The link between health spending and health outcomes for the new English primary care trusts

Our third report on programme budget data analysis builds on a unique methodology developed by the research team at the University of York.   

Background

Since 2003 data on health care expenditure across 23 programmes of care have been prepared by each primary care trust (PCT) in the English NHS. These programme budgeting data seek to allocate exhaustively to disease categories all items of NHS expenditure.  Previous macro-economic studies of the link between spending and outcomes have been inconclusive.

This report

This report describes a model which takes into account population need in a way that has not previously been undertaken. 

The authors note that their work has a number of limitations including the use of a rather narrow outcome indicator (mortality) and the need to assume a relatively stable pattern of spending by PCTs across programmes over the recent past. Notwithstanding these limitations, the study offers clear confirmation that current expenditure by PCTs on some important programmes of care is highly cost-effective and illustrates how programme budgeting data can be used to generate information which might usefully inform PCTs' spending decisions. 

Who should read this report

These results offer policy-makers and the NHS the opportunity to make more informed decisions about whether healthcare expenditure offers value for money and as such provide a basis for setting national and local policy. 

Programme budgeting has the potential to engage clinicians in value for money issues and should allow for more clinical input to PCT budgetary choices and purchasing and ensure that limited resources are used to best effect.  The results have already been picked up by NICE and continue to offer an important resource for informing and complementing their work to set thresholds and accept new technologies.