Unavoidably small hospitals

Overview

The NHS in England has developed criteria to identify the hospitals that are unavoidably small due to remoteness. These were based on the size of the population served being relatively small, and travel times to other hospitals being relatively long. This allows funding formula to be adjusted for the higher costs faced by smaller hospitals serving remote communities. These definitions on remote hospitals were developed in the Advisory Committee on Resource Allocation’s 2015 document 24B: Unavoidable smallness due to remoteness: Identifying remote hospitals. 

These criteria were used to identify 8 hospital sites in Morecambe Bay, Cumbria, the Isle of Wight, Devon, Herefordshire, Lincolnshire, and Scarborough and Ryedale. The extent of their funding adjustments were published in May 2019. The next smallest providers, receiving no funding adjustments, were in West Norfolk and Cornwall. Further information can be found in a Library debate briefing published in March 2020: Unavoidably small hospitals and equality of access to healthcare.

Parliamentary Material

Hospitals: Finance

20 Jun 2022 | 17884

Asked by: Sir Greg Knight

To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential merits of introducing a revised funding formula for unavoidably small hospitals in (a) rural and (b) all other areas to enable them to (i) be more fully utilised as hospitals and (ii) offer a wider range of essential health services; and if he will make a statement.

Answering member: Edward Argar | Department: Department of Health and Social Care (DHSC)

NHS England is responsible for funding allocations to integrated care boards (ICBs), independently of the Government. The allocation formula is informed by an estimation of the relative health needs of local areas, based on factors statistically associated with higher or lower need per head for NHS services. Further cost adjustments are also applied to estimate the unavoidable cost differences between health care providers, based on location. The approach has been reviewed and a target adjustment was included in the 2022/23 ICB allocations.

Hospitals: Finance

01 Mar 2022 | 129240

Asked by: Bob Seely

To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of funding for St Mary’s on the Isle of Wight and other Unavoidably Small Hospitals; and what steps he plans to take to establish a long-term strategy to adjust funding levels relative to that assessment.

Answering member: Edward Argar | Department: DHSC

NHS England is responsible for funding allocations to clinical commissioning groups (CCGs). This process is independent of the Government and the underlying allocation formula is informed by an estimation of the relative health needs of local areas, based on factors statistically associated with higher or lower need per head for NHS services. Further cost adjustments are also applied to estimate the unavoidable cost differences between health care providers, based on location. The Isle of Wight has been supported by increased CCG allocations as per these adjustments to reflect its small size and the associated unavoidable costs.