NHS Merton CCG
Finance Report
Month 11 – as at 28th February 2015
1
Finance Report – Month 11
Contents
Slide Number
EXECUTIVE SUMMARY
3
BALANCED SCORECARD – FINANCE DOMAIN
4
INCOME AND EXPENDITURE POSITION
5
QUALITY, INNOVATION, PRODUCTIVITY AND PREVENTION (QIPP)
6
ACUTE PERFORMANCE
7 – 10
NON ACUTE PERFORMANCE
11
PRESCRIBING AND PRIMARY CARE
12
STATEMENT OF FINANCIAL POSITION
13
CASH AND BETTER PAYMENT PRACTICE POLICY
14
RISKS AND MITIGATIONS
15
APPENDICES
16 - 24
2
EXECUTIVE SUMMARY
Eleven months to 28th February 2015
•
For the eleven months to 28th February 2015, NHS Merton CCG is reporting a year to date and full year improvement from plan of £0.5m. As reported
from Month 9 onwards, this improvement from plan in the year to date and full year position specifically relates to return of the unused legacy
continuing healthcare contributions from NHS England.
•
There has been a non recurrent reduction in the revenue resource limit of £0.2m in Month 11. This relates to a 2013/14 repayment to the South West
London risk pool for learning disabilities.
•
Acute commissioning is over performing by £1.4m year to date, forecast to increase to an over spend of £1.6m by year end. St George’s NHS Trust is
forecast to over perform by £0.7m, this is the position as reported in Month 10. Discussions with the trust regarding a year end settlement are currently
on going. Epsom & St Helier NHS trust are reporting under performance of £0.3m primarily in elective activity and critical care, this has worsened
considerably from what has been reported previously owing to an increase in activity in emergency and outpatient procedures. Kingston Hospital NHS
Foundation trust is forecast to over perform by £0.1m mostly owing to over performance in critical care and outpatients.
•
An over spend of £0.3m is forecast for non acute commissioning. This has worsened slightly from last month owing to an increase in the forecast
position for children’s placements which are now forecast to over spend by £0.5m.
•
Primary care is forecast to over spend by £0.7m, over spends are reported on prescribing, out of hours and care of older people local enhanced
services.
•
An over spend of £0.7m is reported on corporate costs, a full year under spend of £0.2m is reported on running costs owing to lower than anticipated
admin spend at the Nelson Health Centre, however, this is offset by higher than anticipated programme spend related to the Nelson Health Centre.
•
The forecast over spends are being offset by under spends on investments, release of CCG SLA reserve, partial release of contingency fund and
return of Merton’s remaining contribution of £0.7m from the SWL risk pool contribution.
•
QIPP – Year to date over achievement of £0.2m and full year over achievement of £0.1m is forecast.
Recommendation
•
Governing Body is asked to approve the Month 11 finance report and note the risks on slide 15.
3
BALANCED SCORECARD – FINANCE DOMAIN
No.
1
2
3
4
5
6
7
8
9
10
FINANCIAL PERFORMANCE
Primary /
Indicator
Supporting
Indicator
Underlying recurrent surplus
Primary
Surplus - year to date (YTD) performance
Primary
Surplus - full year (FY) forecast
Primary
Management of 2% non recurrent funds
Supporting
within agreed processes
QIPP - year to date delivery
Primary
QIPP - full year forecast
Primary
Activity trends - year to date
Supporting
Activity trends - full year forecast
Supporting
Running costs
Primary
Clear identification of risks against
financial delivery and mitigations
No. Indicator
Primary
FINANCIAL MANAGEMENT
Primary /
Supporting
Indicator
Individual Indicator RAG rating threshold
Self
Assessment
2.50%
1.2%
1.2%
Green
Yes
103%
101%
>= 95% of plan
>= 95% of plan
< 101% of plan
< 101% of plan
< = RCA
Yes
Amber/Red
Red
> = 2.5%
0% - 2.5%
< 0%
Variance <= 0.1% 0.1% > variance <= 0.25% 0.25% > variance < 0.5% Variance => 0.5%
Variance <= 0.1% 0.1% > variance <= 0.25% 0.25% > variance < 0.5% Variance => 0.5%
Yes
£4,992k
Amber/Green
•
The financial
indicators are part of
the CCG assurance
framework used by
NHS England.
•
The overall financial
performance and
financial management
performance is rated
as green.
No
> = 80% of plan
> = 80% of plan
< 102% of plan
< 102% of plan
> = 50% of plan
> = 50% of plan
< 103% of plan
< 103% of plan
< 50% of plan
< 50% of plan
< 104% of plan
< 104% of plan
> RCA
Indicator met in Indicator partially met - Indicator partially met Indicator not met
full
limited uncovered risk material uncovered risk
Individual Indicator RAG rating threshold
Self
Assessment
Green
Amber/Green
Amber/Red
Red
1
Better Payment Practice Code - % payable
within 30 days of receipt - Numbers
Supporting
97%
> = 95%
> = 85%
> = 80%
< 80%
2
Better Payment Practice Code - % payable
within 30 days of receipt - Values
Supporting
99%
> = 95%
> = 85%
> = 80%
< 80%
3
Cash management - month end cash
balance as % of cash drawn
Supporting
1.38%
< = 5%
< = 10%
< = 15%
< 15%
4
INCOME AND EXPENDITURE
Budget
1
Year to date
Actual Variance
199,702
199,702
2
3
4
5
6
7
8
9
10
115,301
18,834
14,616
11,290
20,803
3,641
7,092
6,145
197,720
116,711
18,958
13,507
12,597
20,985
4,098
7,718
2,683
197,257
11
1,982
2,444
Feb-15
In £000's
0 Income
Expenditure
(1,410) Acute
(125) Mental Health
1,108 Community
(1,308) Other non acute
(183) Prescribing
(456) Primary Care*
(626) Corporate and estate
3,462 Reserves
462 Total Expenditure
462 Surplus
Budget
218,166
Forecast
Actual Variance
218,166
•
Year to date (YTD) and full year (FY)
actuals are on target
•
The £319k continuing care provision
created in 13/14 has been released in
Month 11 as NHSE guidance states
that any claims up to 31/04/2014 will be
paid from the legacy provision held by
NHSE.
•
A business case has been submitted by
South West London Commissioning
Collaborative on behalf of South West
London CCGs (excluding Croydon
CCG) to drawdown the increased
surplus in 2015/16.
•
Risks to the position are detailed on
slide 15.
