The Resource Allocation Formula Calculation
June 2011
Difference between recommended NRAC spend per head and an equal share (2011/12) - Population
-200
-150
-100
-50
0
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Sp
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Difference between recommended NRAC spend per head and an equal share (2011/12) - Age sex
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-£50
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Age-sex
Difference between recommended NRAC spend per head and an equal share (2011/12) - Age sex and MLC (cumulative)
-£200
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(£)
Age-sex
MLC
Difference between recommended NRAC spend per head and an equal share (2011/12) - MLC and UXC (cumulative)
-£200
-£150
-£100
-£50
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(£)
MLC
UXC
Difference between recommended NRAC spend per head and an equal share (2011/12)
-£200
-£150
-£100
-£50
£0
£50
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£200
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£350A
yrsh
ire &
Arr
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Bor
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Fife
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& C
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Hig
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Sp
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(£)
NRAC
Formula Structure
Population
Health Board Population %
Age/Sex Cost Weights
Relative need due to age/sex profile
X
Additional Needs
X Relative need due to MLC and other factors
X
Unavoidable Excess Costs
Relative cost of providing services to
different geographical
areas
= Weighted Share %
Care Programmes
The Resource Allocation formula covers six care programmes:
• Acute• Care of the Elderly• Mental Health & Learning Difficulties • Maternity• Community
• GP Prescribing
Hospital and Community Health Services (HCHS)
Prescribing
Weighting of Expenditure across Care Programmes
AcuteCare of
the Elderly
Mental Health & Learning Difficulties
MaternityCommunity
Travel-based
Community Clinic-based
Overall HCHS
GP Prescribing
51.0% 3.5% 12.3% 3.5% 10.9% 5.5% 86.7% 13.3%
Data Source: Costs Book, year ending 31st March 2008
GP Prescribing
• No adjustment is made for unavoidable excess costs
• Funds are allocated to Boards based on the location of GP practices within their area
• Prescribing formula only applies to the cost of prescriptions that are dispensed in the community (i.e. through a community pharmacist or GP)
• Hospital prescribing costs, although not separately identified within the formula, are included within the HCHS allocations
Formula Structure
Population
Health Board Population %
Age/Sex Cost Weights
Relative need due to age/sex profile
X
Additional Needs
X Relative need due to MLC and other factors
X
Unavoidable Excess Costs
Relative cost of providing services to
different geographical
areas
= Weighted Share %
Populations – HCHS (1)
General Register Office for Scotland (GROS) mid year estimates & population projections
• Health Board and datazone populations (rebased)
• Used for the HCHS part of the calculation
Allocation year
Allocations run autumn of year
Projection base available
Projected year
Re-basing of projections
2009/10 2008 2007 2009 Re-based with 2007 MYE
2010/11 2009 2008 2010 Re-based with 2008 MYE
2011/12 2010 2009 2011 Re-based with 2009 MYE
2012/13 2011 2010 2012 Re-based with 2010 MYE2008
Mid-year Estimates (MYE) available
2006
2006
2008
Populations – HCHS (2)
For example, to re-base the 2006 based projection of 2010 populations using 2008 Mid Year Estimate (MYE) for the 2010/11 allocation year the calculation is:
(2008 MYE)
– (2006 based projection of 2008)
+ (2006 based projection of 2010)
• the re-base calculations are produced at health board level then compared to health board MYEs to create an adjustment factor
• This adjustment factor is used to calculate population projections by datazone as GRO do not publish projections at this level
Populations – HCHS (3)
Age (in years) 1 2 …….. 90 Total 1 2 …….. 90 TotalDatazone1 11 36 …….. 23 410 12 45 …….. 26 470 880Datazone2 10 12 …… 12 470 13 14 …… 14 502 972Datazone3 17 31 ……… 14 425 17 37 ……… 15 526 951
Age (in years) 1 2 …….. 90 1 2 …….. 90HB 1 1.01 0.99 ……. 1.03 1 0.99 ……. 1.04HB 2 0.98 1.02 ……. 1 0.99 0.98 ……. 0.99HB 3 1 0.97 …….. 0.99 1.03 1 …….. 0.97
datazone total mid-year estimates
Females (mid-year estimates population)
Males (adjustment factor ) Females (adjustment factor )
Males (mid-year estimates population)
