Transcript Presentation title on one or two lines

Finance Report as at 31st May 2014
1
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Executive Summary as at 31st May 2014

Income & Expenditure
YTD
The CCG is reporting an underspend year-to-date (YTD) and forecast outturn position.

Capital
YTD
No allocations have been announced to date however indications are that minimal funds
are available.

Cash
N/A
YTD
The forecast cash drawdown is in line with the anticipated cash limit.

£915K
£66,712
Forecast
£5,490K
Forecast
N/A
Forecast
£424,023
Target
Forecast
£22,755K £22,755K
Quality, Innovation, Productivity & Prevention (QIPP)
Current QIPP forecasts show full delivery against target.

By Volume By Value
Better Payment Practice Code (BPPC)
The CCG is exceeding its target of paying 95% of valid invoices within 30 days.
2
Non-NHS 98.19%
97.83%
NHS
99.79%
98.38%
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Budget to Actual Variances as at 31st May 2014
3
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Overview of Financial Position as at 31st May 2014
 The current position shows a year to date under-spend of £915K and a forecast
outturn under-spend of £5,490K against a total expected allocation of £424,023K.
This is in line with the Financial Plan submitted to NHS England.
 The CCG’s financial position is under continual review and the current position
shows the organisation to be on track to achieve its key financial targets.
However for much of the programme activity it is too early to form an accurate
position and work is on-going to scrutinise activity and data received.
 Notable exceptions to this include Continuing Healthcare and Community
Services budgets.
 Continuing Healthcare is showing a year to date under-spend due to the risk
share arrangements across the County Durham and Darlington CCG’s not
currently being transacted.
 Pressure is currently being observed within community services, relating to
County Durham and Darlington NHS Foundation Trust out of contract items,
including continence.
4
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Financial Position as at 31st May 2014
YTD Budget
£000's
YTD
YTD
Forecast
Forecast
Variance
Variance
Variance
Variance
(Under)/
(Under)/ 2013-14 Forecast (Under)/
(Under)/
Overspend Overspend Budget Outturn Overspend Overspend
£000's
%
£000's
£000's
£000's
%
YTD
Actual
£000's
Best Case Worst Case
Forecast
Forecast
Variance
Variance
(Under)/
(Under)/
Overspend Overspend
£000's
£000's
Commissioned Services
Acute Services
34,998
34,998
0
209,991
209,991
0
0
0
Community Health Services
7,504
7,628
124
45,024
45,024
0
0
0
Continuing Care Services
2,954
2,884
(70)
17,727
17,307
(420)
(420)
0
Mental Health Services
8,727
8,727
0
52,360
52,360
0
0
0
Primary Care Services
10,748
10,745
(3)
64,490
64,490
0
0
0
1,295
1,295
0
7,769
7,769
0
0
0
0
14,189
14,609
420
0
0
420
0
0
0
66,227
66,278
51
411,550
411,550
(0)
0
0
1,048
998
(51)
6,291
5,962
(329)
(362)
(173)
Running Cost Reserve
0
0
0
692
1,021
329
(138)
173
Total Running Costs
1,048
998
(51)
6,983
6,983
0
0%
(500)
0
915
0
(915)
5,490
0
(5,490)
68,190
67,275
(915)
424,023
418,533
(5,490)
-1%
(500)
(0)
Other
Programme Reserve
Total Commissioned Services
0%
0%
Running Costs
Corporate Costs and Services
1% Required Surplus
GRAND TOTAL EXPENDITURE
5
-5%
-1%
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Acute Commissioning as at 31st May 2014
Acute
YTD
Acute Commissioning Exluding Independent Sector
Independent Sector
Ambulance Services
Non Contract Activity Excluding Independent Sector
Total Acute
Forecast Outturn
Budget
£'000
32,386
661
1,621
330
Actuals
£'000
32,386
661
1,621
330
Variance
£'000
0
0
0
0
Budget
£'000
194,318
3,967
9,726
1,980
Actuals
£'000
194,318
3,967
9,726
1,980
Variance
£'000
0
0
0
0
34,998
34,998
0
209,991
209,991
0
•
Limited data is available at this point in the year as submissions by acute providers are completed as part of the national timetable. It
is anticipated that this information will be received in June as per the national activity submission guidelines and will enable the month
three position to be reflective of this. In the intervening period, budgets are assumed to perform in line with the planning assumptions
on which contract values have been set.
•
The majority of acute contracts have financial plans in place and are agreed with providers, although contracts are not formally signed.