0
126,045
20,546
15,945
12,365
22,694
3,972
7,737
6,701
216,003
127,614
20,683
14,735
13,746
22,893
4,468
8,434
2,927
215,499
(1,569)
(137)
1,210
(1,382)
(199)
(496)
(697)
3,774
504
2,163
2,667
504
*Out of Hours , Loca l Enha nced Servi ces , GP Led Hea l th Centre a nd Col l a bora tive Fees
5
QIPP
Year to date (net)
Budget Actual Variance
Feb-15
In £000's
Forecast (net)
Budget Actual Variance
1
2
3
4
4,624
1,282
5,906
5,070
996
6,066
Schemes
(446) Transactional
286 Transformational
- Other
(160) Total QIPP
5
5,906
6,066
(160) QIPP Target
6,558
6,643
(85)
6
100%
102.7%
-3% % of Target
100%
101.3%
-1%
5,116
1,442
6,558
5,507
1,136
6,643
(391)
306
(85)
•
A YTD over achievement of £0.2m is reported. This is mostly owing
to the acute challenges scheme which is reporting a YTD
achievement of £1.4m. To date £0.7m of challenges have been
agreed, a further £1.5m of most likely challenges are included in
the reported acute position.
•
A FY over achievement of £85k is reported, this relates to higher
than planned savings on the mental health contracts scheme, inreach nursing scheme and the musculoskeletal scheme where
slippage on the planned investment is reported offset by under
achievement of some planned care schemes that owing to
procurement reasons could not be implemented this year.
6
STATEMENT OF CONTRACT POSITION – At Month 10 not Month 11
Provider
St George's
Epsom & St Helier (Acute & Renal)
Epsom & St Helier (SWLEOC)
Kingston Hospital
London Ambulance Service
Moorfields' Eye
Croydon University Hospital
Guy's & St Thomas'
Royal Marsden
Queen Mary's (Roehampton)
Chelsea & Westminster
Imperial College
University College London
King's College
Royal Brompton & Harefield
Bart's & the London
Royal Surrey County
Royal National Orthopaedic
Ashford & St Peter's
Royal Free
Lewisham
North West London
West Middlesex
Great Ormond Street
Total
Plan
Annual
£000's
56,283
31,746
4,428
9,650
5,578
3,328
1,774
1,775
1,697
1,756
1,101
750
707
953
339
274
191
235
0
106
67
122
38
123
123,020
YTD
Plan
£000's
46,837
26,564
3,690
8,015
4,648
2,685
1,484
1,386
1,414
1,463
917
628
589
777
283
233
159
196
0
88
54
102
31
100
102,344
YTD
Actual
£000's
49,089
26,706
3,455
8,279
4,648
3,015
1,600
1,530
1,105
1,644
1,181
685
455
921
301
223
113
157
0
104
74
76
25
73
105,462
YTD
Variance
£000's
(2,252)
(142)
235
(263)
0
(330)
(116)
(144)
309
(181)
(264)
(57)
134
(144)
(18)
10
46
38
0
(16)
(20)
26
6
27
(3,118)
ADJUSTMENTS/CHALLENGES
Plan
Adj
£000's
0
(109)
0
0
0
88
(6)
93
0
0
0
(3)
0
17
0
(4)
0
0
0
0
1
0
0
2
80
Other
Challenges
£000's
(706)
(251)
0
(149)
0
(32)
69
21
0
70
(3)
0
(3)
41
0
(4)
0
0
0
(0)
2
0
0
(3)
(947)
KPIs
£000's
(471)
0
0
(27)
0
0
(15)
(1)
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
(514)
REVISED POSITION SLAM MONTH
YTD
YTD
YTD
Plan
Actual
Variance
£000's
46,837
26,455
3,690
8,015
4,648
2,774
1,478
1,479
1,414
1,463
917
625
589
794
283
229
159
196
0
88
56
102
31
102
102,424
£000's
47,912
26,456
3,455
8,103
4,648
2,984
1,654
1,550
1,105
1,714
1,178
685
452
962
301
220
113
157
0
104
76
76
25
70
104,001
£000's
(1,075)
(1)
235
(88)
0
(210)
(176)
(71)
309
(251)
(262)
(60)
137
(168)
(18)
9
46
38
0
(16)
(20)
26
6
33
(1,577)
The three highest value
contracts will be discussed in
further detail on slides 8 - 10.
Moorfield’s - YTD over
performance of £0.2m is driven
by high cost drugs and day case
activity. The over performance
in day case activity is
particularly being seen in the
cataracts speciality.
Croydon – YTD over
performance of £0.2m is owing
to maternity and critical care.
Royal Marsden – The YTD under
spend of £0.3m is primarily in
electives , emergency and
critical care.
Queen Mary’s – YTD over spend
of £0.3m is owing to high
activity levels in the older
peoples services and electives.
Chelsea & Westminster – The
YTD over spend of £0.3m is in
obstetrics and outpatient follow
ups. Births are above plan.
University College London – YTD
under spend of £0.1m is in
electives and critical care.
7
ST GEORGE’S NHS TRUST - Month 10 extrapolated to Month 11
POD
YTD Plan
Annual Plan Activity
Activity 000s
000s
YTD Actual
Activity
000s
YTD
Variance
Activity
000s
FYO Actual
Activity 000s
FYO Variance
Activity 000s
Annual Plan
£000
YTD
Plan
£000s
YTD Actual
£000s
YTD Variance
£000
FYO Actual
£000s
FYO Variance
£000
Elective
10
9
9
(0)
10
(0)
10,621
9,691
9,727
(36)
10,611
10
Emergency
8
6
7
1
8
1
16,658
15,199
15,509
(310)
16,919
(261)
Non-Elective
1
1
1
0
1
0
168
153
394
(241)
430
(262)
Maternity Pathway
4
3
3
(0)
4
(0)
6,324
5,770
6,176
(406)
6,738
(414)
A&E
31
26
28
1
33
2
3,691
3,368
3,315
53
3,616
75
Out Patient 1st
24
20
20
0
24
0
4,339
3,959
4,061
(103)
4,431
(92)
Out Patient Follow Up
45
37
38
1
46
1
4,359
3,977
4,072
(94)
4,442
(83)
Out Patient Procedure
12
10
12
2
15
2
1,869
1,706
1,924
(219)
2,099
(230)
Unbundled Diagnostics
7
6
7
1
8
1
899
821
888
(67)
968
(69)
Critical Care
3
3
3
(0)
3
(0)
2,677
2,442
2,335
107
2,547
130
Direct Access
28
23
25
2
30
2
2,124
1,938
1,855
83
2,023
101
Drugs & Devices
Other
0
0
0
0
0
0
0
0
0
0
0
0
710
0
648
0
687
(653)
(39)
653
749
(507)
(39)
507
PTS
CQUIN
0
0
0
0
0
0
0
0
0
0
0
0
505
1,337
461
1,220
465
1,296
(4)
(75)
507
1,413
(2)
(76)
56,283
51,352
52,050
(698)
56,987
(704)
TOTAL
Annual QIPP
£000s
420
148
173
741
Commentary
•
The YTD and FY over spend of £0.7m is mostly reported on maternity (£406k), emergency (£310k) and non elective (£241k) seen in general
medicine. The biggest movement is being seen in the general medicine category for emergency activity. It is the lengths of stay for two days and over
where an increase in activity is being seen, this is being investigated with the trust. Negotiations are also on going with regards to reaching a year end
settlement with the trust.