Age (in years) 1 2 …….. 90 Total 1 2 …….. 90 TotalDatazone1 11.11 35.64 …….. 23.69 415.75 12 44.55 …….. 27.04 475.66 891.41Datazone2 9.8 12.24 …… 12 463 12.87 13.72 …… 13.86 495.15 958.15Datazone3 17 30.07 ……… 13.86 427.34 17.51 37 ……… 14.55 520.23 947.57
Females (re-based population projections) datazone total re-based population
Males (re-based population projections)
Populations – GP Prescribing (1)
Community Health Index (CHI) Data
• Provides information on all patients registered with a
GP in Scotland
• Practice population adjusted for list size inflation
• Rescaled to HCHS rebased population projections
• Used for the GP Prescribing part of the formula
Percentage difference between GROS population shares and CHI population shares (GROS minus CHI)
-1.0%
-0.8%
-0.6%
-0.4%
-0.2%
0.0%
0.2%
0.4%A
yrsh
ire &
Arra
n
Bor
ders
Dum
fries
& G
allo
way Fi
fe
Forth
Val
ley
Gra
mpi
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ater
Gla
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& C
lyde
Hig
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d
Lana
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Loth
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Ork
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She
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Tays
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Wes
tern
Isle
s
Source: GROS June 2010 MYE compared to CHI July 2010 list sizes
Total populations: GROS 5.1m, CHI, 5.5m
Populations – GP Prescribing (2)
• The re-base calculations are produced by local council area then compared to local council area mid-year estimates (GROS) to create adjustment factor
• Adjustment factors produced for all combinations of local council area of residence, age and sex
• This adjustment factor is applied to the GP practice population
Population - Questions?
Resource Allocation FormulaAge/Sex Cost Weights
Population
Health Board Population %
Age/Sex Cost Weights
Relative need due to age/sex profileX
Additional Needs
XRelative need due to MLC and other factors
X
Unavoidable Excess Costs
Relative cost of providing services to
different geographical
areas
=Weighted Share %
Age/Sex Cost Weights
Relative need due to age/sex profile
Age/Sex Analysis
• The formula accounts for the effect of age differences on the cost of delivering different NHS services for each sex
• Older and very young people tend to consume
greater resources so the costs rise steeply with age
• Calculations are carried out for each care programme
Combining Costs & Activity Data
Example for the Acute care programme - Age/sex costs per head:
• Twenty age bands are used giving a total of 40 age/sex cost weights
• All are costs per head except maternity which is cost per birth
• Weights are multiplied through the NHS Board populations at datazone level (or births) to give an expected cost that takes into account different demographics
• The age-sex index for each datazone is the ratio of the datazone cost per head to the Scottish cost per head
Age Band 0-1 2-4 5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89 90+
Males 1051 282 218 204 202 211 218 252 295 328 382 491 624 868 1141 1467 1880 2383 2836 3277
Females 897 232 196 186 205 233 262 291 321 367 429 510 592 735 969 1211 1610 2111 2712 3072
Average costs by age & gender
Age sex cost curve (Acute care in Scotland)
£0
£500
£1,000
£1,500
£2,000
£2,500
£3,000
£3,500
0-1 2-4 5-9 10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90+
Age Band
Ave
rag
e co
st p
er H
ead
Males
Females
Age/Sex Analysis - exampleAge group 1 2 …….. …….. 20 1 2 …….. …… 20
Acute cost per head (£) 1,051 282 …….. …….. 3,277 897 232 …….. ……….. 3,072
Age group 1 2 …….. …….. 20 1 2 …….. …….. 20
Total population
Datazone1 11 9 ……. ……. 2.5 14 10 ……. ……. 4 842
Datazone2 11 21 …….. ……. .0 12 21 ……. ……. 1 629
Datazone3 6 9 ……. ……. .0 10 17 …… ………. 1 814Scotland 60,478 87,118 ……. ……. 9,035 57,819 83,222 ……. ……. 25,599 5,201,829
Males (population) Females (population)
Males Females
Age group 1 2 …….. …….. 20 1 2 …….. …….. 20
Total Expected cost
Datazone1 11,600 2,597 8,202 12,599 2,385 13,483 168,464 Datazone2 11,599 5,845 - 10,798 4,772 3,371 168,464 Datazone3 6,327 2,620 - 8,998 4,057 3,371 125,844 Scotland 63,562,378 24,567,276 29,607,695 51,863,643 19,307,504 78,640,128 1,040,365,800
Males expected cost Females expected cost
Total Expected Cost
Total Population
Cost Per Head
Age Sex Index
Datazone1 168,464 842 200 1.00
Datazone2 168,464 629 268 1.34
Datazone3 125,844 814 155 0.77
Scotland 1,040,365,800 5,201,829 200 1.00
GP Prescribing – Age/Sex Analysis (1)
• Sample of 1,000 prescriptions per month over a year.• Pooling samples over the most recent 3 years are