Contracts with County Durham and Darlington NHS Foundation Trust are not yet finalised and negotiations are ongoing to resolve the
outstanding issues.
6
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Community Services as at 31st May 2014
Community
County Durham and Darlington NHS Foundation Trust (CDDFT)
Other NHS
Local Authority Agreements
Independent Sector
Hospices
Total Community
7
YTD
Forecast Outturn
Budget
£'000
5,749
455
283
702
315
Actuals
£'000
5,749
579
283
702
315
Variance
£'000
0
124
0
0
0
Budget
£'000
34,494
2,730
1,698
4,211
1,892
Actuals
£'000
34,494
2,730
1,698
4,211
1,892
Variance
£'000
0
0
0
0
0
7,504
7,628
124
45,024
45,024
0
•
As expected at this early stage of the year limited information is available. It is anticipated that information will be
available for June 2014 which will facilitate more accurate and detailed reporting. Contractual positions are therefore
showing breakeven.
•
Other NHS above includes out of contract charges relating to County Durham and Darlington Foundation Trust which
show as a pressure year to date. Specifically included are Orthotics, Continence and Patient Transport, which are
intended to be incorporated into the contract during 2014/15 financial year.
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Continuing Healthcare as at 31st May 2014
CHC
YTD
Continuing Healthcare (CHC)
Funded Nursing Care (FNC)
Total CHC
Forecast Outturn
Budget
£'000
2,442
513
Actuals
£'000
2,440
444
Variance
£'000
(2)
(69)
Budget
£'000
14,650
3,077
Actuals
£'000
14,641
2,666
Variance
£'000
(9)
(411)
2,954
2,884
(70)
17,727
17,307
(420)
•
Continuing Healthcare (CHC) costs are based on expected year-to-date and forecast outturn from the CHC
database.
•
The position includes an estimate of growth in packages for the 2014/15 financial year of £947k, which has
been reflected in the budget.
•
The risk share arrangements for high cost cases within CHC across the County Durham and Darlington
CCGs is currently not being applied, pending agreement for the 2014/15 financial year.
•
The financial position is based upon 650 approved packages of care which are confirmed as being delivered
to patients. There have been 103 new or changed packages so far this year.
.
8
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Mental Health as at 31st May 2014
Mental Health
YTD
Tees Esk Wear Valley NHS Foundation Trust (TEWV)
Northumberland Tyne and Wear NHS Foundation Trust
Other NHS
Independent Sector
Local Authority Agreements
Total Mental Health
•
9
Forecast Outturn
Budget
£'000
7,660
324
25
387
331
Actuals
£'000
7,660
324
25
387
331
Variance
£'000
0
0
0
0
0
Budget
£'000
45,958
1,942
150
2,325
1,985
Actuals
£'000
45,958
1,942
150
2,325
1,985
Variance
£'000
0
0
0
0
0
8,727
8,727
0
52,360
52,360
0
As expected at this early stage of the year limited information is available. It is anticipated that information will be
available for June 2014 which will facilitate more accurate and detailed reporting. Positions are therefore showing
breakeven.
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Primary Care as at 31st May 2014
Primary Care
YTD
Forecast Outturn
Prescribing
Enhanced Services
Out of Hours
Other
Budget
£'000
9,352
180
984
232
Actuals
£'000
9,352
180
984
229
Variance
£'000
0
0
0
(3)
Budget
£'000
56,112
1,078
5,906
1,394
Actuals
£'000
56,112
1,078
5,906
1,394
Variance
£'000
0
0
0
0
Total Primary Care
10,748
10,745
(3)
64,490
64,490
0
•
10
As expected at this early stage of the year limited information is available. It is anticipated that information will be
available for June 2014 which will facilitate more accurate and detailed reporting. Positions are therefore showing
breakeven.
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Other and Programme Reserve as at 31st May 2014
Other
YTD
Patient Transport Services - North East Ambulance NHS Foundation Trust
Patient Transport Services - County Durham and Darlington NHS Foundation Trust
Patient Transport - Integrated Travel - DCC
Patient Transport
Urgent Care-NHS 111
Property Charges
Reablement
Commissioning Reserves
Safeguarding
Total Other
Forecast Outturn
Budget
£'000
381
34
32
20
163
299
320
0
44
Actuals
£'000
381
34
32
20
163
299
320
0
44
Variance
£'000
0
0
0
0
0
0
0
0
0
Budget
£'000
2,285
206
195
123
977
1,796
1,921
14,189
266
