Publication - Progress report
Programme Budgeting – Testing The Approach in Scotland
This paper describes the pilot application of Programme Budgeting and Marginal Analysis (PBMA) in Scotland. Within the Health Care Quality Strategy for NHSScotland one of the three quality ambitions is concerned with providing a more efficient and effective health service. This paper supports this ambition by discussing how outcome measures could be used, along with cost data disaggregated in this way, to inform discussions around the value for money associated with different programmes.
Appendix A: Detailed breakdown of estimated activity and expenditure by programme
Table A1: Estimated activity by programme
| Programme Budgeting Category | Acute Services discharges | Hospital Sector | Community | Family Health Services | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Geriatric Long Stay discharges | Maternity | Mental Health & Learning Disabilities discharges | Outpatient Services attendances | A&E attendances | Pharmaceutical Services (no. items) | General Medical Services (Practice Team Information - estimated no. consultations) | General Dental Services | General Ophthalmic Services | |||
| Infectious diseases | 12,199 | 39 | - | - | 25,364 | - | - | 4,602,507 | 471,548 | - | - |
| Cancers and Tumours | 188,141 | 517 | - | - | 144,624 | - | - | 1,153,614 | 195,363 | - | - |
| Disorders of Blood | 21,053 | 24 | - | - | 222,650 | - | - | 1,013,227 | 162,478 | - | - |
| Endocrine, Nutritional and Metabolic problems | 23,657 | 106 | - | 3 | - | - | - | 6,885,817 | 717,097 | - | - |
| Mental Health Disorders | 10,714 | 641 | - | 24,119 | 279,450 | - | - | 7,627,007 | 999,863 | - | - |
| Problems of Learning Disability | 95 | 2 | - | 1,636 | 9,875 | - | - | - | 3,975 | - | - |
| Neurological | 150,883 | 891 | - | 78 | 117,623 | - | - | 2,720,779 | 2,312,314 | - | - |
| Problems of Vision | 41,728 | 8 | - | - | 444,996 | - | - | 1,546,507 | 192,884 | - | 2,162,700 |
| Problems of Hearing | 6,775 | 1 | - | - | - | - | - | 226,645 | 377,963 | - | - |
| Problems of circulation | 127,387 | 1,254 | - | 1 | 180,365 | - | - | 23,763,840 | 2,391,296 | - | - |
| Problems of the respiratory system | 125,633 | 731 | - | - | 111,342 | - | - | 6,749,081 | 2,336,456 | - | - |
| Dental problems | 15,091 | - | - | - | 205,976 | - | - | 107,192 | 25,082 | 8,162,987 | - |
| Problems of The gastro intestinal system | 191,157 | 140 | - | 1 | 224,996 | - | - | 7,711,621 | 1,078,704 | - | - |
| Problems of the Skin | 38,220 | 55 | - | - | 491,329 | - | - | 4,214,283 | 1,652,564 | - | - |
| Problems of the Musculo skeletal system | 63,056 | 98 | - | - | 103,889 | - | - | 7,097,592 | 530,546 | - | - |
| Problems due to Trauma and Injuries | 76,301 | 331 | - | 10 | 574,682 | - | - | 1,492,266 | 308,536 | - | - |
| Problems of Genito Urinary system | 96,154 | 213 | - | - | 500,012 | - | - | 1,546,210 | 1,109,337 | - | - |
| Maternity and Reproductive Health | 25,587 | - | - | - | 227,874 | - | - | 818,030 | 564,740 | - | - |
| Conditions of neonates | 1,071 | - | - | - | - | - | - | 2,135 | 2,669 | - | - |
| Adverse effects and poisoning | 41,965 | 13 | - | 32 | - | - | - | - | 49,218 | - | - |
| All Other | 51,681 | 1,211 | 131,660 | 1,411 | 5,813,508 | 1,602,537 | 6,962,090 | 3,590,886 | 6,291,485 | - | - |
| Total | 1,308,550 | 6,276 | 131,660 | 27,291 | 9,678,554 | 1,602,537 | 6,962,090 | 82,869,237 | 21,774,118 | 8,162,987 | 2,162,700 |
Please note that some activity figures quoted in this table may not match published figures due to a level of apportionment that has been applied to the data.
