Observations Body Politic

Resource allocation—it’s a jungle out there

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b77 (Published 14 January 2009) Cite this as: BMJ 2009;338:b77
  1. Nigel Hawkes, freelance journalist
  1. nigel.hawkes1{at}btinternet.com

    Who wins and who loses under the NHS’s new scheme for awarding cash to primary care trusts?

    Only the brave or the foolhardy venture into some areas of NHS management. Among these wild places, none strikes more terror than the one labelled “resource allocation.” Here be man-eating statisticians, steeped in the lore of the jungle and ready to pounce at the sound of a breaking twig. Wizards uttering incantations dance around a cooking pot stocked with tasty data, brewing up heaven knows what. The light is dim, and understanding is even dimmer.

    But duty calls. Just before Christmas the NHS published the long awaited report of its Advisory Committee on Resource Allocation (ACRA), and those of us who have developed a taste for danger were drawn irresistibly towards it. These arcane calculations determine the way in which the NHS cake is sliced and served to the 152 primary care trusts in England that now consume 80% of it (see News, BMJ 2009;338:b115, doi:10.1136/bmj.b115). And nobody, it is fair to say, is ever happy with the way it is done.

    Healthcare needs vary from place to place, so simply …

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