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Agenda Item 10 Enclosure CKWCB/12/115

Report To:

Cluster Board Meeting – 8 May 2012

Title of Report:

Finance and QIPP Highlight Report

FOI Exemption Category:

S22 – Information intended for future publication – until approved by Primary Care Trust Board

Responsible Director:

Jonathan Molyneux, Director of Finance and Efficiency

Report Author and Job Title:

Jonathan Molyneux, Director of Finance and Efficiency

Executive Summary: Finance/Resource Implications: Risk Assessment:

This report summarises the month 12 financial position for NHS Calderdale, NHS Kirklees and NHS Wakefield District. As detailed within the report.

As detailed within the report.

Legal Implications:

Not applicable.

Health Benefits:

Not applicable.

Staffing/Workforce Implications:

Not applicable.

Outcome of Equality Impact Assessment:

Not applicable. Finance and Performance Group – NHS Calderdale

Sub Group/Committee:

Finance and Performance Group – NHS Kirklees Finance and Performance Group – NHS Wakefield District

Recommendation (s):

NOTE the summary of the Cluster’s and individual 3 PCTs financial performance for 2011/12

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Calderdale, Kirklees and Wakefield District Cluster Board Cluster Board Meeting 8 May 2012

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Introduction Separate monthly finance reports are produced for each of the three statutory Primary Care Trusts (PCT’s) and these are reviewed at the Finance and Performance Group for each PCT. These reports are available if required. This report summarises the financial position for the year to 31st March 2012 (Month 12).

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Summary The three PCT’s have all met their key financial targets (within allowable tolerances), including the income and expenditure surplus. A summary of the relevant figures for the cluster and the individual PCT’s is set out on the next page. The cash limit under draw for Kirklees is within the rules and relates to a late reduction in Revenue Resource Limit only. The income and expenditure surplus for the year is £14.8M for the cluster, against a budget of £15M. These figures represent the provisional results for the financial year 2011/12 as set out in the draft accounts and the figures are subject to audit. The draft accounts were submitted to the Department of Health before the national deadline of Monday 23rd April.

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Financial Summary at Month 12 - 2011/12 Income and Expenditure Month 12 Actual - Year to date Total £000

Calderdale Kirklees £000 £000

Income and Expenditure - Annual Outturn Income (RRL) 1,702,829 Expenditure 1,688,048 Surplus 14,781 Budget surplus Variance (Favourable)

Annual Capital Expenditure Actual Budget Variance

Wakefield District £000

357,822 354,354 3,468

691,590 683,351 8,239

653,417 650,343 3,074

15,000 219

3,600 132

8,300 61

3,100 26

3,242 3,290 48

613 613 0

2,141 2,179 38

488 498 10

1,690,022 1,690,822 (800)

351,786 351,786 0

683,360 684,160 (800)

654,876 654,876 0

Annual Cash Allocation Actual Budget Underdraw

Month 12 - Year to date Public Sector Payment Policy (by value) Non NHS creditors % % Actual 99.50 94.00 Target 95.00 95.00 Variance (Unfavourable) 4.50 (1.00)

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% 97.41 95.00 2.41

Key Issues and Risks at Primary Care Trust

NHS Calderdale •

The Primary Care Trusts outturn position shows a surplus of £3.5M against a plan of £3.6M.

NHS Kirklees •

The Primary Care Trusts outturn position shows an under spend of £8,239k against a planned under spend of £8,300k.

NHS Wakefield District •

The Primary Care Trusts outturn position shows an under spend of £3,074k against a planned under spend of £3,100k

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Financial Position The following table details the summary financial position at month 12 for the main budget headings. The summarised financial position for each individual Primary Care Trust is attached at Appendix 1.

