Calculating target allocations for commissioning general practices in England

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d6732 (Published 22 November 2011) Cite this as: BMJ 2011;343:d6732
  1. Gwyn Bevan, professor of policy analysis
  1. 1Department of Management, London School of Economics and Political Science, London WC2A 2AE, UK
  1. r.g.bevan{at}lse.ac.uk

A new formula tackles two of four abiding problems of formula funding in England

In 1946, Aneurin Bevan identified three causes of inequity in healthcare in the United Kingdom: the fact that access depended on ability to pay and the inequitable distributions of both general practitioners and hospitals. From 1948, the NHS was designed to tackle the first two problems: services became free at the point of delivery and medical practice committees exercised “negative direction” over the distribution of general practitioners, which restricted their entry into “overdoctored” areas.1 The effective remedy to the third problem followed the 1976 report of the Resource Allocation Working Party (RAWP), which interpreted its terms of reference as being “to secure through resource allocation a method that would promote equal opportunity of access for those at equal risk.”1 2 This has remained the principal objective of formula funding, which is used to determine estimated equitable target allocations for populations.1 Policies aim to phase budgetary allocations towards targets at a manageable pace of change. The linked study by Dixon and colleagues (doi:10.1136/bmj.d6608) tackles two of four abiding problems of formula funding in England.3

The first problem is …

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