0.3% "1.2% "2.2% 0.0% 0.5% 0.2% 0.3% "0.5% 0.1% "0.4% "0.6% 0.0% 0.0% 0.1% 0.1% "0.9% "0.8% "0.6% "0.1% "1.9% "0.2% "0.5% "0.4% 0.0% 0.0% 0.7% "0.6% 0.5% 0.7% 0.5% 0.5% 0.0% 0.3% 0.2% 0.1% 0.3% 0.0% 0.1% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.3% 0.4% 0.1% 0.0% 0.0% 0.0% 1.4% 0.1% 0.0% 0.0% 0.3% 0.1% 0.0% 0.7% 0.5% 0.0% 200102 0.0% 2.1% 4.9% 0.1% 1.7% 0.6% 0.1% 0.5% 0.4% 0.2% 0.7% 0.1% 0.0% 0.0% 0.0% 0.7% 0.6% 0.1% 2.0% 0.0% 0.3% 0.6% 0.0% 1.6% 0.5% 0.0% 0.2% 0.3% 0.1% 3.2%0 8.0% 0.0% 0.5% 0.0%
Table 91b (Continued) HEALTH AUTHORITIES SURPLUS/(DEFICIT) FOR THE FINANCIAL YEARS 199798 TO 200102
Code QEE QC7 QCR QEF QEG 0135 QD6 QCW QCJ QAY QDL QC1 QEJ QD3 QC5 QC8 QCF QDN QDP QDQ QEK QEL QEQ QAF QC9 QAL QAN QDA QD7 QDC OEM QEN Strategic health authority SANDWELL HA SEFTON HA SHEFFIELD HA SHROPSHIRE HA SOLIHULL HA SOMERSET HA SOUTH & WEST DEVON HA SOUTH CHESHIRE HA SOUTH DERBYSHIRE HA SOUTH ESSEX HA SOUTH HUMBER HA SOUTH LANCASHIRE HA SOUTH STAFFORDSHIRE HA SOUTHAMPTON & SOUTH WEST HAMPSHIRE HA ST HELENS & KNOWSLEY HA STOCKPORT HA SUFFOLK HA SUNDERLAND HA TEES HA WAKEFIELD HA WALSALL HA WARWICKSHIRE HA WEST HERTFORDSHIRE HA WEST KENT HA WEST PENNINE HA WEST SURREY HA WEST SUSSEX HA WIGAN & BOLTON HA WILTSHIRE HA WIRRAL HA WOLVERHAMPTON HA WORCESTERSHIRE HA 199798 000s (365) (636) 949 (3,472) 166 (3,244) 1,220 691 1,196 227 (1,064) (1,644) (2,489) 1,453 (1,000) 1,105 (178) (1,005) (1,537) (2,319) 1,221 2,181 (1,681) 5,077 1,648 (4,541) (770) 1,125 (2,102) 1,824 (684) (4,396) Surplus/(decit) 199899 19992000 200001 000s 000s 000s (3,506) (1,724) (518) (1,344) (601) 836 2,981 (1,463) 3,433 (902) (1,643) (2,215) 61 43 (3,444) (317) (964) (2,053) (1,904) (3,283) (675) 623 (1,116) 7,036 20 1,023 (1,070) (960) (1,242) (769) (671) (2,070) (2,896) (597) (1,368) (1,729) (133) (1,166) (2,632) (1,053) 2,499 (775) (344) (869) (4,593) (165) 103 281 (1,921) (109) (128) (1,400) (909) (8,661) 455 3,633 67 4,830 (4,800) 596 (3,091) 473 (2,812) (1,482) 0 0 1,496 180 625 0 26 1,344 670 0 700 0 2,025 0 0 1 0 0 219 202 577 3,167 0 1,922 722 850 268 0 12 0 41 1,199 200102 000s 2 20 2,499 2,845 983 155 168 174 1,355 54 350 69 2,010 667 30 8 910 118 1,008 2,656 259 369 0 50 1,867 3,093 0 549 597 4 301 199798 "0.2% "0.3% 0.2% "1.5% 0.1% "1.2% 0.3% 0.2% 0.4% 0.1% "0.5% "0.9% "0.8% 0.5% "0.5% 0.7% 0.0% "0.6%. "0.5% "1.1% 0.8% 0.7% "0.5% 0.9% 0.6% "1.2% "0.2% 0.3% "0.6% 0.9% "0.5% "1.4% % of turnover(1) 199899 19992000 200001 "1.7% "0.9% "0.1% "0.6% "0.5% 0.3% 0.8% "0.3% 1.0% "0.2% "0.8% "1.2% 0.0% 0.0% "1.6% "0.2% "0.3% "1.D% "0.5% "1.4% "0.4% 0.2% "0.3% 1.2% 0.0% 0.3% "0.2% "0.3% "0.4% "0.3% "0.4% "0.6% "1.2% "0.3% "0.3% "0.6% "0.1% "0.4% "0.6% "0.2% 0.6% "0.2% "0.1% "0.4% "1.2% 0.0% 0.0% 0.1% "0.4% 0.0% 0.0% "0.6% "0.5% "2.6% 0.1% 0.5% 0.0% 1.0% "0.9% 0.1% "0.7% 0.2% "1.6% "0.4% 0.0% 0.00 0.3% 0.1% 0.5% 0.0% 0.0% 0.3% 0.2% 0.0% 0.5% 0.0% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.1% 0.3% 1.0% 0.0% 0.3% 0.2% 0.2% 0.1% 0.0% 0.0% 0.0% 0.0% 0.3% 200102 0.0% 0.0% 1.1% 0.9% 4.8% 0.1% 0.4% 0.0% 1.7% 0.0% 0.8% 0.3% 0.6% 0.3% 0.0% 0.2% 0.2% 0.1% 0.4% 5.8% 0.1% 0.1% 0.0% 0.0% 0.4% 0.6% 0.0% 0.2% 0.3% 0.0% 0.1%
Source: Audited Health Authority Summarisation Schedules 199798 to 200102. Footnotes: 1. Turnover is Total Income for 199798 through to 199900, Ilustrative Resource Limit for 200001, and Revenue Resource Limit for 200102.
Table 91c PRIMARY CARE TRUSTS SURPLUS/(DEFICIT) FOR THE FINANCIAL YEARS 200001 TO 200506
Code 5L8 5AW 5ED 5FA 5LL 5HG 5C2 5A9 5JE 5GR 5ET 5FL 5F8 5GD 5GE 5FH TAK 5AX 5GP 5H2 5AY 5CC 5HP 5G6 5HQ 5GA 5CE 5G2 5CF 5CG 5K5 5LQ 5JF 5JG 5JL 5A7 5EV 5G8 5DQ 5JX 5J6 5JH 5K7 5MM 5LM 5D4 5CJ Primary care trust ADUR, ARUN AND WORTHING PCT AIREDALE PCT AMBER VALLEY PCT ASHFIELD PCT ASHFORD PCT ASHTON, LEIGH AND WIGAN PCT BARKING AND DAGENHAM PCT BARNET PCT BARNSLEY PCT BASILDON PCT BASSETLAW PCT BATH AND NORTH EAST SOMERSET PCT BEBINGTON AND WEST WIRRAL PCT BEDFORD PCT BEDFORDSHIRE HEARTLANDS PCT BEXHILL AND ROTHER PCT BEXLEY CARE PCT BEXLEY PCT BILLERICAY, BRENTWOOD AND WICKFORD PCT BIRKENHEAD AND WALLASEY PCT BIRMINGHAM NORTH EAST PCT BLACKBURN WITH DARWEN PCT BLACKPOOL PCT BLACKWATER VALLEY AND HART PCT BOLTON PCT BOOTLE AND LITHERLAND PCT BOURNEMOUTH PCT BRACKNELL FOREST PCT BRADFORD CITY PCT BRADFORD SOUTH & WEST PCT BRENT PCT BRIGHTON AND HOVE CITY PCT BRISTOL NORTH PCT BRISTOL SOUTH AND WEST PCT BROADLAND PCT BROMLEY PCT BROXTOWE AND HUCKNALL PCT BURNLEY, PENDLE AND ROSSENDALE PCT BURNTWOOD, LICHFIELD AND TAMWORTH PCT BURY PCT CALDERDALE PCT CAMBRIDGE CITY PCT CAMDEN PCT CANNOCK CHASE PCT CANTERBURY AND COASTAL PCT CARLISLE AND DISTRICT PCT CARRICK PCT 200001 000s 10 200102 000s 458 16 193 0 24 6 97 12 7 216 250 50 0 19 0 9 1 1 0 Surplus/(decit) 200203 200304 000s 000s 968 17 415 141 51 1 1 110 2,995 10 242 85 103 715 (526) 18 4 434 13 219 598 32 0 159 11,206 169 66 1,006 98 0 (289) 280 17 275 (350) 194 34 94 577 508 397 18 15 1,690 824 57 259 104 557 2 1,501 1,328 450 826 5 282 109 (3,008) 25 (4,296) 721 44 103 700 (658) 117 1,249 9,200 291 328 2,063 34 172 356 (1,506) 32 349 33 8 46 91 (2,881) 34 118 18 24 200405 000s 3,653 96 93 542 157 4 263 591 250 98 382 8 213 646 (14,536) 332 (2,749) (1,123) 14 368 933 (2,676) 39 442 86 371 320 750 431 1,088 43 (4,444) 35 405 252 (2,111) 8 22 (7,621) 114 (1,235) (2,276) 90 200506 000s 2,972 105 87 1,800 97 300 1,583 541 413 738 267 1,194 440 154 (20,925) 589 (7,730) (1,386) 97 2,112 974 (8,252) 328 35 (1,836) 19 155 2,800 21 2,826 (208) (8,763) 35 789 115 (4,243) 393 54 (13,678) 175 101 (490) 86 0.1% 0.0% 200001 200102 % of turnover(1) 200203 200304 0.4% 0.0% 0.4% 0.2% 0.1% 0.0% 0.0% 0.0% 1.4% 0.0% 0.3% 0.1% 0.1% 0.6% "0.3% 0.0% 0.0% 0.4% 0.0% 0.2% 0.4% 0.0% 0.0% 0.1% 13.2% 0.1% 0.1% 0.4% 0.0% 0.0% "0.2% 0.3% 0.0% 0.2% "0.2% 0.2% 0.0% 0.1% 0.6% 0.2% 0.4% 0.0% 0.0% 0.7% 0.7% 0.1% 0.4% 0.1% 0.2% 0.0% 0.4% 0.5% 0.5% 0.9% 0.0% 0.3% 0.1% "1.6% 0.0% "2.2% 0.6% 0.0% 0.1% 0.4% "0.5% 0.0% 0.8% 10.4% 0.2% 0.2% 0.6% 0.0% 0.1% 0.2% "1.4% 0.0% 0.3% 0.0% 0.0% 0.0% 0.0% "2.5% 0.0% 0.1% 0.0% 0.0% 200405 1.4% 0.1% 0.1% 0.6% 0.1% 0.0% 0.1% 0.1% 0.1% 0.1% 0.3% 0.0% 0.2% 0.4% "6.5% 0.3% "1.2% "0.8% 0.0% 0.2% 0.5% "1.6% 0.0% 0.2% 0.1% 0.2% 0.2% 0.2% 0.1% 0.4% 0.0% "3.6% 0.0% 0.3% 0.1% "1.5% 0.0% 0.0% "5.5% 0.0% "1.0% "1.2% 0.1% 200506 1.0% 0.1% 0.1% 1.9% 0.1% 0.1% 0.7% 0.1% 0.1% 0.6% 0.2% 0.6% 0.3% 0.1% "9.0% 0.5% "3.3% "0.9% 0.0% 1.1% 0.5% "4.6% 0.1% 0.0% "1.8% 0.0% 0.1% 0.7% 0.0% 0.9% "0.1% "7.2% 0.0% 0.5% 0.0% "2.7% 0.2% 0.0% "9.8% 0.0% 0.1% "0.3% 0.1%
0.0%
0.6% 0.0% 0.4% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.2% 0.2% 0.1%
0.0%
0.0% 0.0% 0.0% 0.0%
925 472 68
0 4 4 9
1.7% 1.2% 0.2%
0.0% 0.0% 0.0% 0.0%
6 88 1,160
0.0% 0.1% 1.2%
9 0
0.0%
0.0% 0.0%
Table 91c (Continued) PRIMARY CARE TRUSTS SURPLUS/(DEFICIT) FOR THE FINANCIAL YEARS 200001 TO 200506
Code 5CJ 5JP 5H4 5KT 5AL 5HA 5CL 5JT 5JC 5JN 5KW 5DV 5H3 5EA 5G4 5C7 5F2 5C3 5GM 5KY 5MD 5KJ 5MA 5K9 5GW 5J9 5CM 5AC 5H7 5KA 5CK 5EK 5EL 5HV 5HT 5KC 5J8 5HX 5KD 5JK 5FT 5KP 5FD 5LN 5HK 5H9 5ML 5KQ Primary care trust CARRICK PCT CASTLE POINT AND ROCHFORD PCT CENTRAL CHESHIRE PCT CENTRAL CORNWALL PCT CENTRAL DERBY PCT CENTRAL LIVERPOOL PCT CENTRAL MANCHESTER PCT CENTRAL SUFFOLK PCT CHARNWOOD AND NW LEICESTERSHIRE PCT CHELMSFORD PCT CHELTENHAM AND TEWKESBURY PCT CHERWELL VALE PCT CHESHIRE WEST PCT CHESTERFIELD PCT CHILTERN AND SOUTH BUCKS PCT CHINGFORD, WANSTEAD AND WOODFORD PCT CHORLEY AND SOUTH RIBBLE PCT CITY AND HACKNEY PCT COLCHESTER PCT COTSWOLD AND VALE PCT COVENTRY PCT CRAVEN, HARROGATE AND RURAL DISTRICT PCT CRAWLEY PCT CROYDON PCT DACORUM PCT DARLINGTON PCT DARTFORD, GRAVESHAM & SWANLEY PCT DAVENTRY & SOUTH NORTHAMPTONSHIRE PCT DERBYSHIRE DALES & SOUTH DERBYSHIRE PCT DERWENTSIDE PCT DONCASTER CENTRAL PCT DONCASTER EAST PCT DONCASTER WEST PCT DUDLEY BEACON AND CASTLE PCT DUDLEY SOUTH PCT DURHAM AND CHESTER-LE-STREET PCT DURHAM DALES PCT EALING PCT EASINGTON PCT EAST CAMBRIDGESHIRE AND FENLAND PCT EAST DEVON PCT EAST ELMBRIDGE AND MID SURREY PCT EAST HAMPSHIRE PCT EAST KENT COASTAL PCT EAST LEEDS PCT EAST LINCOLNSHIRE PCT EAST STAFFORDSHIRE PCT EAST SURREY PCT 200001 000s 0 200102 000s 0 52 4 (5,650) 8 1 10 5 0 (48) 1,810 277 4 509 102 (658) 6 64 48 1,178 0 458 11 83 503 235 (1,189) 971 227 168 1,715 1,056 1,136 603 173 23 567 5 31 1,393 34 448 67 19 52 691 32 212 481 2 (4,390) 31 0 558 (1,831) 0 (3,997) 9 (852) 50 9 31 0 204 142 29 1 84 36 12 467 84 (5,592) 238 8 149 1,045 282 398 758 7 155 238 9 31 831 81 (241) 104 35 100 108 35 869 245 14 (5,294) 63 18 3,519 (3,837) (1,200) (7,144) 249 (4,404) (548) 316 (1,494) 41 43 (1,470) (4,809) 477 32 29 116 (4,840) 10 (1,086) 14 48 53 540 592 442 2,683 20 212 333 12 62 158 127 (2,563) (5,199) 89 111 (4,483) 25 137 3,207 22 18 1,169 185 161 (765) (2,517) (13,070) 1,226 (3,395) (16,468) 583 (5,970) 150 4,316 (4,395) (6,779) (2,900) (2,000) 142 102 (5,656) (1,275) (4,316) (4,595) (2,778) (916) 1,335 504 2,334 1,180 1,599 (2,914) 375 2,090 188 446 37 (5,789) 459 920 203 (7,482) 97 756 Surplus/(decit) 200203 200304 000s 000s 200405 000s 200506 000s 200001 200102 0.0% 0.0% 0.0% 0.0% "3.3% 0.0% 0.0% 0.0% 0.0% 0.0% "0.1% 1.5% 0.3% 0.0% 0.5% 0.1% "0.6% 0.0% 0.0% 0.0% 0.8% 0.0% 0.3% 0.0% 0.0% 0.4% 0.2% "0.6% 1.4% 0.4% 0.2% 1.9% 1.3% 1.2% 0.7% 0.1% 0.0% 0.7% 0.0% 0.0% 1.2% 0.0% 0.2% 0.0% 0.0% 0.0% 0.3% 0.0% 0.1% 0.3% 0.0% "2.4% 0.0% 0.0% 0.2% "2.3% 0.0% "3.9% 0.0% "0.9% 0.0% 0.0% 0.0% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.4% 0.1% "2.7% 0.3% 0.0% 0.2% 1.0% 0.3% 0.4% 0.7% 0.0% 0.1% 0.3% 0.0% 0.0% 0.7% 0.1% "0.1% 0.1% 0.0% 0.1% 0.0% 0.0% 0.5% 0.2% 0.0% "2.4% 0.0% 0.0% 1.3% "4.1% "0.5% "5.8% 0.2% "3.8% "0.3% 0.2% "1.0% 0.0% 0.0% "0.9% "2.4% 0.1% 0.0% 0.0% 0.0% "3.4% 0.0% "0.4% 0.0% 0.1% 0.1% 0.4% 0.6% 0.3% 2.3% 0.0% 0.1% 0.3% 0.0% 0.0% 0.1% 0.1% "0.9% "2.6% 0.0% 0.1% "1.5% 0.0% 0.1% 1.8% 0.0% 0.0% 0.8% 0.0% 0.1% "0.8% "1.0% "11.0% 0.7% "2.8% "8.0% 0.4% "4.0% 0.1% 1.2% "2.6% "3.2% "0.7% "0.9% 0.1% 0.0% "3.8% "1.0% "1.7% "4.6% "2.8% "0.8% 1.0% 0.4% 1.6% 0.9% 0.7% "1.6% 0.3% 0.5% 0.1% 0.3% 0.0% "1.8% 0.2% 0.3% 0.1% "2.3% 0.1% 0.4% % of turnover(1) 200203 200304 200405 200506
23 0
2 8
0.0% 0.0%
0.0% 0.0%
0 552 1 5 86 2
0.0% 0.7% 0.0% 0.0% 0.0% 0.0%
0 299 20 103 4 0 0 11 13
0.0% 0.4% 0.0% 0.4% 0.0% 0.0% 0.0% 0.0% 0.0%
19 29
0.0% 0.0%
Code 5E3 5LR 5MY 5H5 5E5 5EY 5E7 5LY 5D5 5H6 5C1 5AJ 5ER 5FR 5LX 5AE 5HE 5KF 5EC 5GT 5EX 5CA 5A8 5L5 5J1 5KH 5H1 5C9 5DC 5K6 5D9 5FJ 5A4 5MX 5CN 5CP 5F4 5HN 5AT 5JA 5MC 5HY 5LJ 5GF 5G7 5JQ 5DG 5K8 Primary care trust EAST YORKSHIRE PCT EASTBOURNE DOWNS PCT EASTERN BIRMINGHAM PCT EASTERN CHESHIRE PCT EASTERN HULL PCT EASTERN LEICESTER PCT EASTERN WAKEFIELD PCT EASTLEIGH AND TEST VALLEY SOUTH PCT EDEN VALLEY PCT ELLESMERE PORT AND NESTON PCT ENFIELD PCT EPPING FOREST PCT EREWASH PCT EXETER PCT FAREHAM AND GOSPORT PCT FENLAND PCT FYLDE PCT GATESHEAD PCT GEDLING PCT GREAT YARMOUTH PCT GREATER DERBY PCT GREATER YARDLEY PCT GREENWICH PCT GUILDFORD AND WAVERLEY PCT HALTON PCT HAMBLETON AND RICHMONDSHIRE PCT HAMMERSMITH AND FULHAM PCT HARINGEY PCT HARLOW PCT HARROW PCT HARTLEPOOL PCT HASTINGS AND ST LEONARDS PCT HAVERING PCT HEART OF BIRMINGHAM TEACHING PCT HEREFORDSHIRE PCT HERTSMERE PCT HEYWOOD AND MIDDLETON PCT HIGH PEAK AND DALES PCT HILLINGDON PCT HINCKLEY AND BOSWORTH PCT HORSHAM AND CHANCTONBURY PCT HOUNSLOW PCT HUDDERSFIELD CENTRAL PCT HUNTINGDONSHIRE PCT HYNDBURN AND RIBBLE VALLEY PCT IPSWICH PCT ISLE OF WIGHT PCT ISLINGTON PCT 200001 000s 200102 000s 95 Surplus/(decit) 200203 200304 000s 000s 2 (1,394) 134 95 0 2,657 15 22 24 371 43 (3) 124 37 51 23 411 146 906 89 3 (476) 9 32 (3,215) 17 30 (946) 369 (432) 57 2,025 6 40 6 245 22 23 66 (1,599) 82 2,687 9 (413) 5 2,203 2 (3,533) 4 285 0 1,733 208 42 8 139 321 166 4 170 11 28 22 7 374 106 83 58 512 3 (8,504) 12 34 (667) 49 2 68 6,469 467 223 310 124 (672) 20 54 (372) 32 3,086 13 (5,598) 17 2,809 200405 000s 0 (964) 24 196 192 29 1,735 (1,283) 33 111 103 63 49 359 (6,757) 41 46 284 1,099 80 132 (5,887) 141 3 679 1 186 (969) 140 954 (3,258) 9,491 0 (4,897) 526 55 (13,470) 1 4 (6,171) 6 (1,516) 9 (10,119) (361) 20 200506 000s 0 (7,168) 98 206 97 283 78 739 47 171 459 2,702 104 0 104 400 12 603 (1,836) 1,413 0.5% 223 (2,037) 36 (4,505) 4,468 161 (615) (9,372) (5,984) 1,529 69 6,165 0 (9,353) 518 (1,991) (36,506) (4,936) (590) (10,254) (3,553) 1,254 29 (8,007) (6,555) 70 200001 200102 0.1% % of turnover(1) 200203 200304 0.0% "0.8% 0.1% 0.1% 0.0% 1.9% 0.0% 0.0% 0.0% 0.5% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.2% 0.2% 1.1% 0.1% 0.0% "0.2% 0.0% 0.0% "1.6% 0.0% 0.0% "0.5% 0.4% "0.5% 0.0% 0.7% 0.0% 0.1% 0.0% 0.3% 0.0% 0.0% 0.1% "0.8% 0.1% 2.3% 0.0% "0.3% 0.0% 0.9% 0.0% "1.9% 0.0% 0.2% 0.0% 1.1% 0.1% 0.0% 0.0% 0.2% 0.1% 0.2% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.4% 0.1% 0.0% 0.0% 0.4% 0.0% "4.2% 0.0% 0.0% "0.3% 0.0% 0.0% 0.0% 2.1% 0.3% 0.3% 0.4% 0.1% "0.3% 0.0% 0.1% "0.2% 0.0% 2.5% 0.0% "4.1% 0.0% 1.1% 200405 0.0% "0.5% 0.0% 0.1% 0.1% 0.0% 0.8% "0.9% 0.0% 0.1% 0.0% 0.1% 0.0% 0.3% "3.6% 0.1% 0.0% 0.3% 1.0% 0.1% 0.0% "2.3% 0.1% 0.0% 0.3% 0.0% 0.2% "0.4% 0.1% 0.8% "1.2% 2.6% 0.0% "4.8% 0.6% 0.0% "5.0% 0.0% 0.0% "2.1% 0.0% "1.0% 0.0% "6.5% "0.2% 0.0% 200506 0.0% "3.2% 0.0% 0.1% 0.1% 0.1% 0.0% 0.5% 0.1% 0.2% 0.1% 2.1% 0.1% 0.0% 0.1% 0.5% 0.0% 0.5% "1.5% 0.8% 0.1% "0.7% 0.0% "3.7% 1.8% 0.0% "0.6% "4.0% "4.8% 1.2% 0.0% 1.5% 0.0% "9.2% 0.5% "1.6% "12.8% "5.0% "0.5% "3.8% "2.2% 0.8% 0.0% "5.2% "3.7% 0.0%
189 255 10 4 0 36 8 13 31 0 10 2 4 1 14
0.2% 0.2% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0%
120
23 7 0 111 59 3 0 43 793 0 0 4
0.0% 0.0% 0.0% 0.2% 0.0% 0.0% 0.0% 0.0% 0.7% 0.0% 0.0% 0.0%
0 19
0.0% 0.0%
Code 5K4 5LA 5A5 5J4 5LD 5KN 5HJ 5HM 5HH 5EJ 5LF 5D3 5DE 5GC 5FG 5L2 5GL 5AM 5L3 5EH 5FX 5FV 5KM 5E9 5FK 5CQ 5DD 5AV 5A1 5AP 5DK 5D7 5HW 5C5 5KR 5MW 5CH 5FQ 5CD 5AN 5DT 5EG 5DF 5GH 5J7 5EF 5G9 5CR Primary care trust KENNET AND NORTH WILTSHIRE PCT KENSINGTON AND CHELSEA PCT KINGSTON PCT KNOWSLEY PCT LAMBETH PCT LANGBAURGH PCT LEEDS NORTH EAST PCT LEEDS NORTH WEST PCT LEEDS WEST PCT LEICESTER CITY WEST PCT LEWISHAM PCT LINCOLNSHIRE SOUTH WEST TEACHING PCT LOWESTOFT PCT LUTON PCT MAIDSTONE AND MALLING PCT MAIDSTONE WEALD PCT MALDON AND SOUTH CHELMSFORD PCT MANSFIELD DISTRICT PCT MEDWAY PCT MELTON, RUTLAND AND HARBOROUGH PCT MENDIP PCT MID DEVON PCT MIDDLESBROUGH PCT MID-HAMPSHIRE PCT MID-SUSSEX PCT MILTON KEYNES PCT MORECAMBE BAY PCT NELSON & WEST MERTON PCT NEW FOREST PCT NEWARK & SHERWOOD PCT NEWBURY AND COMMUNITY PCT NEWCASTLE PCT NEWCASTLE-UNDER-LYME PCT NEWHAM PCT NORTH AND EAST CORNWALL PCT NORTH BIRMINGHAM PCT NORTH BRADFORD PCT NORTH DEVON PCT NORTH DORSET PCT NORTH EAST LINCOLNSHIRE PCT NORTH EAST OXFORDSHIRE PCT NORTH EASTERN DERBYSHIRE PCT NORTH HAMPSHIRE PCT NORTH HERTFORDSHIRE AND STEVENAGE PCT NORTH KIRKLEES PCT NORTH LINCOLNSHIRE PCT NORTH LIVERPOOL PCT NORTH MANCHESTER PCT 200001 000s 200102 000s Surplus/(decit) 200203 200304 000s 000s 1,826 744 18 3 108 553 47 57 60 1,005 226 976 869 491 77 99 9 1,801 18 25 372 35 218 0 0 10 204 107 69 820 340 (5,498) 368 22 30 0 0 0 234 0 555 61 0 4 5 (2,067) (1,199) 8 61 498 126 60 87 112 632 2 559 381 3 15 71 23 2,874 5 1,158 130 13 92 (388) 1,218 (1,326) 564 872 51 95 15 (3,353) 149 36 (5,381) 173 0 (258) 20 (548) 186 14 0 131 22 200405 000s (10,159) (19,152) (1,853) 3 713 108 928 210 322 (957) 193 430 (6,038) (3,714) (1,489) 119 (196) 356 9 18 381 (826) 88 (4,860) 170 (8,592) 154 (114) 59 (597) 279 (6,668) (1,339) 106 (5,263) 1,298 0 (1,938) 34 (890) (3,860) 291 36 20 827 200506 000s (12,612) (22,052) (7,916) 9 2,554 553 113 38 58 (5,129) 170 39 (8,689) 279 (2,659) 305 (2,398) 240 41 (2,383) 50 1,423 (1,949) (2,347) 104 358 2,231 0 46 (1,392) 62 (2,876) (3,999) 131 301 6 0 (573) 787 (4,375) (6,728) 124 (1,005) 131 3 200001 200102 % of turnover(1) 200203 200304 1.2% 0.3% 0.0% 0.0% 0.0% 0.6% 0.0% 0.0% 0.1% 0.8% 0.1% 0.7% 0.6% 0.3% 0.1% 0.1% 0.0% 1.8% 0.0% 0.0% 0.2% 0.0% 0.2% 0.0% 0.0% 0.0% 0.2% 0.2% 0.0% 0.9% 0.1% "4.1% 0.3% 0.0% 0.0% 0.0% 0.0% 0.0% 0.2% 0.0% 0.4% 0.0% 0.0% 0.0% 0.0% "1.2% "0.5% 0.0% 0.0% 0.1% 0.1% 0.0% 0.1% 0.1% 0.5% 0.0% 0.4% 0.2% 0.0% 0.0% 0.1% 0.0% 2.5% 0.0% 1.2% 0.1% 0.0% 0.1% "0.2% 0.4% "0.8% 0.5% 1.1% 0.0% 0.1% 0.0% "2.4% 0.1% 0.0% "3.9% 0.2% 0.0% "0.5% 0.0% "0.3% 0.1% 0.0% 0.0% 0.1% 0.0% 200405 "5.6% "7.1% "1.0% 0.0% 0.2% 0.1% 0.5% 0.1% 0.2% "0.6% 0.1% 0.2% "3.0% "1.6% "2.0% 0.1% "0.1% 0.3% 0.0% 0.0% 0.2% "0.5% 0.1% "2.3% 0.0% "4.4% 0.1% "0.1% 0.0% "0.5% 0.1% "4.0% "0.7% 0.1% "3.3% 1.3% 0.0% "3.0% 0.0% "0.5% "2.1% 0.2% 0.0% 0.0% 0.4% 200506 "6.2% "7.8% "4.1% 0.0% 0.5% 0.4% 0.1% 0.0% 0.0% "3.1% 0.0% 0.0% "4.3% 0.1% "3.4% 0.3% "0.8% 0.2% 0.0% "2.0% 0.0% 0.8% "1.3% "1.0% 0.0% 0.2% 1.5% 0.0% 0.0% "1.1% 0.0% "1.5% "2.0% 0.1% 0.2% 0.0% 0.0% "0.8% 0.4% "2.2% "3.4% 0.1% "0.6% 0.1% 0.0%
24
0.0%
22 0 3 58 0 0 4 30 0 9 17 5 71 0 3 0 0 37 477 26 422 57 0 0 147 11 0 0 848 525 0 0 0 0 0
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.7% 0.0% 0.2% 0.2% 0.0% 0.0% 0.2% 0.0% 0.0% 0.0% 2.1% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0%
8 177 0
0.0% 0.2% 0.0%
Code 5JM 5AF 5EE 5M8 5CT 5ME 5L6 5E1 5D8 5MP 5LW 5LV TAC 5A2 5EM 5MG 5J5 5DW 5F1 5AQ 5AR 5KV 5FE 5HD 5DL 5C8 5NA 5MR 5M6 5JY 5H8 5MH 5GK 5M9 5FC 5F5 5KK 5KE 5E2 5EP 5EN 5LP 5M2 5DM 5D1 5FW Primary care trust NORTH NORFOLK PCT NORTH PETERBOROUGH PCT NORTH SHEFFIELD PCT NORTH SOMERSET PCT NORTH STOKE PCT NORTH STOKE PCT NORTH SURREY PCT NORTH TEES PCT NORTH TYNESIDE PCT NORTH WARWICKSHIRE PCT NORTHAMPTON PCT NORTHAMPTONSHIRE HEARTLANDS PCT NORTHUMBERLAND CARE PCT NORWICH PCT NOTTINGHAM CITY PCT OLDBURY AND SMETHWICK PCT OLDHAM PCT OXFORD CITY PCT PLYMOUTH PCT POOLE BAY PCT POOLE CENTRAL & NORTH PCT POOLE PCT PORTSMOUTH CITY PCT PRESTON PCT READING PCT REDBRIDGE PCT REDBRIDGE PCT REDDITCH AND BROMSGROVE PCT RICHMOND AND TWICKENHAM PCT ROCHDALE PCT ROTHERHAM PCT ROWLEY REGIS AND TIPTON PCT ROYSTON, BUNTINGFORD AND BISHOPS STORTFORD PCT RUGBY PCT RUSHCLIFFE PCT SALFORD PCT SCARBOROUGH, WHITBY AND RYEDALE PCT SEDGEFIELD PCT SELBY AND YORK PCT SHEFFIELD SOUTH WEST PCT SHEFFIELD WEST PCT SHEPWAY PCT SHROPSHIRE COUNTY PCT SLOUGH PCT SOLIHULL PCT SOMERSET COAST PCT 200001 000s 0 75 200102 000s 233 106 16 1 17 1,385 40 182 121 0 1,059 1,988 244 987 31 27 12 1,179 1 282 93 4 166 0 4 107 9 1,311 217 1,080 0 8 28 584 64 52 600 492 18 938 507 3,194 73 23 116 104 (816) 11 423 344 (4,424) 1,543 59 2 91 320 0 658 13 4 281 30 92 479 349 1,363 502 260 3 109 1,179 7 218 7 839 444 139 394 74 6 466 (6,810) 50 107 64 105 259 183 98 (108) 177 (179) 458 540 9 413 17 260 26 82 385 117 581 275 389 22 8 369 180 1 378 (6,598) 1 34 410 1,043 85 8 214 (8,487) 92 435 209 1,688 (4,243) (1,967) 814 (1,336) 342 (3,647) 570 263 0 1.5% 1.4% 1,311 634 102 0 2,047 824 1,751 558 1,475 (1,301) (4,318) 0 923 85 (5,932) (3,723) (23,651) 52 8 552 733 (3,159) 345 17 Surplus/(decit) 200203 200304 000s 000s 386 2,102 477 251 (1,662) 524 382 (1,452) 200405 000s (5,294) 105 241 (5,202) 200506 000s (12,219) 3,558 247 (4,213) 200001 200102 % of turnover(1) 200203 200304 0.4% 2.1% 0.4% 0.2% 1.1% 0.0% 0.1% 0.1% 0.0% 0.6% 0.9% 0.1% 0.8% 0.0% 0.0% 0.0% 0.7% 0.0% 0.2% 0.1% 0.0% 0.1% 0.0% 0.0% 0.1% 0.0% 0.6% 0.3% 1.9% 0.0% 0.0% 0.0% 0.4% 0.1% 0.0% 0.5% 0.5% 0.0% 0.4% 0.5% 1.9% 0.1% "1.7% 0.5% 0.3% "0.9% 0.0% 0.1% 0.1% "0.4% 0.0% 0.2% 0.1% "1.4% 1.2% 0.0% 0.0% 0.0% 0.2% 0.0% 0.4% 0.0% 0.0% 0.2% 0.0% 0.1% 0.3% 0.3% 0.5% 0.6% 0.4% 0.0% 0.1% 0.4% 0.0% 0.2% 0.0% 0.7% 0.4% 0.1% 0.2% 0.1% 0.0% 0.4% 200405 "4.7% 0.1% 0.1% "2.7% "4.2% 0.0% 0.1% 0.0% 0.1% 0.1% 0.1% 0.0% "0.1% 0.1% "0.1% 0.2% 0.3% 0.0% 0.2% 0.0% 0.2% 0.0% 0.0% 0.2% 0.1% 0.4% 0.1% 0.4% 0.0% 0.0% 0.3% 0.1% 0.0% 0.3% "2.4% 0.0% 0.0% 0.3% 0.4% 0.1% 0.0% 0.1% 200506 "10.4% 2.3% 0.1% "2.0% "4.9% 0.0% 0.2% 0.1% 0.8% "1.8% "0.6% 0.2% "0.8% 0.1% "2.7% 0.2% 0.1% 0.0% 0.6% 0.3% 0.1% 0.0% 0.7% 0.5% 0.8% 0.3% 0.5% "1.2% "5.6% 0.0% 0.8% 0.0% "3.1% "3.1% "7.9% 0.0% 0.0% 0.4% 0.2% "2.3% 0.1% 0.0%
0.0% 0.2%
0.3% 0.1% 0.0% 0.0% 0.0%
0 775 0 3 18 8 3 1,179 5
0.0% 0.4% 0.0% 0.0% 0.0% 0.0% 0.0% 0.8% 0.0%
808 713
207 380 5 20 354 302 731 632 120
0.5% 0.5% 0.0% 0.0% 0.5% 0.4% 0.8% 0.5% 0.1%
Code 5FN 5M1 5JJ J 5DX 5EQ 5A3 5CV 5LK 5HL 5JD 5HC 5AA 5AG 5M5 5K1 5EW 5MF 5KG 5MQ 5FP 5FF 5DY 5MN 5DJ 5MT 5GY 5L1 5AD 5AK 5G1 5F9 5LE 5GX 5J3 5HR 5F7 5JR 5JW 5KL 5DA 5LT 5M7 5L4 5K3 5LH 5K2 Primary care trust SOUTH AND EAST DORSET PCT SOUTH BIRMINGHAM PCT SOUTH CAMBRIDGESHIRE PCT SOUTH EAST HERTFORDSHIRE PCT SOUTH EAST OXFORDSHIRE PCT SOUTH EAST SHEFFIELD PCT SOUTH GLOUCESTERSHIRE PCT SOUTH HAMS & WEST DEVON PCT SOUTH HUDDERSFIELD PCT SOUTH LEEDS PCT SOUTH LEICESTERSHIRE PCT SOUTH LIVERPOOL PCT SOUTH MANCHESTER PCT SOUTH PETERBOROUGH PCT SOUTH SEFTON PCT SOUTH SOMERSET PCT SOUTH STOKE PCT SOUTH STOKE PCT SOUTH TYNESIDE PCT SOUTH WARWICKSHIRE PCT SOUTH WEST DORSET PCT SOUTH WEST KENT PCT SOUTH WEST OXFORDSHIRE PCT SOUTH WESTERN STAFFORDSHIRE PCT SOUTH WILTSHIRE PCT SOUTH WORCESTERSHIRE PCT SOUTHAMPTON CITY PCT SOUTHAMPTON CITY PCT SOUTHAMPTON EAST HEALTHCARE PCT SOUTHEND ON SEA PCT SOUTHERN NORFOLK PCT SOUTHPORT AND FORMBY PCT SOUTHWARK PCT ST ALBANS AND HARPENDEN PCT ST HELENS PCT STAFFORDSHIRE MOORLANDS PCT STOCKPORT PCT SUFFOLK COASTAL PCT SUFFOLK WEST PCT SUNDERLAND TEACHING PCT SUNDERLAND WEST PCT SUSSEX DOWNS AND WEALD PCT SUTTON AND MERTON PCT SWALE PCT SWINDON PCT TAMESIDE AND GLOSSOP PCT TAUNTON DEANE PCT 200001 000s 200102 000s 2 2 0 116 0 0 Surplus/(decit) 200203 200304 000s 000s 26 3,438 1,357 1,183 86 608 264 0 14 53 259 0 1,121 541 1 268 1,274 3,693 203 0 131 47 105 58 702 0 3 2 4 15 158 9 24 1,080 44 1,184 401 2 190 29 (432) (1,581) 89 (298) 1,807 63 592 39 298 (386) 2,025 6 293 55 829 1,220 545 (1,098) 59 (100) 904 323 541 0 273 43 6 497 714 109 36 19 (1,102) 30 0 17 (1,690) 1,084 345 100 673 54 3 (3,480) (4,423) 26 99 0 27 13 59 418 200405 000s (2,424) 9 (2,583) (446) 40 59 912 21 9 15 (966) 19 2,955 4 0 172 (1,719) 9 675 764 14 (5,172) (3,750) (1,535) 45 0 13 (7,152) 140 146 (1,526) 9 (3,725) 48 (6,174) (12,510) 87 (1,819) 0 (449) 563 48 723 200506 000s 1,491 324 (6,137) (812) 59 56 145 226 (2,772) 36 (8,500) 64 3,339 69 0 23 72 6 220 1,340 (5,855) (2,834) (4,911) (5,846) 11 781 3,977 (10,506) (6,200) 855 (5,754) 211 (4,893) 51 (5,167) (11,460) 19 (3,994) (6,708) (3,307) 748 100 453 0.0% 0.0% 0.0% 0.0% 0.2% 0.0% 200001 200102 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% % of turnover(1) 200203 200304 0.0% 1.0% 1.6% 0.9% 0.1% 0.4% 0.1% 0.0% 0.0% 0.0% 0.2% 0.0% 0.8% 0.8% 0.0% 0.2% 1.0% 2.3% 0.1% 0.0% 0.1% 0.0% 0.1% 0.1% 0.3% 0.0% 0.0% 0.7% 0.0% 0.4% 0.4% 0.0% 0.2% 0.0% "0.6% "0.9% 0.0% "0.3% 0.5% 0.1% 0.4% 0.0% 0.3% "0.3% 0.6% 0.0% 0.2% 0.1% 0.5% 0.6% 0.6% "1.5% 0.0% "0.1% 0.7% 0.2% 0.7% 0.0% 0.2% 0.0% 0.0% 0.2% 0.5% 0.1% 0.0% 0.0% "1.1% 0.0% 0.0% 0.0% "1.0% 0.8% 0.1% 0.1% 0.4% 0.1% 0.0% "4.0% "2.3% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.4% 200405 "1.5% 0.0% "2.7% "0.3% 0.1% 0.0% 0.4% 0.0% 0.0% 0.0% "0.7% 0.0% 1.6% 0.0% 0.0% 0.1% "1.1% 0.0% 0.3% 0.5% 0.0% "2.9% "2.1% "1.2% 0.0% 0.0% 0.0% "3.5% 0.1% 0.0% "1.2% 0.0% "3.3% 0.0% "6.2% "5.6% 0.0% "1.2% 0.0% "0.4% 0.3% 0.0% 0.6% 200506 0.8% 0.1% "5.5%5G "0.5% 0.1% 0.0% 0.1% 0.2% "3.0% 0.0% "5.6% 0.0% 1.6% 0.1% 0.0% 0.0% 0.0% 0.0% 0.1% 0.8% "3.1% "1.4% "2.6% "4.3% 0.0% 0.3% 1.8% "4.9% "4.1% 0.2% "4.5% 0.1% "4.1% 0.0% "4.9% "4.9% 0.0% "2.5% "1.5% "2.9% 0.3% 0.0% 0.4%
130
0.4%
0 0
0 0 34
0.0% 0.0%
0.0% 0.0% 0.0%
24 0 0 6 0
0.0% 0.0% 0.0% 0.0% 0.0%
308
0.4%
Code 5A6 5FY 5MK 5AH 5GQ 5CW 5C4 5F6 5CX 5GN 5DP 5E8 5M3 5NC 5C6 5LG 5J2 5GV 5JV 5MJ 5GG 5D6 5KX 5E6 5F3 5D2 5CY 5FM 5DH 5L9 5LC 5G3 TAG 5L7 5DN 5MV 5G5 5DR 5HF 5E4 Primary care trust TEDDINGTON, TWICKENHAM AND HAMPTONS PCT TEIGNBRIDGE PCT TELFORD AND WREKIN PCT TENDRING PCT THURROCK PCT TORBAY PCT TOWER HAMLETS PCT TRAFFORD NORTH PCT TRAFFORD SOUTH PCT UTTLESFORD PCT VALE OF AYLESBURY PCT WAKEFIELD WEST PCT WALSALL PCT WALTHAM FOREST PCT WALTHAMSTOW, LEYTON AND LEYTONSTONE PCT WANDSWORTH PCT WARRINGTON PCT WATFORD AND THREE RIVERS PCT WAVENEY PCT WEDNESBURY AND WEST BROMWICH PCT WELWYN HATFIELD PCT WEST CUMBRIA PCT WEST GLOUCESTERSHIRE PCT WEST HULL PCT WEST LANCASHIRE PCT WEST LINCOLNSHIRE PCT WEST NORFOLK PCT WEST OF CORNWALL PCT WEST WILTSHIRE PCT WESTERN SUSSEX PCT WESTMINSTER PCT WINDSOR, ASCOT AND MAIDENHEAD PCT WITHAM, BRAINTREE AND HALSTEAD CARE PCT WOKING PCT WOKINGHAM PCT WOLVERHAMPTON CITY PCT WYCOMBE PCT WYRE FOREST PCT WYRE PCT YORKSHIRE WOLDS AND COAST PCT 200001 000s 200102 000s 2 10 55 203 0 62 5 14 47 6 2 2 11 5 26 59 1,650 149 7 50 15 18 9 5 148 4 62 19 2,071 26 910 (176) 5 196 7 1,267 529 13 496 785 (5,059) 1,471 221 6,275 1,024 0 616 322 85 81 6 0 10 611 330 603 (474) 130 430 15 (159) 22 7 463 (239) (3,416) 37 529 3 169 1 319 1,322 (2,821) 536 7 24 9 (8,237) 100 (1,928) (1,533) 696 (128) 208 (3,110) 35 44 826 (1,482) (5,669) (2,803) 118 13 108 (3,141) 98 37 50 (429) (1,968) 712 (6,116) (8,935) 490 (3,764) (3,133) 149 (643) 103 (3,863) 14 75 6 (813) 10 (9,735) 108 800 (2,182) (5,156) 30 0 1,315 (3,188) 17 2,554 (11,540) 2,101 1,173 150 477 175 8 16 2 25 10 8 1,318 4 474 140 384 (755) 188 493 6 7 2 (4,916) 12 1,944 (2,538) 4 1,790 149 1,287 260 627 261 483 (1,457) (8,470) 9 3,634 (1,962) Surplus/(decit) 200203 200304 000s 000s 200405 000s 200506 000s 200001 200102 0.0% 0.0% 0.1% 0.4% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 1.4% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.7% 0.0% 0.6% "0.2% 0.0% 0.2% 0.0% 0.7% 0.4% 0.0% 0.3% 0.6% "3.8% 1.6% 0.1% 2.1% 0.8% 0.0% 0.4% 0.3% 0.0% 0.1% 0.0% 0.0% 0.0% 0.2% 0.2% 0.4% "0.4% 0.1% 0.5% 0.0% "0.1% 0.0% 0.0% 0.2% "0.2% "2.4% 0.0% 0.3% 0.0% 0.1% 0.0% 0.2% 1.3% "1.2% 0.5% 0.0% 0.0% 0.0% "2.3% 0.0% "1.0% "1.1% 0.5% "0.1% 0.1% "1.3% 0.0% 0.0% 0.4% "1.0% "3.3% "2.5% 0.1% 0.0% 0.1% "2.4% 0.1% 0.0% 0.0% "0.3% "1.9% 0.5% "4.1% "2.5% 0.2% "2.0% "2.0% 0.1% "0.6% 0.1% "1.5% 0.0% 0.1% 0.0% "0.5% 0.0% "8.0% 0.0% 0.2% "1.3% "3.8% 0.0% 0.0% 0.4% "2.2% 0.0% 1.7% "7.0% 2.0% 0.9% 0.1% 0.4% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.5% 0.0% 0.4% 0.1% 0.2% "0.5% 0.1% 0.2% 0.0% 0.0% 0.0% "2.6% 0.0% 0.7% "0.9% 0.0% 1.0% 0.1% 0.8% 0.1% 0.2% 0.2% 0.3% "1.5% "4.4% 0.0% 1.1% "0.7% % of turnover(1) 200203 200304 200405 200506
0 12 5 17 30 0 0 0 162
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.2%
0.0%
694 1 9
0.8% 0.0% 0.0%
Source: Audited PCT Summarisation Schedules 200001 to 200405, and 200506 Month 12 Financial Monitoring Returns. Footnotes: 1. Turnover is the Illustrative Resource Limit for 200001, and Revenue Resource Limit from 200102 onwards.
Table 91d STRATEGIC HEALTH AUTHORITIES SURPLUS/(DEFICIT) FOR THE FINANCIAL YEARS 200203 TO 200506
Surplus/(decit) 200304 200405 000s 000s 1,668 1,408 5,910 5,234 1,439 10,584 5,063 9,562 8,967 96 7,103 4,581 15,714 1,415 6,092 8,552 4,045 13,146 5,189 6,377 6,286 10,220 1,619 14,845 4,221 6,420 16,867 23,647 20,219 1,976 20,518 6,483 7,127 15,800 5,446 1,015 33,299 77 5,365 2,166 16,282 13,937 22,498 11,874 5,977 18,431 10,535 11,009 9,639 5,889 13,072 32,069 16,261 21,037 (390) 45,125 % of turnover(1) 200304 200405 1.4% 2.1% 3.2% 3.3% 1.3% 2.3% 10.4% 14.0% 4.5% 0.1% 11.1% 4.5% 10.9% 2.1% 3.1% 4.9% 2.1% 14.0% 8.1% 3.3% 5.6% 12.0% 0.9% 11.7% 3.8% 4.3% 20.6% 13.0% 12.6% 2.7% 9.9% 3.6% 5.5% 13.9% 9.9% 1.3% 13.2% 0.1% 7.2% 1.8% 10.3% 15.1% 10.0% 6.1% 3.0% 17.4% 14.0% 5.2% 7.5% 5.3% 6.6% 19.2% 11.5% 11.4% "0.5% 21.5%
Code Q20 Q02 Q27 Q15 Q10 Q13 Q22 Q03 Q14 Q17 Q18 Q25 Q01 Q11 Q05 Q06 Q04 Q09 Q26 Q07 Q08 Q21 Q23 Q19 Q16 Q24 Q28 Q12
Strategic health authority AVON, GLOUCESTERSHIRE AND WILTSHIRE STHA BEDFORDSHIRE AND HERTFORDSHIRE STHA BIRMINGHAM AND THE BLACK COUNTRY STHA CHESHIRE & MERSEYSIDE STHA COUNTY DURHAM AND TEES VALLEY STHA CUMBRIA AND LANCASHIRE STHA DORSET AND SOMERSET STHA ESSEX STHA GREATER MANCHESTER STHA HAMPSHIRE AND ISLE OF WIGHT STHA KENT AND MEDWAY STHA LEICS, NORTHANTS AND RUTLAND STHA NORFOLK, SUFFOLK AND CAMBRIDGESHIRE STHA NORTH & EAST YORKSHIRE & NORTH LINCS STHA NORTH CENTRAL LONDON STHA NORTH EAST LONDON STHA NORTH WEST LONDON STHA NORTHUMBERLAND, TYNE & WEAR STHA SHROPSHIRE AND STAFFORDSHIRE STHA SOUTH EAST LONDON STHA SOUTH WEST LONDON STHA SOUTH WEST PENINSULA STHA SOUTH YORKSHIRE STHA SURREY AND SUSSEX STHA THAMES VALLEY STHA TRENT STHA WEST MIDLANDS SOUTH SHA WEST YORKSHIRE STHA
