1. An introduction to the NRAC formula and TAGRA

2. Background to TAGRA Formed after NRAC report Maintains and develops formula Brings together Government, NHS Boards, and academics Forum for stakeholder engagement Work programme of improvements

3. Members – from boards Richard CopelandNHS GG&C Garry CouttsNHS Highland Karen FaceyNHS Forth Valley Malcolm IredaleNHS Highland Alan GallNHS Grampian Douglas GriffinNHS GG&C Fiona RamsayNHS Forth Valley Andrew RichmondNHS Tayside John Ross ScottNHS Orkney George WalkerNHS Lothian

4. TAGRA core criteria Equity Practicality Transparency Objectivity Avoiding perverse incentives Relevance Stability Responsiveness Face validity

5. NRAC formula

6. Needs based formula To enable every person in Scotland to have equal access to high quality health services according to their need Based on population – but just a start

7. Resource allocation in practice Relative need due to morbidity and life circumstances Additional Needs × Unavoidable Excess Costs of Supply Relative costs of providing services to different geographical areas × NRAC Weighted Target Share % ═ Relative need due to age and sex profile × Age-Sex Cost Weights Population Board population share %

16. The Additional Needs (1) Needs Utilisation 1 National average

17. The Additional Needs (2) Needs Utilisation 1

18. The Additional Needs (4) Utilisation 1 0.85 Needs MLC = constant + Coefficient*need IG 1

19. Data sources Based on intermediate geography Requires national data Requires small area data

20. MH&LD indicators Severe disablement allowance % living in one person households % living in socially rented housing

21. Questions?