Community Care: Finance

(asked on 27th March 2023) - View Source

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what proportion of his Department's annual budget (a) will be spent on community care in 2022-23 and (b) was spent on community care in each of the last five years.


Answered by
Neil O'Brien Portrait
Neil O'Brien
This question was answered on 5th April 2023

Detailed breakdowns of the Department’s expenditure are included in the Departmental Annual Report and Accounts. These breakdowns report the limit of audited expenditure detail that is available, but do not include all spending categories covered in these questions. Where possible, we have included both audited spending data and the Departmental estimates to answer some but not all of these questions below. Final figures for 2022/23 figures are not yet available.

All primary care, including General Medical, Dental, Pharmaceutical and Ophthalmic Services are commissioned and paid for by NHS England and integrated care boards. The following table summarises the expenditure on these services reported in the Department’s Annual Report and Accounts and compares that to the total Departmental Resource DEL (RDEL) spending for the period.

2021-2022

2020-2021

2019-2020

2018-2019

2017-2018

Total Department RDEL Outturn (by million £s)

183,664

181,441

134,183

125,278

120,650

Of which, spending by NHS England on Primary Care -

General Dental Services and Personal Dental Services

3,100

3,062

3,089

2,920

2,945

General, Personal and Alternative Provider Medical Services

11,365

10,399

9,154

8,526

8,274

Pharmaceutical Services

2,341

2,124

1,961

1,935

1,907

General Ophthalmic Services

561

590

548

554

556

17,367

16,176

14,752

13,935

13,682

as a % of total Departmental RDEL

9.5%

8.9%

11.0%

11.1%

11.3%

Source: DHSC Annual Report and Accounts, “Departmental Group Detail – Expenditure” tables

The vast majority of social care funding is held by local Government and is not part of the Department’s budgets. The Department for Levelling Up, Housing and Communities’ core spending power tables provide an overview of the core grants available to local authorities. These can be found at the following link:

https://www.gov.uk/government/publications/core-spending-power-final-local-government-finance-settlement-2023-to-2024

The Department’s Resource DEL budget does fund a smaller amount of social care-related spending. This budget includes some grants paid directly to local Government, with the majority managed by NHS England via the Better Care Fund (BCF). A small amount of central spending is managed directly within the Department. The table below provides estimates of the related expenditure incurred by the Department and compares that to the total Department Resource DEL spending for the period.

2021-2022

2020-2021

2019-2020

2018-2019

2017-2018

Total Department RDEL outturn (by million £s)

183,664

181,441

134,183

125,278

120,650

NHS England contribution to BCF for Adult Social Care

2,007

1,894

1,779

1,627

1,594

The Department’s social care related expenditure (including grants)

1,288

1,443

172

164

166

Total

3,295

3,336

1,951

1,791

1,760

as a % of total Departmental RDEL

1.8%

1.8%

1.5%

1.4%

1.5%

Source: Departmental estimates

Expenditure on community care is not strictly defined and not separately reported in the Department’s Annual Report and Accounts. Provision of community care will cross organisations and expenditure types, so it is not possible to provide separate spending figures for this category.

RDEL expenditure on diagnostics is not strictly defined and not separately reported in the Department’s Annual Report and Accounts. Spending on diagnostic services will cross organisations and expenditure types, so it is not possible to provide separate spending figures for this category.

Capital expenditure on diagnostic equipment is usually made at local level through integrated care system capital envelopes and is subject to local decision making on prioritisation. The national total for all local capital investment is £4.2 billion for 2022/23.

In addition to that, the Government has provided an extra £2.3 billion for the period between 2022/23 to 2024/25 to transform diagnostic services, and to roll out up to a total of 160 community diagnostic centres by March 2025 to help improve diagnostic services up and down the country, and other specific capital funding to improve diagnostic capacity has been provided through national programmes. The following table provides a timeseries showing the periods for which data is available.

2021-2022

2020-2021

2019-2020

Total Departmental CDEL Outturn (by million £s)

7,126

12,683

7,015

National Diagnostic Programme

273

99

97

as a % of total Departmental CDEL

3.8%

0.8%

1.4%

Note: The above shows national capital investment and does not include operational capital.

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