Management costs at the highest spending primary care trusts are four times that of the lowest, even accounting for different population sizes.

Figures collated by the Liberal Democrats and shared with HSJ reveal one PCT spent £15 on management per head of weighted population in 2008-09, while another spent £63.

The Tories and Lib Dems have both pledged to cut management costs by a third at PCTs and strategic health authorities.

Before the election, the Lib Dems also told HSJ all PCTs should aim to reduce their management costs to those of the lowest 25 per cent, spending a maximum £23 per head.

As information was unavailable for 16 PCTs, this leaves 92 above the cut-off point.

But PCT network director David Stout said this was “very crude” because not all organisations carried out the same responsibilities.

Some PCTs had no provider arm or hosted functions on behalf of other organisations, and the costs may have been coded differently.

For example, NHS Isle of Wight spends the highest amount at £63 per head, but has an extended provider function.

In addition, there was some evidence to suggest PCTs with bigger populations had smaller management costs due to economies of scale.

Accordingly, some strategic health authorities have allowed PCTs in cluster arrangements to save 30 per cent overall, rather than expecting this from every organisation.

NHS Peterborough, where former chief executive Angela Bailey resigned in January amid a predicted £6.4m overspend, had the third highest management costs in England at £53 per head.

Interim director of finance Rob Yeomans said the figures included management costs for adult social care services. He added: “However, we are developing plans to reduce management costs as part of our programme to return to financial balance.”

NHS Darlington was second highest, at £54. NHS County Durham and Darlington director of finance Pat Taylor said: “The management cost per head of population identified in the annual accounts for Darlington PCT in 2008/09, represent the transfer of provider services from County Durham PCT to Darlington PCT in August 2008.  

“The costs relate to the provider services of both PCTs and if allocated over the weighted population of County Durham and Darlington would be £36.46 per head.”  

Lowest spenders*

PCTManagement cost per head of weighted population (£) 2008/09
Cornwall and Isles Of Scilly PCT18.60
North Tyneside PCT18.08
Bournemouth and Poole Teaching PCT16.56
Worcestershire PCT16.44
Somerset PCT15.39


Highest spenders*

PCTManagement cost per head of weighted population (£) 2008/09
Isle Of Wight NHS PCT62.51
Darlington PCT54.50
Peterborough PCT52.71
Kingston PCT46.82
South Birmingham PCT45.45


*Source: Liberal Democrats