8
EPSOM AND ST HELIER’S NHS TRUST - Month 10 extrapolated to Month 11
-
POD
YTD Plan
Annual Plan Activity
Activity 000s 000s
YTD Actual
Activity
000s
YTD
Variance
Activity
000s
FYO Actual
Activity 000s
FYO Variance
Activity 000s
Annual Plan
£000
YTD
Plan
£000s
YTD Actual
£000s
YTD Variance
£000
FYO Actual
£000s
FYO Variance
£000
(0)
6
(1)
4,991
4,575
4,371
205
4,768
223
Elective
6
5
5
Emergency
4
3
4
1
4
1
7,303
6,694
6,800
(106)
7,419
(116)
Non-Elective
0
0
0
(0)
0
(0)
566
518
461
57
503
63
Maternity Pathway
3
3
3
0
4
0
3,191
2,925
2,851
74
3,110
81
A&E
18
15
16
1
19
1
1,767
1,620
1,646
(27)
1,796
(29)
Out Patient 1st
17
14
15
1
18
1
2,362
2,165
2,258
(93)
2,463
(101)
Out Patient Follow Up
40
33
38
5
46
6
3,441
3,154
3,101
53
3,383
58
Out Patient Procedure
7
6
7
1
9
2
1,277
1,170
1,488
(318)
1,644
(368)
Unbundled Diagnostics
5
4
4
0
5
0
568
521
514
7
560
8
Critical Care
1
0
0
(0)
0
(0)
819
751
513
238
559
259
Direct Access
843
702
660
(42)
792
(51)
3,520
3,227
3,144
83
3,430
91
Drugs & Devices
0
0
0
0
0
0
495
454
459
(5)
501
(5)
Other
5
4
6
2
7
2
353
323
493
(170)
538
(185)
PTS
CQUIN
0
0
0
0
0
0
0
0
0
0
0
0
313
781
287
716
287
716
0
0
313
781
(0)
0
31,746
29,101
29,101
(1)
31,768
(22)
TOTAL
Annual QIPP
£000s
158
118
129
405
Commentary
•
The YTD position is reporting break-even and the FY position is a minor over spend of £22k. The position has worsened considerably from last month
owing to an increase in emergency activity and outpatient procedures. The over performance of £0.4m in outpatient procedures mainly relates to eyes
and periorbita procedures and disorders category, a shift from day cases to outpatient procedures is being seen in this category. The recording of non
elective activity at the trust is also being investigated.
9
KINGSTON NHS TRUST - Month 10 extrapolated to Month 11
POD
YTD Plan
Annual Plan Activity
Activity 000s 000s
YTD Actual
Activity
000s
YTD
Variance
Activity
000s
FYO Actual
Activity 000s
FYO Variance
Activity 000s
Annual Plan
£000
YTD
Plan
£000s
YTD Actual
£000s
YTD Variance
£000
FYO Actual
£000s
FYO Variance
£000
Elective
1
1
1
0
1
0
1,223
1,116
1,155
(39)
1,260
(37)
Emergency
1
1
1
(0)
1
(0)
2,466
2,251
1,872
380
2,042
424
Non-Elective
0
0
0
0
0
0
0
0
0
0
0
0
Maternity Pathway
2
2
2
0
2
0
2,346
2,142
2,235
(93)
2,438
(92)
A&E
7
6
5
(0)
6
(0)
703
642
607
35
662
41
Out Patient 1st
7
6
6
0
7
0
742
678
796
(119)
869
(127)
Out Patient Follow Up
10
8
7
(1)
9
(2)
687
627
620
8
676
11
Out Patient Procedure
1
1
1
0
2
0
207
189
288
(98)
314
(107)
Unbundled Diagnostics
1
1
1
0
1
0
56
51
59
(8)
64
(9)
Critical Care
0
0
0
0
0
0
247
226
427
(201)
466
(219)
Direct Access
36
30
74
44
88
52
183
167
245
(78)
267
(84)
Drugs & Devices
1
0
1
0
1
0
307
281
311
(31)
340
(32)
Other
1
1
1
(0)
1
(0)
189
164
40
124
44
145
PTS
CQUIN
0
0
0
0
0
0
0
0
0
0
0
0
68
225
62
205
63
196
(0)
9
68
213
0
11
9,650
8,801
8,913
(112)
9,723
(73)
TOTAL
Annual QIPP
£000s
20
18
15
53
Commentary
•
The YTD over performance of £0.1m is mostly owing to an increase in activity in outpatients (£127k), maternity (£92k) and critical care (£219k). The
over spend in critical care is owing to one long stay critical care patient (95 bed days) who was discharged in Month 7’s freeze position. Some of the
over performance is offset by under performance in emergency (£424k). Direct access over performance (£84k) is a result of activity shifts from St
Helier’s to Kingston NHSFT. The FY forecast is over performance of £0.1m.
10
NON ACUTE PERFORMANCE
Budget
Year to date
Actual
Variance
1
2
3
4
13,347
3,080
2,406
18,834
13,347
3,254
2,357
18,959
5
1,196
1,556
6
7
8
9
14,040
6,450
4,219
24,709
10
44,739
13,134
7,010
4,405
24,548
45,062
Feb-15
In £000's
Budget
Forecast
Actual
Commentary
Variance
•
The £0.2m YTD and FY over spend reported
on mental health placements is owing to an
increase in the number of placements.
•
The YTD and FY £0.1m under spend on
mental health ‘other’ relates to lower than
anticipated costs on Mental Health enquiries
and dementia services.
Mental Health:
SWL St Georges MHT
Placements
Other
Total Mental Health
14,561
3,360
2,625
20,546
14,561
3,550
2,572
20,683
(0)
(190)
53
(137)
(359) Learning Disabilities
1,305
1,697
(392)
•
The YTD and FY over spend of £0.4m is
primarily owing to a learning disability
patient currently an inpatient in a hospital.
15,317
7,036
4,652
27,004
14,327
7,647
4,811
26,784
990
(611)
(159)
220
•
The YTD and FY under spend on
community services is owing to slippage on
investment schemes, namely, dementia
nurses, rapid response team and step up
and step down beds. The slippage has
increased from previous months as further
slippage is reported on dementia nurses and
interface geriatricians.
(0)
(174)
49
(125)
907
(560)
(185)
161
Community:
Community Services SLA
Continuing Care
Other
Total Community
(323) Total Non Acute
48,855
49,164
(309)
Community (cont’d)
•
A YTD and FY under performance of £0.2m on continuing care is reported. NHS Merton CCG
has been over charged for block bed recharges, the over charge is currently being calculated,
NHS Sutton CCG will be invoiced for the over charge before year end.
•
The YTD and FY over spend on ‘other’ mostly relates to an over spend on children’s
placements offset by slippage on better care fund investments and musculoskeletal services.
