Dear Colleagues

Attached information below on new publication re implementation of Townsend Review in Wales

Best wishes

David McDaid
LSE Health and Social Care

Targeting Poor Health: Review of rural and urban factors affecting the costs of health services and other implementation issues

David Gordon, Adrian Kay, Michelle Kelly, Shailen Nandy, Martyn Senior, Mary Shaw

Independent Report of the Research Team, July 2004, National Assembly for Wales

http://www.wales.gov.uk/subihealth/content/keypubs/pdf/targeting-poor-health-e.pdf

From Introduction

The purpose of this report is to provide scientific advice on implementation issues arising out of the Townsend Review for allocating NHS resources to Local Health Board (LHB) areas. In particular, this report examines whether specific urban and rural factors result in unavoidable additional costs when providing health services in such areas and whether the NHS Resource Allocation Review (RAR) formula (National Assembly for Wales, 2001) should be adjusted accordingly.

In August 2000, the National Assembly for Wales commissioned the University of Bristol to assemble a research team to produce an independent report on the best methods of allocating NHS resources to small areas. This report was written by a very experienced, multidisciplinary team comprising some of the UK's leading experts in the fields of clinical epidemiology, medical geography, medical sociology and policy studies from the Universities of Bristol, Cardiff and Lancaster. Additional external statistical work was undertaken by the Office for National Statistics.

The independent research team's report proposed that Welsh NHS resources be allocated using a novel and innovative method based on a range of direct indicators of health need. After an extensive consultation exercise with both the public and NHS staff, the National Assembly for Wales decided to implement the proposed NHS resource allocation formula by 42 votes to eight.

Work is now being undertaken to implement the Assembly's decision and this report examines whether additional modifications are needed to the resource allocation formula to allow for unavoidable additional costs arising from:

* the difficulties of providing health care in rural areas;
* the cost of treating people with HIV/AIDS;
* additional costs associated with the health care of asylum seekers/refugees;
* the implications of the prison medical service changes;
* additional costs of meeting the health needs of homeless people;
* the allocation of drug and alcohol abuse health costs;
* additional costs arising from the ethnic composition of LHBs;

Additionally, this report examines the contentious issue of the optimum frequency with which the resource allocation formula should be revised and
updated, (eg, every year, once every five years and so on).