NHS Funding: Clinical Commissioning Groups

This paper and accompanying Excel file gives details of funding allocations for each CCG in England from 2013/14 to 2020/21. The briefing paper also gives details of the process used to allocate the funds | House of Commons Library

In 2018/19 NHS England distributed a total of £74.2 billion across 195 CCGs in England. The overall funding equates to £1,254 per registered patient in England. Funding per head increased in real terms between 2013/14 and 2018/19. The average annual increase from 2013/14 to 2018/19 was 2%. money-2696219_1920.jpg

The formula used to distribute funding means that CCGs with elderly populations, in urban areas, or in more deprived areas tend to have higher allocations than they would under a simple population-based formula.

The highest allocation per patient in 2018/19 is Knowsley CCG in Merseyside (£1,645), the lowest CCG allocation per patient is Oxfordshire CCG (£1,040). All of the 10 highest allocations per patient are CCGs in the North East and North West of England.


Budget 2017: Chancellor pledges extra £2.8bn for NHS

The chancellor has announced £2.8bn of extra revenue funding for the NHS to cope with pressures between now and the end of 2019-20 | via Health Service Journal

The funding will be split over three financial years, with £335m coming this year to help cope with winter pressures. An extra £1.6bn will be made available in 2018-19, followed by £900m in 2019-20.

NHS leaders had insisted an extra £8bn was needed over this period just to maintain day to day services, while the King’s Fund, Nuffield Trust and Health Foundation agreed £4bn was needed next year alone.

The Chancellor also said the government will provide money for an NHS staff pay rise, but only if unions agree to reform the Agenda for Change contract.

See also:


Where next for commissioning?

David Evans chief executive of Northumbria Healthcare NHS Foundation Trust shares his view on where next for commissioning as part of Provider Voices | NHS Providers.


My honest opinion is that the purchaser-provider split has outlived its usefulness. The NHS environment has changed hugely from the time when commissioning seemed like a good idea. Back then, there was plenty of money in the system, and options for getting better deals for your money by managing the market.

Now money is tight, the question must be whether money spent on commissioning wouldn’t be better used delivering services. Look at the situation nationally: some providers are in dire financial straits and their commissioners sit on surpluses. In other places, the reverse applies.

We have seen private providers hit this wall too, as well as some high-profile commissioning decisions (as in Cambridgeshire) that fall foul of the reality of providing services.

Read the full post here

Hulll CCG pools entire budget with council in £600m fund

A Yorkshire clinical commissioning group is aligning its entire budget with a local authority to create a strategic commissioning fund of £600m | HSJ


  • Hull CCG to align entire £400m budget with local authority
  • CCG chief officer joins Hull City Council’s corporate management team
  • Committee in common will approve decisions by new integrated commissioning board

Read the full article here

The clinical commissioning group allocation process

How it works: The clinical commissioning group allocation process | Sarah Bence & Duncan Watson | Healthcare Financial Management Association (HFMA)

business-17965_1920This briefing, part of the HFMA’s How it works series, looks at the process of allocating money from NHS England to clinical commissioning groups (CCGs). The briefing explains how NHS England, with the support of the Advisory Committee on Resource Allocation, calculates the relative need for healthcare funding of each CCG area. Following this the available funding for CCGs is split based on this calculation and on the historic level of funding of the CCG.  This allocation is split into three main sums: the core allocation used for most of the healthcare commissioning that the CCG undertakes; an amount set aside for the better care fund to be put into a pooled budget with the local authorities in the CCG area; and an amount for the running costs of the CCG.

The briefing sets out the circumstances under which there may be additional in-year changes to the allocation, or further non-recurrent funding added to the allocation, for example, for funding transformation projects.

Please note, the full version of this briefing is only available to HFMA members.

Commissioning of specialist palliative care services in England

Lancaster H. et al. BMJ Supportive & Palliative Care | Published Online: 28 February 2017


Objectives: Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise.

Methods: We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services.

Results: 29 CCGs provided information about the number of patients with some form of palliative care needs in their population. For specialist palliative care services, CCGs allocated budgets ranging from £51.83 to £2329.19 per patient per annum. 163 CCGs (77.90%) currently commission 7-day admission to their specialist palliative care beds. 82.84% of CCGs commission 7-day specialist palliative care services in patients’ own homes and out-of-hours services rely heavily on hospice provision. 64 CCGs (31.37%) commission pain control teams, the majority of whom only operate in regular working hours. 68.14% of CCGs reported commissioning palliative care education of any sort for healthcare professionals and 44.85% of CCGs had no plans to update or review their palliative care services.

Conclusions: The most important finding from this exercise is that the information CCGs hold about their population and services is not standardised. However, information based on data that are more objective, for example, population and total budget for palliative care, demonstrate wide variations in commissioning.

Read the full article here