Month 10 Ealing CCG Finance and Activity Performance Report€¦ · Source: Team analysis high quality support to commissioners to improve health and wellbeing Overall financial position

14-Mar-2014

Month 10 Ealing CCG Finance and Activity Performance Report

Acronym Full Provider NameASP Ashford And St Peter's Hospitals NHS Foundation TrustBLT Barts Health NHS TrustC&W Chelsea And Westminster Hospital NHS Foundation TrustCLCH Central London Community Healthcare NHS TrustCNWL Central And North West London MH NHS Foundation TrustEHT Ealing Hospital NHS TrustESH Epsom And St Helier University Hospitals NHS TrustGOSH Great Ormond Street Hospital For Children NHS Foundation TrustGSTT Guys And St Thomas NHS Foundation TrustHRCH Hounslow And Richmond Community Healthcare NHS TrustHUH Homerton University Hospital NHS Foundation TrustHWP Heatherwood And Wrexham Park Hosps NHS Foundation TrustICHT Imperial College Healthcare NHS TrustKCH Kings College Hospital NHS Foundation TrustKHT Kingston Hospital NHS TrustMEH Moorfield's Eye Hospital NHS Foundation TrustNWLHT North West London Hospitals NHS TrustRBH Royal Brompton And Harefield NHS Foundation TrustRFT Royal Free London NHS Foundation TrustRMH The Royal Marsden Hospital NHS Foundation TrustRNOH Royal National Orthopaedic Hospital NHS TrustRSC Royal Surrey County NHS Foundation TrustSGT St George's Healthcare NHS TrustSLAM South London And Maudsley NHS Foundation TrustSWL&StG South West London And St George's Mental Health NHS TrustTHH The Hillingdon Hospital NHS Foundation TrustUCLH University College London NHS Foundation TrustWHH The Whittington Hospital NHS TrustWLMH West London Mental Health NHS TrustWMUH West Middlesex University Hospital NHS Trust

Key messageThe following acronyms are used throughout this pack.

Contract Acronyms

1

Executive Summary Page Contracts Performance PageExecutive Summary 3 Acute Contracts: year to date performance 19CCG Finance dashboard 4 Key issues and actions relating to financial position 20Risk and Opportunities Key Issues & Table 5 Finance performance and key issues and actions (i) & (ii) - acute contracting - ICHT 21-23Key issues and actions relating to financial position 6 Progress on strategic priorities - ICHT 24

Finance performance and key issues and actions - acute contracting - Ealing Hospital NHS Trust 25-27Overall Financial Position Page Finance performance and key issues and actions - Chelsea & Westminster Hospital NHS FT (i) & (ii) 28-30Surplus/deficit including running costs 8 Finance performance and key issues and actions - acute contracting - NWLHT 31-32Budget Movements including running costs 9 Finance performance and key issues and actions - acute contracting - Moorfields Eye Hospital NHS FT 33-34Movements of Variances including running costs 10 Finance performance and key issues and actions - acute contracting - UCLH NHS FT 35-36Break-down of programme spend 11 Finance performance and key issues and actions - acute contracting - THH NHS FT 37-38Break down of running cost spend 12 Finance performance and key issues and actions - acute contracting - West Middlesex Hospital NHS Trust 39-40Breakdown of reserves 13 Communty Provider Finance Performance M10 Ealing ICO 41-42Investments 14 Mental Health Providers Performance M10 43Month 8 QIPP position 15QIPP Variance Movements 16 Appendices PageCapital, creditor payments and cash 17 Appendix 1: RAG Rating Definitions 45

Appendix 2: Financial Schedules 46-56Appendix 3: Imperial Hospital Detail Schedules 57-80Appendix 4: Balance Sheet 81

high quality support to commissioners to improve health and wellbeing

Contents

2

Key messages PageExecutive Summary 3CCG Finance dashboard 4Risk and Opportunities Key Issues & Table 5Key issues and actions relating to Financial Position 6


Section 1: Executive Summary

Overall financial position Executive summary

Overall financial position

Contract performance

Appendix

3

Status

Green

Green

Contract Performance Amber

QIPP Red

Source: Team analysishigh quality support to commissioners to improve health and wellbeing


