Resource Allocation Formula (NRAC)
Results for financial year 2024 to 2025

About this release

Please note that data in the Excel workbooks were revised 15 August 2023 due to two errors: the final NRAC target shares presented for financial year 2021/22 did not include the GP out of hours adjustment and a single data zone was assigned to the wrong Integration Authority. These revisions are minor and unlikely to impact interpretation of the data. Please see the Excel workbooks for more information.

This release by Public Health Scotland (PHS) presents a summary of the latest outputs generated by the National Resource Allocation Formula (NRAC) by NHS Board. The Formula is used to inform the geographical allocation of the NHS Budget in Scotland. Shares for future financial years are calculated in advance to support planning by NHS Boards and Scottish Government. This latest publication of the Formula forecasts how the need for services will be geographically distributed in 2024/25.

Main points

This bar graph shows the NRAC unified shares in percentage terms for each NHS board in Scotland for the financial years 2022 to 2023 and 2024 to 2025. NHS Greater Glasgow & Clyde consistently has the highest proportion of budget whilst NHS Shetland has the lowest.

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NRAC target shares for NHS Boards 2022/23 - 2024/25

The chart above shows how the Formula forecasts the need for healthcare services to be distributed across NHS Boards in 2024/25, comparing against previous forecasts for financial years 2022/23 and 2023/24. Whilst the main driver of a NHS Board's share is the projected size of their resident population, the Formula also takes into consideration other factors that may impact on the need for services such as the age and sex composition of the population, levels of morbidity and the influence of other 'life circumstances' such as levels of deprivation. The Formula also adjusts for the unavoidable excess costs that some NHS Boards may experience in delivering services, for instance in remote and rural areas.

In the latest publication of the Formula, NHS Lothian is forecasted to have the biggest increase in target share from 14.97% in 2022/23 to 15.11% in 2024/25. This is because it is projected to have the largest increase in population in this period, with its population share increasing from 16.82% to 17.04%. This is due to it being the only NHS Board area projected by NRS to increase its population in this period through both net migration into the area and a natural increase in births compared to deaths. NHS Lothian’s final NRAC shares are projected to be less than its population shares due to it being considered to have below national average needs when applying the other elements of the Formula.

Background

It is crucial that resources are distributed fairly, taking account the many factors that influence the need for healthcare in particular areas and the costs of supplying those services. The NRAC Formula was originally developed by the NHS Scotland Resource Allocation Committee (established in 2005) to assist with achieving this, replacing the previous Arbuthnott Formula. The Technical Advisory Group for Resource Allocation (TAGRA) is set up to steer the maintenance and development of the Formula and ensure that it remains fit for purpose.

The Formula uses input data from a wide range of national data sources. Note that not all data inputs can be updated in each year that the Formula is calculated due to data availability. For this publication of the model only the projected populations for 2024/25 were updated. This was mainly due to the impact of COVID-19 which prevented the availability of suitable data on healthcare costs and patient activity data. A more detailed description of how the NRAC target shares are calculated and the data inputs required can be found on the NRAC information page.