The NHS has been through a period of ongoing real-terms increase in its budget. Between 1999/00 and 2009/10, real-terms expenditure rose by 92% and is now £102 Billion in 2011/12 and from in terms of GDP, it has risen from 5% of GDP in the 1990s to over 8% of GDP today. Post credit crunch there is famously: “no more money”. In times of plenty, the temptation is to fight to increase your budget or fight professional colleagues for some of their’s- In times of famine, the mantra needs to be that new improvements, adding higher value, can only be funded by reducing lower value activities. The concept of the Programme Budget is critical here. Before making the case for more of someone else’s Programme Budget, you need to be able to answer – “what am I spending on, say, diabetes, and for what outcome?”. In this series, Asking new questions and and Using Programme Budgets will help you understand these issues.