used to produce cost per head by gender and age (9 age bands)
• The age-sex index for each practice is the ratio of the practice cost per head to the Scottish cost per head
Age group
(years) 0-4 5-14 15-24 24-34 35-44 45-54 55-64 65-74 75+
Males 31 29 52 69 120 184 280 465 570
Females 37 48 53 81 129 209 300 438 540
GP Prescribing - Age Sex Analysis (2)
Average costs by age & gender (GP prescribing)
Three years average age sex cost curve
0
100
200
300
400
500
600
0-4 5-14 15-24 24-34 35-44 45-54 55-64 65-74 75+
Age (years)
co
st
pe
r h
ea
d
Males
Females
Variation in age-sex indices by care programme
-30%
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-10%
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40%Ay
rshi
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Bord
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Shet
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Acute
COTE
MH&LD
Maternity
Community
GP presc
Comparison of age-sex indices for the different care programme, selected NHS Boards
-30%
-20%
-10%
0%
10%
20%
30%
40%
Ayrshire &Arran
Borders Grampian Highland Orkney Western Isles Dumfries &Galloway
Shetland
Acute
COTE
MH&LD
Maternity
Community
GP prescribing
Age Sex Adjustment - Questions?
Resource Allocation Formula Additional Needs
Population
Health Board Population %
Age/Sex Cost Weights
Relative need due to age/sex profile
X
Additional Needs
X
Relative need due to MLC and other factors
X
Unavoidable Excess Costs
Relative cost of providing services to
different geographical
areas
=Weighted Share %
The Additional Needs - Morbidity and Life Circumstances (MLC)
• This adjustment takes into account factors that predict the need for healthcare in addition to the needs due to age and sex
• This index directs relatively greater resources towards Boards with higher additional needs
• The factors that best explain the variation in need for each care programme were identified using statistical linear and log linear regression analysis
The Additional Needs – small area indices
• The index is constructed at the intermediate data zone (IDZ) level (currently there are 1235 IDZs and 6505 data zones)
• Each data zone within an IDZ shares the same index value
• It is updated every three years
The Additional Needs Regression Indices
Regression Index Name Needs variables Topic Source Period
Acute/Care of the Elderly/GP Prescribing
All cause standardised mortality rate - age 75 and under Births & deaths ISD 2001-2005
Limiting long-term illness rate (age-sex standardised using 7yr age bands) Morbidity Census 2001
Mental Health & Learning Disabilities
Proportion claiming severe disablement allowance (% of 16+ population)
Claimant counts & economic indicators SNS 2004
Proportion in one person households Households Census 2001
Proportion in social rented housing Housing SNS 2001
Maternity
Mean House Price Housing SNS 1994-2005
Birth rate per female population Births & deaths GRO(Births) 2005
SEURC supplementary variable Rurality SNS 2004
SNS – Scottish Neighbourhood Statistics
The Additional Needs – Regression Analysis
Coefficients needs indices by diagnostic group using the acute regression index
Care Group\Diagnostic Group Constant Index Coefficient
Acute Cancer 1.003 0.038
Circulatory 1.012 0.107
Digestive 1.008 0.116
Injuries 1.004 0.113
Other Acute 1.004 0.092
Acute Outpatients 1.003 0.040
Respiratory 1.017 0.171
Care of the Elderly 1.029 0.089
Prescribing Cardiovascular 1.003 0.079
Central Nervous System
0.937 0.125
Gastro-intestinal 0.984 0.094
Infections 0.953 0.018
Musculoskeletal 1.019 0.133
Other Prescribing 1.021 0.069
Maternity coefficients of needs index using the maternity regression index and supplementary variable for Maternity
Variable Value
Maternity - Constant 1.011
Maternity - Index Coefficient -0.034
Maternity - Supplementary Variable*: SEURC 1 0.000
SEURC 2 0.055
SEURC 3 0.036
SEURC 4 0.132
SEURC 5 0.033
SEURC 6 0.097
Care Group/Diagnostic Group Constant Index Coefficient
Mental Illness and Learning difficulties*
-0.223 0.139
Coefficients needs indices by diagnostic group using the mental health regression index
The Additional Needs (1)
Needs
Utilisation
1Nationalaverage
The Additional Needs (2)
Needs
Utilisation
1
* Repeat for each diagnostic group
The Additional Needs (3)
DiagnosticGroup
A
B
Utilisation
1
Needs
The Additional Needs (4)
DiagnosticGroup
A
B
Utilisation
1
IDZ 1
0.85
Needs
MLC = constant + Coefficient*need
The Additional Needs (5)
DiagnosticGroup
A
B
Utilisation
1
IDZ 1
MLC = 0.95
Needs
MLC = constant + Coefficient*need
Average across acute diagnostic groups (weighted by costs)
…….
