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Allocating budgets for fundholding and prescribing

BMJ 1996; 313 doi: (Published 23 November 1996) Cite this as: BMJ 1996;313:1274
  1. Azeem Majeed
  1. Senior lecturer in general practice Division of General Practice and Primary Care, St George's Hospital Medical School, London SW17 0RE

    Practice based needs assessment may be the only real answer

    The way in which health authorities come to their decisions about budgets for fundholding and prescribing must seem like an arcane art to many general practitioners. The principle underlying the setting of these budgets is that general practices should receive a fair share of NHS resources and one that reflects the healthcare needs of their patients.1 2 However, there are great practical problems in setting budgets fairly. The main problem is that attempts to explain variations in the use of fundholding procedures and in prescribing costs have not been very successful.3 4 5 The variations between practices are just too large to be explained by currently available information. The most important reason for this is that general practices serve small populations that differ greatly from each other in their demographic, social, and clinical characteristics. There are also large differences in the way in which general practitioners provide care. Hence, resource allocation formulae, such as those used by the NHS Executive to allocate budgets to health authorities, will …

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