Data Source: ISD Data request
Table A2: Estimated cost by programme
| Code | Programme Budgeting Category | All Services | Percentage | Hospital Sector | Community | Family Health Services | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Acute Services | Geriatric Long Stay | Maternity Services | Mental Health & Learning Disabilities | Outpatient Services | A&E | Pharmaceutical Services | General Medical Services | General Dental Services | General Opthalmic Services | |||||
| 01 | Infectious diseases | £85,184,967 | 1.1% | £31,780,338 | £555,511 | - | - | £9,199,277 | - | - | £28,390,532 | £15,259,309 | - | - |
| 02 | Cancers and Tumours | £475,299,004 | 5.9% | £389,749,741 | £8,432,124 | - | - | £25,056,598 | - | - | £45,738,589 | £6,321,952 | - | - |
| 03 | Disorders of Blood | £65,608,322 | 0.8% | £29,122,838 | £330,197 | - | - | £21,985,987 | - | - | £8,911,507 | £5,257,794 | - | - |
| 04 | Endocrine, Nutritional and Metabolic problems | £195,824,862 | 2.4% | £42,188,930 | £2,849,124 | - | £37,418 | - | - | - | £127,544,123 | £23,205,267 | - | - |
| 05 | Mental Health Disorders | £728,254,492 | 9.0% | £31,581,529 | £16,693,721 | - | £473,410,644 | £44,658,771 | - | - | £129,554,256 | £32,355,571 | - | - |
| 06 | Problems of Learning Disability | £49,220,106 | 0.6% | £308,682 | £21,223 | - | £45,934,887 | £2,826,692 | - | - | - | £128,622 | - | - |
| 07 | Neurological | £437,592,278 | 5.4% | £253,364,540 | £19,014,233 | - | £2,565,452 | £19,986,022 | - | - | £67,835,503 | £74,826,529 | - | - |
| 08 | Problems of Vision | £185,093,353 | 2.3% | £51,583,131 | £113,274 | - | - | £35,405,635 | - | - | £12,034,945 | £6,241,713 | - | £79,714,655 |
| 09 | Problems of Hearing | £24,565,963 | 0.3% | £11,434,743 | £5,182 | - | - | - | - | - | £895,147 | £12,230,891 | - | - |
| 10 | Problems of circulation | £756,720,451 | 9.4% | £395,538,916 | £32,712,733 | - | £8,344 | £27,658,041 | - | - | £223,420,040 | £77,382,378 | - | - |
| 11 | Problems of the respiratory system | £508,300,584 | 6.3% | £262,359,340 | £22,068,435 | - | - | £15,320,790 | - | - | £132,944,269 | £75,607,750 | - | - |
| 12 | Dental problems | £374,083,410 | 4.6% | £14,662,735 | - | - | - | £28,945,671 | - | £37,471,000 | £374,856 | £811,669 | £291,817,480 | - |
| 13 | Problems of The gastro intestinal system | £481,524,197 | 6.0% | £336,264,257 | £2,133,943 | - | £13,164 | £30,437,294 | - | - | £77,768,666 | £34,906,872 | - | - |
| 14 | Problems of the Skin | £203,331,806 | 2.5% | £75,363,503 | £781,566 | - | - | £40,155,071 | - | - | £33,554,685 | £53,476,982 | - | - |
| 15 | Problems of the Musculo skeletal system | £290,808,712 | 3.6% | £203,429,496 | £2,600,612 | - | - | £15,639,182 | - | - | £51,970,930 | £17,168,491 | - | - |
| 16 | Problems due to Trauma and Injuries | £357,432,705 | 4.4% | £275,377,840 | £5,623,719 | - | £507,018 | £54,660,274 | - | - | £11,279,629 | £9,984,225 | - | - |
| 17 | Problems of Genito Urinary system | £314,612,189 | 3.9% | £181,919,909 | £4,460,379 | - | - | £56,503,742 | - | - | £35,830,005 | £35,898,155 | - | - |
| 18 | Maternity and Reproductive Health | £77,496,004 | 1.0% | £24,231,488 | - | - | - | £26,367,976 | - | - | £8,621,556 | £18,274,985 | - | - |
| 19 | Conditions of neonates | £1,989,574 | 0.0% | £1,878,189 | - | - | - | - | - | - | £25,006 | £86,379 | - | - |
| 20 | Adverse effects and poisoning | £89,540,357 | 1.1% | £87,309,447 | £273,931 | - | £364,275 | - | - | - | - | £1,592,705 | - | - |
| 21-23 | All Other | £2,363,206,181 | 29.3% | £105,504,726 | £12,046,773 | £214,848,000 | £74,108,005 | £412,448,111 | £148,300,263 | £1,107,522,000 | £84,835,759 | £203,592,544 | - | - |
| Total expenditure | £8,065,689,520 | 100.0% | £2,804,954,316 | £130,716,681 | £214,848,000 | £596,949,207 | £867,255,135 | £148,300,263 | £1,144,993,000 | £1,081,530,000 | £704,610,784 | £291,817,480 | £79,714,655 | |
Data Source: ISD Data request
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Email: Marjorie Marshall
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