respiratory heart cancer other
0.95 0.85 1.1 1.0
0.90IDZ Acute MLC index =
The Additional Needs Indices
• Acute, Care of the Elderly & GP Prescribing: using Acute Regression Index MLC Index = constant + Coefficient*Index
• Mental Health & Learning Difficulties: using Mental Health Regression IndexMLC Index = Exp (constant + Coefficient*Index)
• Maternity: using Maternity Regression IndexMLC Index = constant + Coefficient*Index + Maternity supplementary variable coefficients
Community Additional Needs Index
InCare Group/Diagnostic group Cost weighting %
AcAcute Outpatients
59.49AcCare of the elderly
15.18MeMental health & learning difficulties
20.39MaMaternity
4.94
Cost weightings for community needs index
The additional needs index for community is calculated by combining MLC indices from the four groups ‘acute outpatients’, ‘care of the elderly’, ‘mental health & learning difficulties’ and ‘maternity’ by using community weightings as shown below:
MLC indices by care programme
-20%
-15%
-10%
-5%
0%
5%
10%
15%
20%
Ayr
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rran
Bor
ders Fife
Gre
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Gla
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lyde H
ighl
and
Lana
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Gra
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Tays
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Forth
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Dum
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&G
allo
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She
tland
Acute
COTE
MH&LD
Maternity
Community
GP prescr
MLC indices for different care programmes, selected NHS Boards
-20%
-15%
-10%
-5%
0%
5%
Ayrshire &Arran
Borders Grampian Highland Orkney WesternIsles
Dumfries &Galloway
Shetland
Acute
COTE
MH&LD
Maternity
Community
GP presc
Additional Needs - Questions?
Resource Allocation FormulaUnavoidable excess costs adjustments
Population
Health Board Population %
Age/Sex Cost Weights
Relative need due to age/sex profile
X
Additional Needs
X
Relative need due to MLC and other factors
X
Unavoidable Excess Costs
Relative cost of providing services to
different geographical
areas
=Weighted Share %
Unavoidable Excess Cost Adjustments
• Indices are calculated annually to adjust for the unavoidable excess costs of delivering services in to different geographical areas
• Separate indices are calculated for hospital and community activity
• For hospital activity, indices are calculated for each of the four care programmes (acute, mental health & learning disabilities, care of the elderly and maternity)
• For community services, indices are calculated for clinic based and travel based services
Hospital Unavoidable Excess Cost (1)
• Cost ratio to analyse the variation in local costs relative to the costs for the same service at national average unit costs
• Produced by urban - rural category in which the data zone lies
• The index provides a better reflection of all unavoidable excess costs of supplying health services rather just remoteness
Hospital Unavoidable Excess Cost (2)Scottish Executive Urban Rural Categories (SEURC):
Primary CitiesUrban SettlementsSmall towns – accessibleSmall towns – remoteSmall towns – very remote – mainlandSmall towns – very remote – islandRural areas – accessibleRural areas – remoteRural areas – very remote – mainlandRural areas – very remote – island
Hospital Unavoidable Excess Cost (3)
1 2 3 4 5 6 7 8 9 10Ayrshire & Arran - 58% 19% 3% - - 17% 1% - 2%Borders - 25% 19% 5% - - 44% 7% - -Fife - 62% 18% - - - 21% - - -Greater Glasgow & Clyde 80% 14% 4% - - - 2% - - -Highland - 21% 7% 7% 12% 2% 13% 9% 24% 4%Lanarkshire 40% 39% 9% - - - 12% - - -Grampian 37% 11% 15% 4% - - 24% 8% 1% -Orkney - - - - - 31% - - - 69%Lothian 59% 21% 10% 2% - - 7% 1% - -Tayside 39% 26% 10% - - - 21% 4% 0% -Forth Valley - 71% 10% - - - 17% 2% - -Western Isles - - - - - 30% - - - 70%Dumfries & Galloway - 29% 18% 5% - - 28% 20% - -Shetland - - - - - 32% - - - 68%Scotland 39% 29% 10% 2% 1% 1% 13% 3% 2% 1%
* Key to categories1 = Primary cities. 6 = Island very remote small towns.2 = Urban settlements. 7 = Accessible rural areas.3 = Accessible small towns. 8 = Remote rural areas.4 = Remote small towns. 9 = Mainland very remote rural areas.5 = Mainland very remote small towns. 10 = Island very remote rural areas.