200203 000s 7,362 363 5,268 189 244 41 497 3,907 104 840 6 4,794 5,877 384 4,605 1,071 3,622 12,587 3,122 8,222 2,745 0 4,975 1,219 1,238 9,154 12,474 1,482
200506 000s 11,418 19,318 31,295 3,169 46,738 33,079 5,510 11,127 10,041 4,419 15,442 6,233 15,737 28,426 22,578 18,981 21,923 17,173 10,390 16,637 13,573 13,270 27,308 12,238 17,751 30,096 9,181 50,993
200203 7.0% 0.5% 3.1% 0.1% 0.2% 0.0% 1.2% 3.6% 0.1% 0.9% 0.1% 5.6% 4.5% 0.8% 2.8% 0.6% 2.2% 16.7% 5.7% 4.9% 2.7% 0.0% 3.0% 0.7% 1.2% 7.0% 18.0% 1.3%
200506 7.3% 20.7% 13.8% 1.4% 28.9% 24.6% 9.8% 12.5% 4.2% 3.3% 16.8% 4.5% 9.2% 26.0% 9.7% 9.3% 9.7% 16.7% 14.1% 7.3% 9.7% 11.1 12.6% 8.9% 12.4% 15.3% 10.3% 22.2%
Source: Audited SHA Summarisation Schedules 200203 to 200405, and 200506 Month 12 Financial Monitoring Returns. Footnotes: 1. Turnover is the Revenue Resource Limit.
5.10.3 What steps is the Department taking to improve the ability of NHS bodies to make accurate forecasts of their year-end nancial position? What action is being taken to break the typical cycle identied by the Audit Commission of NHS bodies giving little credence to nancial information early in the nancial year, only to enter into corrective action after nding themselves in danger of overspending later in the year? What was the impact of the publication of mid-year nancial position forecasts in 200506? (Q92) Answer 1. Further to the response given in 2005, we are continuing to work with SHAs to adopt a more comprehensive approach to monitoring. As part of this process, we are working with SHAs to nalise a monthly performance metrics report that will focus on both activity and nancial data. The key indicators in this report will be used as a central element of the challenge function at monthly face-to-face performance management meetings, enable early identication of trends and allow robust conclusions to be drawn. It is intended that SHAs will be able to adopt the same reporting tool to better collate data and manage performance across their organisations. 2. In addition, we now require more data from all NHS bodies on a monthly basis, and have improved the level of performance analysis of this data. We are also more active in challenging SHAs about the quality of the data. 3. To make the monthly monitoring forms simpler for the NHS to compete they have now been changed to resemble the accounts forms where possible. 4. We have also issued more comprehensive guidance to the NHS, both at the start of the year and where issues of data quality are identied. For example, we sought reasons for the signicant change in the nancial position between 200405 month 12 forecasts and nal audited accounts and subsequently issued guidance on the issues identied to avoid a re-occurrence of the problems. 5. In February 2006 the department set up a National Programme OYce (NPO) for turnaround for those organisations with signicant decits. The role of the NPO is to provide co-ordination, review, monitoring and scrutiny of all turnaround projects. This additional scrutiny of the most nancially challenged organisations further adds to the accuracy of the forecasts provided. 6. The department has taken steps to bring performance and nancial management closer together to help ensure that nancial and non-nancial data received from the NHS is consistent and to enable challenge where it is not. These steps include the appointment of the NHS Financial Controller, who is responsible for liaising more closely with SHAs and the department performance colleagues. 7. In a further step towards this aim, the department has agreed the publication of a set of productivity metricscovering clinical productivity, nance, workforce, prescribing and procurementto eVectively encourage benchmarking of performance. This should improve the quality of the data provided by the NHS in its nancial forecasts, and support the identication and take up of best practice. 8. The publication of the mid-year nancial position in 200506 provided a more accurate forecast of the provisional outturn position for the year then has traditionally been provided at the mid-year stage in recent years. 9. With the aim of improved transparency and a continuation in the improvement in the accuracy of nancial forecast the department has committed to publish the quarterly nancial position in 200607. The rst of these quarterly reports was published on 11 August. 10. The problems with in-year forecasting identied by the Audit Commission is partly due to overpessimistic forecasting by NHS bodies. The measures set out above aim to make the forecasting more reliable. 5.10.4 Is there evidence of correlation between the 2005-06 nancial position of Primary Care Trusts and (a) 200506 per cent distance from target revenue allocation and (b) 200506 revenue allocation per unweighted head of population? Could these data be shown in graphical form? (Q93) Answer 1. Provisional analysis of the 200506 forecast outturn position has shown that there is not one single simple cause for decits. There is no single cause of nancial problems. Our analysis shows very little correlation between the size of decits and any of the factors relating to fundingincluding allocations per head, and distance from target. 2. The PCT economy1 position is shown as requested in Figure 93a and Figure 93b. The graphs show there is no signicant relationship between the factors. Figure 93c shows the NHS nancial position by SHA area. 3. These analysis was included in the NHS Financial Performance Report 200506 published 7 June 2006, and the Chief Economic advisor has been commissioned to do a more comprehensive analysis.
Primary care trust economy looks at the combined nancial position of PCTs and the NHS trusts from whom they commission activity. This is done by mapping the nancial position of NHS trusts to each of their commissioner PCTs in proportion to their costed activity with each commissioner. The data used was 200405 hospital episode statistics costed and using the tariV. These gures do not include SHA surpluses as it is not possible to map these to PCTs or NHS trusts.
Figure 93a: 2005/06 PCT health economy surplus/deficit versus closing distance from target
4
2005/06 surplus/(deficit) as a % of SHA economy turnover
0 -10 0 10 20 30 40
-20
-2
-4
-6
-8
-10
2005/06 closing distance from target %
Figure 93b: 2005/06 PCT health economy surplus/deficit versus allocation per unweighted head of population
2005/06 surplus/(deficit) as a % of SHA economy turnover
0 800 -2
900
1000
1100
1200
1300
1400
1500
1600
1700
1800
-4
-6
-8
-10
2005/06 allocation per head s
Figure 93c: NHS FinancialPosition by Strategic Health authority NHS FINANCIAL POSITION BY SHA SHA Health Economy Under/Overspends
KEY breakeven or u/spend o/spend up to and incl. 25m o/spend between 25m and 50m o/spend greater than 50m
Key Q01 Q02 Q03 Q04 Q05 Q06 Q07 Q08 Q09 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 Q19 Q20 Q21 Q22 Q23 Q24 Q25 Q26 Q27 Q28 Norfolk, Suffolk and Cambridgeshire Bedfordshire and Hertfordshire Essex North West London 2005/06 Final Accounts North Central London North East London South East London Q09 South West London Northumberland, Tyne and Wear Q10 County Durham and Tees Valley Q13 North and East Yorkshire and Northern Lincolnshire Q11 West Yorkshire Cumbria and Lancashire London Q12 Greater Manchester Q14 Q27 Cheshire and Merseyside Q05 Q15 Thames Valley Q24 Q06 Q04 Hampshire and Isle Of Wight Q26 Kent and Medway Q08 Q07 Q25 Q01 Surrey and Sussex Q28 Avon, Gloucestershire and Wiltshire Q02 South West Peninsula Q03 Dorset and Somerset Q16 Q20 South Yorkshire Trent Q18 Q17 Q19 Leicestershire, Northamptonshire and Rutland Q22 Shropshire and Staffordshire Q21 Birmingham and The Black Country West Midlands South
2005/06 Month 12
Q09 Q13 London Q05 Q04 Q08 Q06 Q07 Q10 Q11 Q12 Q14 Q27 Q15 Q24 Q26 Q28 Q02 Q20 Q22 Q21 Q16 Q17 Q19 Q03 Q18 Q25 Q01
5.11 NHS Ination 5.11.1 Could the Department give an explanation as to the level of funding set aside for ination in 200607? In particular, can it give the average pay awards to each (subjective) staV group and the ination assumptions for non pay including capital charges? (Q94) Answer 1. NHS funding will rise by 6.6 billion to 84.4 billion in 200607 from 77.8 billion in 200506, equivalent to 5.8% real terms growth. This funding will help the NHS to meet healthcare pressures reected in Local Delivery Plans. However, it is for health economies, including strategic health authorities in partnership with NHS Trusts, Primary Care Trusts and local authorities to determine how best to use their funds to meet national and local priorities for improving health and modernising services; to provide greater choice and better access for patients. The signicant additional resources available will aid them in this process. 2. In 200607, payment by results (PbR) covers elective, non-elective, outpatient and A&E activity for NHS Trusts. The national price tariV underpinning the system is adjusted annually for unavoidable cost pressures. The uplift is based on the same assumptions that underpin the revenue allocations to PCTs. The uplift includes: the expected impact on pay, including Agenda for Change and the consultant contract; increases in the cost of drugs and other technology, including increases arising from NICE appraisal and guidelines; price ination for goods and services; and, an overall 2.5% eYciency gain assumption. 3. For 200607, the total uplift for the national tariV is 4%. The components of this are shown in Table 94a. Table 94a NHS TARIFF UPLIFT 200607 200607 (over 200506 baseline) millions % Baseline Increase in pay and prices Pay Non-pay ination (prices) Clinical Negligence Costs Secondary care drugs Revenue cost of capital Gross pay and price increase EYciency at 2.5% in 200607 Net pay and price increase Reform and quality Consultant Contract NCCG reform Agenda for Change NICE appraisals and guidelines Investment in new capital Total reform and quality Information Technology NHS Connecting for Health Total information technology Technical adjustments Revaluation of NHS estate Total technical adjustments 49,806 1,028 253 141 287 218 1,927 "1,245 682 50 50 635 291 101 1,127 163 163 0 0 Overall 2.06 0.51 0.28 0.58 0.44 3.87 "2.50 1.37 0.10 0.10 1.27 0.58 0.20 2.26 0.33 0.33 0.0 0.0 4.0
Pay 4. Table 94b shows the settlements awarded to those staV whose pay arrangements are determined by the Review Bodies.
Prices 5. The GDP deator is used as a proxy for underlying non-pay ination in the NHS. This needs to be adjusted for assumptions about the level of procurement and other eYciency savings that the NHS is expected to make. Capital Charges 6. At national level, the cost of capital charges paid by the NHS is a circular ow of funds. The total of the capital charges estimates made by NHS Trusts forms part of the total cash resources available through PCT allocations. 7. Indices for land, buildings and equipment are produced for the Department each year by the Valuation OYce, in order that the NHS may calculate capital charges in advance of the nancial year. 8. The aggregate index used to uplift capital charges from 200304 to 200405 levels was 7.6%. Table 94b REVIEW BODY PAY SETTLEMENTS 2006 Group Nursing and Midwifery Allied Health Professionals Consultants Old Contract(1) Consultants New Contract(1) Juniors NCCGs FHS Doctors (GPs) Settlement % 2.50 2.50 1.00 1.00 2.20 2.40 2.20
Source: DDRB amd NOHPRB 2005 Footnotes: 1. Pay settlement staged, 1% from April 2006 increasing to 2.2% from November 2006. 5.11.2 Can the Department show trends in components of HCHS and FHS ination indices in each year since 199798 in as much detail as possible? (Q95) Answer HCHS pay and prices ination. 1. Trends in the Hospital and Community Health Service (HCHS) ination index is shown in Table 95a. The index is calculated by combining the indices for pay ination and price ination. Pay 2. Pay ination is calculated as a weighted average of increase in unit staV cost for each of the staV groups within the HCHS sector. Prices 3. HCHS price ination (ie the non-pay component) is measured by the Health Service Cost Index (HSCI). The HSCI weights together price increases for a broad range of items used by the health service for example, drugs, medical equipment, fuel, telephone chargesusing weights derived from expenditure on these various goods and services reported in nancial returns. Table 95a TRENDS IN COMPONENTS OF THE HCHS INFLATION INDEX
199798 % Total StaV Pay Review Body StaV Non-Review Body StaV Prices HCHS Total 2.5 2.2 3.5 0.4 1.7 199899 % 4.9 5.1 3.9 2.5 4.0 19992000 % 6.9 7.6 4.5 1.2 4.5 200001 % 7.2 7.5 5.8 "0.3 4.2 200102 % 8.3 9.4 6.0 0.1 5.1 200203 % 5.0 5.1 4.8 1.0 3.5 200304 200405 % % 7.3 8.3 4.1 1.5 5.2 4.5 3.7 7.4 1.0 3.4
Footnotes: 1. Prices and total HCHS ination for 200203 and 200304 have been updated following a validation exercise. 2. Pay ination for 200405 includes Foundation Trusts.
FHS Ination
4. The components of the Family Health Service (FHS) ination index are set out in Table 95b. For General Medical and Personal Medical Services (GMS/PMS) and General Dental and Personal Dental Services (GDS/PDS), service specic ination is calculated as the increase year on year in the average cost per practitioner. For both services, the changes in unit costs include volume and quality eVects (eg increase in practice staV numbers or the provision of a changing range of services) as well as pure price eVects. For the Pharmaceutical Service (PhS) and General Ophthalmic Service (GOS), service ination is assumed equal to movements in the GDP deator. 5. We are currently reviewing both indices and considering alternative data sources. Table 95b TRENDS IN COMPONENTS OF THE FHS INFLATION INDEX
199798 % GMS/PMS GDS/PDS PhS GOS FHS Total 5.1 0.3 2.8 2.8 3.0 199899 19992000 % % 2.3 4.6 2.9 2.9 3.0 10.4 1.0 2.3 2.3 4.1 200001 % 3.7 4.0 1.9 1.9 2.7 200102 % 1.0 2.8 2.5 2.5 2.1 200203 % 5.2 4.0 3.2 3.2 3.9 200304 200405 % % 9.7 1.8 2.6 2.6 4.6 n/a 2.5 2.7 2.7 n/a
Footnotes: 1. Due to increasing signicance of Personal Medical and Personal Dental Services, from 200102 onwards,the medical and dental indices have been calculated based on combined GMS and PMS expenditure, and GDS and PDS expenditure. Prior to this only GMS and GDS gures have been used. 2. The new GP contract was introduced from 1 April 2004, the new contract data is practice base and therefore not comparable with GMS/PMS data used for this index. As a consequence, no data is available for GMS/PMS for 200405. 3. The comparatively high GMS/PMS ination gure for 200203 and 200304 is due to a signicant increase in expenditure on PMS. 4. GDP deator as at June 2006 have been used for PhS and GOS in 200405. 5.11.3 What have trends in (a) the NHS ination index (b) sub-indices of the NHS ination index and (c) relative weights given to each sub-index been in each year since 199394? What assumptions underlie the construction of the index and any changes in weighting? (Q96) Answer 1. The trends in the NHS ination index and sub-indices are shown in Table 96a. 2. The NHS ination index is constructed using ve sub-indices. These are: HCHS pay index: This measures the change in average paybill per head of those employed within the HCHS; HCHS price ination: This measures the change in the price of goods and services supplied to the HCHS, it is measured by the Health Service Cost Index; HCHS Capital Ination Index: This reects the changes in prices experienced in HCHS capital projects and is calculated using a mixture of the construction price index and the GDP deator; FHS Index: This is produced using diVerent assumptions for each of the main groups. Details and changes are explained in question 94. From 200405 the FHS index is no longer available due to the introduction of the new GMS contract leading to a discontinuity in the GMS/PMS data series; and, The other Index: This comprises of the revenue and capital expenditure on Central Health Miscellaneous Services (CHMS) and Departmental Administration (including the Medicines Control Agency and NHS Estates). The GDP deator is used in the absence of service specic deators. 3. The discontinuity of the FHS index also aVects the construction of the NHS index. We are currently reviewing the methodology and exploring other data sources. 4. The weights attached to each of the elements for each of the years are shown in Table 96b. 5. The weights attached to each of the elements are similar in magnitude to last year; however, they have changed considerably since 200102. This is due to an increase in the number of PCTs from 164 to 304. PCTs have progressively taken over the commissioning of healthcare from health authorities but also the provision of some services from NHS trusts. The revenue expenditure for the provider function cannot be accurately eliminated from the total revenue expenditure hence year on year increases in total revenue expenditure are not comparable. 6. Change in weights (specically FHS and HCHS) from 200203 is due to a shift in responsibility of healthcare to PCTs.
Table 96a NHS INFLATION INDEXTRENDS Year 199293 199394 199495 199596 199697 199798 199899 19992000 200001 200102 200203 200304 200405 HCHS pay 100.0 104.2 107.7 112.5 116.2 119.1 124.9 133.5 143.1 155.0 162.8 174.7 182.6 HCHS prices 100.0 101.4 102.3 105.6 107.2 107.6 110.3 111.6 111.2 111.3 112.5 114.1 115.3 HCHS capital 100.0 103.4 112.9 118.0 119.7 124.7 128.5 132.1 139.7 148.8 155.4 149.5 154.6 Table 96b NHS INFLATION INDEXWEIGHTS Percentage Year 199293 199394 199495 199596 199697 199798 199899 19992000 200001 200102 200203 200304 200405 HCHS pay 49.0 49.0 49.0 49.0 50.0 47.0 47.0 46.0 46.0 47.0 48.0 45.0 47.0 HCHS prices 21.0 21.0 21.0 21.0 21.0 25.0 25.0 24.0 22.0 21.0 32.0 30.0 32.0 HCHS capital 6.0 5.0 6.0 5.0 4.0 3.0 3.0 3.0 4.0 4.0 4.0 4.0 4.0 FHS 21.0 22.0 22.0 22.0 23.0 23.0 22.0 24.0 26.0 26.0 14.0 18.0 14.0 Other 3.0 3.0 3.0 3.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 NHS total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 FHS 100.0 100.6 102.9 105.5 109.0 112.2 115.6 120.3 123.6 126.2 131.1 137.2 n/a Other 100.0 102.5 103.8 106.8 110.2 113.6 116.7 119.5 122.2 125.3 129.5 133.2 136.9 NHS total 100.0 102.7 105.4 109.3 112.4 114.8 119.3 124.8 130.1 136.2 141.1 147.9 n/a
5.12 EYciency 5.12.1 What progress has been made towards a replacement for the Cost Weighted Activity Index? What assessment has been made of recent trends in NHS productivity? (Q97) Answer 1. To measure progress against the 2002 spending review value for money PSA target, the Department developed an interim cost eYciency measure. The measure is calculated by comparing increases in NHS expenditure adjusted for both input cost ination and increases in expenditure on improving the quality of NHS services, with increases in NHS outputs as calculated by the new NHS output index. This latter index, replaced the Cost Weighted Activity Index (CWAI) and is calculated using data primarily published in the National Schedule of Reference Costs and using over 1,900 individual activity categories. The new NHS Outputs index represents an improvement over the old CWAI, as: CWAI only included 12 activity types and placed 60% of the expenditure weight on in-patients and a further 20% of the weight on outpatients which means; CWAI gave no credit for more complex case-mix; and By shifting activity to more cost eVective settings, such as from in-patients to outpatients, CWAI reduced recorded output (whilst still an issue with the new NHS Outputs index, its eVect is minimised).
In addition; CWAI had a secondary care focus and failed to include new types of NHS activity; and quality of care was not considered. 2. One of the principal recommendations of the Atkinson Review of the Measurement of Government Output and Productivity for the National Accounts was that quality of care should be included in NHS output and productivity measures. In response to the Atkinson Review, on 7 December 2005, the Department published Healthcare Output and Productivity: Accounting for Quality Change a technical paper which explains progress in developing more accurate methods of measuring healthcare output and productivity, including quality change. The paper builds on the key recommendations of the Atkinson Review, research by the University of York, National Institute of Economic and Social Research (NIESR), and by the Department. 3. On 27 February 2006, ONS published their second article on health productivity Public Service Productivity: Health. ONS estimate that including adjustments for quality, (originally outlined in Accounting for Quality Change) such as lower hospital mortality, estimated benets from hospital treatment, shorter waiting times, improved blood pressure control, lives saved from statins, in addition to the increasing value of health, NHS productivity has risen on average by up to 1.6% a year between 1999 and 2004. 5.12.2 What are the expected redundancy costs of the current re-organisation of Strategic Health Authorities and Primary Care Trusts? (Q98) Answer 1. There will be a number of redundancies in SHAs and PCTs following the restructuring brought about by Commissioning a Patient-Led NHS. 2. Redundancy costs are very heavily inuenced by the number and age prole of the staV leaving. The detail is not yet nalised, but assuming an average prole costs estimates would be somewhere around 325 million under existing NHS redundancy rules. 5.13 Managing the Department of Health 5.13.1 What was the total expenditure, grant-in-aid funding and whole time equivalent staYng of each of the Department of Healths Arms Length Bodies in 200506? (Q99) Answer The information requested is given in Table 99. Table 99 GRANT IN AID, EXPENDITURE AND STAFFING OF ARMS LENGTH BODIES IN 200506
Department of Health Arms Length Body Healthcare Commission (HC) Mental Health Act Commission (MHAC) Commission for Social Care Inspection (CSCI) Independent Regulator of NHS Foundation Trusts (Monitor) Commission for Patient and Public Involvement in Health (CPPIH) Human Fertilisation and Embryology Authority (HFEA) Human tissue Authority (HTA) Council for Healthcare Regulatory Excellence (CHRE) General Social Care Council (GSCC) Postgraduate Medical Education and Training Board (PMETB) Grant in Aid (see note 7) thousands 68,851 5,310 82,864 16,200 31,515 5,489 1,224 2,232 10,675 3,229 Gross Operating Costs (see note 8) thousands 76,879 5,665 141,153 15,869 30,458 10,933 1,201 2,399 13,293 5,145 Headcount WTE 780 42 2,479 49 173 190 18 116 237 15 Information Source
Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Provisional gures given by DoF John Tuck
Department of Health Arms Length Body Dental Vocational Training Authority (DVTA) Medicines and Healthcare products Regulatory Agency (MHRA) National Institute for Clinical Excellence (NICE) National Patient Safety Agency (NPSA) Health Protection Agency (HPA) National Biological Standards Board (NBSB) National Treatment Agency (NTA) National Blood & Transplant (NHS BT) NHS Litigation Authority (NHS LA) Health and Social Care Information Centre (HSC IC) NHS Connecting for Health (NHS CfH) (12) NHS Institute for Innovation and Improvement (NIII) NHS Appointments Commission (NHSAC) NHS BSA Prescription Pricing Authority (PPA) Dental Practice Board (DPB) NHS Pensions Agency (NHSPA) NHS Counter Fraud and Security Management Service (NHS CFSMS) NHS Purchasing and Supply Agency (NHS PASA) NHS Logistics NHS Direct (NHS D) NHS Professionals (NHS P) NHS Estates (NHS E) Total Source: As stated in table.
Grant in Aid (see note 7) thousands 272 63,000 27,031 32,935 142,655 10,807 12,187 37,728 0 43,843 0 37,970 4,156 432 74,054 23,811 27,595 16,474
Gross Operating Costs (see note 8) thousands 222 70,000 26,178 33,264 227,296 17,425 12,219 402,830 13,022 44,316 538,321 42,478 5,420 477 73,749 27,104 27,249 17,719
Headcount WTE 3 819 185 304 3,012 302 137 5,986 167 358 1,412 701 57 3 2,849 250 391 268
Information Source
Fig from 200506 Annual Accounts Provisional gures given by MHRA Brian Pocknall Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from the Draft 200506 Annual Accounts Fig from Connecting for Health data Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts Fig from 200506 Annual Accounts
25,843 0 7,296 43,927 2,288 861,893
26,497 72,100 149,136 32,950 6,323 2,169,290
350 1,474 3,154 649 207 27,033
Footnotes: 1. The Human Tissue Authority came into being on 1 April 2005 and hence is a new ALB this year. 2. Health Development Agency merged with the National Institute for Clinical Excellence on 1 April 2005 and hence is not on this years list. 3. National Clinical Assessment Authority merged with the National Patient Safety Agency on 1 April 2005 and hence is not on this years list. 4. NHS Modernisation Agency (NHSMA) and NHSU merged to form the NHS Institute for Innovation and Improvement (NIII). 5. National Blood Authority and UK Transplant Merged mid year to form NHS Blood and Transplant and are shown as the new body. The Income and Expenditure shown above is comprised of the sixmonths to 30 September 2005 of NBA and UKT and six months to 31 March 2006 of NHS BT. 6. NHS BSA has run in shadow form in 200506 and whilst not part of the ALB sector until it goes live in 200607 is included here for completeness. 7. NHS Information Service dissolved. The Health and Social Care Information Centre and NHS connecting for Health (NHS CfH) were created to move IT inthe Health sector forward. 8. NHS Estates (NHSE) was dissolved mid year, gures shown to closure at 30 September 2006.
9. Grant in Aid refers to Revenue only. 10. Gross operating costs exclude: Depreciation and Amortisation. Capital Charges. Prot/Loss on Disposal of Fixed Assets. Impairments. 11. The gures for Connecting for Health (CfH) comprise those for the whole agency, as it is not possible to provide a breakdown for that element of their organisation that was previously part of the NHS Information Authority. As part of the Department of Health, CfH receives an allocation of DH funds rather than Grant in Aid. The gure given in the Gross Operating Costs column is the near-cash spend of CfH for 200506, which excludes the non-cash items listed in note 10. The gure of 1,412 represents CfH headcount not WTEs.