At month 10, Ealing CCG is reporting a year to date surplus of £1.9m and a forecast surplus of £7.1m. The year to date surplus has decreased (0.1m) and the FOT surplus has increased by £0.2m for Programme Budgets.The year to date position has remained consistent with last month and the FOT surplus has improved by £0.1m for Running Cost Budgets. The financial annexes and commentary reflect the agreement with Ealing Hospital Trust for a maximum contracting value of £86.5M, which reflects the final agreed payment and includes £2.6m maternity support and is net of the ICE penalty of £1.6m; this has had an impact on reported contract values and forecast outturn/overperformance. The contract continues to be monitored for d li f t t d ti it l lThe YTD position has worsened by (£0.1m) from month 9 at an aggregate level, with an improvement in the acute, mental health and community positions offset by worsening in other areas. These movements are detailed on slide 11.

The forecast outturn has improved by £0.2m from Month 9.

There is a net opportunity of £4.4m which is detailed on slide 5. This is an increase from M9 of £3.4m. This is largely due to a reduction in risks relating to Acute Perfomance and Other Activity £1.5m and Contractual benefits not achieved £1.1m, and an increase in opportunities mainly relating to Capital funding from NHSE for GPIT of £1.6m. The CCG are currently looking at options within Ealing and across the Collaborative to effectively utilise these funds this year.

Acute contracts are reporting a year to date position of (£6.3m) higher than plan. The impact of over performance has been mitigated by the application of acute reserves £4.9m and by reporting a post challenge position (challenges and mitigations amounts to £3.3m) . After application of reserves the overall year to date variance against plan for Acute services is an overspend of (£1.3m), with a forecast overspend of (£1.9m).

ICHT, West Middlesex and C&W are the top three over performing contracts. The key pressures at ICHT relate to maternity, outpatients and non electives; at C&W relates to outpatients and day cases and at West Middlesex relates to maternity and outpatients. These are discussed in detail in the contracts performance section of this report.

The current year to date delivery of QIPP is behind plan by 25% (£3,242k). The under achievement noted in the year to date position is driven by Acute schemes.

Year end outturn is currently forecasting a delivery of 79% against plan (£12.8m expected savings against a target of £16.3m).

Executive Summary

4

Indicator Target ActualRating this

month

Financial position year to date £0k £1,866k variance from planned position

Financial position forecast outturn £0k £6,835k variance from planned position

Running costs forecast outturn £0k £300k 0.0% variance from planned position

QIPP year to date £13,332k £9,893k (26%) variance from plan

QIPP forecast outturn £16,254k £12,395k (24%) variance from plan

Investment spend £2,996k £3,190k 6.5% year to date variance from plan

Risks and opportunities Risk/opportunity £0k £4,403k (net risk) / opportunity outside reported position (likely case)

Payables - Better Payment Practice Code 95.0% 97.0% 97.0% of invoice value paid in 30 days

Capital forecast outturn £0k £0k 0.0% forecast variance from allocation - please see note 1

Cash £332,688k £316,681k 4.8% year to date variance from cash limit

Note


Risk and Opportunities reflect total likely risk identified in month 9 of (£3.9m) and total likely opportunity of £5.8m.

NOTE 1: CAPITAL - NHSE has confirmed that CCGs requesting Capital for this financial year will be required to seek approval via the PID process. Only requests that have been approved through the PIDs process will qualify for Capital funding.

