Sharing resources for health in England : report of the Resource Allocation Working Party.

  • Great Britain. Resource Allocation Working Party
Date:
1976
Catalogue details

Licence: Open Government Licence

Credit: Sharing resources for health in England : report of the Resource Allocation Working Party. Source: Wellcome Collection.

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    which do not entail patient flows, eg laundry services, nor do they make any allowance for the extra costs of maintaining ‘centres of excellence’ of one sort or another, including research and development activity, the benefits of which are expected to extend beyond the District in which they are provided. An adjustment for the first category can be made when comparing revenue targets with the starting position. The second category cannot at present be dealt with in this way, and must therefore become a factor to be considered when determining the progress which can and should be made towards target. Authorities will also need to bear in mind the real but unquantifiable impact upon the services they provide of de- privation in its wider social sense. It is conceivable that a particular AHA or District would always be maintained at a level above its indicated target, and that, correspondingly, others would never reach theirs. 3.10 Too rigid an interpretation ought not, in our view, to be placed upon revenue targets assessed on the lines recommended. They nevertheless provide an objective yardstick of relative disparity against which the need for resources, and therefore, the crucial allocation process, can be deter- mined. In the final analysis, judgement must play a considerable part, and it is, therefore, important that there should be open discussion between RHAs, AHAs and DMTs on the way in which targets need to be interpreted in relation to allocations. COMPARISON OF ACTUAL POSITION WITH TARGETS 3.11 Once revenue targets have been established, the next step is to determine how far each District’s resource requirement has already been achieved. This cannot be done simply by comparing the target allocation with that actually received by each District. Since District targets are based on the whole of a RHA’s target, the whole of the RHA’s actual allocation for services in the current year must be used for comparison, if like is to be compared with like. But the whole RHA allocation is not parcelled out to Districts. Part of it is spent at Regional, and part at Area level. Some of the money spent by RHAs and AHAs goes on specific services to particular Districts. Examples are senior medical staff salaries, CHC expenses and contractual arrange- ments for hospital services. This expenditure is clearly part of the resources of the Districts concerned, and should be included in an assessment of their actual resources. 3.12 A modest proportion of the RHA allocation is spent at RHA or AHA level in ways which preclude attribution to Districts on a user basis. 4]
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