Calderdale, Kirklees and Wakefield District Cluster Board Month 12 Financial Position 2011/12

Commissioned Services Prescribing Pharmacy Contract Primary Medical Services Dental Services Opthalmic Services Headquarters Services Commissioning Intentions Specific Reserves Uncommitted reserve Non recurrent reserve Kirklees Community Health Services QIPP efficiencies - Calderdale QIPP efficiencies - Kirklees QIPP efficiencies - Wakefield Strategic Investment Fund (SIF) - Wake Management costs savings target Total expenditure

5

Expend to Annual Date Budget £000 £000 1,234,271 1,240,555 168,041 164,701 33,828 34,635 141,569 141,765 47,585 48,547 9,383 9,804 73,499 76,379 683 683 9,425 5,560 4,907 0 193 0 (2) (2) (4,140) (4,301) (11,957) (10,728) (10,431) (10,325) (4,000) (4,000) (5,025) (5,225) 1,687,829 1,688,048

Year-end variance £000 6,284 (3,340) 807 196 962 421 2,880 0 (3,865) (4,907) (193) 0 (161) 1,229 106 0 (200) 219

QIPP The table below summarises the total of the QIPP schemes across the CKW cluster. The detail of the individual Primary Care Trust’s QIPP plans are attached at Appendix 2. NHS Calderdale is showing over-achievement against its QIPP plans. NHS Kirklees is reporting achievement of its QIPP target at the year-end after using £1,229K planned contingency.

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NHS Wakefield is reporting an under-achievement of £106K at the year-end on its QIPP plans mainly on primary care projects. This under-achievement has been funded from contingency reserves. The running costs target has been over-achieved across the Cluster by £200K.

Calderdale, Kirklees and Wakefield District Cluster Board Efficiencies at Month 12

QIPP Projects

Target Savings savings to date £000 £'000

Year-end variance £000

Primary Care Projects

9,012

8,598

414

Community Care Projects

5,805

5,876

(71)

Acute Care Projects

9,362

8,190

1,172

Corporate HQ projects

2,216

2,690

(474)

133

0

133

Mitigations - Kirklees

0

1,229

(1,229)

Total QIPP Projects

26,528

26,583

(55)

Specialised commissioning Group

Running costs

Savings Running costs total

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Target Savings savings to date £000 £'000 5,025 5,025

5,225 5,225

Year-end variance £000 (200) (200)

Statement of Financial Position (SOFP) Appendix 3 details the SOFPs (equivalent to Balance Sheet) of the three PCTs as at 1 April 2011 and 31 March 2012.

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Year End Accounts The monthly management accounts for the year 2011/12 have been reported to and reviewed by the PCT Clinical Commissioning Executive, the Finance sub groups and the Cluster Board on a monthly basis. In addition each PCT has produced a set of Statutory Accounts for the year. These are produced to a tight timetable, the draft accounts for all PCTs were submitted by 23 April deadline and the final audited accounts have to be with the Department of Health by 8 June 2012.

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Recommendation The Cluster Board is asked to: •

NOTE the summary of the Cluster’s and 3 PCTs financial performance against key financial targets for the year 2011/12

Jonathan Molyneux Director of Finance and Efficiency Calderdale, Kirklees and Wakefield District Cluster Board

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Appendix 1 NHS Calderdale Annual Budget £000 Commissioned Services Prescribing Pharmacy Contract Primary Medical Services Dental Services Opthalmic Services Headquarters Services Specific Reserves Non recurrent reserve QIPP efficiencies Management costs savings target Total expenditure

260,960 34,425 6,480 28,386 9,673 1,891 15,254 3,000 193 (4,140) (1,900) 354,222

Expend to Date £000 261,486 34,282 6,870 28,464 10,290 1,936 17,427 0 0 (4,301) (2,100) 354,354

Year-end variance £000 526 (143) 390 78 617 45 2,173 (3,000) (193) (161) (200) 132

