Scottish health service costs
Summary for financial year 2022/23

About this release

This release by Public Health Scotland (PHS) provides an annual update on operating costs within NHSScotland in the financial year 2022/23. It includes the cost of running all services that are provided to patients in any setting by the 14 territorial NHS boards, the State Hospital and the National Waiting Times Centre at the Golden Jubilee University National Hospital.

REVISION 12 April 2024: A small amount of data in Excel workbooks R100, R100T and R920 were revised, primarily affecting hospital patient expenditure, such as the cost per inpatient case. Please see the Excel workbooks or the metadata revisions section of the report for more detail.

Main points

Trend in real terms operating costs by sector for last ten financial years The trend over the last ten years shows that hospital sector is the highest sector for expenditure each year with resource transfer being the lowest expenditure sector. In previous years the family health sector has been the second highest expenditure group but in 2020 to 2021 the Community sector became the second highest costing sector. In real terms total expenditure has increased from £12.1 billion in 2012 to 2013 financial year to £15.4 billion in 2021 to 2022.

Close

Figure 1: Trend in expenditure, 2012/13 to 2022/23

In the financial year 2022/23:

• £16 billion was spent on health service operating costs, a 3.6% (£562 million) increase on the £15.4 billion spent in 2021/22.
• After estimating and removing the impact of inflation, expenditure is estimated to have increased in real terms by 24% since 2012/13 but decreased by 2.8% in the last year. This reduction follows a period of accelerated growth from 2019/20 to 2021/22, which was in part due to additional non-recurring funds made available to help mitigate the impact of the COVID-19 pandemic.
• £3.6 billion was spent on services based in the community. Expenditure in this category increased by nearly a third in 2020/21 due partly to the response to the pandemic, including the introduction of the Test & Protect and the vaccination programmes, and continued to increase (3.7%) in 2021/22. Community staff costs increased by £97 million in the last year, yet overall community expenditure decreased by 1.8%, most likely due to the reduced need for COVID-related programmes during 2022/23.
• £8.9 billion was spent on hospital-based services. There have been steady and significant year-on-year increases in expenditure since 2018/19, amounting to a 30.8% total increase in that period. This represents a 14.5% increase in real terms, although there has been a slight decrease of 0.4% in real terms expenditure in the last year.
• The combined cost of staff working in the hospital and community sectors accounted for £8.2 billion of expenditure, and a year-on-year increase of £529 million (6.9%), now constituting 51.5% of total operating costs. This proportion has risen from 47.6% in 2017/18, increasing every year since. This is due in part to increasing numbers of staff, particularly during the pandemic, but also larger annual pay awards in recent years in response to general inflation.
• Family Health Services (FHS) expenditure, which includes the costs associated with running local GP surgeries, providing dental and ophthalmic services and the provision of prescriptions and local pharmacy services, increased by 5.2% to £3.1 billion. In real terms, expenditure in this sector is estimated to have risen by just 3.6% since 2012/13.

Background

Total expenditure reported for NHSScotland excludes that by other national NHS organisations, including NHS24 and NHS Education for Scotland - limited information on their expenditure is provided in separate tables in the file listings. It also excludes any capital expenditure, such as that used to build new facilities.

Following the COVID-19 pandemic, this year's release is based on a full set of Scottish Financial Returns (SFRs) for the first time since 2019/20, with the exception of NHS Borders who have provided a partial data submission. Due to concerns regarding data quality, NHS Dumfries and Galloway have removed their 2021/22 submission. Figures presented for NHSScotland for 2021/22 have therefore been revised since the previous publication and are now calculated using estimated data for NHS Dumfries and Galloway. Please see the report for more information.

Historic costs can be expressed in ‘real terms’ (adjusting for inflation). To obtain ‘real terms’ figures, the costs have been divided by an adjustment factor (the ‘GDP deflator’) determined by HM Treasury. Real terms costs therefore estimate approximately what the services provided in a previous year would have cost in financial year 2022/23, after making an adjustment for inflation.
For more information on the terms used in this summary, please see the report.

Files listings for financial year 2022 to 2023

View and download all data files for the financial year 2022 to 2023.

Further information

The most recent detailed data files available relate to the 2022 to 2023 publication.

The next release date of this publication is to be confirmed.