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NHS National Services Scotland ISD Scotland & NHS National Services Scotland


Latest Publications

Published: 02 December 2014
Scottish Health Service Costs
Publication Summary Download pdf file [10kb]
Full Report Download pdf file [483kb]

Scottish Health Service Costs (known as the Costs Book) is the only source of published costs information for NHSScotland (NHSS), and provides a detailed analysis of where resources are spent in the NHSS. This information is mainly derived from financial and statistical data compiled by Scottish Health Boards. It is published by ISD with the support of the Scottish Government Health Department (SGHD) and is used mainly for comparison across health care providers to ensure efficiency and to benchmark costs.

The NHSS is primarily organised into 14 health boards, 8 special health boards. The net operating cost of these bodies is recorded in their annual accounts.

A summary of the annual accounts for 2013/14 is provided in the following report:
Rep 086Download Excel file[25kb] - NHS Board Operating Costs and Capital Expenditure

SGHD are responsible for the administration of government finance for NHSScotland. More information on the annual accounts of the NHS Boards is available from SGHD website.

The Costs Book is compiled annually and is currently structured to analyse around 94% of the NHSS net operating costs, presenting information on the boards that provide hospital and community care directly to patients. For 2013/14, this reflects health care expenditure within the 14 health board areas and at two special boards, namely the State Hospital and Golden Jubilee National Hospital - amounting to £10.5 billion. In addition to this, information on two other special boards that provide direct patient care - Scottish Ambulance Service and National Services Scotland (including the Scottish Breast Screening Programme) - is shown separately in Special Boards.

The Costs Book has financial information from each board for hospital and primary care services. The primary care service is split into "community services" and "family health services". The range of services covered in each sector include:

  • hospital services - ranging from complex surgery by consultants at large city hospitals to outpatient clinics at rural community hospitals
  • community services - home visits by district nurses, for example, or prevention services such as breast screening and health promotion
  • family health services - provided by the family doctor (GP) service and the "High Street" dentists, opticians and pharmacists.

While the Costs Book reconciles to the expenditure reported in board annual accounts, certain items of income and expenditure are excluded from the analysis of costs presented in the Costs Book reports. Board operating costs include Resource Transfer and healthcare services purchased from local authorities, voluntary organisations and the private sector.

Summary Reports

Revision Note: Within the publication on the 2nd of December 2014, the GDS figure for Western Isles was understated by £3.784m in respect of salaried dentists and should have read as £4.041m. These salaried costs were incorrectly reported within the medical and nursing staff costs within Community Services. All figures and reports in relation to this were subsequently revised on 23rd December 2014.

R100Download Excel file [270kb] - executive summary
A summary report, for Scotland and by board, profiling the main elements of the data that is analysed in more detail elsewhere in the Costs Book.

R100TDownload Excel file [270kb] - trend over five years
Similar to the R100 executive summary report but including a comparison with the previous four years.

R300sDownload Excel file [118kb] - net expenditure by board of treatment*, by care type
A series of summary reports, for Scotland and by board, showing expenditure on the main types of healthcare.
* Board expenditure is irrespective of the residency of the patients treated.

Detailed Reports

Costs Book Detailed tables provide further analysis of data for 2013/14

Full file listings

Costs book reports downloads and SFRs are available on the File Listings page


Costs Book Archive - data for previous years.


Reference Information - for guidance manuals and reference files.

Please direct enquiries or requests for Costs information to the Costs Book mailbox:

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