11
PRESCRIBING AND PRIMARY CARE BUDGETS
Year to date
Budget
Actual
Variance
1
2
20,803
20,803
20,985
20,985
3
4
5
6
7
8
1,034
944
413
1,173
77
3,641
1,265
930
413
1,297
196
4,100
9
24,444
25,085
Feb-15
In £000's
Prescribing:
(183) Prescribing
(183) Total Prescribing
(231)
15
(124)
(119)
(459)
Primary Care:
Local enhanced services
GP led health centre
111 service
Out of hours service
Other
Total Primary Care
(642) Total Prescribing & Primary Care
Budget
Forecast
Actual
Commentary
Variance
22,694
22,694
22,893
22,893
(199)
(199)
1,128
1,030
450
1,280
84
3,972
1,376
1,014
450
1,415
213
4,468
(248)
16
(135)
(129)
(496)
26,666
27,361
•
The £0.2m YTD and FY over
spend of £0.2m on prescribing is
owing to an increase in items
prescribed in particular for
cardiovascular, central nervous
system, respiratory and endocrine
system.
•
The YTD and FY over spend of
£0.2m on local enhanced services
relates to an over spend of £0.3m
on the Care of Older People LIS
offset by a slight under spend on
the Diabetes LES.
•
The FY over spend of £0.1m
reported on Out of Hours is owing
to recharges from Sutton CCG for
Merton patients attending the
Seldoc Out of Hours service.
•
The YTD and FY over spend on
‘other’ primary care relates to
statutory medical fees, the over
spend arose owing to a number of
claims related to the last quarter of
13/14 received in 14/15.
(695)
12
STATEMENT OF FINANCIAL POSITION (SOFP)
Commentary
STATEMENT OF FINANCIAL POSITION AS AT 28th FEB 2015
Closing Balance
ADJ-14
Non-current Assets
Property, Plant And Equipment
32,122.40
Non-current Assets
32,122.40
Current Assets
Current Trade And Other
Receivables
4,478,186.64
Current Assets
Cash And Cash Equivalents
173,242.32
Current Assets Total
4,651,428.96
Current Liabilities
Current Trade And Other
Payables
(14,931,084.71)
Current Liabilities
Current Other Liabilities
(51,449.73)
Current Liabilities
Provisions
(47,824.39)
Current Liabilities
(15,030,358.83)
Non-Current Liabilities: NC Provisions
(271,004.85)
Non-Current
(271,004.85)
Grand Total
(10,617,812.32)
Closing Balance
ADJ-14
Financed by Taxpayers
General Fund
Equity:
Financed by
Grand Total
10,617,812.32
10,617,812.32
10,617,812.32
QTR 1
92,098.33
92,098.33
QTR 2
89,316.80
89,316.80
QTR 3
190,929.79
190,929.79
Jan-15
315,223.57
315,223.57
Feb-15
489,161.04
489,161.04
2,330,770.02
(538,352.96)
1,792,417.06
2,572,511.21
(37,790.44)
2,534,720.77
2,316,247.56
(450,037.76)
1,866,209.80
2,513,876.29
(608,218.91)
1,905,657.38
2,338,715.15
221,673.62
2,560,388.77
(14,400,013.97) (13,624,010.61) (15,003,921.29) (14,711,244.17) (15,190,187.67)
(1,268,020.69)
(2,733.14)
18,681.53
(43,977.17)
(172,882.21)
(47,824.39)
(47,824.39)
(47,824.39)
(47,824.39)
271,004.85
(15,715,859.05) (13,674,568.14) (15,033,064.15) (14,803,045.73) (15,092,065.03)
(271,004.85)
(271,004.85)
(271,004.85)
(271,004.85)
(271,004.85)
(271,004.85)
(271,004.85)
(271,004.85)
(271,004.85)
(271,004.85)
(14,102,348.51) (11,321,535.42) (13,246,929.41) (12,853,169.63) (12,313,520.07)
QTR 1
14,102,348.51
14,102,348.51
14,102,348.51
QTR 2
11,321,535.42
11,321,535.42
11,321,535.42
QTR 3
13,246,929.41
13,246,929.41
13,246,929.41
Jan-15
12,853,169.63
12,853,169.63
12,853,169.63
•
The £315k for property, plant
and equipment is made up of
assets under construction which
mainly relate to IT equipment
for the Nelson Health Centre.
•
Accounts receivables balance
has increased by £0.2m from
previous month. The movement
is due to an increase in aged
receivables of £0.1m and an
increase in the continuing care
risk pool of £0.1m.
•
The cash position is as per the
cash flow statement on slide 14.
•
Current liabilities have
decreased by £0.2m from last
month. The decrease is due to
a decrease in payables of
£0.6m and an increase in
accruals of £0.4m. The £15m
total comprises of £11m of
payables and £4.3m of
accruals.
•
The £48k current provision and
£271k non current provision is
the £319k continuing care
provision created in 2013/14.
Feb-15
12,313,520.07
12,313,520.07
12,313,520.07
13
CASH MANAGEMENT AND BETTER PAYMENT PRACTICE POLICY
Commentary
STATEMENT OF CASH FLOWS AS AT 28th FEB 2015
2015
Qtr1
Cash Flow s f rom Operating Activities:
Net operating costs f or the f inancial year
Depreciation and amortisation
Interest Paid
(Increase) decrease in trade and other receivables
Increase (decrease) in trade and other payables
Provisions utilised
Increase (decrease) in provisions
Net Total of Cash Flow s f rom Operating Activities
Cash Flow s f rom Investing Activities:
(Payments) f or property, plant and equipment
Proceeds f rom disposal of assets held f or sale:
property, plant and equipment
Net Total of Cash Flow s f rom Investing Activities
Cash Flow s f rom Financing Activities:
Net parliamentary f unding received
Net Total of Cash Flow s f rom Financing Activities
Grand Total
Qtr2
Qtr3
Jan-15
Feb-15
(53,658,718.00)
0.00
(70.00)
(53,415,640.87) (54,905,662.21) (17,689,959.38) (17,587,560.81)
0.00
0.00
0.00
0.00
70.00
0.00
0.00
0.00
2,147,416.62
685,500.22
0.00
0.00
(50,825,871.16)
(241,741.19)
256,263.65
831,268.67
175,161.14
(2,041,290.91)
1,358,496.01 (1,258,915.82)
607,848.54
0.00
0.00
0.00
0.00
0.00
0.00
0.00
(318,829.24)
(55,698,602.97) (53,290,902.55) (18,117,606.53) (17,123,380.37)
(14,077.56)
48,679.90
(101,612.99)
(170,192.15)
(173,937.47)
(45,898.37)
(59,975.93)
(45,898.37)
2,781.53
0.00
(101,612.99)
45,898.37
(124,293.78)
0.00
(173,937.47)
50,174,251.81
50,174,251.81
(711,595.28)
56,196,383.96
56,662,796.59
500,562.52
52,980,268.22
52,980,268.22
(412,247.32)
18,083,719.16
18,083,719.16
(158,181.15)
18,127,210.37
18,127,210.37
829,892.53
Qtr1
(711,595.28)
173,242.32
(538,352.96)
Qtr2
500,562.52
(538,352.96)
(37,790.44)
2015
Qtr3
(412,247.32)
(37,790.44)
(450,037.76)
Jan-15
(158,181.15)
(450,037.76)
(608,218.91)
Feb-15
829,892.53
(608,218.91)
221,673.62
Cas h Movem ent
Opening Cas h Balance
Clos ing Cas h Balance
•
The cash target has been amended
from 5% to 1.25% of the monthly
cash draw down. The month end
cash balance as at 31st January is –
3.51% of the cash drawn.
