London capitation weighting: social deprivation, homelessness and mental health

Inner London, together with many other inner city areas, faces a crisis of funding in health services. Budgets are now allocated to commissioning authorities primarily on the basis of the sizes of resident populations. Although it is recognised that different communities have different needs and that some adjustment to this simple approach (capitation weighting) is required, there is no clarity about the best mechanism to achieve a fair resolution (Stern, 1992). Those inner city areas with high levels of social deprivation, high indices of health service need and especially those with high numbers of homeless people require additional resources to provide acceptable levels of overall care. Failure to take adequate account of these pressures may result in further gradual reductions in funding and consequently in service provision.