5.13.2 Could the Department detail and comment on the extent of savings from its own change programme and the review of Arms Length Bodies? What further savings are anticipated in 200607 and 200708? What risk assessment has been undertaken to accompany these change programmes and to indicate the limits to further savings? What have the redundancy and relocation costs of these change programmes been? (Q100) Answer 1. The Change Programme was undertaken to support the transformation of the whole NHS and social care system. The predominant aim was to have a smaller strategic Department with operational responsibility devolved throughout the health and social care system. There was no specic nancial target set as part of the DH Change Programme. However, the administration costs agreed in the 2004 Spending Review reected the reduction in size and shape of the Department as a consequence of the Change Programme. 2. From the review of arms length bodies (ALBS), 55 million recurrent cash releasing savings were achieved in 200506 and a further 95 million is expected in 200607 and 50 million in each of the following two years. 3. The Departments Change Programme was managed as a project, and operational risksfor example, the risk of failing to complete the necessary human resources work to the planned timetablewere managed using project management principles. The risk assessments for these were reviewed by the Programme Board regularly. in addition, the Change Programme presented a variety of strategic risks to the Departments business, for example the possibility of a sustained decline in morale, or that the balance of skills in the Departments staV might not match the needs of the continuing business. These were not subject to formal risk assessments in the same way, but were reviewed by senior managers and the Departmental Board during the course of the programme. 4. The limits to further savings are also subject to continuing review, in the light of changes to the Departments workload. Savings in future years will be settled as part of the Comprehensive Spending Review. 5. ALBs capability to deliver these savings has been assessed in an extensive business planning cycle for each body covering this year and the next two. In addition, delivery will be monitored using the Departments standard performance management procedures for its ALBs including quarterly balanced scorecards and review meetings with the bodies themselves. 6. Transition costs for relocation and redundancies as a result of the ALB review were 10 million in 200506 and are expected to be around 13 million in 200607. 5.13.3 Could the Department detail (a) administrative and (b) programme expenditure on consultants in 200506? Could the Department comment on these data and the quality of them? (Q101) Answer 1. DH expenditure on consultancy services for 200506 is given in Table 101. 2. We have previously been unable to report spending against our programme budgets due to denitional diYculties. For example, the term consultancy is very broad and not well dened; this has led to a number of nancial transactions being scored inappropriately. 3. To assist in the re-coding of data and for the purpose of interpretative analysis, we have now dened consultancy where all of the following criteria are met: an arrangement where an individual or organisation is engaged to provide expert analysis and advice which facilitates decision making; to perform a specic one oV task or set of tasks; and, to perform a task involving skills or perspectives which would not normally be found within the Department. 4. We have undertaken considerable work to validate the 200506 programme and administrative data, and this has enabled us to provide a much more accurate gure for consultancy expenditure.
Table 101 DH EXPENDITURE ON CONSULTANCY SERVICES, 200506 millions Administrative expenditure Programme expenditure Total 6. Departmental Report 6.1 Public Service Agreement (PSA) Targets 6.1.1 SR 2004, target 1. The department has not reported on the latest life expectancy gures. What are the current life expectancy gures for newborns? (Q102) Answer 1. The latest published data relate to the three-year period 200204. In England in 200204, the period of life expectancy at birth was as follows: Male76.6 years; and Female80.9 years. 2. These have risen from a baseline of 75.0 years for males and 79.9 years for females in 199799. 3. The SR 2004 target 1 is to reach a period life expectancy of 78.6 years for males and 82.5 years for females, by 200911 (the 3-year average centred around 2010). 4. The next data update, to incorporate gures for 2005, is due for publication in late November 2006. 5. Period life expectancy for a given area and time period is calculated using age specic mortality rates for that area and time period and makes no allowance for changes in mortality rates in future years. 6. Period life expectancy at birth gures for England are available calculated by the Government Actuarys Department from data for single calendar years and also calculated using data averaged over a period of three consecutive years. The latter has the eVect of smoothing year-by-year variations. 6.1.2 SR 2004, target 2. Why has the gap in infant mortality between routine and manual and other groups widened? Why has the relative gap in life expectancy at birth increased, and why has the gap for females widened so much more than for males (by 8% and 1% respectively)? (Q103) Answer 1. We know that health inequalities are persistent, stubborn and diYcult to change. We have been very open about the high degree of challenge the target represents. The drivers of infant mortality and low life expectancy are complex and there is no simple answer to the question of why gap continues to widen. 2. The Status Report on the Programme for Action (2005) showed that the infant mortality gap between routine and manual groups and the whole population widened from 13% in 199799, to 16% in 200002, and 19% in 200103, in line with the previously reported trend. However, the latest data for 200204 show no further widening in the gapit remains at 19%. The infant mortality rate has fallen for all social groups since 199799, the baseline period for the target. It stands at a historic low4.9 deaths per 1,000 live births for the population as a whole and 5.9 per 1,000 live births for routine and manual groups. It has fallen faster in higher social groups than in routine and manual groups resulting in a widening of the relative health inequalities gap. 3. An internal review of the infant mortality aspect of the target is in hand to actively address the widening gap identied in the Status Report. Its aim is to improve local delivery of the target by focusing action in areas with the highest incidence of infant mortality in routine and manual groups, and on interventions most likely to be eVective in reducing the rate among these groups. 4. It should be noted that there is a time lag between the implementation of new policy initiatives and achievement as reected in the data. Infant mortality rates are published annuallycurrently the latest data available are for 2004. 5. Life expectancy is improving across England for both men and women, but it is currently improving more slowly in the Spearhead Group of areas with the worst health and deprivation and the relative gap in life expectancy continues to widen. 6. The Status Report identied a range of indicators, many of which continue to show no narrowing of the gap. However, there are some signs of progress, for example on child poverty and housing. We have already seen reductions in Cancer and Cardiovascular (CVD) inequalities, with a 9.4% reduction in the absolute cancer inequality gap and a 24.7% reduction in the absolute CVD inequality gap. 6.0 127.0 133.0
7. It is expected that changes in the long established gap in life expectancy across geographical areas will take time to halt and reverse, and there are diVerent lead times (the gap between change in exposure to risk and change in disease rate) for diVerent diseases, some of which are very lengthy. 8. Reversing the widening trend in the inequalities gap will need sustained commitment at national and local level. The Status Report shows how far we have to go and signals where action is needed. 9. Initial work to partition the change in the inequality gap by age group and disease category shows that although changes in mortality for females in the ages of ve to 74 have worked to reduce the gap, deaths in the under one years and deaths in the 75 and over age group have actually widened the overall gap. 10. In terms of the major diseases which are causing the widening for women, although action on CVD is narrowing the gap in inequalities, cancer and a range of all other causes are widening the gap.
6.1.3 SR 2004, target 2. What action has the Health Inequalities Unit identied as necessary to improve the Departments ability to hit the life expectancy target? (Q104) Answer 1. At the end of 2005, a review of the Health Inequalities Life Expectancy Target, commissioned by DH and Treasury, identied the following key actions to deliver the target: Improving our understanding of the key interventions which will impact on life expectancy in Spearhead areas by 2010. The main diseases, which are leading to shorter lives in Spearhead areas, are cardiovascular diseases and respiratory diseases. Fast gains in life expectancy can be made by reducing the prevalence of smoking, eVective control of blood pressure and cholesterol and good care of people with long-term conditions. Improving performance management. We have made health inequalities a Top 6 priority for the NHS and a mandatory target within Local Area Agreements, with the aim of seeing faster improvements in Spearhead areas compared to the England average. We need to ensure that inequalities is addressed through Local Delivery Plans and the new commissioning agenda. Communication and engagement. An essential part of this will be spreading best practice across the Spearhead areas and providing support for areas that are struggling. We know, for example, that some Spearhead areas have the best smoking cessation services and highest rates of quitters, others are well below average. People in Spearhead areas have high needs and need the best quality services. That will be the challenge for the new SHAs and PCTs. 2. We also need better mechanisms to engage with people living in deprived communities as, in general, the aspirations and expectations they have about health and life expectancy are lower than elsewhere. 6.1.4 CSR 1998, targets 3 and 4. Both these targets show slippage. Why has this happened and what action is being taken to address it? (Q105) Answer 1. The most recent position, based on the latest available data and analysis by the Department of Health, is provided in the Table 105a to Table 105d. 2. Latest data for 200204 (three-year average) for CSR 1998 target 3 (reduction in the death rate from accidents) show an increase of 1% from the baseline (199597). 3. On the basis of one years extra data we would not expect to see much change on the position reported last year, especially as the monitoring data for target 3 are three-year average rates and there are two overlapping years of data between the latest three-year average and the gures reported last year (the average of 2002, 2003, 2004 compared with the average of 2001, 2002, and 2003). Based on data to 200204, the 65 and over group continues to account for the main part of the increase in the death rate from accidents. Falls account for the main part of the increase in the death rate from accidents in those over 65. 4. Latest data for nancial year 200304 for CSR 1998 target 4 (reduction in the rate of hospital admission for serious accidental injury) show an increase of 4.5% from the baseline (199596), again based on one years extra data from that reported last year. As before, the 65 and over group accounts for the main part of the increase in the admission rate. Falls account for nearly three-quarters of admissions for serious accidental injury in the 65 and over group, and are a key factor in the increase in the admission rate. 5. The latest data available for CSR 1998 targets 3 and 4 pre-dates a key milestone of the National Service Framework for Older People for all local health and social care systems to establish an integrated falls service by April 2005. Falls services may help address the current slippage against CSR 1998 targets 3 and 4 once these become fully established and integrated. 6. Despite the slippage in the 65 and over age range, the latest data show a continuing reduction in accident death rates in age bands under 15 and 1524 years. Serious accidental injury rates among children are also continuing to decrease. This is associated with work being taken across Government to prevent, for example, land transport accidents, re deaths and falls from height in the construction industry.
Table 105a
DEATH RATES FROM ACCIDENTSPROGRESS BY SELECTED AGE GROUPS Death rate from accidents per 100,000 population)(1)(3) Age group Under 15 15 to 24 25 to 64 65 and over 199597 200103 200204 4.1 17.8 13 50.1 3 15.3 13.1 56.6 2.9 15.2 12.9 57.6 % change 199597 to 200204(2) "29% "15% "1% 15%
Source: OYce for National Statistics Footnotes: 1. Death rates are directly age-standardised rates for all persons, England. 2. A % change less than 0 is a reduction, greater than 0 is an increase. 3. 199597 data coded used ICD9 (codes E800-E928 exc. E870E879 used for accidents); 200103 and 200204 data coded using ICD10 (codes V01-X59 used for accidents). Due to the change from ICD9 to ICD10 there are small discontinuities in the comparison between the periods.
Table 105b
DEATH RATES FROM ACCIDENTS AMONG 65 AND OVER CONTRIBUTION OF SELECTED ACCIDENT CATEGORIES (Death rate from accidents per 100,000 population)(1)(4) Accident category 199597 200103 200204 % change for ages 65 and over 199597 to 200204(2)(3)(5) "2% 12% 0% "1% "1% 8%
Land transport Falls Drowning and submersion Smoke, re and ames Poisoning Other and unspecied incidents Source: OYce for National Statistics.
7.8 14.1 0.4 2.3 1.1 24.3
7.0 19.0 0.4 1.6 0.9 27.7
6.6 20.0 0.4 1.6 0.8 28.1
Footnotes: 1. Death rates are directly age-standardised rates for all persons, England. 2. The contributions from each accident category are the impact of each category on the % change for all accidents (not the % change in the death rate for each category). 3. A contribution to % change less than 0 is a reduction, greater than 0 is an increase. 4. 199597 data coded used ICD9 (codes E800-E928 exc E870-E879 used for accidents); 200103 and 200204 data coded using ICD10 (codes V01-X59 used for accidents). Due to the change from ICD9 to ICD10 there are small discontinuities in the comparison between the periods. 5. The contributions from each category sum to the % change for all accidents for ages 65 and over.
Table 105c ADMISSION RATES FOR SERIOUS ACCIDENTAL INJURY PROGRESS BY SELECTED AGE GROUPS (Admission rate for serious accidental injury per 100,000 population)(1) Age group Under 15 5 to 14 15 to 64 65 and over 199596(3) 131.7 120.8 221.2 1,280.2 200203 97.2 84.1 223.3 1,442.5 200304 90.2 77.8 226.1 1,459.4 % change 199596 to 200304(2) "31% "36% 2% 14%
Source: Data based from Hospital Episode Statistics (ICD10 codes Vo1-X59, Y40-Y84 used for all accidents). Footnotes: 1. Admission rates are directly age-standardised rates for all persons, England. 2. A % change less than 0 is a reduction, greater than 0 is an increase. 3. Figures for 199596 are estimates based on trend for subsequent years (due to data quality problems for some areas in 199596). Table 105d ADMISSION RATES FOR SERIOUS ACCIDENTAL INJURY AMONG AGES 65 AND OVER CONTRIBUTION OF SELECTED ACCIDENT CATEGORIES (Death rate from accidents per 100,000 population)(1) Accident category Land transport Falls Drowning and submersion Smoke, re and ames Poisoning Other and unspecied incidents 199697 52.7 941.9 0.1 4.3 9.7 300.4 200304 48.4 1,057.7 0.2 2.3 9.6 341.2 % change for ages 65 and over(2)(3) "0.3% 8.8% 0.0% "0.2% 0.0% 3.1%
Source: Data based from Hospital Episode Statistics (ICD10 codes Vo1-X59, Y40-Y84 used for all accidents). Footnotes: 1. Admission rates are directly age-standardised rates for all persons, England. 2. The contributins from each accident category are the impact of each category on the % change for all accidents (not the % change in the admission rate for each category). 3. A contribution to % change less than 0 is a reduction, greater than 0 is an increase. 4. Comparison is with 199697 rather than 199596 due to data quality problems for some areas in 199596. 6.2 Capital Investment 6.2.1 A number of changes have been made to the commissioning of PFI projects. In particular, SHAs have been asked to work with Trusts and PCTs to reaYrm their capital investment plans in light of movement of services into community settings, and the introduction of Payment by Results. Furthermore, trusts with signicant decits have been prevented from proceeding to market with large capital projects without plans to deal with the decits before nancial close. How many capital projects, and to what value, have been delayed or cancelled by PCTs and Trusts as a result of these reviews since April 2005? (Q106) Answer 1. Since the announcement of the PFI revalidation process on 26 January the PFI schemes at the following trusts have all had reviews completed by the Department (the capital value of each scheme is given in brackets after the name of the trust): Walsall Hospitals NHS Trust (142 million). Salford Royal Hospitals NHS Trust (112 million). South Devon Healthcare NHS Trust (163 million.) Tameside and Glossop (68 million).
University Hospitals Leicester (711 million). University Hospital of North StaVordshire (272 million). 2. On 18 August 2006, it was announced that these schemes had been reviewed and would be allowed to proceed to the next stage of the approvals process. 3. In addition, two other Trusts had schemes that were very close to nancial close when the revalidation process was announced: Barts and The London NHS Trust (1 billion). St. Helens and Knowsley NHS Trust (338 million). University Hospital Birmingham NHS Trust (627 million). 4. These schemes had their key assumptions tested by the main principles of the review process in March and April 2006, but were not subject to a formal review. 5. A consideration of the nancial health of the trust and the local health economy has been a key element of the review process. One of the conditions under which approval was given to the six schemes announced on 18 August was that before contracts could be signed trusts will need to be in good nancial health, delivering at least run-rate balance (which means month on month balance where a trust has an underlying decit) prior to the date of signature. 6. The review process concerns only those schemes with a capital value greater than 75 million (Tameside and Glossop NHS Trust had its scheme reviewed because it was batched with the scheme at Salford Royal Hospitals NHS Trust). The purpose of the process is to ensure that all schemes properly take account of the current reforms to the NHS such as choice, a movement of services into primary and community settings and the new nancial regime. The reviews ensure that only schemes that have clearly demonstrated their long-term aVordability and sustainability are allowed to proceed. 7. The reviews have not resulted in delay to any schemes since they focus on aspects that would usually have been considered as part of the approval of nal business cases. 8. One scheme, at Essex Rivers NHS Trust (185 million), has been cancelled as a result of the review process. This was announced by the Trust itself on 14 June. 9. A further 27 schemes are still to be reviewed. We intend to announce the outcomes of these reviews in due course. 6.2.2 A May 2006 BMA survey concluded that three quarters of GP practices felt their premises were not suitable for their future needs and six in every 10n practices worked from premises unsuitable for their current needs. The Association called for a sustained and consistent government commitment to recurrent revenue to back up capital investments. What is the Departments assessment of the suitability of those GP surgeries which have not beneted from LIFT funding for meeting current and future needs? What plans, if any, does the Department have to increase funding to support capital investment in primary care outside LIFT schemes? (Q107) Answer 1. The Department holds no recent comprehensive survey data on the circa 9,000 GP premises in England. It is expected that PCTs should be aware of the condition of the GP premises in their areas and the priorities for capital investment. 2. It should be pointed out that the BMAs survey was far from comprehensive, covering just 3% of GP premises, and its conclusions are surprising, given that between publication of the NHS plan in July 2000 and the end of 2004 approaching 3,000 premises were replaced or substantially refurbished. 3. Most of these premises improvements were achieved without NHS LIFT, but now that NHS LIFT is very much on stream it is delivering on average one new building per week during 2006 with 80 facilities open to date. The PCTs where LIFT companies are established cover more than half of the countrys population. 4. We are nevertheless aware that much remains to be done and this year we have allocated over 2 billion in operational and strategic capital to the NHS to address local investment priorities, including the condition of primary care estate that isnt covered by LIFT schemes. These capital allocations represent on average 19% growth compared to 200506s allocations. 6.2.3 The Department has not allocated 1 billion (19%) of its capital budget as there may be additional costs arising from accelerated Foundation Trust capital expenditure and implementation of the White Paper. Given that Monitor would be expected to hold data on Foundation Trusts planned capital expenditure, why is the Department unable to forecast this more accurately? Has the Department nalised its use of the unallocated budget yet, and if so, how will it be applied? (Q108)
Answer 1. A potential acceleration of Foundation Trusts capital expenditure was just one of the factors, which, at the time of producing the Departmental Report and the slightly earlier main estimate for Parliament, might have given rise to a signicant increase in recorded capital expenditure. Two other major issues were: Connecting for Health, where a review of capitalisation policies was under consideration, which might have increased the proportion of the planned expenditure to be capitalised; and, The White Paper Community Hospitals programme, which had not at the time been fully dened and costed. 2. It was because of all three factors, that we considered it reasonable to regard the 1,009 million that at the time had not been earmarked for other uses as a necessary contingency, of which 500 million had already been agreed with the Treasury as Departmental Unallocated Provision (DUP) ie only to be drawn when need could be demonstrated. 3. Forecasting NHS capital expenditure has always been problematic whatever basis is used. We chose to use the same basis for our initial forecasting of Foundation Trusts capital expenditure as we used for NHS Trusts, which was to aggregate a pro-rata (based on Turnover) share of each investment programme aimed at the Trust sector. At the time, DH Finance was not in possession of a recent forecast from Monitor of 200607 Foundation Trust capital expenditure to use as an alternative scenario, to inform our assumptions about capital spend. 4. Now that the year is underway and we are in the process of agreeing Public Dividend Capital Allocations for Foundation Trusts, we will have a bottom-up, project-based estimate for Foundation Trust capital expenditure to inform our Spring Supply estimates for Parliament and we will undertake a further check using Monitors forecast of capital spend. 5. We will continue to consider further uses for DHs unspent capital until Spring Supply though we do not expect further large allocations to be made. The capital commitments as at 14 August 2006 are shown in Table 108. This shows an under-commitment including the DUP agreed with Treasury of 733 million. Table 108 APPLICATION OF CAPITAL RESOURCES AS AT 27 JULY COMPARED TO APPLICATIONS IN APRILS 2006 DEPARTMENTAL REPORT
millions Disposition of resources agreed at time of February 2006 main estimates & DR2006 Total capital resource for Investment in Health Less: PFI Investment Gross Public Capital available for investment in DH and NHS Less: Capital funding for Department of Health operations Capital grants to independent sector parties Costs from the management and disposal of the retained estate: NHS Trust Receipts from asset sales (normally re-invested locally) CFH central capital spend Other central capital spend, including Capital Funding for ALBs and funds for innovations in capital procurement HCHS capital available for allocation to NHS Organisations: To be allocated as follows: Direct allocations to Strategic Health Authorities, NHS Trusts and Primary Care Trusts SHA Stategic Capital Trust and PCT Operational Capital Total Direct Allocations for local prioritisation Programme Capital Budgets and un-committed funds Unspent Programme Capital b/f from 200506 PACS & other local implementation of CfH Community Hospitals Choose & Book Incentives 6,543 "1,111 5,432 18 66 10 120 1,000 144 "1,358 4,074 16 66 0 120 920 201 "1,323 4,109 Disposition of resources agreed at 27 July 2006 Finance & Investment Sub-Committee of DH Board 6,543 "1,111 5,432
941 1,100 2,041
941 1,101 2,041 23 207 20 55
124 20 55
millions Disposition of resources agreed at time of February 2006 main estimates & DR2006 Resource cover and enabling for IS procurements Coronary Heart Disease CAMHS Specialist Services and other Childrens investements Drugs Misuse DSPD Mental health place of safety and PICU development High Secure Facilities Older people, including funds for Audiology and improving environments in care-homes and hospices Dental School expansion Medical school places & radiology Academies Improving provision of decontamination services in the NHS Public capital elements of major PFI schemes and other investments in physical capacity Estimated capital expenditure by rst 32 FTs Dentistry - funding for premises improvements Emergency Care (ambulance performance incentives) Learning Dissability transferring service users from NHS to tenented accommodation in line with policy Funding to improve environments in care homes and hospices Emergency preparedness Various small pilot schemes CancerRadiotherapy training Contingency (including 500 million DUP) 114 40 37 38 20 65 23 26 20 18 43 15 365 Disposition of resources agreed at 27 July 2006 Finance & Investment Sub-Committee of DH Board 114 40 50 38 20 65 23 30 20 7 43 109 326 40 25 25 50 2 1 2 733 2,033 2,068
1,009
6.2.4 In its submission to the Committees inquiry into NHS Decits, the Department identied that there was slippage in capital expenditure of 1,162 million in 200506, compared with 547 million in 200405. What steps has the Department taken to speed up the delivery of capital projects? Based on the most recent data from NHS bodies, what is the expected underspend at the end of 200607? (Q109) Answer 1. As stated in the report on 200506s nancial performance that was published on 7 June alongside the Chief Executives Report, rather than being due exclusively due to the NHS lacking the capacity to deliver capital projects, the NHS 1,162 million underspend was due to range of factors, including deliberate slippage to free up cash to nance revenue overspends. 2. Furthermore, capital investment is not a free good and gives rise to revenue capital charges. As a consequence, it may be one of the rst things to be postponed in organisations that have decits to tackle. It is therefore improved revenue performance and the measures that are being put in place to achieve this (eg introducing turnaround teams at Trusts with large decits) which will have the greatest impact in increasing the rate of capital investment in the NHS. 3. At Month 3, the NHS was forecasting a capital underspend of 416 million against the capital earmarked for it in 200607. Although the outturn may end up being higher than this, it does look as though there will be a lower capital underspend than in 200506. 6.3 Reforms to the Management of the NHS 6.3.1 A review by the Kings Fund, Assessing the New NHS Consultant Contract, has identied signicant variation in the implementation of the consultant contract. For example, (i) 7am to 7pm working days have been classied as two PAs by some trusts and three PAs by others; (ii) there are disparities in the classication of emergency work between Bands; and, (iii) there are diVering ceilings on the number of PAs a consultant can be contracted for in a week. Why has there been such variation in the implementation of the consultant contract? (Q110) Answer 1. With the exception of work done in premium time (7 pm to 7 am in the week and work done at weekends), a programmed activity has a timetable value of four hours. Therefore, a normal 12-hour working day cannot be covered by two programmed activities. We understand the report is referring to one trust in London. We have no reason to believe variations such as this are widespread.
