An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report...
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![Page 1: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/1.jpg)
An introduction to the NRAC formula and TAGRA
![Page 2: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/2.jpg)
Background to TAGRA
• Formed after NRAC report
• Maintains and develops formula
• Brings together Government, NHS Boards, and academics
• Forum for stakeholder engagement
• Work programme of improvements
![Page 3: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/3.jpg)
Members – from boardsRichard Copeland NHS GG&C
Garry Coutts NHS Highland
Karen Facey NHS Forth Valley
Malcolm Iredale NHS Highland
Alan Gall NHS Grampian
Douglas Griffin NHS GG&C
Fiona Ramsay NHS Forth Valley
Andrew Richmond NHS Tayside
John Ross Scott NHS Orkney
George Walker NHS Lothian
![Page 4: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/4.jpg)
TAGRA core criteria
• Equity• Practicality• Transparency• Objectivity• Avoiding perverse incentives• Relevance• Stability• Responsiveness• Face validity
![Page 5: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/5.jpg)
NRAC formula
![Page 6: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/6.jpg)
Needs based formula
To enable every person in Scotland to have equal access to high quality health
services according to their need
• Based on population – but just a start
![Page 7: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/7.jpg)
Resource allocation in practice
Relative need due to
morbidity and life
circumstances
Additional Needs
×
Unavoidable Excess Costs of
Supply
Relative costs of
providing services to
different geographical
areas
×
NRACWeighted
Target Share
%
═
Relative need due to age and sex profile×
Age-Sex Cost Weights
Population
Board population
share%
![Page 8: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/8.jpg)
Difference between recommended NRAC spend per head and an equal share (2011/12)
-£200
-£150
-£100
-£50
£0
£50
£100
£150
£200
£250
£300
£350A
yrsh
ire &
Arr
an
Bor
ders
Fife
Gre
ater
Gla
sgow
& C
lyde
Hig
hlan
d
Lana
rksh
ire
Gra
mpi
an
Ork
ney
Loth
ian
Tay
side
For
th V
alle
y
Wes
tern
Isle
s
Dum
frie
s &
Gal
low
ay
She
tland
Sp
end
per
per
son
(£)
NRAC
![Page 9: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/9.jpg)
Difference between recommended NRAC spend per head and an equal share (2011/12) - Population
-200
-150
-100
-50
0
50
100
150
200
250
300
350A
yrsh
ire &
Arr
an
Bor
ders
Fife
Gre
ater
Gla
sgow
& C
lyde
Hig
hlan
d
Lana
rksh
ire
Gra
mpi
an
Ork
ney
Loth
ian
Tay
side
For
th V
alle
y
Wes
tern
Isle
s
Dum
frie
s &
Gal
low
ay
She
tland
Sp
end
per
per
son
(£)
![Page 10: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/10.jpg)
Difference between recommended NRAC spend per head and an equal share (2011/12) - Age sex
-£200
-£150
-£100
-£50
£0
£50
£100
£150
£200
£250
£300
£350
Ayr
shire
& A
rran
Bor
ders
Fife
Gre
ater
Gla
sgow
& C
lyde
Hig
hlan
d
Lana
rksh
ire
Gra
mpi
an
Ork
ney
Loth
ian
Tay
side
For
th V
alle
y
Wes
tern
Isle
s
Dum
frie
s &
Gal
low
ay
She
tland
Sp
end
per
per
son
(£)
Age-sex
![Page 11: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/11.jpg)
Difference between recommended NRAC spend per head and an equal share (2011/12) - Age sex and MLC (cumulative)
-£200
-£150
-£100
-£50
£0
£50
£100
£150
£200
£250
£300
£350A
yrsh
ire &
Arr
an
Bor
ders
Fife
Gre
ater
Gla
sgow
& C
lyde
Hig
hlan
d
Lana
rksh
ire
Gra
mpi
an
Ork
ney
Loth
ian
Tay
side
For
th V
alle
y
Wes
tern
Isle
s
Dum
frie
s &
Gal
low
ay
She
tland
Sp
end
per
per
son
(£)
Age-sex
MLC
![Page 12: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/12.jpg)
Difference between recommended NRAC spend per head and an equal share (2011/12) - MLC and UXC (cumulative)
-£200
-£150
-£100
-£50
£0
£50
£100
£150
£200
£250
£300
£350A
yrsh
ire &
Arr
an
Bor
ders
Fife
Gre
ater
Gla
sgow
& C
lyde
Hig
hlan
d
Lana
rksh
ire
Gra
mpi
an
Ork
ney
Loth
ian
Tay
side
For
th V
alle
y
Wes
tern
Isle
s
Dum
frie
s &
Gal
low
ay
She
tland
Sp
end
per
per
son
(£)
MLC
UXC
![Page 13: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/13.jpg)
Difference between recommended NRAC spend per head and an equal share (2011/12)
-£200
-£150
-£100
-£50
£0
£50
£100
£150
£200
£250
£300
£350A
yrsh
ire &
Arr
an
Bor
ders
Fife
Gre
ater
Gla
sgow
& C
lyde
Hig
hlan
d
Lana
rksh
ire
Gra
mpi
an
Ork
ney
Loth
ian
Tay
side
For
th V
alle
y
Wes
tern
Isle
s
Dum
frie
s &
Gal
low
ay
She
tland
Sp
end
per
per
son
(£)
NRAC
![Page 14: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/14.jpg)
NRAC 2011/12 MLC index
-20%
-15%
-10%
-5%
0%
5%
10%
15%
20%
Ayr
shire
& A
rran
Bor
ders Fife
Gre
ater
Gla
sgow
& C
lyde
Hig
hlan
d
Lana
rksh
ire
Gra
mpi
an
Ork
ney
Loth
ian
Tays
ide
Fort
h V
alle
y
Wes
tern
Isle
s
Dum
frie
s &
Gal
low
ay
She
tland
Per
cent
age
diff
eren
ce fr
om n
atio
nal a
vera
ge n
eed
(%)
Overall MLC
![Page 15: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/15.jpg)
NRAC 2011/12 MLC index compared to MH&LD index
-20%
-15%
-10%
-5%
0%
5%
10%
15%
20%
Ayr
shire
& A
rran
Bor
ders Fife
Gre
ater
Gla
sgow
& C
lyde
Hig
hlan
d
Lana
rksh
ire
Gra
mpi
an
Ork
ney
Loth
ian
Tays
ide
Fort
h V
alle
y
Wes
tern
Isle
s
Dum
frie
s &
Gal
low
ay
She
tland
Per
cent
age
diff
eren
ce fr
om n
atio
nal a
vera
ge n
eed
(%)
Overall MLC
MH&LD MLC
![Page 16: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/16.jpg)
The Additional Needs (1)
Needs
Utilisation
1Nationalaverage
![Page 17: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/17.jpg)
The Additional Needs (2)
Needs
Utilisation
1
![Page 18: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/18.jpg)
The Additional Needs (4)
Utilisation
10.85
Needs
MLC = constant + Coefficient*need
IG 1
![Page 19: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/19.jpg)
Data sources
• Based on intermediate geography
• Requires national data
• Requires small area data
![Page 20: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/20.jpg)
MH&LD indicators
• Severe disablement allowance
• % living in one person households
• % living in socially rented housing
![Page 21: An introduction to the NRAC formula and TAGRA. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government,](https://reader037.fdocuments.us/reader037/viewer/2022110405/56649ee55503460f94bf3e34/html5/thumbnails/21.jpg)
Questions?