•
The BPPC is above target in terms of
volume and value of invoices.
Better Payment Practice Code
Period
Apr-14
Ma y-14
Jun-14
Jul -14
Aug-14
Se p-14
Oct-14
Nov-14
De c-14
Ja n-15
Fe b-15
Cumulative %
Invoice Count
687
639
658
1051
668
785
946
612
1009
1129
865
9049
Invoice Count
(Passed)
668
625
628
1028
662
773
902
590
994
1111
831
8812
% Passed
97%
98%
95%
98%
99%
98%
95%
96%
99%
98%
96%
97.4%
BPPC Amount
£000's
17,547
16,136
16,923
19,572
17,197
18,124
16,447
17,548
18,287
18,730
17,556
194,067
Invoice
Amount
(Passed)
£000's
17,529
15,620
16,731
19,201
17,017
18,078
16,616
17,338
18,280
18,471
17,552
192,433
% Amount Passed
100%
97%
99%
98%
99%
100%
101%
99%
100%
99%
100%
99.2%
14
RISKS AND MITIGATIONS
Financial Risk Analysis: Month 11
Worst
£000's
Likely
£000's
Best
£000's
1
Planned Surplus
2,163
2
3
4
5
Risks
Acute SLAs
Continuing Care SLAs
Total Risks
-800
-200
-1,000
-441
-100
-541
0
-25
-25
6
7
8
9
10
11
Mitigations
Contingency (0.5%)
Contract reserves
Non recurrent measures
CHC risk pool adjustment
Total Mitigations
0
0
0
504
504
0
0
541
504
1,045
0
0
600
504
1,104
12
Net risk
-496
504
1,079
13
Risk adjusted performance
1,667
2,667
3,242
2,163
2,163
•
Worst case acute risk relates to the risk of potential over performance in acute over and above the position reported and the reserves available.
•
The continuing care risk relates to higher than anticipated growth in placements.
•
Non recurrent measures to mitigate risks are year end settlements, continuing care block bed over charges and receipt of funding from other CCGs for
GP Led Health Centre recharges.
15
APPENDICES
Appendix
number
Description
Slide number
1
Acute Commissioning
17
2
Mental Health
18
3
Other Non Acute
19
4
Primary Care & Prescribing
20
5
Corporate and Estates
21
6
Reserves
22
7
QIPP dashboard
23
8
Investments dashboard
24
16
ACUTE COMMISSIONING – Appendix 1
Year To Date
Merton CCG - ACUTE COMMISSIONING
Budget
£000's
1
2
3
4
5
6
7
8
9
10
11
12
FOUNDATION TRUSTS
KINGSTON NHS TRUST
MOORFIELDS EYE HOSPITAL
GUYS & ST THOMAS' HOSPITAL TRUST
THE ROYAL MARSDEN HOSPITAL TRUST
CHELSEA & WESTMINSTER HLTHCARE TRUST
UNIVERSITY COLLEGE LONDON HOSPITALS TRUST
KINGS HEALTHCARE TRUST
THE ROYAL BROMPTON & HAREFIELD HOSPITALS TRUST
ROYAL SURREY COUNTY & ST LUKE'S HOSPITAL TRUST
THE ROYAL FREE (HAMPSTEAD) NHS TRUST
ASHFORD & ST PETERS NHS TRUST
GREAT ORMOND ST HOSPITAL FOR CHILDREN NHS TRUST
13
14
15
16
17
18
19
20
21
22
23
24
ACUTE TRUSTS
ST GEORGE'S HEALTHCARE TRUST
EPSOM & ST. HELIER UNIVERSITY HOSPITALS NHS TRUST
LAS - EMERGENCY SERVICE CONTRACT
CROYDON UNIVERSITY HOSPITAL NHS TRUST
QUEEN MARYS ROEHAMPTON
IMPERIAL COLLEGE NHS TRUST
BARTS & THE LONDON NHS TRUST
THE ROYAL NATIONAL ORTHOPAEDIC HOSPITAL TRUST
LEWISHAM HOSPITAL NHS TRUST
NORTH WEST LONDON HOSPITALS TRUST
WEST MIDDLESEX NHS TRUST
GENERAL ACUTE COMMISSIONING
Accrual
Actual
Variance
Budget
Forecast
Variance
£000's
£000's
£000's
£000's
£000's
£000's
8,801
3,051
1,627
1,556
1,009
648
874
311
175
96
(0)
113
9,798
3,512
1,775
1,253
1,106
547
927
380
133
102
8
92
(885)
(229)
(70)
(37)
190
(50)
131
(49)
(9)
12
(8)
(15)
8,913
3,283
1,705
1,216
1,296
497
1,058
331
124
114
(0)
77
(113)
(232)
(78)
339
(287)
151
(184)
(20)
52
(17)
0
36
9,650
3,328
1,775
1,697
1,101
707
953
339
191
105
0
123
9,723
3,583
1,865
1,326
1,414
543
1,156
362
136
125
0
84
(73)
(255)
(90)
371
(313)
164
(203)
(22)
56
(19)
0
39
51,112
33,160
5,112
1,626
1,610
687
252
215
61
112
35
112,241
57,316
32,577
5,512
1,870
1,749
735
260
167
67
116
40
120,041
(5,507)
325
(399)
(50)
137
19
(18)
6
16
(32)
(12)
(6,534)
51,809
32,902
5,113
1,820
1,886
754
242
173
83
84
28
113,507
(698)
257
(1)
(194)
(276)
(67)
10
42
(22)
28
7
(1,265)
56,019
36,174
5,577
1,774
1,756
750
274
235
67
122
38
122,756
56,723
35,914
5,578
1,995
2,057
860
264
189
99
91
31
124,117
(704)
260
(1)
(221)
(301)
(111)
11
46
(33)
30
8
(1,361)
1,664
1,987
324
2,311
(648)
1,815
2,522
(706)
NON-SLA & OTHER
ESH - LASERCARE CONTRACT (SK!)/ DEXA (ST ANTHONY'S)/DERMATOLOGY
239
170
CHRONIC FATIGUE SYNDROME / LIQUID BASED CYTOLOGY / PATH FORMS
106 (ESH) 83
SYSTEMS RESILIENCE
1,042
1,112
DRUGS - IFR
8
26
PARTIALLY COMPLETED SPELLS & MATERNITY PATHWAY
(0)
5
(91)
16
(42)
0
(386)
78
99
1,070
26
(381)
160
7
(28)
(17)
381
212
116
1,137
9
0
85
108
1,167
31
(416)
127
8
(30)
(22)
416
499
25 NON CONTRACT ACTIVITY
26
27
28
29
30
Actual
before
Accrual
£000's
Full Year Forecast Outturn