2. A Practical Guide to Calculating On-Call Work was issued in March 2004 and a Guide to Determining On-Call Availability Supplements was issued in August 2004. 3. This depends on what is agreed at job plan reviews with individuals. Consultants may choose to contract with their employer for additional programmed activities; indeed, it is a requirement of the contract that they oVer their employer rst call on an additional programmed activity before they undertake any private work. 4. The 2003 contract was neither implemented at a uniform rate or in exactly the same way in each and every NHS organisation. Those organisations with a large number of consultants or more complex multi site structures or less well developed HR or medical management structures or less relaxed working relationships understandably took longer than others. In some organisations job planning was already well established whilst others were undertaking this activity, in any meaningful or robust sense, for the rst time.
6.3.2 The same review also identied that the rst round of job planning has been largely a retrospective mapping exercise of how consultants spend their time, rather than a prospective exercise intended to enable Trusts to meet their aims better. What specic steps is the Department taking to ensure that Trusts take a prospective approach to job planning, and what evidence is there that progress is being made? What process would a Trust have to go through to alter the terms of those contracts made under the new arrangements which it already holds with its consultants? (Q111) Answer 1. The Consultant Contract Implementation Team produced a number of guidance documents including Consultant Job Planning: Standards of Best Practice, January 2004, and the Consultant Job Planning Toolkit, January 2005. The Toolkit included a section on eVective job planning; a training package; a reference manual; and an evaluation framework. It was jointly launched with the BMA at a national conference and this was followed by roadshows and training days around the countryall SHAs and Trusts were given the chance to attend these. The Toolkit is available on line and includes a training package which trusts can use locally. 2. The Consultant Contract Benets Realisation Team (CCBRT) worked for SHAs from March 2005 to 31 May 2006 to collect and share examples of good practice in producing jobs plans across the NHS. Their report has been delivered to the oYce of the SHAs. We understand that it suggests that Trusts are becoming more proactive in their attitude towards job planning. 3. Job plans agreed under the contract should be kept under regular review and renewed annually through negotiation between individual consultants and their employers. A survey carried out in October 2005 by the Health and Social Care Information Centre for the Department of Health showed that the number of programmed activities per week per consultant had fallen slightly from a similar survey carried out by the Department of Health in October 2004. The PAs had fallen from an average of 11.17 in October 2004 to 10.83 in October 2005. 4. The process for trusts to alter the terms of a consultants contract lies in the Job Plan review. The Job Plan sets out all of a consultants NHS duties and responsibilities and the service to be provided for which the consultant is accountable. As well as listing the NHS duties of the consultant, the Job Plan also lists the number of programmed activities for which s/he is contracted and paid, his/her objectives and agreed supporting resources. 5. It is a requirement of the contract that the Job Plan is reviewed annually, and this may result in a revised prospective Job Plan. However, the consultant and manager may conduct interim reviews and agree changes (if necessary) where duties, responsibilities, accountability arrangements or objectives have changed or need to change signicantly within the year.
6.3.3 There is evidence that a number of consultants in London are working beyond the number of PAs they are contracted for eg the Royal College of Physicians reported that the average consultant physician is working for 14.9 PAs per week compared to the average consultant contract of 11.1 PAs. How has the Department assessed the real working hours of consultants beyond their contracted hours and what implications do you see for service quality and morale? (Q112) Answer 1. Consultants enjoy a high level of independence and professional autonomy and may through personal choice and preference work additional hours in any given period whilst reducing their hours at other times. Furthermore, the additional contribution may be of their own choosing and not at the direction of the employer. 2. Also, it was never expected that excess working hours for any or all would be eradicated overnight the contract is a way of bringing hours under control by agreement.
3. The most eVective way of narrowing any gap is in eVective management and skilful job planning, especially objective setting. A survey in October 2005 carried out by the Health and Social Care Information Centre for the Department of Health showed that the average number of PAs per consultant had fallen from 11.17 in 2004 to 10.83 in 2005. 4. The Healthcare Commissions staV survey, conducted in October 2005, found that the staV were generally satised with their jobs with evidence of sustained improvement in key areas such as training, learning and development, access to exible working, support staV with dependents and staV safety work. This is despite the challenging times faced by the NHS. All 570 NHS trusts and 25 Strategic Health Authorities in England took part in the survey. A total of 209,124 NHS employees responded, which 58% of those staV who were invited to take part in th survey. The occupational group distribution of respondents to the survey was broadly similar to that of the NHS workforce in England as a whole. 5. Consultants are paid for the work they agree in their job plan. Consultants may through personal choice and preference work additional hours in any given period whilst reducing their hours at other times. Furthermore, the additional contribution may be of their own choosing and not at the direction of the NHS employer. If the job plan is for more than 11 PAs then the NHS Trust should challenge and address this through its approach to job planning. 6.3.4 Based on the unaudited accounts, please explain how much PCTs expenditure on GMS in 200506 is expected to have been compared to the allocation made? (Q113) Answer The information requested is given in Table 113. Table 113 200506 NGMS ALLOCATION AND GIG ENVELOPE AGAINST Q4 INTERIM YEAR-END SPEND millions 200506 provisional gure based on un-audited accounts) 1,993 2,023 1,098 649 182 413 68 346 45 873 7,691
Total Allocation GMS (Global Sum and MPIG) PMS Contracts Quality Outcome Framework (QOF) Enhanced Services PCO Admin (discretionary payments) Premises (including actual/notional rents and improvement grants) Information Technology Out of hours Other Dispensing Total 1,941 2,254 927 676 94 452 65 105 65 917 7,495
Variance (under)/over 51 "231 171 "26 88 "38 4 242 "20 "44 196
Source: Quarter 4 FIMS (FHS)4 200506 aunaudited returns from 303 PCTs, England. 6.3.5 Where PCTs have made available additional resources to support the GP contract, how have these additional resources been nanced? Please provide specic details. (Q114) Answer 1. The new contracts were backed by a guaranteed 36% increase in resources in England, rising from 5 billion in 200203 to 6.8 billion in 200506. Such increases for primary care are unprecedented and a measure of the Governments commitment to improved care for all. 2. Evidence from PCT expenditure forecasts show that PCTs have made available additional resources to secure the range of services and improvements in care to meet national and local priorities. The overall increase in resources is now forecast to be nearly 50% for the three-year period (equating to spend on primary medical care services of around 7.5 billion in 2005062). 3. The increased investment is directly benetting the vast majority of patients who are experiencing improvements not only in the range of services available locally but also improvements in the quality of clinical services they receive.
2
Forecast outturnstill subject to nal validation.
4. We identied for 200405 that PCTs had to manage a nancial pressure of 150 million. Current 200506 forecasts identify there is likely to be a similar nancial pressure that PCTs will be managing overspends of 150 million to 200 million, however, nal gures will not be available until late autumn to conrm in the context of up to a 7 billion allocation as a consequence of resourcing the contracts. 5. This is a consequence of continued overspend on allocation primarily from: high achievement in the Quality and Outcomes Framework; increased spend on out-of-hours; but oVset by further eYciency savings in PMS contracts. 6. High levels of achievement in the Quality and Outcomes Framework are to be congratulated. It shows we have a system in place that motivates general practice to provide high quality evidence based clinical care. This benets the vast majority of patients and improves health prevention in ten of the most common longterm illnesses as well as impacting on the wider NHS, for example, fewer avoidable hospital admissions due to better chronic disease management. 7. Increased spending on out-of-hours shows that PCTs are maximising use of their unied budgets in order to establish integrated networks of unscheduled care provision so that when patients contact out-ofhours services they can be assured that their clinical needs will be consistently met through fast and convenient access to care, delivered by the most appropriate professional in the most appropriate place. 8. Revisions to the GMS contract negotiated by NHS Employers ensure the contract will continue to: deliver better services for patientsthrough investment in new services including incentives for improved access and choice; be fair to the professionin view of the substantial investments made over the last three years, practices can maintain their prot levels where they deliver our priorities; and represent good value for money to taxpayersand for 200607 introduce zero increase for ination and new service investments funded in the main from recycled eYciency savings. 9. The agreement also includes an ongoing commitment that the GP contract will continue to deliver eYciencies and productivities in the future. 10. Information specically on how PCTs have made available resources over and above allocated sums is not available centrally. 6.3.6 In its recent report on out-of-hours care, the NAO found that, if all PCTs matched the best in their rural/urban classication, up to 134 million could be saved in the commissioning of primary care. What steps has the Department taken to address the variation in costs, and what value of savings does it expect PCTs to make and when? (Q115) Answer 1. There is considerable scope to provide a more cost eVective out-of-hours service. The NAO report makes clear that it is unrealistic to expect savings of 134 million but that savings of some 50 million should be achievable if the least eYcient services upped their game. PCTs and service providers can look to improve cost eVectiveness in a number of ways: Driving value for money from future tendering processes based on real competition. Continuing to test the cost eVective use of other health professionals alongside GPs in out-ofhours teams. Developing activity and cost data to better understand what is happening and where there is room to improve performance. Analysing case mix to see if particular patient groups can be targeted to reduce reliance on the outof-hours services and respond better to their needs. Commissioning integrated urgent care services to reduce duplication and multiple hand-oVs between services which patients experience as a disjointed journey to the care they need. Providers making further operational improvements to deliver more eVective use of staV and infrastructures 2. We have supported the NHS in this in two ways: We wrote to PCTs on the day of publication of the NAO report with data showing their position compared to the most cost eVective service in their grouping. We expect PCTs will consider the data and take action to improve their respective position. SHAs will have a key performance management role in ensuring this. The National Audit OYce and Department hosted a joint conference for SHAs, PCTs and outof-hours providers on the 20 July 2006. The main focus of the conference was for PCTs and outof-hours providers to learn from the many examples of best practice that were shared on the day. The conference also involved master classes to ensure PCTs could identify and take action on the changes required in their benchmark groupings as well as any general lessons.
3. We have not set a specic timetable for savings to be achieved, Primary care trusts (PCTs) are responsible for the commissioning of local services and are expected to plan for and achieve nancial balance. We expect each PCT to consider the NAOs report and to look for appropriate measure to improve their eVectiveness in the cost of out-of-hours services. 6.3.7 In the Departmental Report, the Department states that 32 Trusts have now achieved Foundation status, and a further 24 have applied to Monitor for FT status. It is envisaged in the Report that most acute and mental health trusts will apply for Foundation status within the next three years. Subsequent reports in the press suggest that well under 50% of Trusts are set to achieve Foundation status by April 2008. Others may be held back for years by their inability to break even and by the cost of hospital building schemes under private nance initiatives. What is the Departments current assessment of the number of trusts that will achieve foundation status in each of the next three years, and how does this compare to your original projections? (Q116) Answer 1. There are now 48 NHS foundation trusts, 45 of these are acute trusts and three are mental health trusts. Further waves of NHS foundation trusts are set to follow. 2. The DH is establishing a timeframe for when the remaining acute and mental health NHS trusts are likely to become NHS foundation trusts. All acute NHS trusts have completed the Whole Health Community Diagnostic Programme. This process identies the key areas each trust should address in order to be able to apply successfully for foundation trust status. It is a rigorous 10-week assessment covering strategy and business planning, governance, service performance and external relations. Mental health NHS trusts are also completing a diagnostic exercise. In the light of the diagnostic process, a trajectory is being developed for when the remaining NHS acute health trusts are likely to be able to become foundation trusts. Until this is conrmed, we cannot legitimately answer the question in full. 3. Today, NHS foundation trusts account for some of the best-performing elements of the NHS, supported by local communities, and providing new, innovative services to patients. It remains the Governments policy that all NHS acute and mental health trusts should be in a position to apply for foundation status at the earliest available opportunity. The Whole Health Community Diagnostic Programme will provide a sense of readiness for each acute Trust that has not yet applied for foundation status and a clear view of actions needed to secure a successful application. 6.3.8 The Department expects that the cost of Wave 1 and Wave 2 ISTCs may amount to an investment of 3 billion over ve years. Overall, what is the total minimum payment which will be made to suppliers during this period, irrespective of levels of demand? (Q117) Answer 1. The gure stated is incorrect. As set out in the 2006 Departmental Report, it is expected that the second phase of our procurement from the independent sector for elective procedures will represent an investment of approximately 3 billion over ve years. 2. This is in addition to Wave 1 of the programme which represents an investment of approximately 1.6 billion over ve years. For Wave 1 this amount is the minimum take payment to providers over the life of the contracts. Figures for the Phase 2 electives procurement are not yet available as the procurement is ongoing and contracts, which are not expected to be on the same level of take-or-pay basis as wave 1, are subject to negotiation. 6.3.9 How many practices are currently making use of the opportunities to commission using an indicative budget oVered by PBC and what proportion of the total budget available for PBC is managed in this way? How do these gures compare with the Departments targets? (Q118) Answer 1. As of 31 August 2006, 6,260 GP practices (74%) had taken up an incentive payment to become involved in practice based commissioning (PBC). 2. Practice indicative budgets must include as a minimum: all services covered by the national tariV under payment by results in 200607; and prescribing. 3. Further to this, the Department does not collect data on the proportion of the total PCT budget devolved as indicative budgets to practices. 4. There are no Department targets for practice uptake of PBC, or the proportion of the total PCT budget devolved as indicative budgets. 5. This is the only data available for this year. This year is a foundation year to ensure that the building blocks are in place. Practice uptake is an indication of the success of this policy, but it only provides information of practice interest, not change in behaviour. We are considering the indicators for next year
(following achieving universal coverage) which will look to understand in more detail the changes made under PBC. The intention is to publish these indicators towards the end of the year. 6.3.10 What incentive do practices have to make use of PBC? (Q119) Answer 1. PBC gives practices greater freedoms to redesign services to better meet the needs of their patients, therefore improving patient care. It gives primary care clinicians access to commissioning decisions which were previously not available to them. It incentivises better use of resources, and facilitates demand management. 2. In addition to this, the new GMS contract contains a directed enhanced service (DES) for PBC. The PBC DES enables practices to access resources to support PBC. 3. The DES has two components; the rst is payable to practices on the production of a plan which sets out how services will be redesigned. The plan will be agreed with the PCT. The rst component amounts to 95 pence per patient. 4. The second component is available for reinvestment in redesigned services for patients. It is made available once practices have delivered the objectives set out in the plan. As a minimum, component two amounts to 95 pence per patient. Where practices free up resources above this amount, they can instead choose to access these freed up resources to reinvest in patient care. 6.3.11 How is commissioning being integrated at the primary care and social care interface, and in particular how is PBC coordinating with Local Area Agreements and Local Strategic partnerships? (Q120) Answer 1. Integrating commissioning at a primary care and social care level is a signicant driver behind many of the recent NHS reforms. 2. Following on from Health reform in Englandupdate and commissioning framework (July 2006), a second phase of the commissioning framework will be published in December 2006. This will address commissioning for primary care services, health and wellbeing, long-term conditions, and joint commissioning with local government. It will build upon the existing commissioning exibilities established in Section 31 of the 1999 Health Act. 3. Practice based commissioning (PBC) gives practices greater exibilities to redesign local services to ensure they better meet the needs of their patients. To achieve this they need to engage with other partners when reshaping health services. 4. The process of practices identifying what service improvements will be made, how this will free up resources and the subsequent use of such resources must take into account the priorities in Local Area Agreements agreed with local partners. 6.3.12 The technical guidance for the implementation of Payment by Results in 200607 suggests that there were some data quality issues associated with the 200405 reference costs data. What were these issues and how have they been addressed? What implications do these data quality issues have for the fairness of the PBR tariV? (Q121) Answer 1. The technical guidance was referring to the normal data cleaning stage within the tariV calculation process. It did not mean that there were abnormal data quality issues with 200405 reference costs compared to previous years. 2. For the purposes of calculating the tariV, outliers are removed to ensure that the average cost data used are representative and not skewed. This process ensures that the PbR tariV is fair to organisations and they will not suVer any consequence of unrepresentative costing information submitted as part of the reference costs. 6.3.13 Some changes have been made to strengthen the labour element of the market forces factor (MFF) eg it has been expanded from 119 to 303 zones. However, it is based on labour market data from 200103. How accurate will this labour market data be for 200607 and 200708, especially given the signicant economic and wage growth in England since then? (Q122) Answer 1. The calculations for the MFF are based on geographical wage diVerentials between areas. Economic and wage growth will not aVect the calculated MFF values, if that growth is fairly general across the country. It is only if parts of the country grow very diVerently from others that geographical wage diVerentials will be aVected. The diVerentials are expected to be reasonably stable over short to medium timescales, for example, over ve years.
2. 2003 was the latest year for which labour market earnings data were available at the time of the last resource allocation round. 2005 is now the latest year available. The OYce for National Statistics (ONS) does not produce projections of geographical labour market earnings. 3. Research currently underway for the Department of Health and the Advisory Committee on Resource Allocation (ACRA) includes updating labour market information that the MFF calculations are based on. The research is specically looking at updating the labour market information from 200103 to 200305. 4. Provisional results indicate that the wage diVerentials have not changed substantially between 200103 and 200305. 6.3.14 The adjustment to the tariV for capital costs is based on average capital costs. For some trusts with large capital programmes, this might underfund their expenditure. How many Trusts receive an allocation for capital costs which is lower than their capital costs, and how much is the shortfall in each case? What steps is the Department taking to adjust for this? (Q123) Answer 1. Under Payment by Results (PbR), providers do not receive a specic allocation for the revenue cost of their capital investments. 2. The national tariV is currently based on average costs reported by NHS organisations. These average costs will show the full cost of providing the service, including the cost of buying and maintaining buildings. The annual tariV uplift takes account of anticipated increases in capital charges, and the revenue impact of new Private Finance Initiative projects becoming operational. 3. We recognise that a tariV based on national average costs may not always fully reect the local costs of a brand new facility. For this reason, the NHS Bank has provided additional funding, above and beyond the national tariV, to help pay the procurement costs of large PFI hospitals, and to help with the running costs of any major capital investment, whether PFI or publicly funded, for the rst ve years of its operation. In future SHAs will be responsible for managing these arrangements. 4. Sound capital investment can contribute to increased productivity, for example, through economies of scale by consolidation of multiple sites, better clinical adjacencies, more eYcient use of utilities, and so on. The overall aVordability of large capital programmes ultimately depends on eVective nancial management by Trusts. To obtain the necessary approvals, Trusts will need to demonstrate that they are planning operational eYciencies for their new facilitieseg through more aggressive benchmarking of Length Of Stay, day case rates and unit costs. 5. We are implementing a more exible nancial regime under the Foundation Trust model in parallel with the roll-out of PbR. The more exible nancial regime allows Trusts greater access to diVerent capital funding options. 6.3.15 Data from Monitor has identied bad debts in Foundation Trusts of 28m because Primary Care Trusts may not pay for treatment of local patients. What is the value of disputed payments between Primary Care Trusts and NHS Trusts and how many Trusts and PCTs are involved? What mechanisms exist to resolve disputes, and how have these mechanisms been employed since the introduction of PBR? (Q124) Answer 1. The pre-audited Foundation Trust (FT) accounts state that the charge to I&E for provisions for bad and doubtful debts (including disputed balances) is 28 million in 200506. 2. The Department does not collect information on the value or number of disputed payments between PCTs and NHS trusts. 3. The NHS Bank issued best practice guidance to all NHS bodies on the mechanisms to resolve disputes between NHS organisations in April 2004. Briey, where an agreement cannot be reached between individual organisations the billing organisation should seek conciliation from the local SHA. In the event of the conciliation failing to secure resolution the SHA should make a ruling which is binding on both parties. This does not apply to disputes between FTs and PCTs as they have contracts that are legally binding. 4. The Departments model contract for FTs includes a dispute resolution procedure. Briey, this is in three stages: (1) First the Parties will attempt to settle any dispute that arises out the Agreement by negotiation represented by senior clinicians or commissioning oYcers on each side for an initial period and then by Chief Executives on each side for second period, (both periods need to be agreed locally: 10 and ve Operational Days is suggested); (2) Secondly if negotiation fails, the Parties will attempt to resolve the dispute by submitting it to mediation, within a short period to be agreed locally (ve Operational Days is suggested) by a mediation service provider agreed by the Parties, or, in default, The Centre for EVective Dispute Resolution (CEDR); and (3) If the dispute remains unsolved by mediation after a further period to be agreed locally (20 Operational Days is suggested) the Parties will submit the dispute to a decision by a panel of
