The financial problems faced by some National Health Service Primary Care Trusts may have more to do with the types of patients they serve than the way they are managed. Research released today shows that trusts in deficit tend to be in better off areas.The research, published in the open access journal BMC Health Services Research, studied 29 trusts that are in deficit and 29 in surplus. It found those with a shortfall tended to be in relatively affluent rural areas in the East of England, while those with a budget surplus served more deprived urban areas. It reveals marked socioeconomic and density differences between the populations served by the two groups and concludes the differences between trusts’ financial performance are unlikely to be due to bad management alone and must be influenced by the characteristics of the populations they cover.
The study was carried out by Padmanabhan Badrinath and colleagues from the Suffolk West Primary Care Trust, who looked in detail at the allocation of staff and resources as well as at the demographic and socioeconomic profiles of the PCTs in greatest financial surplus and deficit.
The study shows that 14 of the 29 trusts running in deficit are in the East of England. By contrast, the majority of those in surplus are mainly in Birmingham, the Black Country and greater Manchester. The research team found no differences in the mean age of the populations served by the two groups but they did discover that PCTs in deficit tend to be in prosperous, mixed urban, rural or coastal areas. Trusts in deficit are also in areas seven times less densely populated than those served by a trust in surplus. The former receive 205 pounds less per resident than those in urban areas.
The authors say that if financial deficits were due to poor management alone they would not expect to see a clustering of the PCTs most in deficit in one region of the country as was observed in this study.
Today’s report, “Characteristics of Primary Care Trusts in financial deficit and surplus – a comparative study in the English NHS,” has been written by Padmanabhan Badrinath, Rosemary A Currell and Peter M Bradley. It is available on the BioMed journal site, http://www.biomedcentral.com/bmchealthservres/