Programme Budgeting in NHSScotland

Executive Summary

• The programme budgeting analysis shows that in 2011/12 the largest areas of spend across NHSScotland were for the disease categories Mental Health, Circulation, Respiratory, Gastro-Intestinal and Cancer. Together these 5 categories were responsible for over a third of spend, at approx. £3,305 million: they represented 8.6%, 8.6%, 6.3%, 6.2% and 5.9% of the total identified (£9,282 million) respectively.

• Spend across all 23 programme budgeting categories is presented along with additional detail for 4 of the highest spending. The pattern of spend is similar, although not identical, to that within the NHS in England and Wales. Like other analyses of cost data it confirms that the majority of that spend was within the acute hospital sector.

• This paper is an update to a 2012 paper which, using data from 2007/08, described two possible approaches to identifying the costs associated with particular programmes of care in NHSScotland. The second of these approaches was the application of programme budgeting methodology, as used in both England and Wales, to disaggregate NHSScotland activity and costs by 23 diagnostic categories.

• Within the Health Care Quality Strategy for NHSScotland^[2] one of the three quality ambitions is concerned with providing a more efficient and effective health service. Programme budgets allow us to view the data in a different way from that routinely published in Scotland, looking at the distribution of spend across disease categories. This, combined with outcome measures, can be used in discussion on the value for money associated with different programmes.