Scottish health service costs
Summary for financial year 2023/24

About this release

This release by Public Health Scotland (PHS) provides an annual update on operating costs within NHSScotland in the financial year 2023/24. 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.

Main points

Trend in real terms and cash terms expenditure for the last eleven financial years for NHSScotland. In cash terms, there have been year-on-year increases in total operating costs while the only reduction in total real terms expenditure was in 2022 to 2023 financial year when there was a decrease of 3.2%. Total real terms expenditure has increased from £13.8 billion in 2013 to 2014 to £17.2 billion in 2023 to 2024. The trend over the last eleven years shows that the Hospital sector has the highest level of expenditure each year while Resource Transfer has the lowest. In previous years the Family Health sector had the second highest level of expenditure but in 2020 to 2021 the Community sector became the second highest costing sector.

Close

Figure 1: Trend in expenditure, 2013/14 to 2023/24

1. Please note the different scale used on the secondary axis for expenditure per sector.
2. Resource Transfer is expenditure that is transferred from NHS boards to local authorities to support the provision of integrated health and social care.

In the financial year 2023/24:

• £17.2 billion was spent on health service operating costs, a 7.3% (£1.2 billion) increase on the £16 billion spent in 2022/23.
• After estimating and removing the impact of inflation, expenditure has increased in real terms by 1.1% in the last year, and by 24.6% since 2013/14. During this period, the only year-on-year real terms decrease (-3.2%) was in 2022/23, which followed a period of accelerated growth from 2019/20 to 2021/22, in part due to additional non-recurring funds made available to help mitigate the impact of COVID-19 pandemic.
• £9.7 billion was spent on hospital-based services. This accounts for 56.5% of total operating costs, the highest proportion since 2015/16. There have been relatively substantial year-on-year increases in expenditure since 2019/20, amounting to a 32.7% total increase in that period (an 11.4% increase in real terms). In the last year, real terms expenditure increased by 2.5%.
• £3.7 billion was spent on services based in the community, representing a 4.9% increase in expenditure but a real terms decrease of 1.2%. This is the second consecutive year in which real terms expenditure has fallen. It follows notable increases in community expenditure during 2020/21 and 2021/22, due partly to the response to the pandemic, including the introduction of the Test & Protect and the vaccination programmes.
• The combined cost of staff working in the hospital and community sectors accounted for £9 billion of expenditure, an increase of £725 million (8.8%) and now constituting 52.2% 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, and 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 6.3% to £3.3 billion. In real terms, expenditure in this sector is estimated to have risen by just 3.9% since 2013/14, considerably less than the hospital and community sectors.

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.

This release and the 2022/23 release are based on a full set of Scottish Financial Returns (SFRs) with the exception of NHS Borders who provided a partial data submission in each year. Releases in 2020/21 and 2021/22 were based on reduced data submissions due to the impact of the COVID-19 pandemic. Please see the report for more information and for details of revisions to 2022/23 data.

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 2023 to 2024

View and download all data files for the financial year 2023 to 2024.

Further information

The most recent detailed data files available relate to the 2023-2024 publication

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