Forecast year-end variance %

0.20 (0.42) 6.02 0.27 6.38 2.38 14.25 (100.00) (100.00) 3.89 10.53 0.04

NHS Kirklees Annual Budget £000 Commissioned Services Prescribing Pharmacy Contract Primary Medical Services Dental Services Opthalmic Services Headquarters Services Specific Reserves Uncommitted reserve Kirklees Community Health Services QIPP efficiencies Management costs savings target Total expenditure

491,816 69,629 14,028 54,863 21,046 3,890 32,225 4,225 4,907 (2) (11,957) (1,380) 683,290

Expend to Date £000 497,134 67,853 14,090 55,292 21,054 4,267 32,411 3,360 (2) (10,728) (1,380) 683,351

Forecast year-end variance £000 5,318 (1,776) 62 429 8 377 186 (865) (4,907) 0 1,229 0 61

Forecast year-end variance %

1.08 (2.55) 0.44 0.78 0.04 9.69 0.58 (20.47) (100.00) 0.00 (10.28) 0.00 0.01

NHS Wakefield

Commissioned Services Prescribing Pharmacy Contract Primary Medical Services Dental Services Opthalmic Services Headquarters Services Health and Social care Commissioning Intentions Specific Reserves Non recurrent reserve QIPP efficiencies Management costs savings target Total expenditure

Forecast Forecast Annual Expend to year-end year-end Budget Date variance variance £000 £000 £000 % 481,495 481,935 440 0.09 63,987 62,566 (1,421) (2.22) 13,320 13,675 355 2.67 58,320 58,009 (311) (0.53) 16,866 17,203 337 2.00 3,602 3,601 (1) (0.03) 26,020 26,541 521 2.00 0 0 0 0.00 683 683 0 0.00 2,200 2,200 0 0.00 0 0 0 0.00 (14,431) (14,325) 106 (0.73) (1,745) (1,745) 0 0.00 650,317 650,343 26 0.00

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Appendix 2

Calderdale

QIPP Projects

Target savings £'000

Savings to date £000

Year-end variance £000

Primary Care Projects Medicines management

640

694

(54)

Community Care Projects Mental Health Continuing Care Procurement contract savingsa

400 500 100

193 775 138

207 (275) (38)

Non elective activity Elective activity High cost drug expenditure

1,000 1,000 500

1,000 1,000 501

0 0 (1)

Total QIPP Projects

4,140

4,301

(161)

Acute Care Projects

Running costs

Target savings £'000

Corporate contribution Running costs total

1,900 1,900

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Savings to date £000 2,100 2,100

Year-end variance £000 (200) (200)


Kirklees

QIPP Projects

Target savings £'000

Savings to date £000

Year-end variance £000

Primary Care Projects 462

Contracts Dental

462

0

150

150

0

Medicines Management

3,200

3,316

(116)

Total Primary Care

3,812

3,928

(116)

Community Care Projects Mental Health Other and Provider services Public Health Total Community Care

1,400 1,691 96 3,187

1,270 1,691 96 3,057

130 0 0 130

1,389

0

1,389

IFRs

300

0

300

Evidence based protocols Minor Hand surgery

440 360

264 228

176 132

COPD & Heart Failure

232

232

0

PCI

199

199

0

Oxygen

105

0

105

22

22

0

Case Managers

300

150

150

Vunerable People

315

315

0

Falls & Bone Health

400

169

231

WheelChair

450

0

450

Walk in Patients

250

250

0

Paediatric usage

280

198

82

(1,800)

0

(1,800)

Acute total

3,242

2,027

1,215

Corporate HQ Projects

1,716

1,716

0

0

1,229

(1,229)

11,957

11,957

0

Acute Care Projects Clinical stop list

Chronic Pain

Other

Planned contingency Total QIPP Projects

Running costs

Target savings £'000

Corporate contribution Running costs total

1,380 1,380

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Savings to date £000 1,380 1,380

Forecast year-end variance £000

0


Wakefield

QIPP Projects

Target savings £'000

Savings to date £000

Year-end variance £000

Primary Care Projects Extended prescribing

2,520

2,580

(60)