31 TOTAL NON-SLA & OTHER
32 TOTAL ACUTE COMMISSIONING
1,395
1,395
(503)
892
503
1,473
975
115,301
123,423
(6,713)
116,710
(1,409)
126,045
127,614
(1,569)
17
Mental Health & PLD – Appendix 2
Year To Date
Merton CCG - NON ACUTE COMMISSIONING
1
2
3
4
MENTAL HEALTH CONTRACTS
SOUTH WEST LONDON AND ST GEORGES MENTAL HEALTH TRUST
SUSSEX FOUNDATION PARTNERSHIP - TIER 4 DETOX SERVICE
SOUTH LONDON & MAUDSLEY
SABP & MH NCAS
5
6
7
8
JOINT AGENCY, VOLUNTARY & INDEPENDENT SECTOR CONTRACTS
CAMHS DEVELOPMENT FUND/YOUTH OFFENDING TEAM
MERTON VOLUNTARY SECTOR / CARERS SUPPORT
ADVOCACY SERVICES
DEMENTIA SERVICES (Alzheimer's)
Full Year Forecast Outturn
Budget
Actual
before
Accrual
Accrual
Actual
Variance
Budget
Forecast
Variance
£000's
£000's
£000's
£000's
£000's
£000's
£000's
£000's
13,347
295
231
37
13,261
315
175
7
87
(26)
79
66
13,347
289
254
73
(0)
6
(23)
(37)
14,561
322
252
40
14,561
315
277
80
(0)
7
(25)
(40)
183
76
12
156
87
75
10
58
54
1
1
17
140
76
11
75
43
(0)
1
81
200
83
13
171
153
83
12
82
47
(0)
1
89
NAMED PATIENTS & PLACEMENTS
9 MENTAL HEALTH PLACEMENTS AND UNCONTRACTED ACTIVITY
3,080
3,091
163
3,254
(174)
3,360
3,550
(190)
OTHER MENTAL HEALTH SERVICES
10 TALKING THERAPIES IAPT, CDAS, ADHD, SUN
11 MENTAL HEALTH RESILIENCE
12 MH ENQUIRIES/NSF IMPLEMENTATION COSTS
1,180
110
126
1,135
0
0
183
110
10
1,318
110
10
(138)
0
116
1,287
120
138
1,438
120
12
(151)
0
126
18,834
18,214
744
18,959
(125)
20,546
20,683
(137)
0
0
1,196
1,196
0
220
1,055
1,276
0
43
237
280
0
263
1,293
1,556
0
(263)
(96)
(359)
0
0
1,305
1,305
0
287
1,410
1,697
0
(287)
(105)
(392)
13 TOTAL MENTAL HEALTH
14 MERTON ROAD LD
15 LEARNING DISABILITIES NCA (CNWL)
16 LEARNING DISABILITIES CONTINUING CARE
17 TOTAL LEARNING DIFFICULTIES
18
Other Non Acute – Appendix 3
18 END OF LIFE - LOCAL ENHANCED SERVICE
19 NURSING - MARIE CURIE - CANCER
20 BEREAVEMENT SERVICES
21 HOSPICES
22 SWL CANCER NETWORK AND ESH CANCER NURSE
23 TOTAL END OF LIFE CARE AND HOSPICES
38
83
79
590
156
946
9
98
1
652
180
940
8
(6)
8
(53)
(14)
(57)
17
92
9
599
166
883
21
(8)
70
(9)
(10)
63
42
91
86
643
170
1,032
19
100
10
654
181
964
23
(9)
76
(11)
(11)
68
24 HOME OXYGEN SERVICE
25 CARDIOLOGY
26 TOTAL LONG TERM CONDITIONS
198
53
251
160
22
182
36
(22)
14
196
(0)
196
2
53
55
216
58
274
214
0
214
2
58
60
42
67
11
175
69
0
601
31
189
1,186
19
55
6
148
84
53
436
13
170
985
8
19
5
8
20
(3)
165
0
(30)
192
28
73
11
156
105
50
601
13
140
1,176
15
(6)
0
20
(36)
(50)
(0)
18
49
9
46
115
19
191
75
0
656
34
206
1,342
30
80
12
170
116
55
656
16
153
1,288
16
35
7
21
(41)
(55)
(0)
18
53
54
27
28
29
30
31
32
33
34
35
36
URGENT CARE
GPSI'S COMMISSIONING - MINOR SURGERY
OPHTHALMOLOGY (LOW VISION SERVICE)
BPAS
MARIE STOPES INTERNATIONAL
HEALTH COACHING
INTERMEDIATE CARE COMMISSIONING (BEDS)
DIABETES EYE SCREENING PROGRAMME
BETTER CARE FUND
TOTAL URGENT AND INTERMEDIATE CARE
37
38
39
40
41
42
COMMUNITY SERVICES
PODIATRY
MERTON ICES
PATIENT TRANSPORT
MERTON MUSCULOSKELETAL SERVICE
TOTAL COMMUNITY SERVICES
14,040
74
226
0
275
14,616
13,209
61
185
0
67
13,522
(75)
13
41
0
6
(15)
13,134
74
226
0
73
13,507
907
0
(0)
0
202
1,109
15,317
81
247
0
300
15,945
14,327
81
247
0
80
14,735
990
0
0
0
220
1,210
43
44
45
46
47
48
PAEDIATRIC, AUDIOLOGY AND DESIGNATED CHILD DEATH DOCTOR CONTRACT
527
MERTON CHILDREN - SCPS
701
CHC CHILDREN PERSONAL HEALTH BUDGETS
0
SLAM CAMHS AND AD HOC
0
SAFEGUARDING CHILDREN BOARD
32
TOTAL CHILDREN SERVICES
1,260
559
1,127
0
113
20
1,820
(5)
(2)
0
(50)
12
(44)
555
1,126
0
63
32
1,776
(27)
(425)
0
(63)
0
(515)
575
765
0
0
35
1,375
605
1,228
0
69
35
1,937
(30)
(463)
0
(69)
0
(562)
49
50
51
52
53
FUNDED NURSING CARE
JOINT FUNDED
PERSONAL HEALTH BUDGETS
CONTINUING CARE PLACEMENTS - MERTON
TOTAL ADULT CONTINUING CARE
1,375
427
0
4,648
6,450
1,035
166
(5)
5,642
6,837
28
222
5
(82)
173
1,062
388
0
5,560
7,010
312
39
0
(911)
(560)
1,500
465
0
5,071
7,036
1,159
423
0
6,065
7,647
341
42
0
(993)
(611)
44,739
43,775
1,287
45,062
(323)
48,855
49,164
(309)
54 TOTAL NON ACUTE COMMISSIONING
19
Primary Care & Prescribing – Appendix 4
Year To Date
Merton CCG - PRIMARY CARE & PRESCRIBING
1
2
3
4
PRESCRIBING
SCRIPTSWITCH
CENTRAL DRUGS
TOTAL PRESCRIBING
5
6
7
8
9
10
11
12
13
14
15
16
LES - NEAR PATIENT TESTING
LES - ATRIAL FIBRILATION
LES - ANTI COAG
LES - PHLEBOTOMY
LES - POST OPERATIVE WOUND CARE
LES - MENORRAGHIA
LES - GYNAECOLOGY
LES - UROLOGY
LES - DIABETES
LES - CARE OF OLDER PEOPLE
LES - OTHER
LOCAL ENHANCED SERVICES