CCG Finance Dashboard

5

AmountRisks £000s Probability Value Probability Value Probability Value

Non validation of NCA and contract invoices leads to inability to challenge (100) 50% (50) 0% 0 100% (100)New continuing care high cost patients (50) 50% (25) 0% 0 100% (50)CCG spend is currently billed to NHSE and is reattributed (2,000) 0% 0 0% 0 100% (2,000)QIPP slippage (240) 10% (24) 0% 0 100% (240)Overseas visitors (262) 50% (131) 0% 0 100% (262)UCC income not recovered from CCGs out of NWL (400) 20% (80) 0% 0 100% (400)Recharge of PH drugs to LBE (350) 50% (175) 0% 0 100% (350)Contractual benefit not achieved (700) 100% (700) 50% (350) 100% (700)Total (4,102) (1,185) (350) (4,102)NHSE spend is currently billed to CCGs and is reattributed 2,000 0% 0 100% 2,000 0% 0CSU Telephony invoice 210 25% 53 100% 210 0% 0Contract reserve 2,100 100% 2,100 100% 2,100 50% 1,050contingency - tranche 1 400 100% 400 100% 400 0% 0contingency tranche 2 700 100% 700 100% 700 100% 700adjustment for MH/LD high cost placement 340 25% 85 100% 340 0% 02% headroom not allocated 500 100% 500 100% 500 0% 0EHT residual BTA issues 200 50% 100 100% 200 0% 0LBE billing St. Martin's House 100 50% 50 100% 100 0% 0NHSE GP IT capital 1,600 100% 1,600 100% 1,600 0% 0Total 8,150 5,588 8,150 1,750

Net (Risks) & Opportunities 4,048 4,403 7,800 (2,352)

Risks and opportunities are not reflected in the forecast outurn postion, as there is uncertainty about whether they will crystallise; but should they occur in whole or in part they could alter the reported forecast postion.

The risks fall into two broad categories : where there is a risk that the CCG will forego some expected benefit ( eg UCC income not billed to other commissioners due to information governance and reporting issues, or differing assessments of the impact of terms in (often informal) agreements). The opportunities are mainly around the phasing of developmental expenditure (e.g.will there be service delivery this year? ) and the level of funding needed to off-set the risks should they occur. There is an expectation that as the CCG enters the last months of the financial year the uncertainty around crystallisation will reslove with the number of risk/opportunities reducing.

Key Messages

RIS

KO

PPO

RTU

NIT

IES

Likely Case Best Case Worst Case

Risks and Opportunities: Key Messages

Risks and Opportunities Table

6

Issue Key drivers

Financial impact

YTD, £m Action Owner Timeline

ICHT £5.2

£5.2m represents the projected variance based on the Month 9 mitigated variance position of £4.7m. The main drivers of the over performance are Maternity (£0.7m), Non Elective (£1.2m) and Outpatients (£2.7m). Challenges of £1.3m ytd are included in the reported position. Action: CSU to pursue outstanding challenges and reconciliation with NHS-E.

CSU On going

West Middx £0.6

£0.64m represents the projected variance based on the Month 9 mitigated variance position of £0.57m. The main drivers of the over performance are Maternity (£0.2m) and Outpatients (£0.3m). Challenges of £0.2m ytd are included in the reported position. Action: CSU to maintain close monitoring of performance and activity.

CSU On going

C&W £0.5

£0.54m represents the projected variance based on the Month 9 mitigated variance position of £0.48m. The main drivers of the over performance are Outpatients (£0.5m) and Daycases (£0.2m). Challenges of £0.1m ytd are included in the reported position. Action: CSU to maintain close monitoring of performance and activity.

CSU On going

Total £6.3

Continuing Care £0.9

The main driver of overperformance in Continuing Care is Physical Disabilities Clients aged over 65 (£0.8m), Mental Health Clients aged under 65 (£0.1m) and Physical Disabilities Clients aged under 65 (£0.4m) offset by underspends in Funded Nursing Care £0.3m and Palliative Care Clients £0.3m. Action: Continue with improvements in financial control and case monitoring already underway.

CCG - continuing care On going

Prescribing £1.1

The overspend in Prescribing is generated from GP Prescribing figures (£0.9m) including £0.3m income from LBE for Public Health Drugs and Central Drugs (£0.1m) for April to November forecasted forward to January using the new PPA profile of spend issued in January. This has resulted in a worsening of the prescribing position in month of (£0.3m). Action: Continue delivery of QIPP project and close working with practices to reduce costs and improve quality.

CCG - medicines management On going

Corporate & Estates (Programme)

£0.8

The main overspending areas are GP IT BAU (Business As Usual) (£0.4m), NHS Property Service Recharge (£0.4m) and GP IT Hardware Refresh/Systm One Projects (£0.2m). These are offset by underspends in the Contuining Care team budget charges £0.2m. Action: Maintenance of financial management of GP IT and other projects.

