Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what the (a) primary, (b) inpatient, (c) hospital day and (d) outpatient care costs are to the NHS of treating respiratory diseases.

NHS expenditure on problems of the respiratory system was £4.69 billion in 2012/13 (aggregate Primary Care Trust (PCT) Programme Budgeting estimates). This figure includes expenditure in the following settings:

[1] Elective and non-elective in patients. Day cases are included within this figure but cannot be separately identified.

An equivalent figure for 2013/14 is not available. Clinical commissioning group expenditure has been published but this does not cover the same range of services as the PCT expenditure.

Expenditure on primary care appointments is not included in the total expenditure on problems of the respiratory system because this data is not held centrally.

Expenditure in areas such as outpatients and community care are likely to be underestimates because complete data is not held centrally.

Notes:

Expenditure data included are taken from the 2012/13 programme budgeting returns. Programme budgeting returns are based on a subset of PCT accounts data and represent a subset of overall NHS expenditure data.

Calculating programme budgeting data is complex and not all healthcare activity or services can be classified directly to a programme budgeting category or care setting. When it is not possible to reasonably estimate a programme budgeting category, expenditure is classified as ‘Other’. Expenditure on General Medical Services and Personal Medical Services cannot be reasonably estimated at disease specific level, and is separately identified as a subcategory of ‘Other’ expenditure.

The allocation of expenditure to programme budgeting subcategories is not always straightforward, and subcategory level data should therefore be used with caution.

Estimates of expenditure are calculated using price paid for specific activities and services purchased from healthcare providers. PCTs follow standard guidance, procedures and mappings when calculating programme budgeting data.

The analysis of programme budgeting data by care setting was introduced for the first time in 2010/11. For this reason, programme budgeting data within individual care settings should be interpreted with caution.

Due to differences in the level of information available to PCTs on accident and emergency (A&E) attendances a national split has been applied to PCT total A&E expenditure to apportion it across programme budgeting categories.