Distribution of NHS funds between fundholding and non-fundholding practices

Abstract

Objectives: To estimate the amount spent on specific hospital care by health agencies in 1993-4 and compare it with the resources allocated to patients registered with fundholding practices for the same type of care. To investigate whether fundholding practices and health agencies pay different amounts for inpatient care.

Design: Examination of hospital episode statistics, 1991 census data, and family health services authority and health agency records.

Setting: Health agencies and fundholding practices in the former North West Thames Regional Health Authority.

Main outcome measures: Amount per capita allocated to inpatient and outpatient care for patients registered with fundholding and non-fundholding practices. Average specialty cost per finished consultant episode for health agencies and fundholding practices.

Results: The ratio of per capita funding for patients in non-fundholding practices to those in fundholding practices ranged from 59% to 87% for inpatient and day case care and from 36% to 106% for outpatient care. Average specialty costs per episode were similar for fundholding practices and health agencies.

Conclusions: Fundholding practices seem to have been funded more generously than non-fundholding practices in North West Thames.