CCG - finance On going

Total £9.0


Acute contracts over-performance

Programme cost over-

spends

Act

ions

for C

SU

Key issues and actions relating to Financial Position

7

Overall Financial Position PageSurplus/deficit including running costs 8Budget Movements including running costs 9Movements of Variances including running costs 10Break-down of programme (commissioning) spend 11Break down of running cost spend 12Breakdown of reserves 13Investments 14Month 8 QIPP Position 15QIPP Variance Movements 16Capital, creditor payments and cash 17


Section 2: Overall Financial Position


Overall financial position Contract

performance Appendix Executive

summary

8

Key message

2 3 5 6 8 9

Budget Actual Variance Budget Forecast Variance

Allocation Resource limit 343,970 343,970 0 425,152 425,152 0

Acute Contracts 176,057 182,318 (6,262) 211,216 219,048 (7,832)

Acute In Year Risk Reserve 4,944 0 4,944 5,933 0 5,933

Other Acute Commissioning 18,339 17,765 574 21,916 21,339 577

Continuing Care 11,572 12,448 (876) 13,887 14,895 (1,008)

Community Health 33,520 31,412 2,108 41,242 39,017 2,225

Mental Health 39,090 37,952 1,138 47,259 46,000 1,259

Prescribing 32,316 33,376 (1,060) 38,942 40,223 (1,280)

Primary Care 10,139 10,019 120 12,644 12,230 413

Other 11,109 9,930 1,180 23,013 16,465 6,548

Running Costs Corporate Costs 6,883 6,883 1 9,100 8,800 300Net Expenditure 343,970 342,103 1,867 425,152 418,017 7,135

Surplus/(Deficit) position 0 1,867 1,867 0 7,135 7,135


The key area of over performance in month 10 continues to be Acute Contracts (£6.3m) which are then offset by the SLA In year risk reserve of £4.9m. The main driver of the over performance is ICHT (£5.2m), West Middlesex (£0.6m), Chelsea & Westminster (£0.5m) and NWLHT (£0.4m).

Continuing Care is also overspent (£0.9m), a large proportion of which is related to Continuing Care Physical Disability Clients over 65 and under 65. Prescribing is overspent (£1.1m). The main driver is GP Prescribing and Central Drugs costs. Corporate and Estate non running costs is also over spent (£0.8m). This area is shown within the "Other" category in the table below. The main drivers of over spend in Corporate & Estates are the GP IT spend being higher than the allocation received from NHS England (£0.4m), charges from NHS Property Services (£0.4m) and GP IT Hardware Refresh/Systm One Project (£0.2m): not all of the costs of NHS PS (nationally) could be recovered from tenants and an agreement with DH means that such a shortfall can be recovered from commissioners; therefore the CCG is being charged on the basis of the 2012/13 figures used when allocations were set for the new commissioning architecture.

The above identified over performance has been mitigated by release of uncommitted reserves £7.3m within the "other" category below and underspend in other areas.

Year to date (£k) Full year (£k)

Commissioned services

Surplus/Deficit including Running Costs

9

Key message

Summary

Initiative Month 9Budget

ChangesClassification

Changes Month 10 Further detail £k £k £k £k

Programme 403,379 2,100 0 405,479 IAT Reversal of Contribution to NWL Strategy

Programme - Contingency and Reserves 10,573 0 0 10,573

Planned Surplus/Deficit 0 0 0 0 Running Costs 9,100 0 0 9,100 Total Allocation 423,052 2,100 0 425,152

Detail

Acute 236,017 3,047 0 239,065 Reflects IAT reversal and increase in budgets funded from Contingency £240k and Contract Balance £707k; reflects agreement with Ealing Hospital

Mental Health 47,259 0 0 47,259

Continuing Care 13,887 0 0 13,887

Community ( Inc. LES) 54,427 (542) 0 53,886 Reflects agreement with Ealing Hospital and consequential budget re-alignement.