Full Year Forecast Outturn
Budget
Actual
before
Accrual
Accrual
Actual
Variance
Budget
Forecast
Variance
£000's
£000's
£000's
£000's
£000's
£000's
£000's
£000's
20,132
75
595
20,803
14,777
72
353
15,202
5,571
16
197
5,784
20,348
88
550
20,985
(216)
(13)
46
(183)
21,962
82
650
22,694
22,198
96
599
22,893
(235)
(14)
50
(199)
6
5
194
139
22
79
59
28
44
458
0
1,034
(0)
3
202
125
10
23
44
20
3
668
(257)
840
6
1
2
13
8
53
23
16
12
33
258
426
6
4
204
138
17
76
67
36
15
701
0
1,265
(0)
0
(10)
1
5
3
(9)
(8)
29
(243)
0
(231)
7
5
212
152
24
86
64
31
47
500
(0)
1,128
7
4
221
151
19
83
73
39
16
765
(2)
1,376
0
1
(9)
1
5
3
(9)
(8)
31
(265)
2
(248)
17 111 CONTRACT
18 PMS - OUT OF HOURS
19 TOTAL OUT OF HOURS
413
1,173
1,586
275
1,257
1,532
138
40
178
413
1,297
1,710
0
(124)
(124)
450
1,280
1,730
450
1,415
1,865
0
(135)
(135)
20
21
22
23
77
0
944
1,021
110
40
930
1,079
46
0
0
46
156
40
930
1,125
(79)
(40)
15
(104)
84
0
1,030
1,114
170
43
1,014
1,227
(86)
(43)
16
(113)
24,444
18,652
6,433
25,085
(642)
26,666
27,361
(695)
GP - STATUTORY MEDICAL FEES
QMS
WILSON WALK IN CENTRE (UNREGISTERED PATIENTS)
TOTAL PRIMARY CARE OTHER
24 TOTAL PRIMARY CARE & PRESCRIBING
20
Corporate and Estates – Appendix 5
Year To Date
Merton CCG - CORPORATE & ESTATES
1
2
3
4
5
6
7
8
9
10
12
13
14
15
16
ADMINISTRATION & BUSINESS SUPPORT
CEO/ BOARD OFFICE
CHAIR AND NON EXECS
CLINICAL SUPPORT
COMMISSIONING
CORPORATE COSTS & SERVICES
EDUCATION AND TRAINING
ESTATES AND FACILITIES
FINANCE
GENERAL RESERVE - ADMIN
PATIENT AND PUBLIC INVOLVEMENT
PERFORMANCE
QIPP
QUALITY ASSURANCE
SERVICE REFORM & PLANNING
17 TOTAL RUNNING COSTS
18
19
20
20
21
22
GP IT (SLCSU)
CONTINUING CARE TEAM (SLCSU)
ISPS (SLCSU)
RECLASSIFICATION OF RUNNING COSTS TO PROG COSTS
INFECTION CONTROL (SLCSU)
TOTAL CSU CHARGES
23
24
25
26
27
28
29
30
MEDICINES MANAGEMENT
SAFEGUARDING
INTERPRETING SERVICES
CLINICAL LEADS/TRANSFORMATIONAL SERVICE MANAGERS
NELSON LOCAL CARE CENTRE
DEPRECIATION
LEVIES/PPI/PRC TRAINING
TOTAL OTHER CORPORATE COSTS
31 PROPERTY COSTS
32 TOTAL CORPORATE & ESTATE COSTS
Full Year Forecast Outturn
Budget
Actual
before
Accrual
Accrual
Actual
Variance
Budget
Forecast
Variance
£000's
£000's
£000's
£000's
£000's
£000's
£000's
£000's
139
545
155
277
361
2,310
41
332
7
141
24
153
70
20
0
185
540
152
166
372
2,170
(144)
92
58
0
38
179
(6)
26
89
(44)
(71)
3
19
(27)
(70)
166
65
1
(0)
(2)
(15)
65
(2)
385
140
469
155
185
345
2,100
23
158
59
(0)
36
164
59
24
474
(2)
76
0
93
15
210
18
174
(51)
141
(12)
(11)
11
(4)
(474)
151
595
169
303
393
2,520
45
362
8
154
26
167
76
22
0
153
512
169
202
377
2,291
25
172
64
0
39
179
64
26
517
(2)
83
0
101
16
229
20
190
(56)
154
(13)
(12)
12
(4)
(517)
4,576
3,918
472
4,391
185
4,992
4,791
201
504
299
23
0
27
853
504
299
23
394
27
1,247
(45)
(0)
0
145
0
100
459
299
23
539
27
1,347
44
0
(0)
(539)
(0)
(495)
550
326
25
0
30
930
501
326
25
588
30
1,470
49
(0)
0
(588)
(0)
(540)
299
69
18
634
0
0
69
1,089
316
123
8
509
(150)
0
104
910
(5)
(34)
3
93
785
0
19
860
311
88
11
602
635
0
123
1,770
(12)
(19)
7
31
(635)
0
(54)
(682)
326
76
20
691
0
0
75
1,188
353
96
12
657
693
0
134
1,945
(27)
(20)
8
34
(693)
0
(59)
(757)
575
(1,181)
1,390
209
366
627
228
399
7,092
4,895
2,822
7,717
(625)
7,737
8,434
(697)
21
Reserves – Appendix 6
Year To Date
Merton CCG - Reserves & Other
1
2
3
4
5
6
CCG SLA RESERVE
CONTINGENCY (0.5%)
NON RECURRENT FUND (1.5%)
QUALITY PREMIUM
NETA RESERVE
TOTAL RESERVES
Full Year Forecast Outturn
Budget
Actual
before
Accrual
Accrual
Actual
Variance
Budget
Forecast
Variance
£000's
£000's
£000's
£000's
£000's
£000's
£000's
£000's
1,431
991
2,693
426
603
6,145
0
(438)
1,633
0
0
1,196
0
616
(20)
426
464
1,487
0
179
1,613
426
464
2,683
1,431
812
1,080
0
139
3,462
1,559
1,081
2,938
465
658
6,701
0
195
1,760
465
507
2,926
1,559
886
1,178
0
151
3,774
22
QIPP DASHBOARD – Appendix 7
GROSS QIPP SAVINGS
ID Transformational QIPP CATEGORY
and transactional
1
PROJ. DESCRIPTION
Total Scheme Value
Investment to
deliver Project
Net QIPP
PROJECT COSTS
NET QIPP SAVINGS
QIPP IN MONTH
Planned YTD Actual YTD Variance Planned YTD Actual YTD Variance Planned YTD Actual YTD Variance
Planned
Actual
Variance Movement
(£000s)
(£000s) YTD (£000s) (£000s)
(£000s) YTD (£000s) (£000s)
(£000s) YTD (£'000s) February 15 February 15 YTD (£000s) in Month
(£000s)
(£000s)
(£000s)
Full Year
NET FOT
Forecast (RAG RATED)
(£000s)
(£000s)
1 Transformational Urgent Care
Expansion of CPAT
300
-
300
270
