Bristol Primary Care Trust (PCT) used programme budgeting in 2008/09 to analyse how it invests its healthcare funding. The PCT analysed all of the money it spent in 2006/07, by major health condition and the key health outcomes achieved by expenditure.
These analysis reports link programme spending with health outcomes and help the PCT to assess the efficiency, effectiveness and equity of its services.
The Trust has been endorsed for using programme budgeting in line with the World Class Commissioning competencies, prioritising investment according to local needs, and making sound financial investments to ensure sustainable development and value for money.
The PCT has undertaken extensive analysis of its healthcare funding. This includes benchmarking by each major health condition and comparing it to national, cluster and core city averages and the associated spending. For example, the Cancers and Tumours report considers prevalence and mortality rates in relation to deprivation levels and health outcomes, such as years lost due to mortality in comparison to other PCTs. These comparisons of health outcomes enable the PCT to assess if its spending is effective.
A presentation about programme budgeting was made to the PCT's Board. This gave the Board a greater understanding of this area, and provided the opportunity to challenge and identify areas for improvement. The analysis from programme budgeting has been used to inform investment in the Outline Project Plan for 2009/10. The analysis was also used in the decision making around future investment and disinvestment decisions.
The analysis and understanding of programme budgeting enables the PCT to:
- improve data quality
- use detailed analysis tools to support commissioning and strategic planning
- develop five year plans for the main health categories, such as mental health
- identify areas for improvement to deliver its strategic priorities