Prescribing 38,942 0 0 38,942

Corporate and Estates 12,409 0 0 12,409

Reserves and Contingency 11,009 (406) 0 10,604 Other adjustements from reseves and contingencies to balance year end postion

Running Costs 9,100 0 0 9,100

Total 423,052 2,100 0 425,152

Source: PMO QIPP report


The CCG received a new allocation of £2.1m in month 10. The allocations related to a reversal of the deduction for contribution to the NWL Financial strategy £2.1m which was deducted in Month 9.

Budget Movements including Running Costs

10

Key message

Analysis of Variance

Initiative Month 10 Month 9 Movement Month 10 Month 9 Movement Further detail £k £k £k £k £k £k

Acute Contracts (6,262) (6,859) 597 (7,832) (9,570) 1,738 Main positive movements in YTD and FOT Variance are EHT, Moorfields and UCLH. This was due to the budget being increased in line with the latest contract values.

Acute In Year Risk Reserve 4,944 5,867 (923) 5,933 7,823 (1,890) Movement on YTD and FOT is due to a budget movement to EHT of (£1.89m).

Other Acute Commissioning 574 561 14 577 559 18

Mental Health Commissioning 1,138 981 157 1,259 1,169 90 Main movements positive movement in the ytd variances are in Mental Health Treatment & Care

and MH NCAs and the main positive movement in FOT variance is MH NCAs.

Continuing Care (876) (596) (280) (1,008) (888) (120) Main areas of worsening overspend are in Physical Disabilities Clients aged over 65, MH Clients aged over 65, Palliative Care Clients and Physical Disabilities Clients aged under 65

Community 2,108 1,399 709 2,225 2,917 (692) Main movement in the FOT is due to a reduction in the income with regards to the risk share agreement with the ICO.

Prescribing (1,060) (744) (316) (1,280) (999) (282)

Month 10 position reflects actuals to Month 8 and estimates for Month 9 and 10 based on the new 2013-14 PPA Profile which was issued this month which has resulted in a worsening of the position by (£0.3m) ytd and (£0.3m) FOT. The Month 10 position includes invoices raised for Public Health drugs to LBE forecasted to Month 10.

Primary Care 120 51 68 413 298 115 Main improvement in YTD and FOT position is associated with TDL Pathology.

Corporate & Estates (752) (360) (392) (792) (652) (140)

Main negative movements in YTD position are NHS Property Services (relating to charges for Martins House) and GP IT Hardware Refresh/Systm One Projects and the main negative movements in the FOT position is associated with NHS Property Services (again relating to Martins House).

Reserves and Contingency 1,931 1,680 251 7,340 6,021 1,319 £2.0m of the contingency reserve has been release to offset overspend areas offset by an

increase in the commitment against the contract balance reserve of (£0.7m)

Running Costs 1 15 (15) 300 190 110Forecast outturn has been revised to show a £300k underspend (190k in month 9). This takes into account the revised expectation that the CCG will not incur costs for the Strategy and Transformation Team in 2013-14.

Total 1,867 1,996 (129) 7,135 6,868 267

Source:PMO QIPP report


The main negative movement in the YTD position is due to Acute SLAs (largely relating to ICHT, West Middlesex, Chelsea & Westminster and NWLHT) .

Variance Year to date FOT Variance

Movements of Variances including Running Costs

11

Key message

2 3 5 6 8 9

Budget Actual Variance Budget Forecast Variance REF

Acute Contracts 181,001 182,318 (1,318) 217,149 219,048 (1,899) page 16

Other Acute Activity Services 18,339 17,765 574 21,916 21,339 577

Total Acute Services 199,340 200,083 (743) 239,065 240,387 (1,322)Continuing Care 11,572 12,448 (876) 13,887 14,895 (1,008)

Community Health 33,520 31,412 2,108 41,242 39,017 2,225

Mental Health 39,090 37,952 1,138 47,259 46,000 1,259

Prescribing 32,316 33,376 (1,060) 38,942 40,223 (1,280)

Primary Care 10,139 10,019 120 12,644 12,230 413

Corporate & Estates 9,178 9,930 (752) 12,409 13,201 (792)