Health BoardSEURC categories*
Percentages Health Board’s resident in each urban-rural category
Hospital Unavoidable Excess Cost (4) – Example: Acute care programme
Excess Costs index = 0.98
Datazone Local cost National cost Ratio SEURC SEURC description1 1,209,638 1,448,280 0.84 3 Small towns – accessible 2 698,237 704,695 1 7 Rural areas – accessible3 1,975,964 1,960,365 1.01 3 Small towns – accessible 4 1,121,826 1,093,976 1.03 2 Urban Settlements5 1,339,308 1,357,458 0.99 1 Primary Cities6 1,811,989 1,983,150 0.92 1 Primary Cities7 1,907,485 1,409,637 1.36 10 Rural areas – very remote – island8 1272175 1236150.57 1.04 4 Small towns – remote. . . . .. . . . .. . . . .. . . . .
6505 1087565.2 1285651.24 0.85 5 Small towns – very remote – mainland
Datazone SEURC1 33 315 337 359 369 3116 3405 3
. .
. .
. .
. .6115 3
SEURC SEURC descriptionAcute excess
cost index
1 Primary Cities 1.012 Urban Settlements .993 Small towns – accessible .984 Small towns – remote .975 Small towns – very remote – mainland 1.036 Small towns – very remote – island 1.087 Rural areas – accessible .988 Rural areas – remote .989 Rural areas – very remote – mainland 1.0110 Rural areas – very remote – island 1.12
Community Unavoidable Excess Cost (1)
Travel based services
Travel Simulation Model based on:
• Census output areas (~ 42,604 output areas ) data
• Data about drive time to small settlement’ (3000+ people) or ‘large settlement’ (10,000+ people) size
• Assumptions about contact duration, setup time, Island contact time, base location & proportion of home visit
• Population weighted by age-sex
Community Unavoidable Excess Cost (2) – Travel based services adjustment
Community Psychiatric Team 13.5 45 5 15 / 20 (Urban) 120 3,000 50 90
Physiotherapy 2.2 60 5 15 / 20 (Urban) 120 3,000 50 50
Occupational Therapy 1.3 60 5 15 / 20 (Urban) 120 3,000 50 50
District Nursing 15.2 29 5 15 / 20 (Urban) 120 3,000 91 91
Health Visiting 7.7 29 5 15 / 20 (Urban) 120 3,000 48 90
Speech Therapy 1.8 29 5 15 / 20 (Urban) 120 10,000 25 90
Addiction Services 2.6 50 5 15 / 20 (Urban) 120 10,000 25 25
Chiropody 2.4 29 5 15 / 20 (Urban) 120 10,000 25 90
Midwifery 2.9 29 5 15 / 20 (Urban) 120 10,000 25 25
Dietetics 0.7 29 5 15 / 20 (Urban) 120 10,000 35 35Community Learning Disabilities Teams 2.7 29 5 15 / 20 (Urban) 120 10,000 70 70
Large Settlement Services 47 29 5 15 / 20 (Urban) 120 10,000 25 25
Within-Settlement Travel Time (min)
Island Contact Time (min)
Base Location (Settlement)
Home-Visits (%)
Rural Home-Visits (%)Service
Expenditure Weight (%)
Contact Duration (min)
Setup Time (min)
Community Unavoidable Excess Cost (3)Clinic based services
• For clinic based services the costs of providing services in remote general practices taken from the Scottish Allocation Formula (SAF)
• SAF - Scottish version of the UK General Medical Services Formula
• Take remote and rural need index from SAF report
• Take CHI populations extract by GP practice & data zone
Community Unavoidable Excess Cost (4)Clinic based services
• Map GP practice level index to CHI file then average to data zone, using a weighted average of index weighted by population per practice
• Convert the needs index to a relative index by dividing through by the national average value, e.g. to get 1.05 etc where Scotland is 1