Actuals
£'000
2,285
206
195
123
977
1,796
1,921
14,609
266
Variance
£'000
0
0
0
0
0
0
0
420
0
1,295
1,295
0
21,958
22,378
420
•
As expected at this early stage of the year limited information is available. It is anticipated that information will be
available for June 2014 which will facilitate more accurate and detailed reporting.
•
Reserves include the 2.5% non recurrent spend, earmarked reserves and contingency to be deployed during the
course of the year.
11
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Running Costs as at 31st May 2014
Income
Pay
Non Pay
NECS Contract
Running Cost Reserve
Budget
£'000
(3)
288
103
660
0
YTD
Actual
£'000
(3)
247
94
660
0
Variance
£'000
(0)
(42)
(9)
(0)
0
Total Running Costs
1,048
998
(51)
Forecast Outturn
Budget
Actual Variance
£'000
£'000
£'000
(20)
(20)
0
1,731
1,717
(15)
620
306
(315)
3,959
3,959
0
692
1,021
329
6,983
6,983
•
Running costs are currently showing a year-to-date underspend of £51k and a break-even forecast outturn position.
Approximately £82k of accruals were incorporated into the year-to-date position, mainly in relation to audit fees /
external consultancy fees that have not yet been invoiced.
•
No risks have been identified at month two but budget and actual spend will be regularly monitored to ensure that any
potential risks are promptly identified.
•
There is a budget of £692k in the General Reserve to be deployed on CCG priorities throughout the year.
12
0
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Quality Innovation Productivity & Prevention (QIPP) as at
31st May 2014
The table below summarises the latest forecast savings by key programme areas as at 31st May 2014, compared to the
original QIPP plan for the year. A number of red rated schemes remain owing to ongoing contract negotiations. This has
slowed QIPP delivery against plan for the first two months of the year, although forecasts remain at target levels.
Original Plan Latest Forecast
Area of QIPP Savings
Acute / Ambulance
Mental Health / LD
Community Services
CHC / FNC
Prescribing
Primary Care
Running Costs
£'000
5,064
200
581
0
629
0
187
£'000
4,687
200
581
377
629
0
187
Total Allocative QIPP
Technical QIPP
Grand Total QIPP
6,660
16,095
22,755
6,660
16,095
22,755
RAG Percentages - Total QIPP
RAG Percentages - Allocative QIPP
Schemes RAG Breakdown
Green
Amber
Red
£'000
£'000
£'000
1,731
1,513
1,442
0
200
0
0
0
581
377
0
0
629
0
0
0
0
0
187
0
0
Total
£'000
4,687
200
581
377
629
0
187
2,924
16,095
19,019
6,660
16,095
22,755
2,023
0
2,023
9%
30%
1,713
0
1,713
8%
26%
Total QIPP
Allocative QIPP
84%
44%
Notes:
1. Allocative QIPP plan comprises £6,170k recurring, plus £490k non-recurring = £6,660k Total
2. Technical QIPP = Efficiency removed from tariff/prices paid to providers (4% in 14/15)
3. Allocative QIPP - Efficiency driven out of the healthcare system by commissioners, e.g. pathway changes
13
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Better Payment Practice Code (BPPC) at 31st May 2014
The Better Payment Practice Code (BPPC) requires NHS organisations to pay all invoices by the due date or within 30
days of receipt of a valid invoice, whichever is later.
Better Payment Practice Code - 30 Days
Number
£000's
Non-NHS
Total Non-NHS Trade Invoices Paid in the Year
Total Non-NHS Trade Invoices Paid Within 30 Day Target
Percentage of Non-NHS Trade Invoices Paid Within 30 Day Target
1,272
1,249
98.19%
5,032
4,923
97.83%
NHS
Total NHS Trade Invoices Paid in the Year
Total NHS Trade Invoices Paid Within 30 Day Target
Percentage of NHS Trade Invoices Paid Within 30 Day Target
432
425
98.38%
54,825
54,708
99.79%
14
Durham Dales, Easington and Sedgefield Clinical Commissioning Group
Prescribing Analysis 31st May 2014
Scheme
DDES Practice Prescribing Total
Central Charges PPA to Jan
Nutricia (Enteral Feeds)
Meds Mgmt CSU
Meds Mgmt Ind Sector
Prescribing Incentive Scheme
N Tees Prescribing Spec Procurement
15
Total (per PPA) Apr / May Accrual Anticipated YTD
£000's
£000's
£000's
0
8952
8952
0
236
236
103
103
18
18
9
9
33
33
1
1
9352
9352
YTD Budget
£000's
8952
236
103
18
9
33
1
9352
YTD Over
/(Under) Spend
£000's
0
0
0
0
0
0
0
0
CCG FOT
£000's
53710
1417
616
110
54
200
6
56112
FOT Over
Annual Budget /(Under) Spend
£000's
£000's
53710
0
1417
0
616
0
110
0
54
0
200
0
6
0
56112
0
Durham Dales, Easington and Sedgefield Clinical Commissioning Group