experts, who are appointed during a short period to be agreed locally (5 Operational Days is suggested), of either one or two experts from each side with a third or fth appointed jointly by agreement or in default by CEDR and the decision of the panel will be nal and binding and (33.4) enforceable in the courts. 5. The FT may be using its own contract rather than the Departments model, and therefore other dispute arrangements may apply. 6. The Department does not collect information relating to the application of dispute resolution mechanisms by individual bodies. There has been no change to the recommended best practice guidance issued since the introduction of PBR. 6.3.16 To what extent does PBR create incentives for Trusts to improve and potentially manipulate the coding of their activity to increase their income? We understand that coding will be audited by the Audit Commission. How will errors in the coding be corrected and what sanctions applied if trusts are found to have over-reported their activity? (Q125) Answer 1. Clinical and administrative data will drive reimbursement under PbR and there is therefore a very strong incentive to ensure that the data is correct. Where data quality is currently poor, changes designed to improve data quality could legitimately result in increased income without increased productivity. In these cases, the Code of Conduct provides guidance on how such changes should be agreed between provider and commissioner and cannot result in changes in payment in-year. 2. There is also a theoretical possibility of data manipulation not in order to improve data quality but to increase income. The Department is therefore working with the Audit Commission on an Assurance Framework for PbR which aims to support the improvement of data quality and to ensure that those improvements are legitimate. 3. The Framework will strengthen existing arrangements for the local monitoring of data quality but also proposes the introduction of national benchmarking of data between providers (so that unusual practice can be identied) and independent external audit of clinical coding against case notes. The audits can be targeted using the results of the national benchmarking as well as random to monitor general standards of data quality. 4. Where such an audit reveals error which has resulted in payments already made being identied as inaccurate it will usually be too late to amend the payment and the emphasis will be on improving future reconciliation. The Commission is therefore recommending that specic actions should ow from audits. These could include nancial penalties for poor data quality; further investigations at the expense of the ttust where data quality is poor or specic concerns are raised and referral of cases of suspected fraud to the NHS Counter Fraud and Security Management Service. 5. The Department is currently considering these recommendations. 6.4 Expenditure 6.4.1 What common traits has the Department identied in those PCTs which are under or over target share? For example, are they predominantly urban or rural, or disadvantaged or prosperous at either extreme. (Q126) Answer 1. Figure 126a to Figure 126d show that under target PCTs are proportionately more likely to be in the East and West Midlands and East of England. They are more likely to be disadvantaged and predominantly rural. Over target PCTs are proportionately more likely to be in London and the South East. They are also more likely to be prosperous and urban. 2. There are 88 Spearhead PCTs, based upon the Local Authority areas that are in the bottom fth nationally for three or more of the following ve indicators: Male life expectancy at birth. Female life expectancy at birth. Cancer mortality rate in under 75s. Cardio Vascular Disease mortality rate in under 75s. Index of Multiple Deprivation 2004 (Local Authority Summary), average score. 3. There are 44 Growth Area PCTs in one of four DCLG growth areas: Ashford. London, Stansted, Cambridge, Peterborough. Milton Keynes and South Midlands. Thames Gateway. 4. The DEFRA rural and urban classication of PCTs is according to the level and type of rurality found within each PCT at the time of the 2001 Census.
Figure 126a: Range of 2006-07 opening DFTs by SHA
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0.6
0.5
0.4
0.3
0.2
0.1
0 North East North West Yorkshire and the Humber East Midlands West Midlands East of England London South East Coast South Central South West
More than 4% under target 2% to 4% over target
2% to 4% under target More than 4% over target
2% under target to 2% over target
Figure 126b: Range of 2006-07 opening DFTs by spearhead classification
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0.35
0.3
0.25
0.2
0.15
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0.05
0 More than 4% under target 2% to 4% under target 2% under target to 2% over target 2% to 4% over target More than 4% over target
Spearhead PCTs
Other PCTs
Figure 126c: Range of 2006-07 opening DFTs by growth area
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0 More than 4% under target 2% to 4% under target 2% under target to 2% over target 2% to 4% over target More than 4% over target
Growth area PCTs
Other PCTs
Figure 126d: Range of 2006-07 opening DFTs by rurality
0.45 0.4 0.35 0.3 0.25 0.2 0.15 0.1 0.05 0 More than 4% under target 2% to 4% under target Predominantly rural 2% under target to 2% over target 2% to 4% over target Major and large urban More than 4% over target
Other urban and mixed rural
6.4.2 For those PCTs who face higher costs under PBR, what will the nancial impact of the decision to change the purchasing parity adjustment from 100% to 50% be, and how many PCTs will be aVected? (Q127) Answer The impact at PCT level of the decision to change the purchasing parity adjustment from 100% to 50% in 200607 is presented in Table 127. Table 127 IMPACT OF 200607 PPA (AT 50% AS ALLOCATED) COMPARED TO WHAT PPA WOULD HAVE BEEN AT 100% 000s Variance (50%100%) 000s ("ve means lower adjustment under 50% PPA, !ve higher) "2,609 "1,038 "2,710 1,079 1,199 5,581 844 3,944 2,592 "852 288 2,373 138 "122 "4,452 1,140 1,272 "2,688 3,074 3,011 "565 "3,868 6,693 261 "1,113 "902 "958 "2,220 3,372 250 1,944 1,518 "3,921 1,344 4,410 "1,041 1,316 3,832 "121 6,384 41 1,343 4,569 "3,022 "15 "310 "3,572 7,331 "2,553
PCT Code 5L8 5AW 5ED 5FA 5LL 5HG 5C2 5A9 5JE 5GR 5ET 5FL 5F8 5GD 5GE 5FH TAK 5GP 5H2 5CC 5HP 5G6 5HQ 5CE 5G2 5CF 5CG 5K5 5LQ 5JF 5JG 5JL 5A7 5EV 5G8 5DQ 5JX 5J6 5JH 5K7 5MM 5LM 5D4 5JP 5H4 5KT 5AL 5HA 5CL
PCT Name Adur, Arun and Worthing PCT Airedale PCT Amber Valley PCT Asheld PCT Ashford PCT Ashton, Leigh and Wigan PCT Barking and Dagenham PCT Barnet PCT Barnsley PCT Basildon PCT Bassetlaw PCT Bath and North East Somerset PCT Bebington and West Wirral PCT Bedford PCT Bedfordshire Heartlands PCT Bexhill and Rother PCT Bexley PCT Billericay, Brentwood and Wickford PCT Birkenhead and Wallasey PCT Blackburn with Darwen PCT Blackpool PCT Blackwater Valley and Hart PCT Bolton PCT Bournemouth Teaching PCT Bracknell Forest PCT Bradford City Teaching PCT Bradford South and West PCT Brent Teaching PCT Brighton and Hove City PCT Bristol North PCT Bristol South and West PCT Broadland PCT Bromley PCT Broxtowe and Hucknall PCT Burnley, Pendle and Rossendale PCT Burntwood, Licheld and Tamworth PCT Bury PCT Calderdale PCT Cambridge City PCT Camden PCT Cannock Chase PCT Canterbury and Coastal PCT Carlisle and District PCT Castle Point and Rochford PCT Central Cheshire PCT Central Cornwall PCT Central Derby PCT Central Liverpool PCT Central Manchester PCT
000s Variance (50%100%) 000s ("ve means lower adjustment under 50% PPA, !ve higher) "1,229 "325 "705 "2,787 "3,821 1,725 "655 "931 "4,131 "1,290 "2,459 "1,134 "5,877 "1,373 "2,054 "1,716 "2,141 2,603 1,621 "706 "645 2,783 13 673 842 1,499 198 4,181 "846 276 866 "4,297 "1,974 "4,176 "598 3,395 3,059 2,840 "522 "389 1,152 1,011 "4,523 531 2,257 "2,054 "8,918 "1,202 420 "999 "1,838 "626 "499 "1,636 "951 303 999 1,071 "403 "4,336 4,078
PCT Code 5JT 5JC 5JN 5KW 5DV 5H3 5EA 5G4 5F2 5C3 5GM 5KY 5MD 5KJ 5MA 5K9 5GW 5J9 5CM 5AC 5H7 5KA 5CK 5EK 5EL 5HV 5HT 5KC 5J8 5HX 5KD 5JK 5FT 5KP 5FD 5LN 5HK 5H9 5ML 5KQ 5E3 5LR 5MY 5H5 5E5 5EY 5E7 5LY 5D5 5H6 5C1 5AJ 5ER 5FR 5LX 5HE 5KF 5EC 5GT 5EX 5A8
PCT Name Central SuVolk PCT Charnwood and North West Leicestershire PCT Chelmsford PCT Cheltenham and Tewkesbury PCT Cherwell Vale PCT Cheshire West PCT Chestereld PCT Chiltern and South Bucks PCT Chorley and South Ribble PCT City and Hackney Teaching PCT Colchester PCT Cotswold and Vale PCT Coventry Teaching PCT Craven, Harrogate and Rural District PCT Crawley PCT Croydon PCT Dacorum PCT Darlington PCT Dartford, Gravesham and Swanley PCT Daventry and South Northamptonshire PCT Derbyshire Dales and South Derbyshire PCT Derwentside PCT Doncaster Central PCT Doncaster East PCT Doncaster West PCT Dudley Beacon and Castle PCT Dudley South PCT Durham and Chester"le"Street PCT Durham Dales PCT Ealing PCT Easington PCT East Cambridgeshire and Fenland PCT East Devon PCT East Elmbridge and Mid Surrey PCT East Hampshire PCT East Kent Coastal PCT East Leeds PCT East Lincolnshire PCT East StaVordshire PCT East Surrey PCT East Yorkshire PCT Eastbourne Downs PCT Eastern Birmingham PCT Eastern Cheshire PCT Eastern Hull PCT Eastern Leicester PCT Eastern Wakeeld PCT Eastleigh and Test Valley South PCT Eden Valley PCT Ellesmere Port and Neston PCT Eneld PCT Epping Forest PCT Erewash PCT Exeter PCT Fareham and Gosport PCT Fylde PCT Gateshead PCT Gedling PCT Great Yarmouth PCT Greater Derby PCT Greenwich Teaching PCT
000s Variance (50%100%) 000s ("ve means lower adjustment under 50% PPA, !ve higher) "4,323 2,417 "463 "675 148 173 "3,476 "1,420 843 2,606 612 1,220 1,231 1,424 "1,582 1,577 "1,231 "2,362 "1,620 2,183 "6,668 1,666 "1,874 "720 "110 "687 645 766 "1,341 "4,399 1,019 1,489 1,019 "596 "1,552 1,940 "916 1,682 1,834 "2,493 749 2,130 "1,392 1,264 "2,064 "1,552 1,704 "936 1,099 3,259 "2,804 "812 "940 "613 1,778 "1,135 981 "511 "731 1,235 "368
PCT Code 5L5 5J1 5KH 5H1 5C9 5DC 5K6 5D9 5FJ 5A4 5MX 5CN 5CP 5F4 5HN 5AT 5JA 5MC 5HY 5LJ 5GF 5G7 5JQ 5DG 5K8 5K4 5LA 5A5 5J4 5LD 5KN 5HJ 5HM 5HH 5EJ 5LF 5D3 5GC 5L2 5GL 5AM 5L3 5EH 5FX 5FV 5KM 5E9 5FK 5CQ 5DD 5A1 5AP 5DK 5D7 5HW 5C5 5KR 5MW 5CH 5FQ 5CD
PCT Name Guildford and Waverley PCT Halton PCT Hambleton and Richmondshire PCT Hammersmith and Fulham PCT Haringey Teaching PCT Harlow PCT Harrow PCT Hartlepool PCT Hastings and St Leonards PCT Havering PCT Heart of Birmingham Teaching PCT Herefordshire PCT Hertsmere PCT Heywood and Middleton PCT High Peak and Dales PCT Hillingdon PCT Hinckley and Bosworth PCT Horsham and Chanctonbury PCT Hounslow PCT Hudderseld Central PCT Huntingdonshire PCT Hyndburn and Ribble Valley PCT Ipswich PCT Isle of Wight PCT Islington PCT Kennet and North Wiltshire PCT Kensington and Chelsea PCT Kingston PCT Knowsley PCT Lambeth PCT Langbaurgh PCT Leeds North East PCT Leeds North West PCT Leeds West PCT Leicester City West PCT Lewisham PCT Lincolnshire South West Teaching PCT Luton PCT Maidstone Weald PCT Maldon and South Chelmsford PCT Manseld District PCT Medway PCT Melton, Rutland and Harborough PCT Mendip PCT Mid Devon PCT Middlesbrough PCT Mid"Hampshire PCT Mid"Sussex PCT Milton Keynes PCT Morecambe Bay PCT New Forest PCT Newark and Sherwood PCT Newbury and Community PCT Newcastle PCT Newcastle"under"Lyme PCT Newham PCT North and East Cornwall PCT North Birmingham PCT North Bradford PCT North Devon PCT North Dorset PCT
000s Variance (50%100%) 000s ("ve means lower adjustment under 50% PPA, !ve higher) 3,246 138 11 "861 "1,556 6,181 1,448 "1,809 5,999 278 "3,281 3,025 "4,435 3,366 "5,305 4,455 "984 "4,723 "3,268 "3,093 "3,739 4,011 3,153 1,586 2,088 "8,609 "2,786 "376 81 "1,270 "1,707 "387 1,535 74 3,397 "273 898 "678 "782 818 1,659 "448 2,393 1,949 553 4,078 1,196 "2,568 "1,547 "2,941 171 342 "2,818 "3,605 "3,005 55 3,179 "2,539 328 1,192 1,459
PCT Code 5AN 5DT 5EG 5DF 5GH 5J7 5EF 5G9 5CR 5JM 5AF 5EE 5M8 5ME 5L6 5E1 5D8 5MP 5LW 5LV TAC 5A2 5EM 5MG 5J5 5DW 5F1 5KV 5FE 5HD 5DL 5NA 5MR 5M6 5JY 5H8 5MH 5GK 5M9 5FC 5F5 5KK 5KE 5E2 5EP 5EN 5LP 5M2 5DM 5D1 5FW 5FN 5M1 5JJ 5GJ 5DX 5EQ 5A3 5CV 5LK 5HL
PCT Name North East Lincolnshire PCT North East Oxfordshire PCT North Eastern Derbyshire PCT North Hampshire PCT North Hertfordshire and Stevenage PCT North Kirklees PCT North Lincolnshire PCT North Liverpool PCT North Manchester PCT North Norfolk PCT North Peterborough PCT North SheYeld PCT North Somerset PCT North Stoke PCT North Surrey PCT North Tees PCT North Tyneside PCT North Warwickshire PCT Northampton PCT Northamptonshire Heartlands PCT Northumberland PCT Norwich PCT Nottingham City PCT Oldbury and Smethwick PCT Oldham PCT Oxford City PCT Plymouth Teaching PCT Poole PCT Portsmouth City Teaching PCT Preston PCT Reading PCT Redbridge PCT Redditch and Bromsgrove PCT Richmond and Twickenham PCT Rochdale PCT Rotherham PCT Rowley Regis and Tipton PCT Royston, Buntingford and Bishops Stortford PCT Rugby PCT RushcliVe PCT Salford PCT Scarborough, Whitby and Ryedale PCT Sedgeeld PCT Selby and York PCT SheYeld South West PCT SheYeld West PCT Shepway PCT Shropshire County PCT Slough PCT Solihull PCT Somerset Coast PCT South and East Dorset PCT South Birmingham PCT South Cambridgeshire PCT South East Hertfordshire PCT South East Oxfordshire PCT South East SheYeld PCT South Gloucestershire PCT South Hams and West Devon PCT South Hudderseld PCT South Leeds PCT
000s Variance (50%100%) 000s ("ve means lower adjustment under 50% PPA, !ve higher) "916 1,648 "3,812 "326 1,769 1,089 1,217 4,684 "5,945 8 3,762 1,359 "334 "864 "2,059 "3,058 "489 1,003 1,234 "5,146 448 5,284 1,534 "4,212 "1,680 "3,455 9,125 "5,419 "143 991 1,425 2,254 2,953 "743 127 632 158 "1,398 3,255 10,976 "2,054 1,551 "64 "4,790 3,866 382 2,651 2,325 "835 60 1,691 "967 1,947 869 "860 2,986 3,723 886 "6,117 1,335 "1,749
PCT Code 5JD 5HC 5AA 5AG 5M5 5K1 5MF 5KG 5MQ 5FP 5FF 5DY 5MN 5DJ 5MT 5L1 5AK 5G1 5F9 5LE 5GX 5J3 5HR 5F7 5JR 5JW 5KL 5L7 5LT 5M7 5L4 5K3 5LH 5K2 5FY 5MK 5AH 5GQ TAL 5C4 5F6 5CX 5GN 5DP 5E8 5M3 5NC 5LG 5J2 5GV 5JV 5MJ 5GG 5D6 5KX 5E6 5F3 5D2 5CY 5FM 5DH
PCT Name South Leicestershire PCT South Liverpool PCT South Manchester PCT South Peterborough PCT South Sefton PCT South Somerset PCT South Stoke PCT South Tyneside PCT South Warwickshire PCT South West Dorset PCT South West Kent PCT South West Oxfordshire PCT South Western StaVordshire PCT South Wiltshire PCT South Worcestershire PCT Southampton City PCT Southend on Sea PCT Southern Norfolk PCT Southport and Formby PCT Southwark PCT St Albans and Harpenden PCT St Helens PCT StaVordshire Moorlands PCT Stockport PCT SuVolk Coastal PCT SuVolk West PCT Sunderland Teaching PCT Surrey Heath and Woking PCT Sussex Downs and Weald PCT Sutton and Merton PCT Swale PCT Swindon PCT Tameside and Glossop PCT Taunton Deane PCT Teignbridge PCT Telford and Wrekin PCT Tendring PCT Thurrock PCT Torbay PCT Tower Hamlets PCT TraVord North PCT TraVord South PCT Uttlesford PCT Vale of Aylesbury PCT Wakeeld West PCT Walsall Teaching PCT Waltham Forest PCT Wandsworth PCT Warrington PCT Watford and Three Rivers PCT Waveney PCT Wednesbury and West Bromwich PCT Welwyn Hateld PCT West Cumbria PCT West Gloucestershire PCT West Hull PCT West Lancashire PCT West Lincolnshire PCT West Norfolk PCT West of Cornwall PCT West Wiltshire PCT
000s Variance (50%100%) 000s ("ve means lower adjustment under 50% PPA, !ve higher) "2,640 376 "1,178 651 "2,818 1,233 922 "290 1,131 "562 0
PCT Code 5L9 5LC 5G3 TAG 5DN 5MV 5G5 5DR 5HF 5E4
PCT Name Western Sussex PCT Westminster PCT Windsor, Ascot and Maidenhead PCT Witham, Braintree and Halstead PCT Wokingham PCT Wolverhampton City PCT Wycombe PCT Wyre Forest PCT Wyre PCT Yorkshire Wolds and Coast PCT Total
Source: 200607 PbR Baseline Exercise. 6.4.3 The Human Resources Development Strategy will fall from 62.8 million in 200506 to 49.8 million in each of the subsequent years. What are the reasons for this? (Q128) Answer 1. The sum of overall funding for the Human Resource Development Strategy (HRDS) Grant and the National Training Strategy (NTS) Grant is the same as in 200506, 157.609 million. 2. We have however, re-aligned funding by moving a 13 million sub-programme, to support postqualifying training of registered social workers and other key professional groups in the social care workforce, from the HRDS Grant into the NTS Grant. Therefore, although the HRDS grant has been reduced to 49.750 million the NTS grant has increased to 107.859 million. 3. This transfer of funding was approved by the Local Government Association. 6.4.4 From 200607, the method of allocating the funding Formula grant to local authorities is changing based on a Relative Needs Formula (RNF) for each service block. It is intended that the resource allocation will more accurately reect need for services. What diVerence does the change make for individual councils? Will there be cuts in funding and, if so, how much will be cut and which councils will be aVected? (Q129) Answer 1. Responsibility for the administration of the general formula grant resides with the Department for Communities and Local Government. 2. The new adult social services RNF formula incorporates the latest available 2001 census data, is based on up to date surveys of social service clients and has been developed following a rigorous process of academic research. As a result, it better reects the actual need for services for older people, younger adults and children and will therefore achieve a more equitable allocation of resources. 3. The Department of Health recognised that introducing the new formula will cause a step-change in allocations for a number of councils, especially in relation to funding for younger adults services and have therefore applied appropriate oor damping mechanisms to help local authorities manage any redistributive eVect. 4. A oor of 2.7% above 200506 allocations has therefore been applied to the Younger Adults RNF formulae to help local authorities to manage this change. 5. The calculation of Formula Grant is subject to a funding oor and therefore no councils will receive a cut in funding. The current Local Government Finance Settlement announced that the overall grant allocated to local authoriteies would increase by 2.7 billion (4.5%) in 200607, and by 3.1 billion (5%) in 200708. 6. In 200607, every local authority providing social services received at least a 2.0% increase in formula grant compared to 200506, on a like-for-like basis. 6.5 Activity, Performance & EYciency 6.5.1 The Department expects to save 500 million annually through the reduction of the number of arms length bodies (ALBs), SHAs and PCTs in its delivery chain. The Technical Note states that the transitional costs of restructuring the ALBs (eg early retirement or redundancy costs) will not be taken into account in assessing the eYciency savings. Are the savings on the restructuring of the SHAs and PCTs also gross of transitional costs? How much are the transitional costs for restructuring ALBs, SHAs and PCTs expected to be? (Q130)
Answer 1. The EYciency Technical Note sets out how Gershon eYciency benets will be calculated. These are dened as annual savings sustainable beyond March 2008 that can be reinvested into front-line services. Transitional costs are one-oV costs occurring during implementation of business changes. 2. During the Gershon reporting periods up to 2008, we therefore state the sustainable benet that has been realised after excluding known non-recurrent transition costs. 3. However, for both the ALB and SHA/PCT programmes, transitional costs will have ceased before March 2008. The full expected 500 miilion saving in 2008 is therefore cash releasing as dened by Gershon, available for reinvesting in front-line care from 200809. 4. As noted in the response to Question 98, at this time it is not possible to conrm or accurately forecast transitional (redundancy) costs for SHA/PCT restructuring. 5. Transition costs for relocation and redundancies as a result of the ALB review were 10 million in 200506 and are expected to be around 13 million in 200607. 6.5.2 What steps has the Department taken to ensure that there is no adverse impact on service quality arising from the PCT and SHA restructuring programme? (Q131) Answer 1. At an organisational level, transition arrangements are in place to make sure that all NHS bodies can continue to carry out their core functions and commission quality care for patients. The new PCTs have been set up in shadow form as old PCTs are winding down, so the handover of management functions will be seamless. 2. Stronger commissioning with more involvement from front-line staV like GPs will mean that NHS services reect patients needs more closely and should help to accelerate improvements in local services not set services back. 3. The reconguration of PCTs is the rst stage in delivering a robust infrastructure from which to strengthen the commissioning function of PCTs. The next stage focuses on ensuring that each PCT has the necessary leadership skills and capability. A tness for purpose programme is being implemented in some PCTs and will be rolled out across all PCTs between now and March 2007. 4. This programme, alongside a broader development programme for PCTs, will ensure that all PCTs including those where no changes are being made to the boundariesare strong, condent organisations with a high degree of professionalism and a constructive culture. They will be led by people who will be able to demonstrate to their staV and the communities they serve that PCTs are t for driving forward the NHS reforms that we are currently implementing. 6.5.3 A component of the Departments EYciency targets was a reduction or elimination of central budgets. This is expected to save 500 million. The Technical Note makes clear the review of current budgets was intended to take place in autumn 2005 with benets occurring from April 2006. However, the central revenue and capital budgets planned for 200607 of 14.8 billion (Fig 3.8) are higher than those planned for 200506 of 13.7 billion (Fig 3.8 of the 2005 Departmental Report). What savings and reductions has the Department planned to make in 200607, and why has the overall gure for central budgets gone up between 200607 and 200506? (Q132) Answer 1. The gures quoted include capital expenditure forecasts for each year. However, the estimated eYciency saving related to revenue expenditure and specically to the reduction or elimination of existing individual revenue budgets so that the underlying rate of growth would be reduced. This was the principle on which the original forecast as part of our Gershon target was agreed with Treasury and the OYce of government Commerce. 2. The equivalent gures for revenue from Fig 3.8 of DR 2005 and DR2006 are 11.7 billion and 11.9 billion ie a 2% growth. 3. This 2% growth in central budgets compares to an overall revenue growth of 7.8% in 200607 over 200506. Had central budgets been allowed to grow at the level of the revenue settlement then the value for 200607 central budgets would have been 12.6 billion, an increase of 0.9 billion on 200506. 4. Therefore, the gures illustrate that the Department has achieved signicant real savings on central budgets. However we have recognised the inherent diYculties of presenting these as solely down to eYciency and advised OGC at our last review in May that we would not include these in our declared Gershon eYciency gains. 5. It is not possible to supply a like for like comparison of individual budgets in 200506 and 200607 because, as a consequence of the review of 200607 budgets, responsibility and resource for a signicant proportion have been transferred to the NHS via SHAs. 6. This reects the desire to ensure better, more timely targeting of central funding to meet local priorities.
6.5.4 The basis of measurement for the Departments eYciency under the Public Funding & Regulation workstream is the Departments administration cost limit. However, this will be aVected in 200607 by the reclassication of the Health and Social Care Information Centre from administration to programme budgets. Will this reclassication be counted as an eYciency saving? (Q133) Answer 1. The DH Change programme resulted in some functions and their related headcount and staYng costs being eliminated or reduced, and also in some other functions being transferred to other organisations outside of the core department. 2. The EYciency Technical Note makes clear that the latter reductions are not counted as eYciency savingsdeclared eYciency savings are lower less than the absolute reduction in ACL expenditure. To ensure this, the 2003 baseline ACL, is reduced by the operating cost of any transferred functions. 3. The Health & Social Care Information Centre falls within this category of transferred organisations and as such is now funded from programme budgets. The above adjustment ensures that this reclassication does not count as part of our eYciency saving. 6.5.5 A further component of the eYciency plans is to increase the income recoverable where personal injury compensation is payable. Income has only increased by 8 million (7%) between 200304 and 200405, even though the law has enabled income to be collected in a greater range of circumstances since 2003. What targets does the Department have for revenue collection going forward, and how does it plan to strengthen revenue collection? (Q134) Answer 1. The increase in income of 8 million relates only to recoveries from the existing road traYc accident (RTA) scheme introduced by the Road TraYc (NHS Charges) Act 1999, which allows costs to be recovered in road traYc accident cases only and represents a signicant increase on the previous year. 2. Part 3 of the Health and Social Care (Community Health and Standards) Act 2003 made provision for the establishment of a scheme to recover the costs of providing treatment to an injured person where that person has made a successful personal injury compensation claim against a third party. This builds on the existing scheme. 3. For a variety of reasons, Part 3 of the 2003 Act has not yet been commenced, and the expanded Injury Costs Recovery (ICR) scheme is therefore not yet in eVect. The intention is that it will be implemented from 29 January 2007. Once bedded in, we envisage that the expanded scheme could result in recovered income of approximately 190 million pa over and above the 120 million ! pa that the RTA scheme already recovers (using the recovery rates currently in place for the RTA scheme), money that will be returned direct to the NHS trusts that provided treatment. 4. However, as with the RTA scheme, the ICR scheme will only come into play if the injured person makes a personal injury compensation claim which is successful. Moreover, injured persons have up to three years after the incident in which to make a claim, which may then take several months, perhaps years, to reach a settlement. All of this is entirely outside the Department of Healths control, and rightly so. Thus, it will be several years before the ICR scheme is fully bedded in, and it is inappropriate to set targets for the level of income recovered when we have no inuence on the fundamental trigger point for the scheme. 5. Nevertheless, there is already a centralised and eYcient method of recovery for the RTA scheme, which is administered on behalf of the Department of Health by the Compensation Recovery Unit (CRUpart of the Department for Work and Pensions). These arrangements will continue to apply in respect of the ICR scheme. Compensators will have a legal obligation to inform the CRU of all compensation claims made and the CRU carries out regular compliance checks to ensure this action is being taken. 6.5.6 The Main Estimates suggest that the Department will only recover 25 million of the costs of treating visitors from the European Economic Area. This is down from 27 million in 200506. Why is revenue declining given the increasing numbers of overseas visitors, and the increasing costs of healthcare? What steps is the Department taking to boost recovery? More generally, what is the Departments estimate of the costs of treating all overseas visitors, and how much is actually recovered, either by Trusts or the Department? (Q135) Answer 1. Successive Governments have not required the NHS to provide statistics on the number of overseas visitors seen or treated under the provisions of the NHS (Charges to Overseas Visitors) Regulations 1989, as amended, or on the costs of treatment. It is therefore not possible to provide the information requested on the estimated costs of treating all overseas visitors, nor the amounts recovered. 2. However, the UK has bilateral arrangements with several EEA Member States and claims are made against other member states. These claims are mainly based on statistical data and depend on a number of factors. This means that the amount recovered may uctuate from year to year. The estimated outturn is shown in Table 135, which shows the amount recovered in each year since 200203 and is more than the main estimated budgets.