Reserves and Contingency 1,931 0 1,931 10,603 3,264 7,340 page 11

Total Other 11,109 9,930 1,180 23,013 16,465 6,548

Total commissioning spend 337,087 335,220 1,866 416,052 409,217 6,835


Other areas of over performance outside of Acute services has been detailed below:

1) Continuing Care year to date overspend totals (£0.9m) with a FOT overspend of (£1.0m). The largest pressure on the budget is from Physical Disability Clients aged over 65 amounting to year to date overspend of (£0.8m) and a forecast overspend of (£0.9m). In addition the budget for Physical Disability Clients aged under 65 is overspent by (£0.4m) to date and a forecast variance of (£0.6m). The drivers of the overspend have been partially mitigated by underspends in Funded Nursing Care year to date variance of £0.3m and forecast variance of £0.4m and Palliative Care year to date variance £0.3m and forecast variance of £0.4m.

2) Prescribing year to date overspend of (£1.1m) and a forecast overspend of (£1.3m). Included in the GP Prescribing position is a mitigation of expected income related to the recharge of Public Health related drugs that have been recharged to the London Borough of Ealing. A revised PPA profile has been issued this month which has resulted in an worsening of the position by (£0.3m) from Month 9.

3) Corporate & Estates year to date overspend of (£0.75m) and a forecast overspend of (£0.79m). The main drivers of overperformance are the recharges from NHS Prop Co and GP IT BAU.


Commissioned services

Break-down of Programme Spend

12

Key message

Commissioning Spend Breakdown Budget Actual Variance Budget Actual Variance

Allocation Resource Limit 6,883 6,883 0 9,100 9,100 0

Running costs Pay Costs 3,512 3,553 (41) 5,084 4,529 555

CSU Costs 3,221 3,177 44 3,866 3,866 0

Other Non Pay Costs 150 152 (2) 150 405 (255)

Surplus/deficit for running costs 0 1 1 (0) 300 300

Source: Financial ledgerhigh quality support to commissioners to improve health and wellbeing

The running cost budgets are on-target and showing a breakeven position at the end of January (month 10). The forecast outturn has been revised to show a £300k underspend (190k in month 9). This takes into account the revised expectation that the CCG will not incur costs for the Strategy and Transformation Team in 2013-14. There are in-year cost pressures include consultancy costs, NHS Property Co. charges in excess of budget, interim and one-off project costs which have been provided for. Projects currently underway include procurement of pathology contract re-tendering, the Referral Facilitation Service (RFS) and out-of-hours services.


Break down of Running Cost Spend

13

Key message

Budget Actual Variance Budget Forecast Variance

• Contingency 1,931 0 1,931 4,981 475 4,506

The contingency is held to offset risks and pressures not covered elsewhere; in the light of current assessment of risks and opportunities this is informally offsetting many of the year-ends risks around achievement of income and other benefits under - usually informal - agreements.

• Contract Balance 0 0 0 4,340 2,100 2,240

If this funding is not needed to offset further contractual pressures the CCG is planning to use this to help pump-prime work/services to deliver service changes and other improvements identified in next years commissioning intentions, and other non-recurrent uses to improve services to patients

• 2013-14 LSG Deductions 0 0 0 189 189 0We are expecting Phase 1 work of the Pan-London Technical Group on Specialist Commissioning to be revenue neutral to the CCG. Phase 2 is currently being reviewed.

• 2% Headroom 0 0 0 1,093 500 593 This is earmarked for funding non recurrent projects.

0 0 0 0 0 0

TOTAL Reserves 1,931 0 1,931 10,603 3,264 7,340

Source: Financial ledger


Further uncommitted reserves have been partially released into the FOT position as at month 10. The release of reserves has been used to partially offset the full year pressure on Acute Services (£1.9m), (£1.0m) in Continuing Care, (£1.3m) in Prescribing and (£0.8m) in Non Running Cost Corporate & Estates. The partial release of all uncommitted reserves has resulted in an unplanned FOT surplus in programme costs of £6.8m.


Non Recurrent Reserve

Further detail

Breakdown of Reserves

14

Budget Actual Variance Budget Forecast Variance Further detail

GP IT hardware refresh/SystmOne project 1,074 1,268 (194) 1,611 1,611 0

Project underway and being closely monitored to ensure the budget is observed and there is operational delivery; post month 10 NHSE capital has been made available for these projects.

