North West London
Month 4 Budget Update
SaHF & NWL Strategy and Transformation Programmes
August 2014
Purpose / Summary
This paper provides the month 4 budget update for NWL-wide financial strategy/
SaHF including Strategy & Transformation programmes.
It updates the budgets proposed at the previous Collaboration Board, including
reflecting NHSE confirmed contribution.
The Collaboration Board are asked to:
a) agree the proposed budget changes on slides 5 & 6 for recommendation to
CCG Governing Bodies
b) note the month 4 budget report and balanced forecast outturn on S&T budgets
on slides 7 and 8
2
Contents
1
Sources of funding
2
Applications of funding
3
Budget Analysis
4
Month 4 S&T budget report
5
Forecast outturn S&T spend
3
Sources of funding
Initial funding
Revised funding
A
CCGs contribute to the programme from the 2.5% top
slice
£41.7m1
£41.7m1
B
NHS E fund equivalent of the 2.5% contribution from
services they commission
£16.3m
£13.6m2
C
HENWL contribute for the development of community
education networks across NWL
£1.0m
£1.0m
Total resource available
£59.0m
£56.3m
Additional sources of funding
E
NHS E contribute to the Prime Minister’s challenge
fund
£5.0m
£5.0m
F
Balance of PM match funded locally by CCGs
£2.5m
£2.5m
1 includes
Richmond CCG contribution of £1m
to £15m to reflect NHSE budget and then subsequently to £13.6m as a result of surplus control
total target
2 reduced
4
Applications of funding
Initial funding
Revised funding
-
S&T projects (including HENWL contribution)
£31.9m
£31.9m
-
Provider support
£27.1m
£22.75m
£1.95m
£3.90m
£0.60m
£11.60m
£4.70m
£1.50m
£2.85m
£1.95m
£3.90m
£0.60m
£11.60m
£4.70m
-
-
-
Ealing
Hillingdon
Imperial (A&E)
NWLHT (CMH plus A&E)
West Mids
West Mids Transaction Related Costs
NWLHT Transaction Related Costs
Carried forward to 2015/16
Over commitment
Total
-
£59.0m
£2.0m
(£0.35m)
£56.3m
Notes
• Total funding available reduced by £2.7m
• S&T projects budget unchanged
• Provider support reduced by £4.35m
• £2m carried forward to 15/16 (by Brent CCG) as part of agreeing 14/15 revised plans with NHSE
• Balance of over-commitment of £0.35m
5
In Year Budget Pressures
• The following SaHF implementation in year funding pressures have been
reviewed by the COs and proposed to fund:- Further resilience in respect of A&E closures £0.35m
- Maternity transition £0.83m
- Imperial emergency surgery £0.25m
• Agreement of these would increase the total over-commitment to £1.75m
• It is proposed that the following approach to balancing the budget is adopted. In
priority order:a)
b)
c)
d)
Seek re instatement from NHSE of £1.5m reduction related to control totals
Review S&T budgets to identify in year slippage on plans
Mid year review of CCG forecast outturns for additional contribution
CCGs miss control totals agreed with NHSE
6
Breakdown of agreed 2014/15 S&T budget – Unchanged
Whole systems
1
2
3
4
SaHF
implementation
Transforming
Mental Health
services
CCGs
£5.5m
£3.0m
£2.1m
£3.2m
£13.3m
-
£1.0m
£1.0m
£2.8m
-
£24.7m
£7.2m
Whole systems
implementation
Enhanced
integration
Primary care
transformation
S&T
£5.0m
£3.5m
PC Cocommissioning
Primary Care
development +
PM match fund
Hub business
case
development
Informatics
strategy
£1.25m
£2.5m
£1.25m
£0.3m
5 year strategy
Programme
Office
Implementation
mngt and
governance
Local H & M.H.
business case
delivery
Imp. of 2014
changes (A&E,
Maternity)
£0.2m
£1.5m
£2.6m
£4.0m
£1.0m
Slide 7
Hospital BC
assurance &
IMBC
Workforce
Communicatio
ns
£1.0m
£2.0m
£1.0m
Transforming
Mental Health
services
£2.0m
Other costs (core team, non-pay, events)
1 Balance of PM match fund of £2.5m funded locally by CCGs (i.e. total match fund £5m).
2 PM match fund of £5m to be funded by NHS England
Total
£31.9m
Inc. £1m HENWL7
BUDGET
COMMITTED SPEND
YTD
YTD
Whole systems
£0.7m
£0.9m
-
Whole systems implementation
£0.1m
-
-
TOTAL
£0.8m
£0.9m
£0.1m
Primary care
transformation
PC co-commissioning
GP Development + PM match fund
Hub business case development
Primary care IT strategy
TOTAL
£0.2m
£0.1m
£0.2m
£0.1m
£0.6m
£0.5m
£0.5m
£0.3m
-£0.1m
3
SaHF
Implementation
5 year strategy
Programme office
Implementation planning and governance
LH & MH business case delivery
Imp. of 2014 changes (A&E, maternity)
Hospital BC assurance & IMBC
Workforce
Communications
TOTAL
£0.1m
£0.4m
£0.6m
£1.2m
£0.1m
£0.7m
£0.2m
£0.4m
£3.7m
£0.1m
£0.4m
£0.5m
£1.2m
£0.1m
£0.8m
£0.2m
£0.3m
£3.6m
-£0.1m
£0.1m
-£0.1m
-£0.1m
4
Trans-forming
mental health
services
£0.3m
£0.3m
-
£0.8m
£0.9m
£0.1m
£6.2m
£6.2m
-
Month 4 S&T budget report
VARIANCE
YTD
Committed Spend YTD
1
2
Enhanced
integration
TOTAL
Other costs
5
(core team,
non-pay,
events)
Total
TOTAL
8
Forecast outturn S&T spend
BUDGET
FORECAST
OUTTURN
VARIANCE
Enhanced
integration
Whole systems
Whole systems implementation
TOTAL
£5.0m
£3.5m
£8.5m
£5.0m
£3.5m
£8.5m
-
Primary care
transformation
PC co-commissioning
GP Development + PM match fund
Hub business case development
Primary care IT strategy
TOTAL
£1.3m
£2.5m 1
£1.3m
£0.3m
£5.3m
£1.3m
£2.5m
£1.3m
£0.3m
£5.3m
-
3
SaHF
Implementation
5 year strategy
Programme office
Implementation planning and governance
LH & MH business case delivery
Imp. of 2014 changes (A&E, maternity)
Hospital BC assurance & IMBC
Workforce
Communications
TOTAL
£0.2m
£1.5m
£2.6m
£4.0m
£1.0m
£1.0m
£2.0m
£1.0m
£13.3m
£0.2m
£1.5m
£2.6m
£4.0m
£1.0m
£1.0m
£2.0m
£1.0m
£13.3m
-
4
Trans-forming
mental health
services
TOTAL
£2.0m
£2.0m
-
5
Other costs
(core team,
non-pay,
events)
TOTAL
£2.8m
£2.8m
-
£31.9m
£31.9m
-
1
2
Total
1
includes £1m HENWL contribution
9