3. The Department is currently reviewing the collection of information on EEA visitors to ensure that it is as accurate and comprehensive as possible to ensure that the correct amount of money is recovered from other EEA states. Table 135 UK CLAIMS AGAINST MEMBER STATES Year 200203 200304 200405 200506 Claim type Actual cost Lump sums Total Actual cost Lump sums Total Actual cost Lump sums Total Actual cost Lump sums Total UK claims against Member States thousands 14,200 17,300 31,500 15,248 9,926 25,174 18,700 12,500 31,200 20,600 14,400 35,000
Source: The 200506 Resource Accounting and Budgeting (RAB) Outurn exercise. Footnotes: 1. The information is compiled in line with the requirements of Government Accounting 2000 and National Audit OYce (NAO). 2. Claims against the UK are made in national currency and converted in to sterling by using the quarterly mean exchange rates published by the EU commission. 3. Actual costs under Article 93 of Regulation 574/72 include E111s/EHIC (temporary visitors and E112 cases (referrred patients). 4. Lump sums under Articles 94 & 95 of Regulation 574/72 include 121s (pensioners). 5. Figures may not add up due to rounding. 6.5.7 Expenditure on NHS Pensions is expected to be 11.1 billion in 200708, an increase of 193% on 200001. During this time, its share of the total resource budget of the Department of Health will have climbed from 7.7% to 11.1%. How does the Department propose to address the signicant increase in NHS pension costs? (Q136) Answer 1. The gures quoted of 7.7% to 11.1% are not directly comparable gures, due to a transfer of funds from the Departmental annually managed expenditure (AME) to cover pension indexation in 200304 of 1.6 million. 2. To calculate actual percentage of resource budget (DEL) in 200001 the pensions transfer has been included at 1.1 million (deated by the overall DEL growth from 200001 to 200304). 3. The actual comparable gures are 10% in 200001 and 11% in 200708, the actual increase forecast being in the region of 1%. 4. Growth in pay and pensions forms a key part of the analysis of baseline pressures forecasts that are used to inform discussions with HMT at spending review. Also, new policy commitments ae subject to robust aVordability analysis which cover workforce and pension implications. 5. The Department also suggests in evidence to the pay review bodies that pensions implications are considered in their overall pay settlement recommendations. 6. Under the reformed NHS pension Scheme, normal pension age will increase from 60 to 65 for new entrants, reducing the long-term pressure on the scheme. 6.5.8 The BMA has stated that the increased pay under the new GMS contract will result in an increase in the number of GPs taking early retirement in the next two years. The same issue may apply in other areas of the Health Service. What impact did the Department expect the pay arrangements to have on the retirement plans for GPs, consultants and other NHS staV when the reforms were introduced, and how do these compare to the actuarys current expectations? Based on the latest data available, how do current rates of early retirement compare to these expectations and to previous years? What evidence is there of increased interest in early retirement eg more purchases of added years or AVCs or greater numbers of enquiries to NHS Pensions on the subject? Can we have what gures you have available? (Q137)
Answer 1. The available data on GP retirements provided by the Business Services Authority Pensions Division is given in Table 137. The data suggests that there has been an increase in voluntary early retirements in the years ending in March 2006 and that this has continued so far in the year ending March 2007. But, because of the restrictions in terms of the data, as explained in the table notes, it is not possible to conrm the scale of any change. 2. The overall numbers of GPs retiring, signicantly reduced in the period 20042006 but then appear (based on initial 2007 data) to be returning to historic levels. Whilst choosing to take early retirement may be a factor in the increase, the levels of retirement down to ill-health has signicantly reduced due possibly to the way the new contract allows GPs to better manage individual workload. But, overall it is not possible to say what the overall long-term eVects of new contractual arrangements might be in terms of an increase in early retirement. 3. Following the introduction of the pensions on-line system, which has enabled many enquiries about early retirement to be handled locally, it is not possible to give useful information about levels of enquiries. 4. Information on experience compared to actuarial assumptions is normally produced in the regular cycle of pension scheme valuations, the next of which is expected to be published next year. 5. We expected no signicant eVects on retirements from Agenda for Change or the Consultant contract. Table 137 GENERAL PRACTITIONERS RETIREMENTS AND REASONS FOR RETIREMENT Reasons for retirement Deferred Unknown and pension voluntary early Ill Health benet retirement 185 171 140 142 151 196 147 117 90 70 28 1,437 82 72 61 62 63 93 77 37 47 31 2 627 49 46 35 34 39 35 34 33 43 74 125 547 Total pension awards 781 740 630 568 789 888 782 639 535 567 727 7,646
Year end 31 March 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Total
Age 465 451 394 330 536 564 524 452 355 392 572 5,035
Source: Business Services Authority Pensions Division. Footnotes: 1. The NHS Pension Division administers the scheme for members in England and Wales. The data reects all retirements. It has not been possible to disaggregate Welsh doctor data. 2. Retirement data held by the NHS Pensions Division is designed primarily to record scheme membership to allow the calculation and payment of retirement pensions and to support periodic actuarial investigations by the government Actuary to ensure that contribution rates will allow the scheme to meet its future liabilities. This means that data can only, be routinely extracted by individual member, to calculate benets, or for actuarial groups for valuation. 3. The NHS Pension Divisionss data recording system manages over 1.2 million active records Most of which are subject to regular updates year on year. Retirement data will therefore represent a snapshot at a given period, which will be subject to change over time. 4. The table above does not reect accurately the position of all retirement pensions awarded in scheme year-end 2006. Whilst the data is always representative of a snapshot at the time of the extract, systems that record certain types of pension awards have not yet been updated to reect those completed in the nal three to four months of the scheme year-end 2006. This time lag of updating will cause a shortfall in all the gures stated. It is impossible to project how many awards processed have not yet been updated on the system. 5. The gures include all retirements on grounds of age, ill health, premature retirements following redundancy or interests of eYciency and voluntary early retirement before age 60 (introduced from 6 March 1995). Where possible data is shown separately for each category.
6.5.9 Based on the Departments reporting of progress against CSR 1998, target 32, there has been little progress in reducing sickness absence across the NHS since 2000. How is the 4.6% absence rate broken down between long- and short-term absences and between diVerent kinds of staV? The Department has reported a 65 million eYciency gain for reduced sickness and use of agency staV. Of this, how much relates to reduced use of agency staV, and how much to reduced sickness? (Q138) Answer 1. The national sickness and absence gure for the NHS is based on an overall sickness and absence rate provided by each NHS organisation. In 2005, the overall sickness and absence gure for the NHS fell slightly to 4.5% from 4.6% in 2004. This gure is the percentage of working days lost due to sickness within an organisation and the national average is calculated using a weighted average based on the staV numbers at each organisation. Statistics on the length of absences and absence rates for diVerent types of staV are not collected. 2. The annual national sickness and absence gures since 2000 are given in Table 138. 3. 41 million of the 65 million relates to reduced sickness. This is the calculated reduced cost of labour resulting from the 0.1% reduction in paid sickness hours. Table 138 NATIONAL NHS SICKNESS AND ABSENCE RATES, ENGLAND Year 2000 2001 2002 2003 2004 2005 Source: The Information Centre for Health and Social Care. Annual rate (%) 4.7 4.5 4.6 4.7 4.6 4.5
7. Full List of Questions 1.1.1 What has net NHS expenditure and annual change in net NHS expenditure been (a) in current prices (b) in real terms and (c) adjusted for NHS-specic ination in each year and planned year since 199394? What has net NHS expenditure been as a proportion of GDP in each year since 199394? (Q1)............................................................................................................................. 1.1.2 What has net NHS expenditure, net NHS expenditure per head and net NHS expenditure as a proportion of GDP been in (a) England (b) Wales (c) Scotland (d) Northern Ireland and (e) the United Kingdom in each year since 199798? (Q2)..................................................................... 1.2.1 Could table 2.2.1, detailing trends in actual and planned expenditureon health and personal social services by area of expenditure, be updated, together with the commentary on it? (Q3) ...... 1.2.2 What is the Departments assessment of expenditure on each programme in 200405 against plans for that year, and anticipated expenditure by programme in 200506 against plans for that year and outturn in 200405? (Q4) .................................................................................................... 1.2.3 What has additional NHS expenditure in 200506 compared with 200405 been spent on? Is it possible to provide a more detailed breakdown than last year? (Q5) ....................................... 1.3.1 Can the Department detail improvements in the scope and quality of programme budgeting? What changes are planned over the next year? (Q6)....................................................... 1.3.2 What was expenditure on cancer (a) in (b) as a proportion of total expenditure and (c) per head of population by Primary Care Trust in 200304 and 200405? Could the Department comment on these data and the quality of them? (Q7) .................................................................... 1.4.1 What has NHS income from charges been since 199798, by type of charge? (Q8) ........... 2.1.1 Could the department detail NHS capital spending by category of expenditure from 199798 to 200708? (Q9)................................................................................................................... 2.2.1 Could the Department list all publicly funded capital projects with a total cost above 10 million which are under construction? Could this include original and current estimated completion dates and costs and percentagetime/cost overruns and savings? (Q10) ............................................. 2.2.2 Could the Department provide a commentary on publicly funded capital projects where there are signicant discrepancies between original estimates of completion dates and/or expenditures and current estimates? (Q11) ......................................................................................... 2.3.1 Could the Department provide expenditure proles of capital expenditure on PFI schemes from 199798 onwards by (a) region and (b) scheme by broad capital cost of scheme? (Q12) ....... 2.3.2 Could the Department detail increases to the capital cost of PFIschemes and comment on any increases over 10%? (Q13) ........................................................................................................... 2.3.3 Could the Department provide an update of Tables 5.3.5, showing, for projects over 25 million in value, a comparison between the PFI price and the publicly nanced option? The publicly nanced comparators costings should be broken down into (a) basic construction contract, distinguishing pre-implementation and post-implementation costs (b) the value of risk adjustment, again distinguishing pre-implementation and post implementation costs, in both million and percentage terms, and (c) the nal total real full-life costof both options. (Q14) ............................ 2.3.4 What is the value of annual unitary payments made in the latest available year for each PFI scheme in operation? What is the Reference Cost Index (excluding Market Forces Factor) position of each trust, where theEngland average equals 100? (Q15) ............................................... 2.3.5 Could the Department list PFI schemes subject to an increase in theunitary fee, including the increases and explanation of them? (Q16) ................................................................................... 2.4.1 Could the Department list all NHS LIFT schemes and their expectedcapital costs? (Q17) 2.4.2 What has revenue spending on GP premises been in each year since 199798? Could the Department comment on the consistency of this series? (Q18) ......................................................... 2.5.1 Could the Department tabulate Local Authority Personal Social Services capital expenditure, broken down into maintenance and new acquisitions, and income, broken down into sale of buildings and sale of equipment, from 199798 to 200506? (Q19) ...................................... 2.5.2 What Personal Social Services PFI projects have been (a) approved and (b) given ministerial approval? Could details of value, approval date andcompletion date be included? (Q20) ............... 2.5.3 Could the Department compare actual capital spend by social services departments with allocations in each year since 199798? Could the Department comment on comparability through the period? (Q21) ................................................................................................................................ 3.1.1 How many (a) total doctors (b) consultants (c) GPs (d) total qualied nursing and midwifery staV (e) midwives (f) practice nurses (g) total qualied scientic and therapeutic staV (h) radiographers (i) clinical psychologists (j) total NHS infrastructure support staV (k) clerical and administrative staV and Health Select Committee: Public Expenditure Inquiry 2006 (1) managers
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and senior managers have been employed by the NHS in each year since 1997, in headcount and full time equivalent terms? Where available, what are the latest quarterly gures? (Q22) ............... 3.1.2 How many GPs (a) joined and (b) left the NHS in each year since 1997? (Q23) ............... 3.1.3 How many (a) doctors (b) nurses (c) midwives and (d) radiographers are projected to complete undergraduate or pre-registration training in each of the next ve years? How many are projected to reach retirement age in each of the next ve years? Could the Department comment on relative trends? (Q24)..................................................................................................................... 3.1.4 What was total expenditure on (a) agency nurses and (b) other agency staV in each year since 199798? (Q25)........................................................................................................................... 3.1.5 What was expenditure on (a) agency nurses and (b) other agency staV in each NHS Trust, Primary Care Trust and Strategic Health Authority in 200304 and 200405, in s and as a percentage of turnover? (Q26) ............................................................................................................ 3.2.1 What has the top (discretionary and non-discretionary, and including merit or distinction awards where appropriate) and bottom of the payscale and average full time earnings been for: (a) Nursing and Midwifery Grades DI (b) Nursing/Midwifery/Health Visitor Consultants (c) House OYcers (d) Senior House OYcers (e) Specialist Registrars (f) Associate Specialists (g) StaV Grade (h) Consultants (i) General Practitioners and (j) Salaried General Practitioners employed by PCTs been in each year since 199798? Why do average full time earnings exceed the top of payscales in some cases? (Q27) ............................................................................................................................... 3.2.2 What are the expected costs of Agenda for Change in each year from 200506 to 200809? Have these estimates changed, and if so, can the changes be explained? (028) ................................ 3.2.3 What is the current Agenda for Change assimilation rate? Can the Department comment on this gure? (029) ............................................................................................................................ 3.2.4 What are the expected costs of the new consultant contract in each year from 200506 to 200809? Have these estimates changed, and if so, can the changes be explained? What have consultant earnings been in each year since 200102? (Q30)............................................................. 3.2.5 What are the expected costs of the new GMS contract in each year from 200304 to 200607? (Q31).................................................................................................................................... 3.2.6 What is the funding for the new pharmacy contract in 200506 and 200607 and what will be the basis for such funding in subsequent years? Could the Department comment on the provision, and funding, of enhancedand advanced services? (Q32).................................................................... 3.2.7 What are the expected costs of the new dental contract in each year from 200506 to 200809? (Q33).................................................................................................................................... 3.2.8 What are the expected costs of the Options for Excellence social care workforce scheme, by year? Could the Department comment on the progress of the scheme? (Q34)............................ 3.3.1 What has NHS expenditure on the purchase of healthcare from non-NHS bodies been in each year since 199798? How much activity did this purchase? Could the Department provide a detailed breakdown of these data where available? (035) .................................................................. 3.3.2 Could the Department provide a list of all Independent Sector Treatment Centres (ISTCs) currently in operation, or with contracts already signed, including (a) name and location (b) company running the ISTC (c) services contracted for, by type and volume (by Healthcare Resource Group if possible) (d) value of contract per year, the period of the contract and whether it is on a take or pay basis and (e) a comparison with the cost at national tariV prices of providing the same type and volume of services? (036) ........................................................................................... 3.3.3 What has NHS expenditure on healthcare provided in other EEA member states or Switzerland been in each year since 200203? What is it expected to be in future years? (037)...... 3.4.1 Could the Department detail expenditure and projected expenditure on the National Programme for IT? Can the Department estimate the extent of local additions to NHS Connecting for Health funding? Could the Department comment on any cost overruns and delays? (Q38) ..... 3.4.2 What have the costs of implementing Choose and Book been to date? How does this compare with original estimates? (Q39) ............................................................................................. 3.4.3 How has the Department deployed the additional funding granted asa result of the Health Committees report into New Medical Technologies towards improving the management of patients through the use of telecare in liaison with social services? How was the funding for such schemes deployed in the last nancial year and how much will it be in the future? Is this money ring-fenced? (040) ................................................................................................................................ 3.4.4 How many, and what proportion of, practices are involved in practice-based commissioning (PBC), and what is progress towards the universal coverage of PBC? (Q41) ............................... 3.4.5 How much is available to PCTs to provide out-of-hours services? What proportion of practices have opted out of providing out-of-hours services? (042) ..................................................
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3.4.6 How much NHS expenditure was paid, or is forecast to be paid, to trusts via the national tariV in each year from 200405 to 200708? How much activity did this purchase? (Q43) ........... 3.4.7 Can the Department detail the current timetable for the implementation of Payment by Results, explaining any delays? (Q44) ................................................................................................ 3.4.8 How much extra funding is being provided to NHS bodies to assist with the continued phasing-in of Payment by Results in 200607 and 200708? (Q45) .................................................. 3.5.1 What are the expected costs of implementing each NICE recommendation, technology appraisal and clinical guideline in 200607? (Q46) ............................................................................ 4.1.1 What was HCHS expenditure by service sector and age group in (a) ? 2003-4 and (b) 200405? (Q47).................................................................................................................................... 4.1.2 Could a table be provided detailing gross expenditure on HCHS and FHS by sector in each year since 199798? (Q48)................................................................................................................... 4.2.1 Can the Department detail (a) Primary Care Trust allocations (b) distance from target allocation in 000s and in percentage terms and (c) allocations per weighted and unweighted head. of population in each year from 200304 to 200708 in each Strategic Health Authority area? Can data for individual PCTs be provided as an appendix? (Q49) .......................................................... 4.2.2 What was the average percentage absolute adjustment made to crude Primary Care Trust populations for (a) age structure (b) additional need (c) market forces and (d) other in the 200708 weighted capitation formula? (Q50) ................................................................................................... 4.2.3 What percentage adjustments were made to crude populations for (a) age structure (b) additional need (c) market forces and (d) other for each Primary Care Trust in the 200708 weighted capitation formula? (Q51)................................................................................................................... 4.3.1 What was pharmaceutical expenditure in each year from 199798 to 200506, by sector and generic/branded drugs? (Q52) ...................................................................................................... 4.4.1 Could the Department detail actual and planned expenditure on supra-regional and centrally commissioned services in each year from 200304 to 200708? (Q53) ............................... 4.5.1 What has net expenditure by central and local government on community care been in each year since 199798? Can the data be broken down by residential and non-residential care and include social security and housing expenditure contributing to community care objectives? (Q54) ............ 4.5.2 What was expenditure on NHS Continuing Care in each Strategic Health Authority in the latest available year, in absolute and per 100,000 population terms? Could the Department comment on these data? (Q55) ........................................................................................................................... 4.6.1 What was Personal Social Services expenditure on adults by client group and type of provision in (a) current prices and (b) real terms from 199798 to 200405? Could both client group and type of provision totals be included? (Q56) ................................................................................ 4.6.2 Could the Department detail trends in the unit costs of the main social services for adults each year since 1999-2000? How do costs vary between authorities? Could the Department comment on these gures? (Q57)........................................................................................................................ 4.6.3 What grants were available for Personal Social Services in each year since 200304? Could the Department comment on these data? (Q58) ................................................................................ 4.6.4 Could the Department detail trends in the Personal Social Services Pay and Price Index since 199798 and outline the assumptions behind the index? What are the expected nancial eVects of demographic pressures onPSS over the next ve years? (Q59) ..................................................... 4.6.5 Could the Department detail trends in sales and charges as a percentage of gross Personal Social Services expenditure on adults by typeof service (a) nationally and (b) by local authority? (Q60) ................................................................................................................................................... 4.6.6 What proportion of (a) contact hours of home help/care and (b) supported residential care was purchased by local authorities from the independent sectors, nationally, by region and by local authority, in the latest year for which data are available? Could the Department comment on thesedata? (Q61).................................................................................................................................. 4.6.7 Could the Department comment on the replacement of Formula Spending Shares for Personal Social Services with Relative Needs Formula calculations? (Q62) ..................................... 5.1.1 How many admissions, removals and decisions to admit were there in each year since 198889? What was non-emergency and emergency activity in each year? What was the waiting list, and how many suspensionsand self-deferrals were outstanding, at the end of each year? (Q63)..... 5.1.2 What were (a) mean and (b) median waiting times for inpatient admission in each year since 198889? Could these data be shown in tabularand graphical form? (Q64)............................ 5.1.3 Could the Department detail (a) numbers of First Finished ConsultantEpisodes (FFCEs), broken down into ordinary and day cases (b) admissions by type of admission and (c) episode/spell
