Assessing unmet need for fair allocation of NHS funding

The Academy of Medical Sciences, supported by the British Academy and NHS England, have published a report of a roundtable on unmet need in healthcare.

The roundtable, held on 31 July 2017, brought together a range of experts from across the social, epidemiological, economic, statistical and health services sciences to discuss the assessment of unmet need in healthcare for the purposes of improving the NHS allocations formulae.

The NHS allocations formulae, which support the direction of over £100 billion of funding each year, are designed to estimate differences in the healthcare needs of the population across different Clinical Commissioning Groups (CCGs). These formulae are developed by NHS England with oversight from the Advisory Committee on Resource Allocation, which is made up of independent experts. Approximately £9bn of this funding is distributed according to a proxy measurement designed to contribute to a reduction in health inequalities and in “unmet need”.

Unmet need stems either from people not accessing NHS services for their health problems, or receiving inappropriate care once in the care of the NHS. The roundtable focused on assessment of the unmet need for people who were not accessing healthcare services. Participants discussed ways in which this unmet need might be assessed and quantified so that allocations formulae can be improved to better reflect the differences in unmet need in different areas.

Participants agreed on a number of potential projects that could better assess unmet need including:

  • A comprehensive literature review of the evidence for assessing unmet need.
  • Utilising existing data sources such as patient level primary and secondary care data linked to health surveys.
  • Creating a bespoke data source for assessing unmet need from primary care records.
  • Enhancing the current proxy by developing bespoke measures of mortality and morbidity amenable to healthcare

The findings of the meeting will be used by NHS England to inform their policies and direct their future work towards improving the formulae.

To download the meeting note please use the link to the right of the page.

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