Winter Pressures Investment 1,431 1,431 0 2,862 2,862 0 Fully committed.

SaHF Transformation funding 411 411 0 669 669 0 Fully committed.

QIPP Investment 81 81 0 97 97 0 Funding associated with improvements in Diabetic Care; expected to be fully spent

2,996 3,190 (194) 5,239 5,239 0


Key messageMost of the investments listed below are non recurrent with Winter Pressures and SaHF Transformation funding being specific in year non recurrent resource limit increases. The GP IT hardware refresh will be completed this year; the SystmOne Project will continue into next year.


Investments

15

Key message

QIPP initiatives (Net QIPP)

Initiative Plan Actual Var Plan Forecast Var Further detail £k £k £k £k £k £k

Acute Services 8,025 4,142 (3,883) 9,885 5,666 (4,219) The principal variance is associated with the ICE scheme.

NCAs 63 63 0 75 75 0

Community Services 938 1,196 258 1,125 1,435 310 This has been negotiated into the contract.

Mental Health 833 833 0 1,000 1,000 0 Linked to service change around MH provision

Continuing Care 750 900 150 900 900 0 Fully achieved.

Prescribing 2,724 2,760 36 3,269 3,319 50 The achievement of this QIPP by the Medicines Management Team is mitigating substantial financial pressures being reported

Total 13,332 9,893 (3,439) 16,254 12,395 (3,859)



Year to date Full year

Month 10 QIPP performance FOT achievement is 79% against the full year plan. A key driver for the 21% FOT adverse variance from plan is the impact of a small number of schemes which are no longer being pursued. The figures reflect the impact of in year mitigations.

M10 QIPP Position

16

Key message

QIPP initiatives (Net QIPP)

Initiative Month 10 Month 9 Movement Month 10 Month 9 Movement£k £k £k £k £k £k

Acute Contracts (5,009) (4,530) (479) (7,252) (6,801) (451)

Acute In Year Risk Reserve 0 0 0 0 0 0Other Acute Commissioning 0 0 0 0 0 0

Mental Health Commissioning 0 0 0 0 0 0

Continuing Care 150 225 (75) 0 0 0

Community 1,385 1,359 26 2,949 2,949 0

Prescribing 36 29 7 50 50 0

Primary Care 0 0 0 394 394 0

Corporate & Estates 0 0 0 0 0 0Reserves and Contingency 0 0 0 0 0 0

Running Costs 0 0 0 0 0 0

Total (3,439) (2,917) (522) (3,859) (3,408) (451)



This report analyses month on month variances, both year to date and forecast outturn. Further detail is given in the Appendix.

QIPP Variance Year to date QIPP FOT Variance

QIPP Variance Movements

17

Key message

InvoiceCount

InvoiceCount

(Passed)

% Passed InvoiceAmount

InvoiceAmount(Passed)

% AmountPassed

£ £NHS 1039 934 89.9% 239,508,933 233,767,678 97.6%Non NHS 9645 9231 95.7% 29,526,633 27,312,868 92.5%Total 10684 10165 95.1% 269,035,565 261,080,546 97.0%

Planned Cash Limit: 399,226£ Drawn Down to Date: 316,681£ 79%Planned Draw Down at Month Ten: 332,688£ Under Drawn: 16,007-£

Source: CSU analysis

•

Capital

Ealing CCG has received a GP IT Capital allocation from NHS England of £2,533,236, following approval of submitted business cases. The CCG will procure and pay for the assets and recharge NHS England in full. The assets will be recorded in NHS England's accounts and future depreciation will be charged to an NHS England central budget.


Creditor payments

•

We are currently working with budget holders to ensure that invoices are coded and outstanding queries are dealt with promptly in order that invoice are paid within payment terms.

Cash

•

Capital, Creditor Payments and Cash Capital, Creditor Payments and Cash

Documents

Month 10 Ealing CCG Finance and Activity Performance Report€¦ · Source: Team analysis high quality support to commissioners to improve health and wellbeing Overall financial position