51 52 54 55 56 57
58
59
60 61 62
63
64
65
66 68
69
70
71 72
73 74
ratios by Strategic Health Authority in the past three years for which data are available? Could the Department comment on the use of FFCEs rather than Finished Consultant Episodes (FCEs)? (Q65) ................................................................................................................................................... 5.1.4 How many patients were waiting for inpatient treatment, by time waiting and Strategic Health Authority in commissioner-based form at the last available count? What were the mean and median waiting times in eachcase? (Q66) ........................................................................................... 5.1.5 In latest quarter for which data are available, how many patients waited (a) over three months and (b) over six months for inpatient treatment by Strategic Health Authority of residence and specialty? (Q67)............................................................................................................................ 5.2.1 How many (a) GP referrals for rst outpatient appointment (b) other rst outpatient referrals (c) rst attendances and (d) other attendances were there in each year since 198889? (Q68) 5.2.2 What were (a) mean and (b) median waiting times for outpatient appointments in each year since 198889? Could these data be shown in tabular and graphical form? (Q69) .................. 5.2.3 How many new outpatient attendances were there by Strategic Health Authority in the past three years for which data are available? What are these data equivalent to per 1,000 population? (Q70) ............................................................................................................................... 5.2.4 Of patients not yet seen following written referral at the end of the latest quarter for which data are available, how many had been waiting (a) less than 13 (b) 13-17 (c) 17-21 and (d) more than 21 weeks, by Strategic Health Authority, in commissioner-based form? (Q71) ....................... 5.2.5 Of patients seen following written referral in the latest quarter for which data are available, how many waited (a) less than 13 weeks and (b) more than 13 weeks, by Strategic Health Authority of residence and specialty? (Q72) ....................................................................................................... 5.2.6 Could the Department comment on the progress of the Outpatient Commissioning Dataset? How much has been spent on the project, by year? How much is planned to be spent, by year? When are data likely to be published and in what form? Could the Department comment on the quality of these data? Could the Department comment on the possibility of making diagnosis and procedure mandatory in data submission? (Q73)............................................................................... 5.3.1 How many NHS GP consultations are estimated to have taken place in each year since 1989? (Q74) ......................................................................................................................................... 5.3.2 Could the Department provide evidence of any shift in activity from secondary to primary care settings? Could the Department comment on these data and the likely impact of such service reconguration? (Q75) ........................................................................................................................ 5.4.1 Could the Department comment on recent relative trends in waiting lists and times and rates of NHS activity? Could these comparative trends be shown graphically where appropriate? (Q76) ................................................................................................................................................... 5.4.2 What progress has been made towards monitoring the target of no patients waiting more than 18 weeks from GP appointment to treatment? Have any pilot studies taken place? If so, what were the results? When does the Department expect National Statistics accredited data to be published? (Q77) ................................................................................................................................. 5.4.3 What additional mechanisms are in progress to deal with waiting listsand times, and what is expenditure and projected expenditure on these additional mechanisms? (Q78)........................... 5.5.1 By sector, in each year since 199798, (a) how many available bedswere there (b) how many beds were occupied (c) what was the occupancy rate and (d) average length of stay? (Q79) .......... 5.5.2 How many (a) general and acute and (b) total beds were available ineach Strategic Health Authority in the latest year for which data are available? How many, and what proportion, were occupied? (Q80)................................................................................................................................... 5.6.1 How many delayed discharges from acute hospital beds were there in the last year, by Strategic Health Authority and broad reason for delay? What proportion of available beds are occupied by patients subject to delayed discharge by Strategic Health Authority? (Q81)................ 5.7.1 How many consultant episodes of patients with mental illness and how many per 1,000 population were there amongst residents of each (a) Strategic Health Authority and (b) Primary Care Trust area in 200304 and 200405? (082) ................................................................................ 5.7.2 Could the Department update the information given in Tables 3.4.1, on patients under the care of a learning disability or mental illness consultant, including (a) numbers of patients (b) discharges by length of stay, age and destination and (c) beds and residential places available? How many repeat admissions of such patients were there? (Q83) ............................................................. 5.7.3 How many people were admitted to (a) NHS facilities and (b) independent hospitals under the 1983 Mental Health Act in 200405, by Trust and type of section? (Q84) ................................ 5.7.4 How many patients with (a) mental illness and (b) learning diYcultieshave been resident in each high secure hospital in each year since 1997? Are any data available for medium security
75
76
77 78 79
80
81
82
83 85
86
88
89 90 92
93
94
95
96 99
hospitals and prisons? (085)................................................................................................................ 101 5.7.5 Is there any evidence of increasing emphasis on talking therapies in NHS mental health treatment? (Q86) ................................................................................................................................. 106 5.8.1 Could the Department comment on trends in (a) NHS star ratings and (b) social services star ratings performance? How many NHS organisations and councils saw a drop in their rating in each year for which data are available? Can the Department comment on any common factors between organisations with a ratings drop? (087).............................................................................. 109 5.9.1 What were management costs by type of NHS organisation and as a share of total NHS expenditure in each year since 199798? (Q88) .................................................................................. 112 5.9.2 Could the Department detail expenditure on management consultants as part of turnaround teams, nationally and by organisation? Could the Department comment on the availability of more general data concerning NHS expenditure on external consultants? (Q89) ...................................... 113 5.10.1 What has the NHS nancial balance been in each year since 199798? (Q90) .................. 114 5.10.2 What have decits and surpluses been in each (a) NHS Trust (b) Primary Care Trust and (c) Strategic Health Authority been in each year since 199798 for which data are available, in s and as a percentage of turnover? (Q91) ............................................................................................. 115 5.10.3 What steps is the Department taking to improve the ability of NHS bodies to make accurate forecasts of their year-end nancial position? What action is being taken to break the typical cycle identied by the Audit Commission of NHS bodies giving little credence to nancial information early in the nancial year, only to enter into corrective action after nding themselves in danger of overspending later in the year? What was the impact of the publication of mid-year nancial position forecasts in 200506? (Q92) ................................................................................... 116 5.10.4 Is there evidence of correlation between the 200506 nancial position of Primary Care Trusts and (a) 200506 per cent distance from target revenue allocation and (b) 200506 revenue allocation per unweighted head of population? Could these data be shown in graphical form? (Q93) ......................................................................................................................... 118 5.11.1 Could the Department give an explanation as to the level of funding set aside for ination in 200607? In particular, can it give the average pay awards to each (subjective) staV group and the ination assumptions for non pay including capital charges? (Q94)........................................... 119 5.11.2 Can the Department show trends in components of HCHS and FHS ination indices in each year since 199798 in as much detail as possible? (Q95) .......................................................... 121 5.11.3 What have trends in (a) the NHS ination index (b) sub-indices of the NHS ination index and (c) relative weights given to each sub-index been in each year since 199394? What assumptions underlie the construction of the index and any changes in weighting? (Q96)................................... 123 5.12.1 What progress has been made towards a replacement for the Cost Weighted Activity Index? What assessment has been made of recent trends in NHS productivity? (Q97) ............................... 125 5.12.2 What are the expected redundancy costs of the current re-organisation of Strategic Health Authorities and Primary Care Trusts? (Q98) ..................................................................................... 127 5.13.1 What was the total expenditure, grant-in-aid funding and whole time equivalent staYng of each of the Department of Healths Arms Length Bodies in 200506? (Q99) ............................ 128 5.13.2 Could the Department detail and comment on the extent of savings from its own change programme and the review of Arms Length Bodies? What further savings are anticipated in 200607 and 200708? What risk assessment has been undertaken to accompany these change programmes and to indicate the limits to further savings? What have the redundancy and relocation costs of these change programmes been? (Q100)............................................................................................. 129 5.13.3 Could the Department detail (a) administrative and (b) programme expenditure on consultants in 200506? Could the Department comment on these data and the quality of them? (Q101).................................................................................................................................................. 131 6.1.1 SR 2004, target 1. The department has not reported on the latest life expectancy gures. What are the current life expectancy gures for newborns? (0102)................................................... 132 6.1.2 SR 2004, target 2. Why has the gap in infant mortality between routine & manual and other groups widened? Why has the relative gap in life expectancy at birth increased, and why has the gap for females widened so much more than for males (by 8% and 1% respectively)? (0103) .. 133 6.1.3 SR 2004, target 2. What action has the Health Inequalities Unit identied as necessary to improve the Departments ability to hit the life expectancy target? (Q104) ..................................... 135 6.1.4 CSR 1998, targets 3 and 4. Both these targets show slippage. Why has this happened and what action is being taken to address it? (Q105)............................................................................... 136 6.2.1 A number of changes have been made to the commissioning of PFI projects. In particular, SHAs have been asked to work with Trusts and PCTs to reaYrm their capital investment plans in
light of movement of services into community settings, and the introduction of Payment by Results. Furthermore, trusts with signicant decits have been prevented from proceeding to market with large capital projects without plans to deal with the decits before nancial close. How many capital projects, and to what value, have been delayed or cancelled by PCTs and Trusts as a result of these reviews since April 2005? (0106)......................................................................................................... 138 6.2.2 A May 2006 BMA survey concluded that three quarters of GP practices felt their premises were not suitable for their future needs and six in every 10 practices worked from premises unsuitable for their current needs. The Association called for a sustained and consistent government commitment to recurrent revenue to back up capital investments. What is the Departments assessment of the suitability of those GP surgeries which have not beneted from LIFT funding for meeting current and future needs? What plans, if any, does the Department have to increase funding to support capital investment in primary care outside LIFT schemes? (Q107).................................................................................................................................................. 140 6.2.3 The Department has not allocated 1 billion (19%) of its capital budget as there may be additional costs arising from accelerated Foundation Trust Health Select Committee: Public Expenditure Inquiry 2006 capital expenditure and implementation of the White Paper. Given that Monitor would be expected to hold data on Foundation Trusts planned capital expenditure, why is the Department unable to forecast this more accurately? Has the Department nalised its use of the unallocated budget yet, and if so, how will it be applied? (Q108).............................................. 141 6.2.4 In its submission to the Committees inquiry into NHS Decits, the Department identied that there was slippage in capital expenditure of 1,162 million in 200506, compared with 547 million in 200405. What steps has the Department taken to speed up the delivery of capital projects? Based on the most recent data from NHS bodies, what is the expected underspend at the end of 200607? (Q109) ..................................................................................................................... 143 6.3.1 A review by the Kings Fund, Assessing the New NHS Consultant Contract, has identied signicant variation in the implementation of the consultant contract. For example, (i) 7am to 7pm working days have been classied as two PAs by some trusts and three PAs by others; (ii) there are disparities in the classication of emergency work between Bands; and, (iii) there are diVering ceilings on the number of PAs a consultant can be contracted for in a week. Why has there been such variation in theimplementation of the consultant contract? (Q110).......................................... 144 6.3.2 The same review also identied that the rst round of job planning has been largely a retrospective mapping exercise of how consultants spend their time, rather than a prospective exercise intended to enable Trusts to meet their aims better. What specic steps is the Department taking to ensure that Trusts take a prospective approach to job planning, and what evidence is there that progress is being made? What process would a Trust have to go through to alter the terms of those contracts made under the newarrangements which it already holds with its consultants? (Q111) ............................................................................................................................. 145 6.3.3 There is evidence that a number of consultants in London are working beyond the number of PAs they are contracted for eg, the Royal College of Physicians reported that the average consultant physician is working for 14.9 PAs per week compared to the average consultant contract of 11.1 PAs. How has the Department assessed the real working hours of consultants beyond their contracted hours and what implications do you seefor service quality and morale? (Q112)............ 147 6,3.4 Based on the unaudited accounts, please explain how much PCTs expenditure on GMS in 200506 is expected to have been compared to the allocation made? (Q113) .............................. 148 6.3.5 Where PCTs have made available additional resources to support the GP contract, how have these additional resources been nanced? Please provide specic details. (Q114) .................... 149 6.3.6 In its recent report on out-of-hours care, the NAO found that, if all PCTs matched the best in their rural/urban classication, up to 134 million could be saved in the commissioning of primary care. What steps has the Department taken to address the variation in costs, and what value of savings does it expect PCTs to make and when? (Q115) .................................................... 151 6.3.7 In the Departmental Report, the Department states that 32 Trusts have now achieved Foundation status, and afurther 24 have applied to Monitor for FT status. It is envisaged in the Report that most acute and mental health trusts will apply for Foundation status within the next three years. Subsequent reports in the press suggest that well under 50% of Trusts are set to achieve Foundation status by April 2008. Others may be held back for years by their inability to break even and by the cost of hospital building schemes under private nance initiatives. What is the Departments current assessment of the number of trusts that will achieve foundation status in each of the next three years, and how does this compare to your original projections? (Q116) . 153 6.3.8 The Department expects that the cost of Wave 1 and Wave 2 ISTCsmay amount to an investment of 3 billion over ve years. Overall, what is the total minimum payment which will be made to suppliers during this period, irrespective of levels of demand? Q117 ................................. 154
6.3.9 How many practices are currently making use of the opportunities tocommission using an indicative budget oVered by PBC and what proportion of the total budget available for PBC is managed in this way? How do thesegures compare with the Departments targets? (Q118).......... 155 6.3.10 What incentive do practices have to make use of PBC? (Q119) ........................................ 156 6.3.11 How is commissioning being integrated at the primary care and social care interface, and in particular how is PBC coordinating with Local Area Agreements and Local Strategic partnerships? (Q120) ........................................................................................................................... 157 6.3.12 The technical guidance for the implementation of Payment by Results in 2006-07 suggests that there were some data quality issues associated with the 2004-05 reference costs data. What were these issues and how have they been addressed? What implications do these data quality issues have for the fairness of the PBR tariV? (Q121) ................................................................................. 158 6.3.13 Some changes have been made to strengthen the labour element of the market forces factor (MFF) eg it has been expanded from 119 to 303 zones. However, it is based on labour market data from 2001-03. How accurate will this labour market data be for 2006-07 and 2007-08, especially given the signicant economic and wage growth in England since then? (Q122) ............................. 159 6.3.14 The adjustment to the tariV for capital costs is based on average capital costs. For some trusts with large capital programmes, this might underfund their expenditure. How many Trusts receive an allocation for capital costs which is lower than their capital costs, and how much is the shortfall in each case? What steps is the Department taking to adjust for this? (Q123).................. 160 6.3.15 Data from Monitor has identied bad debts in Foundation Trusts of 28 million because Primary Care Trusts may not pay for treatment of local patients. What is the value of disputed payments between Primary Care Trusts and NHS Trusts and how many Trusts and PCTs are involved? What mechanisms exist to resolve disputes, and how have these mechanisms been employed since the introduction of PBR? (Q124).............................................................................. 161 6.3.16 To what extent does PBR create incentives for Trusts to improve and potentially manipulate the coding of their activity to increase their income? We understand that coding will be audited by the Audit Commission. How will errors in the coding be corrected and what sanctions applied if trusts are found to have over-reported their activity? (Q1125)......................................... 163 6.4.1 What common traits has the Department identied in those PCTs which are under or over target share? For example, are they predominantly urban or rural, or disadvantaged or prosperous at either extreme. (Q126) .................................................................................................................... 164 6.4.2 For those PCTs who face higher costs under PBR, what will the nancial impact of the decision to change the purchasing parity adjustment from 100% to 50% be, and how many PCTs will be aVected? (Q127)....................................................................................................................... 165 6.4.3 The Human Resources DevelopmentStrategy will fall from 62.8 million in 2005-06 to 49.8 million in each of the subsequent years. What are the reasons for this? (Q128).............................. 166 6.4.4 From 2006-07, the method of allocating the funding Formula grant to local authorities is changing based on a Relative Needs Formula (RNF) for each service block. It is intended that the resource allocation will more accurately reect need for services. What diVerence does the change make for individual councils? Will there be cuts in funding and, if so, how much will be cut and which councils will be aVected? (Q129).............................................................................................. 167 6.5.1 The Department expects to save 500 million annually through the reduction of the number of arms length bodies (ALBs), SHAs and PCTs in its delivery chain. The Technical Note states that the transitional costs of restructuring the ALBs (eg early retirement or redundancy costs) will not be taken into account in assessing the eYciency savings. Are the savings on the restructuring of the SHAs and PCTs also gross of transitional costs? How much are the transitional costs for restructuring ALBs, SHAs and PCTs expected to be? (Q130) .......................................................... 168 6.5.2 What steps has the Department taken to ensure that there is no adverse impact on service quality arising from the PCT and SHA restructuring programme? (Q131) ...................................... 169 6.5.3 A component of the Departments EYciency targets was a reduction or elimination of central budgets. This is expected to save 500 million. The Technical Note makes clear the review of current budgets was intended to take place in autumn 2005 with benets occurring from April 2006. However, the central revenue and capital budgets planned for 2006-07 of 14.8 billion (Fig 3.8) are higher than those planned for 2005-06 of 13.7 billion (Fig 3.8 of the 2005 Departmental Report). What savings and reductions has the Department planned to make in 2006-07, and why has the overall gure for central budgets gone up between 2006-07 and 2005-06? (Q132) .............. 170 6.5.4 The basis of measurement for the Departments eYciency under the Public Funding & Regulation workstream is the Departments administration cost limit. However, this will be aVected in 2006-07 by the reclassication of the Health and Social Care Information Centre from administration to programme budgets. Will this reclassication be counted as an eYciency saving? (Q133).................................................................................................................................................. 171
6.5.5 A further component of the eYciency plans is to increase the income recoverable where personal injury compensation is payable. Income has only increased by 8m (7%) between 200304 and 2004-05, even though the law has enabled income to be collected in a greater range of circumstances since 2003. What targets does the Department have for revenue collection going forward, and how does it plan to strengthen revenue collection? (Q134) ......................................... 172 6.5.6 The Main Estimates suggest that the Department will only recover 25 million of the costs of treating visitors from the European Economic Area. This is down from 27 million in 2005-06. Why is revenue declining given the increasing numbers of overseas visitors, and the increasing costs of healthcare? What steps is the Department taking to boost recovery? More generally, what is the Departments estimate of the costs of treating all overseas visitors, and how much is actually recovered, either by Trusts or the Department? (Q135) .................................................................... 174 6.5.7 Expenditure on NHS Pensions is expected to be 11.1 billion in 2007-08, an increase of 193% on 2000-01. During this time, its share of the total resource budget of the Department of Health will have climbed from 7.7% to 11.1 %. How does the Department propose to address the signicant increase in NHS pension costs? (Q136) ............................................................................ 175 6.5.8 The BMA has stated that the increased pay under the new GMS contract will result in an increase in the number of GPs taking early retirement in the next two years. The same issue may apply in other areas of the Health Service. What impact did the Department expect the pay arrangements to have on the retirement plans for GPs, consultants and other NHS staV when the reforms were introduced, and how do these compare to the actuarys current expectations? Based on the latest data available, how do current rates of early retirement compare to these expectations and to previous years? What evidence is there of increased interest in early retirement eg more purchases of added years or AVCs or greater numbers of enquiries to NHS Pensions on the subject? Can we have what gures you have available? (Q137)...................................................................... 176 6.5.9 Based on the Departments reporting of progress against CSR 1998, target 32, there has been little progress in reducing sickness absence across the NHS since 2000. How is the 4.6% absence rate broken down between long- and short-term absences and between diVerent kinds of staV? The Department has reported a 65 million eYciency gain for reduced sickness and use of agency staV. Of this, how much relates to reduced use of agency staV, and how much to reduced sickness? (Q138) 177
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Public Expenditure On Health and Personal Social Services 2006