GP Prescribing – Unavoidable Excess Costs
• The GP prescribing excess cost index is set to one for all practices as prescriptions are reimbursed at national fixed prices
Different unavoidable excess cost indices by care programme
-20%
-10%
0%
10%
20%
30%
40%
50%
60%
Acute
COTE
MH&LD
Maternity
Community travel
Community clinic
Unavoidable excess costs indices by care programme, selected NHS Boards
-10%
0%
10%
20%
30%
40%
50%
60%
Ayrshire &Arran
Borders Grampian Highland Orkney WesternIsles
Dumfries &Galloway
Shetland
Acute
COTE
MH&LD
Maternity
Community travel
Community clinic
Unavoidable Excess costs - Questions
Overall Results • The indices for HCHS and GP Prescribing parts of
the formula are calculated separately
• Final index for age/sex, additional needs and unavoidable excess cost at data zone level/GP practice are produced by using care programme weightings from the Costs Book to combine all different care programme indices
• The indices are relative to the Scottish average value equal to 1.0
Data Sources
• Costs data is based on the Scottish Health Service Costs Book
• Activity data:
- Healthcare data for individual patients is collected as a series of Scottish Morbidity Records (SMR)
- Other data sources, including • Practice Team Information (PTI)• General Register Office (GRO)
Data SourcesCosts dataHospital
SFR 5.3 Inpatient total net expenditure by specialtySFR 5.5 Daycase total net expenditure by specialtySFR 5.6 Outpatient Treatment total net expenditure by specialtySFR 5.7 Outpatient Consultant Clinics total net expenditure by specialtySFR 5.7n Nurse-Led Outpatient Clinic total net expenditure by specialtySFR 5.9 Day Patient total net expenditure by Specialty
Community
SFR 8.3 Community Health Services Expenditure by service
Data Sources – Hospital Activity data
Care Programme Patient Type Data Scheme Activity used to proportion costs
Acute Daycases SMR01 Discharges
Inpatients SMR01 Discharges for total cost, length of stay for variable cost
Outpatients/Daypatients SMR00 New outpatient attendances
Care of the Elderly
Inpatients SMR50 Length of stay
Mental Health & Learning Disabilities
Inpatients SMR04 Length of stay
Outpatients/Daypatients SMR00 New outpatient attendances
Maternity Inpatients/Daycases SMR02 Discharges for total cost, length of stay for variable cost
SMR01 (abortions)
Discharges for total cost, length of stay for variable cost
Outpatients/Daypatients SMR00 New outpatient attendances
Births GRO Births
Cost Source of Scotland level patient activity profiles by age-sex
District nursing District nurse patient contacts from Practice team Information (PTI)
Health visiting Health visitor patient contacts from PTI
Midwifery New outpatient attendances for obstetric services
Psychiatric team Patient contacts from PTI for mental health
Learning difficulties team New outpatient attendances for learning difficulties services
Child health Population aged 14 and under
Specialist nursing Patient contacts from PTI
Addiction services Drug and alcohol misuse data
Family planning Female population aged 15-44
Allied health professionals (AHPs)
Clinical psychology All staff contacts from PTI
Physiotherapy All staff contacts from PTI
Occupational therapy
All staff contacts from PTI
Chiropody All staff contacts from PTI
