Annex A > Chapter 7 - Supra Regional Services > The national framework
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The national framework
Introduction
7 The SRS was intended to support the national development of highly specialised services, which required particular clinical expertise or experience, might need particular facilities and equipment, and for which the demand was such that they could not economically be provided in each region. It was hoped that by providing a special funding system, dedicated to an individual service, proliferation in the development of these services could be limited.
8 The funds for the SRS were acquired by `top-slicing' a levy each year from the funds allocated by Parliament for Hospital and Community Health Services. The levy had the effect of reducing (marginally) the overall amount available for RHAs to spend on local health services. The SRS funds were then administered directly by the Department (of Health and Social Security, from 1988 of Health), on the advice of the SRSAG. The secretariat of the SRSAG liaised directly with the health authorities and later the trusts that provided services funded through this mechanism. The financial implications of SRS for Bristol are set out in Chapter 6 - Funding and Resources.
9 The top-sliced amount was then used to provide secure funding direct from the Department to centres `designated' to receive such funds as part of a designated service. It was as part of the SRS that, between 1984 and 1994, funds were made available for the designated service of NICS.
10 NICS related to children under 1 year of age only: `infants' meant children under 1, and the term `neonates' meant children under 1 month of age. Throughout the period of the Inquiry's Terms of Reference, the arrangements for organising and funding cardiac surgery for older children, those aged between 1 and 16, were the same as those which applied to the vast majority of children's and adult acute healthcare services. Thus, there were no special arrangements for funding paediatric cardiac surgery for children aged over 1. It was funded through the Regional Health Authority (RHA), until the provider-purchaser split took effect in 1991, after which they were provided in accordance with arrangements (`contracts') made between the provider unit and the District Health Authority (DHA) purchasers.
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