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Public Expenditure On Health and Personal Social Services 2006

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House of Commons Health Committee

Public Expenditure on Health and Personal Social Services 2006

The Health Committee

Public Expenditure 2006

NHS Plan and Reform

Breakdown of Spending Programme

Activity, Performance and Efficiency

Public Expenditure 2006

Full List of Questions

Public Expenditure Committee: Evidence Ev 1

Ev 2 Public Expenditure Committee: Evidence

N Ireland Net NHS Expenditure Net NHS spend per head

Public Expenditure Committee: Evidence Ev 3

Ev 4 Public Expenditure Committee: Evidence

58,157 2,146 60,303

63,001 2,665 65,666 8.9 6.0 5.5

70,112 3,184 73,297 11.6 9.3 9.0

76,620 3,325 79,945 9.1 6.5 6.7

83,239 3,345 86,584 8.3 5.5 5.8

2,566 289 2,854

2,804 353 3,157 10.6 7.7

4,381 393 4,774 51.2 48.1

5,180 205 5,385 12.8 10.1

6,167 130 6,297 16.9 13.9

295 20 315 "4.2

286 27 312 "0.8

261 10 271 "13.2

259 10 269 "0.8

Public Expenditure Committee: Evidence Ev 5

200506 Estimated Outturn outturn "6.8 "2.8 14

200607 Plan "15.3 14

200708 Plan "3.3 14

1,046 103 1,149 7.6 4.7

1,026 140 1,166 1.5 "0.6

1,180 141 1,321 13.3 10.6

1,315 132 1,448 9.6 6.8

64,181 3,461 67,643

69,306 3,992 73,298 8.4 5.5 5.1

77,847 4,513 82,361 12.4 10.0 10.0

84,387 4,147 88,534 7.5 4.9 5.8

92,173 4,073 96,246 8.7 5.9 6.4

251 50 300 21.4 18.2

245 46 291 "3.1 "5.1

251 46 297 2.1 "0.4

273 46 319 7.5 4.7

1,896 0 1,896 30.8 27.3

1,912 0 1,912 0.9 "1.2

1,628 0 1,628 "14.9 "16.9

1,666 0 1,666 2.3 "0.3

Ev 6 Public Expenditure Committee: Evidence

200506 Estimated Outturn outturn 53 0 53 7.2 4.4 53 0 53 0.9 "1.1

200607 Plan 53 0 53 0.0 "2.4

200708 Plan 53 0 53 0.0 "2.6

65,876 3,513 69,389

71,505 4,042 75,547 8.9 6.0 5.7

80,058 4,559 84,617 12.0 9.7 9.6

86,319 4,193 90,512 7.0 4.4 5.2

94,165 4,119 98,284 8.6 5.8 6.3

14,763 2,077 16,839

15,586 2,800 18,386

n/a n/a n/a

n/a n/a n/a