Programme Budgeting in NHSScotland

Background

1. Programme Budgeting (PB) involves the presentation of estimates of expenditure in ‘programmes’ across an entire budget. For example within the health budget the programme may reflect different diseases, different levels of care (primary, secondary and tertiary) or different locations of care.

2. There is a high level of interest in information being provided in a different format than that routinely provided in the NHSScotland costs book^[3]. The costs book provides a detailed analysis of where resources are spent in NHSScotland. It disaggregates by location of care – GP, community, hospital – and by health board, hospital and specialty. The analysis reported here focuses on why rather than where. It involved grouping expenditure and activity by the 23 programmes of care used in the NHS in England. These programmes reflect ICD10 disease categories, plus an ‘other’ category. A full description of the methodology is included in Appendix B.

3. Programme budgeting data has been routinely published for the NHS in England since 2002. Information on the process and aggregate results are published on the NHS England site^[4]. A description of the early experience from England was included in the previous paper.

4. NHSScotland activity was allocated to these programmes, with the exception of community and prevention activity and expenditure, which it was not possible to disaggregate at this time. Total estimated expenditure by programme is disaggregated and shown in Table A1 in Appendix A.