NHS England is responsible for decisions on the weighted-capitation formula used to allocate resources between clinical commissioning groups. This process is independent of Government. NHS England takes advice from the Advisory Committee on Resource Allocation, a group of academics and other experts.
Target allocations include three adjustments that specifically support remote or sparsely populated areas:
- an emergency ambulance costs adjustment to reflect longer travel times in sparsely populated areas;
- an adjustment to remove from the formula supply induced demand in urban areas where people live close to a hospital; and
- an adjustment to support continued provision by hospitals with 24 hours, seven days a week accident and emergency services that are remote from the wider hospital network and have unavoidably higher costs.
The tendency for rural populations to be older, is naturally taken into account in the overall formula.