Dietetics All staff contacts from PTI
Speech therapy All staff contacts from PTI
Other services
Community dentistry
Patients treated in the community dental service
Home dialysis Population aged 50-65
Breast screening Female population aged 50-69
Incontinence Population aged ≥65
Health promotion Population all ages
Other Total patient contacts from PTI
Data Sources: Community activity
Bring all pieces together
• Population • Age sex adjustment • Additional needs adjustment
• Unavoidable excess costs adjustment
HCHS & GP prescribing
HCHS only
HCHS part of the formula (1)
For each formula component the final index is calculated using the individual care programme indices and weights
All indices shown within the flowchart are comparable to a Scotland index of 1.00
HCHS part of the formula (2)
Adjusted population is calculated by multiplying the final indices for three formula’s components by crude population
HCHS Target Shares – 2011/12HCHS
HB HB name Population
Share1
Age-sex share
Age-sex and MLC share
Overall share
A Ayrshire & Arran 7.02% 7.31% 7.38% 7.36%
B Borders 2.18% 2.32% 2.09% 2.10%
F Fife 7.00% 7.12% 6.93% 6.87%
G Greater Glasgow & Clyde 22.93% 22.23% 24.40% 24.15%
H Highland 5.99% 6.34% 5.94% 6.36%
L Lanarkshire 10.80% 10.53% 10.98% 10.88%
N Grampian 10.54% 10.49% 9.67% 9.65%
R Orkney 0.38% 0.41% 0.37% 0.43%
S Lothian 16.05% 15.46% 14.95% 14.80%
T Tayside 7.71% 8.11% 7.91% 7.88%
V Forth Valley 5.63% 5.54% 5.49% 5.46%
W Western Isles 0.50% 0.55% 0.53% 0.62%
Y Dumfries & Galloway 2.84% 3.15% 2.97% 3.00%
Z Shetland 0.42% 0.43% 0.39% 0.46%
GP Prescribing Target Shares – 2011/12
Prescribing
HB Health Board Population Share1 Age-sex share Age-sex and MLC
shareOverall share
A Ayrshire & Arran 7.03% 7.50% 7.63% 7.63%
B Borders 2.15% 2.38% 2.03% 2.03%
F Fife 6.98% 7.11% 6.90% 6.90%
G Greater Glasgow & Clyde 23.04% 21.95% 24.88% 24.88%
H Highland 5.96% 6.55% 6.03% 6.03%
L Lanarkshire 10.71% 10.46% 11.38% 11.38%
N Grampian 10.51% 10.47% 9.30% 9.30%
R Orkney 0.38% 0.42% 0.38% 0.38%
S Lothian 16.06% 15.04% 14.20% 14.20%
T Tayside 7.69% 8.11% 7.66% 7.66%
V Forth Valley 5.72% 5.68% 5.62% 5.62%
W Western Isles 0.50% 0.57% 0.55% 0.55%
Y Dumfries & Galloway 2.85% 3.31% 3.07% 3.07%
Z Shetland 0.42% 0.44% 0.38% 0.38%
Unified Budget Target Shares – 2011/12
Total
HB Health Board Population Share1 Age-sex share
Age-sex and MLC share
Overall share
A Ayrshire & Arran 7.02% 7.34% 7.41% 7.40%
B Borders 2.18% 2.33% 2.08% 2.09%
F Fife 7.00% 7.12% 6.92% 6.87%
G Greater Glasgow & Clyde 22.94% 22.20% 24.46% 24.25%
H Highland 5.99% 6.37% 5.96% 6.31%
L Lanarkshire 10.78% 10.52% 11.03% 10.95%
N Grampian 10.54% 10.49% 9.62% 9.60%
R Orkney 0.38% 0.41% 0.37% 0.42%
S Lothian 16.05% 15.40% 14.85% 14.72%
T Tayside 7.71% 8.11% 7.87% 7.85%
V Forth Valley 5.64% 5.56% 5.51% 5.48%
W Western Isles 0.50% 0.55% 0.53% 0.61%
Y Dumfries & Galloway 2.84% 3.17% 2.98% 3.01%
Z Shetland 0.42% 0.43% 0.39% 0.45%
Percentage change in per capita funding due to the resource allocation formula
-15.00%
-10.00%
-5.00%
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
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Questions?
Further Information
• Queries – [email protected]
• 0131 275 6719 / 0131 275 6117
• www.nrac.scot.nhs.uk
• www.tagra.scot.nhs.uk