Clinical commissioning groups (CCGs) will be responsible for around £65 billion of NHS expenditure in England in 2012/13, and the NHS Commissioning Board will control a further £21 billion, according to the first estimates of funding in the planned new health structures.
In addition, around £5.2 billion will be spent on public health services, of which at least £2.2 billion will go direct to local authorities to be spent on action to help their local communities stay as healthy as possible and reduce health inequalities. For the first time, these funds will be protected, says the government.
These figures have been developed by mapping Primary Care Trust (PCT) spending in 2010/11 onto the future structure, subject to the passage of the Health and Social Care Bill, and uplifting them to 2012/13 levels. Also subject to the Bill's passage, the NHS Commissioning Board would take responsibility for the allocation of resources to the CCGs from 2013/14.
Understanding baseline spend is just the first step in establishing future budgets, and further analysis will build on this, say health officials. The newly-published figures will help to plan for the distribution of resources in the new system in a way that meets the needs of local population, and will also support local organisations to plan for the transfer of public health responsibilities to local authorities and of commissioning to CCGs, they add.
Emerging CCGs are already spending nearly £30 billion as delegated from PCTs, and by April, the government says, it wants local doctors, nurses and other health professionals to be involved in shaping all the spending decisions for which they will in future be responsible.
"This is important to ensure that emerging CCGs start working on managing their budgets, developing relationships with local partners and playing an active role in planning services for 2012/13, taking ownership for the areas which they will inherit when they become locally responsible for commissioning," it says.
"In the future, we want money to get to where it matters most - to the front line, where it can have the greatest impact on health," noted Health Secretary Andrew Lansley. "The health professionals who care for us, and the general practitioners who look after their local populations, are best equipped to design the shape of local health services. Through the CCGs, they will now have that power," he said.
"We want to get the best value out of every penny spent in the NHS and our modernisation plans will help to cut waste, reduce bureaucracy and simplify NHS structures so that they money invested will improve frontline care for patients," added Mr Lansley.
The NHS Confederation said it welcomed the publication of the spending estimates, but also warned that the figures need to be treated with some caution.
"Much of the information used to draw up these projections has never been collected in this way before, so there will be a number of issues that need to be ironed out," said David Stout, the Confederation's deputy chief executive.
"These budgets may look quite different when they are finalised, especially as responsibilities for certain services such as infection control and emergency planning are still being finalised," he added.
- The Advisory Committee on Resource Allocation (ACRA) will publish its formula for allocating resources to CCGs and local authorities for their new public health responsibilities in due course. ACRA is an independent expert body, supported by a technical advisory group, which makes recommendations to the Health Secretary on potential changes to the weighted capitation formula between PCT allocation rounds.