PBMA for HE Evaluation

YHPHO has become part of Public Health England, joining its Knowledge and Intelligence Team (Northern and Yorkshire).

This page is an historical archive only.

PCT Spend and Outcome Tool and Factsheets

The Department of Health has commissioned the Association of Public Health Observatories (APHO) to develop a tool which helps commissioners to link health outcomes and expenditure. The development of this tool and a Spend and Outcome Factsheet for every PCT in England has been led by Yorkshire and Humber Public Health Observatory.

PCTs can use the tool and the factsheets to gain an overview of outcome and expenditure across all programmes. The tool allows for further exploration of the data.
Spend and outcome tool (SPOT)

PBMA Pilot Site Reports

The NHS Institute for Innovation and Improvement funded a study to road-test PBMA in three English Regions. The reports below summarise the findings from the pilot sites. The three sites which took part in the study were Newcastle ( Child and Adolescent Mental Health), Norfolk (Mental Health) and Hull (Diabetes.)


To optimize how resources are allocated within a budget, a reliable method for making choices about which interventions and programmes to fund is required. Programme Budgeting Marginal Analysis (PBMA) can be used as a systematic way of identifying the range of options available, the resources required to produce the options and their expected effectiveness.

NHS Programme Budgeting allocates Primary Care Trust (PCT) and Strategic Health Authorities (SHAs) expenditure, including primary care services, to programmes of care based on medical condition.

There are 23 programme budget categories (listed below), they are based off the International Classification of Diseases Version 10 codes (ICD 10).

PBC  Description  Expanded description 
Total  Infectious Diseases  All disease caused by infectious organisms, excluding Tuberculosis and Sexually transmitted disease  
HIV & AIDS  Sub-category of Infectious Diseases: HIV infection 
Other  Sub-category of Infectious Diseases: Excludes HIV infection 
Cancers & Tumours  All cancers and tumours, malignant and benign. Including those with suspected or at risk of developing cancer 
Blood Disorders  Disorders of the blood and blood forming systems 
Total  Endocrine, Nutritional and Metabolic Problems [ENM]  Disorders of internal metabolism and its regulation  
Diabetes  Sub-category of ENM: Diabetes 
Other  Sub-category of ENM: Excludes Diabetes 
Total  Mental Health Problems  Problems of mental health including patients with Alzheimer's syndrome 
Substance Abuse  Sub-category of MH problems: Substance Abuse 
Dementia  Sub-category of MH problems: Dementia 
Other  Sub-category of MH problems: Excludes substance abuse & dementia 
Learning Disability Problems  Patients where the primary issue is the problem of learning disability 
Neurological System Problems  Problems relating to the Neurological system 
Eye/Vision Problems  Problems relating to the eye and vision 
Hearing Problems  Problems relating to the ear and hearing and balance 
10  Total  Circulation Problems  Problems relating to the heart, and the circulation of blood in central and peripheral vessels 
10  Coronary Heart Disease  Sub-category of Circulation: Problems relating to atheroma of the coronary arteries 
10  Cerebrovascular Disease  Sub-category of Circulation: Problems due to interruptions to the blood supply of the brain 
10  Other  Sub-category of Circulation: Excludes conditions associated with 10A & 10B 
11  Respiratory System Problems  Problems of respiration, including tuberculosis and sleep apnoea 
12  Dental Problems  Problems due to the teeth, including preventive checks and community surveys 
13  Gastro Intestinal System Problems  Problems of the gastro intestinal systems 
14  Skin Problems  Problems of the skin, including breast. 
15  Musculo Skeletal  System Problems (excluding Trauma) Problems of the Musculo Skeletal system, excluding trauma 
16  Total  Trauma & Injuries (inc burns)  Problems of Trauma & Injuries (including burns) 
16  Falls  Sub-category of Trauma & Injuries: Falls ( Elderly NSF) 
16  Other  Sub-category of Trauma & Injuries: Excludes Falls (16A) 
17  Total  Genito Urinary System Disorders (except infertility)  All Genito urinary problems except for those relating to infertility 
17  Genital tract Problems  Sub-category of GUS: Genital tract Problems 
17  Renal problems  Sub-category of GUS: Renal problems 
17  Chronic Renal Failure  Sub-category of GUS: Chronic Renal Failure (Renal NSF) 
17  Other  Sub-category of GUS: Excludes conditions associated with 17 A, B & C 
18  Maternity & Reproductive  Health Maternity and problems associated with reproduction 
19  Neonates  Conditions of babies in the neonatal period. 
20  Poisoning  Poisoning, toxic effects and other adverse events, whether accidental or deliberate 
21  Total  Healthy Individuals  Individuals who have no current problems but who are involved in programs for prevention of illness and promotion of good health 
21  NSF Prevention programme  Sub-category of Healthy Individuals: Specific Prevention interventions for CHD, Cancer Diabetes and Chronic Renal Failure 
21  NSF Mental health prevention  Sub-category of Healthy Individuals: Intervention to reduce the risk of development of mental illness 
21  Other  Sub-category of Healthy Individuals: Excludes programmes associated with 21A & 21B 
22  Social Care Needs  Problems related to life-management difficulty and problems related to care-provider dependency 
23  Other  Other conditions and Other congenital malformations 
Source : Appendix 2 - Programme Budgeting Guidance Manual, Department of Health

The Department of Health website for the National Programme Budget project can be accessed from the link below, also listed are useful links to data and methodology included on the website.

DoH National Programme Budget project website
Click here for more information

Programme Budgeting Guidance Manual - provides detailed explanation on how the data is collected and what it is used for
Click here for more information

PCT expenditure across the programme budget codes - allows comparison between PCTs across any of the programme budget codes.
Click here for more information

Interactive atlasses (NHS Net only) - NHS users can access the data as an interactive atlas, allowing visual comparison acoss all PCTs and correlation with other datasets such as IMD 2004 (requires SVG browser plugin).
Click here for more information

Save to Invest - refers to "work in progress" which has been undertaken by the London Health Observatory and London PCTs to support effective and equitable commissioning for hospital care.
Click here for more information

Better Allocation for Better Health and Healthcare: The First and Second Annual Population Value Reviews. Offers a step by step approach to using the Programme Budget information available through the National Programme Budget Project website to carry out an annual population value review.
Click here for more information

Last Updated: Friday, 25th November 2011

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