270
-
-
-
-
270
270
-
30
30
-
-
300
G
2 Transformational Urgent Care
Review and Development of Intermediate Care Beds
62
-
62
47
16
31
-
-
-
47
16
31
16
16
-
(31)
31
R
3 Transformational Urgent Care
Inreach nursing
18
-
18
16
78
(62)
-
-
-
16
78
(62)
2
10
(8)
70
88
G
4 Transformational Urgent Care
Development of HARI
120
-
120
90
-
90
-
-
-
90
-
90
30
-
30
(120)
-
B
4 Transformational Urgent Care
Care delivery by Locality based MDT
120
-
120
108
113
(5)
-
-
-
108
113
(5)
13
15
(3)
8
128
G
5 Transformational Planned Care
MSK - deliver on appropriate pathway
260
137
123
234
170
63
123
-
123
110
170
(60)
12
50
(37)
39
220
G
6 Transformational Planned Care
Cardiology - new models of care
130
58
72
115
-
115
52
-
52
64
-
64
8
-
8
-
-
B
7 Transformational Planned Care
Respiratory - Reduce attendances at Hospital
40
-
40
36
-
36
-
-
-
36
-
36
3
-
3
(40)
-
B
8 Transformational Planned care
Dermatology - Review & Redesign Dermatology
161
114
47
143
-
143
101
-
101
42
-
42
5
-
5
-
-
B
9 Transformational Planned care
DESP Surveillance Clinic
-
-
-
-
-
-
-
17
(17)
-
(17)
17
-
-
-
(15)
(15)
G
10 Transformational Planned Care
Diabetes- Tier 3
86
-
86
71
5
66
-
-
-
71
5
66
16
-
16
(57)
5
R
Transformational Planned care
Health Coaching
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(61)
-
G
11 Transformational Prescribing
Care Homes Pharmacy
75
60
15
65
-
65
55
-
55
10
-
10
5
-
5
(30)
-
B
12 Transformational Prescribing
Prescribing Workstreams & Clinical Interventions
400
1
399
381
351
30
1
-
1
380
351
29
19
0
19
(30)
370
A
13 Transformational Prescribing
Nutrition
30
49
(19)
25
34
(9)
45
29
16
(20)
4
(24)
1
(3)
4
16
2
B
14 Transformational Prescribing
MMT Care Homes
60
-
60
59
6
52
-
-
-
59
6
52
2
-
2
(52)
8
R
480
395
(162)
(95)
29
-
43
70
(14)
(70)
65
523
465
G
G
158
1,479
2,558
6,067
0
(190)
(161)
14
117
232
553
14
77
232
554
0
40
(1)
150
(88)
173
1,556
2,790
6,642
15 Transactional
16 Transactional
Mental Health
Placements
17 Transactional
18 Transactional
19 Transactional
Continuing Care
Placements
Acute portfolio Acute Challenges
Acute portfolio Curtailing Growth
PROGRAMME TOTAL (£000s)
Mental Health Contracts
Mental Health Placement Review
347
400
0
0
347
400
318
300
480
395
(162)
(95)
-
-
-
318
300
173
1,406
2,790
6,977
0
0
0
419
173
1,406
2,790
6,558
159
1,289
2,558
6,283
158
1,479
2,558
6,112
0
(190)
170
377
46
331
159
1,289
2,558
5,906
23
G
G
G
INVESTMENT DASHBOARD – Appendix 8
INVESTMENT
CATEGORY
1 BCF
2 BCF
3 BCF
4 BCF
5 BCF
6 BCF
7
BCF
8 BCF
9 BCF
10 BCF
11 BCF
12 BCF
13 BCF
14
15
16
17
18
19
QIPP
QIPP
QIPP
QIPP
Total Investment
(£000s)
Planned YTD
(£000s)
Integrated locality teams (tfrd to reserves)
Integrated Complex Older Patients Pathway
(ICOPP)
Dementia nurses
Expert Patient Programme
Telehealth
Rapid Response Team at ESH and STAR team at
STG's
Community Preventions Admissions Team (CPAT) Nursing homes (tfrd to reserves)
Prevention of admission (step up beds)
Step down beds
In reach into St George's - 72 hr intensive
rehabilitation
Increased night nurses to support carers
Interface Geriatricians
OPARS
Reserves
Total
-
-
-
-
-
104
95
54
41
300
96
96
275
88
88
50
-
200
183
-
Funding for cardiology QIPP plan
MSK
Dermatology
Care homes pharmacy
20 QIPP
Prescribing workstreams and clinical interventions
21
22
23
24
25
26
27
28
29
30
30
Nutrition
Total
QIPP
Dementia screening
Additional resource in Liaison Psychiatry
Other
Bereavement services for bereaved parents
Other
Bereavement services
Other
IVF
Other
Cardiology - Rehab
Other
LES - Care of Older People
Total
PROGRAMME TOTAL (£000s)
Other
Other
Year to date (YTD)
Actual YTD
Variance YTD
(£000s)
(£000s)
PROJ. DESCRIPTION
Planned
(£000s)
Full Year (FY)
FOT (£000s)
Variance
(£000s)
NET FOT (RAG
RATED) (£000s)
-
-
B
104
59
45
A-R
275
38
88
300
96
96
60
-
300
36
96
B
A-R
B
-
183
200
-
200
B
-
-
-
-
-
-
B
245
245
225
225
-
225
225
245
245
30
245
215
B
R
150
138
138
-
150
150
-
G
66
109
50
381
2,041
60
99
46
349
1,871
242
60
99
46
349
1,629
66
109
50
381
2,041
299
66
109
50
381
1,742
58
137
114
60
53
126
105
55
-
53
126
105
55
58
137
114
60
-
58
137
114
60
B
B
B
B
R
B
B
B
B
B
1
1
-
1
1
1
0
A-R
49
419
45
384
29
29
16
355
49
419
33
34
16
385
103
50
26
60
800
0
500
1,539
3,999
94
46
24
55
733
952
3,207
701
701
972
94
46
24
55
733
(701)
251
2,235
103
50
26
60
800
0
500
1,539
3,999
10
100
765
875
1,208
103
50
26
50
700
0
(265)
664
2,791
A-R
R
B
B
B
B
R
R
B
G
A-R
24