Experts warn North East will suffer under proposed new NHS funding formula

A new proposed formula for NHS funding could "widen the north-south health divide", experts have warned

Nursing staff dispensing drugs from a trolley
Nursing staff dispensing drugs from a trolley

Experts in the North East have warned that the region and other disadvantaged areas will lose out if a proposed NHS funding formula is given the green light.

NHS England is currently reviewing the funding formula that is used to allocate money to Clinical Commissioning Groups across England.

The controversial revisions would mean that there will be no weighting for levels of deprivation in local areas, or places which have poor health outcomes.

Independent experts have now warned that this “could widen the North-South health divide by reducing NHS services in the North.”

Prof Clare Bambra and Dr Alison Copeland from Durham University argue that “the more affluent, healthier South East will benefit most and the poorer, less healthy North will lose out substantially.”

They say that NHS funding is allocated to areas on the principle of providing “equal opportunity of access for equal need.” To help achieve this, the current NHS allocation formula incorporates a deprivation related measure, known as the “health inequality weighting.”

Clare Bambra, professor of public health policy and director of the Wolfson Research Institute at Durham University, said: “The proposed new formula would be another hit for the North East and I would urge people in the region to contact their MP.

“People should be concerned. Our local authorities are already making cuts and it seems that the North East is having to pay a high price.”

The relative roles of deprivation and age as determinants of health have been subject to political debate over the past year and NHS England is now consulting on a new “weighted capitation formula.” This removes the health inequality weighting and increases the emphasis given to age.

Last week, The Journal revealed that if the formula had been deployed for 2013/14 the NHS in the North would have lost £228m of funding.

In Clinical Commissioning Groups like South Eastern Hampshire, where healthy life expectancy is 68 years for women, NHS funding will increase by £164 per person, an increase of 14%. Meanwhile, Sunderland Clinical Commissioning Group, where healthy life expectancy is 58 years for women, NHS funding will decrease by £146 per person, a reduction of 11%.

“Although these changes are not on the scale that a purely ‘age only’ allocation formula would produce, they are still sufficient to undermine the principle of equal opportunity of access for equal need,” explained the Durham University academics, whose work is published in the online medical journal

“They are also potentially a first step towards an age only allocation, and they could widen the north-south health divide by reducing NHS services in the north.”

It is expected that the review group will make detailed proposals to NHS England’s Board in December to inform 2014-15 allocations and a final report in July 2014 to inform 2015-16 allocations.

A spokesperson for NHS England, said: “NHS England has a legal duty to ensure equal access for equal need and to contribute to addressing health inequalities. We need to therefore consider how best we ensure funding is distributed to meet these objectives.

“The purpose of the allocations review is to consider a range of options for the future approach to allocation of funds.

“It is only right that we examine the risks and benefits of a range of options. We will also need to consider how any change to the formula is implemented and over what period of time.

“The review group has just completed a round of regional engagement events, at which representatives from all NHS organisations came together to hold honest and

pragmatic discussions about how funding should be allocated.”


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