Total Primary Care

590 1,450 4,560

396 1,000 3,976

194 450 584

Community Care Projects Mental Health Interagency value Community Services Public Health Total Community Care

500 0 435 683 1,618

500 0 496 717 1,713

0 0 (61) (34) (95)

500 960 1,752 200 208 3,620

1,898 480 876 200 208 3,662

(1,398) 480 876 0 0 (42)

Corporate HQ Projects

500

974

(474)

Specialised commissioning Group

133

0

133

10,431

10,325

106

Enhanced service review Primary care

Acute Care Projects Admission and discharge criteria Incentivising primary care access Admission avoidance in primary care Negotiating lower prices Planned procedures not carried out

Acute Total

Total QIPP Projects

Running costs

Corporate contribution Running costs total

Target savings £'000

Savings to date £000

1,745 1,745

1,745 1,745

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Year-end variance £000

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Statement of Financial Position

Appendix 3

The Table below shows the cluster PCTs opening Statement of Financial Position, the position at the end of March, the year end balances.

NHS Kirklees

NHS Calderdale

NON CURRENT ASSETS Property, Plant and Equipment Intangible Assets Trade and Other Receivables TOTAL Non Current Assets CURRENT ASSETS Inventories Trade and Other Receivables Cash and Cash Equivalents Sub Total Current Assets Non-Current Assets Held for Sale TOTAL Current Assets TOTAL ASSETS CURRENT LIABILITIES Trade and Other Payables

Balance 01/04/2011 £k 5,630 0 0 0 5,630

Balance 31/03/2012 £k 5,741 0 0 0 5,741

0 4,046 1 4,047 0 4,047 9,677

Balance 01/04/2011 £k

NHS Wakefield District

Balance 31/03/2012 £k

Balance 01/04/2011 £k

Balance 31/03/2012 £k

32,444 20 0 32,464

33,499 0 573 34,072

11,865 0 564 12,429

11,841 0 0 11,841

0 5,328 2 5,330 0 5,330 11,071

236 4,587 1 4,824 801 5,625 38,089

258 2,427 1 2,686 801 3,487 37,559

360 7,230 5 7,595 623 8,218 20,647

0 7,287 5 7,292 120 7,412 19,253

(22,633)

(25,901)

(44,654)

(40,556)

(51,488)

(44,712)

Provisions

0

(1,693)

(967)

(4,821)

(3,044)

(4,192)

Borrowings

0

0

(22,633) (18,586) (12,956)

(27,594) (22,264) (16,523)

(712) (46,333) (40,708) (8,244)

(712) (46,089) (42,602) (8,530)

0 (54,532) (46,314) (33,885)

0 (48,904) (41,492) (29,651)

Total Non-Current Liabilities ASSETS LESS LIABILITIES (Total Assets Employed)

0 (3,664) 0 (3,664) (16,620)

0 (2,448) 0 (2,448) (18,971)

(9) (1,180) (25,581) (26,770) (35,014)

0 (1,413) (24,815) (26,228) (34,758)

(564) (100) 0 (664) (34,549)

0 0 0 0 (29,651)

TAXPAYERS EQUITY General Fund Revaluation Reserve Total

(17,239) 619 (16,620)

(19,809) 838 (18,971)

(37,343) 2,329 (35,014)

(37,289) 2,531 (34,758)

(39,161) 4,612 (34,549)

(34,262) 4,611 (29,651)

Total Current Liabilities NET CURRENT ASSETS/(LIABILITIES) TOTAL ASSETS LESS CURRENT LIABILITIES NON-CURRENT LIABILITIES Trade and Other Payables Provisions Borrowings

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/CKWCB.12.115_Finance_and_QIPP_hig  

http://www.kirklees.nhs.uk/fileadmin/documents/meetings/8_May_2012/CKWCB.12.115_Finance_and_QIPP_highlight_report.pdf

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