Priority setting in the NHS: reports from six districts

District health authorities must make choices on the use of their funds and the priorities that should be pursued. In future they may be able to place greater weight on the views of local people and evidence on cost effectiveness of different services. This paper reviews developments in a recent study of six district health authorities with an interest in priority setting. On the whole they had avoided excluding services entirely from their contracts; they experienced difficulty in comparing different services, and made more progress by analysing priorities within individual service areas than by comparing quite different services. The absence of information to guide priority setting was a major problem. A major effort had been made to involve the public in decision making, and a range of tools and methods developed to support work on priority setting. The impact of the work done so far has varied; district health authorities are still at an early stage in developing their work on priority setting.