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North West London
Month 12 Budget Update SaHF & NWL Strategy and Transformation Programmes
April 2016
1
This paper provides the month 12 budget update for NWL-wide financial strategy/ SaHF
including Strategy & Transformation programmes.
The main points to note are:
1. Sources of funding and total budget, including split across the programmes, has
remained the same from last month;
2. The S&T year end position is an overspend of £0.2m due to a higher than expected bill
for staff retention payments from LNWH Trust.
The Collaboration Board are asked to:
a) Note the final 15/16 Year - end position;
Summary
2
Contents
Sources of funding
Applications of funding
Budget analysis
1
2
3
Year end outturn 4
5 Appendix A Consultancy contracts let
3
Sources of funding
Total resource available
CCGs contribution to the programme1 £55.1m
TOTAL
1 Hounslow CCG did not require the full £5.4m of Part C support and were able to return £1.7m. West London CCG did not require any funding back so Brent CCG as the other large contributor was refunded the surplus value, reducing their overall contribution to Part C from £10.2m to
£8.5m.
NHSE contribution (including extra £1m from NHSE to Support SaHF)
£14.6m
£69.7m1
The proposed application of this resource is as per the previous papers:
- £30m to Strategy & Transformation;
- £37.7m to Provider support; £2.5m to Harrow CCG.
The overcommitment of £0.5m is covered by carried forward underspend from 14/15. An update
on each of these areas is given in the following slides.
4
The budget allocations for Strategy and Transformation are shown in the table below:
Application of funds (1)
5
.
Total Budget
Central TeamReturned to
CCGs
(agreed
September 2015)
Total
S&T projects £m £m £m
Enhanced Integration/Whole
Systems3.3 6.8 10.0
Primary care transformation 2.3 2.0 4.3
SaHF implementation 6.8 6.8
Transforming Mental Health
Services1.5 1.0 2.5
Other costs (core team, non-pay,
events)6.4 6.4
Total 20.3 9.8 30.0
Plan
The provider support costs as at M12 is shown in the table below. The final outturn was an overspend of
£0.2m, due to a higher than expected bill for staff retention payments to London North West Hospitals
Trust. This was in relation to the maternity transition and was billed very late, thus had not been included
in previous forecasts.
Application of funds (2) Provider support
6
Provider support
Forecast
outturn at
M10
Actual
spend
M12 Variance
£m £m £m
Maternity* 6.8 7.0 (0.2)
Paediatrics* 5.9 5.9 0.0
Main SaHF
Double running:
a) THH 3.0 3.0 0.0
b) Chel West 2.3 2.3 0.0
c) LNWHT 11.0 11.0 0.0
- CW/ West Mid merger 4.0 4.0 0.0
ImBC costs 0.7 0.7 0.0
Trust support to CIP identification process 0.6 0.6 0.0
Trust ImBC support 3.3 3.3 0.0
Delivery Architecture 0.2 0.2 0.0
Total 37.7 37.9 (0.2)
*Further detail provided on next slide
Application of funds (3) Provider support
£m Reason for payment
Maternity costs:
WMUH 2.9 Lease on temporary maternity unit
ICHT 1.0 0.75m CNST, 0.25m midwife ramp up costs
THH 0.8 Midwifery ramp up costs, ward improvements
LNWHT (EHT) 1.3 Income support, medical rota support, agency premium for transition period
LNWHT (NWP) 0.3 Midwife support packages (inc. retention premia for transition)
WMUH 0.3 Midwifery ramp up costs
All trusts 0.4 Transitional estates costs to support new community clinics
Sub-total Maternity 7.0
Paediatric costs:
THH 3.3 Capacity investment to support paediatric changes
LNWHT 1.3 Capacity investment to support paediatric changes
WMUH 1.5 Paediatric investment support – PDC request refused
Sub-total Paediatrics 6.1
The following table provides a breakdown of the payments made to support the
maternity and paediatric transitions in 15/16:
Month 12 S&T budget report Year end outturn
Whole Systems Integrated Care
1
Primary Care Transformation
Acute Reconfiguration
3
Mental Health Transformation
4
Cross Cutting and Core Team
5
Transition and Shadow Running (to CCG’s)
Whole systems implementation
Workforce & Change Academy
TOTAL
Primary Care Network Support (to CCG’s)
Primary Care System Wide Support
Hub OBC Development
TOTAL
ImBC and OBC Development
Paediatric Implementation
Maternity Implementation
System Wide Support & Ops Leadership
TOTAL
Mental Health Wellbeing & Strategy
Mental Health Urgent Care
Mental Health Transformation (to CCG’s)
TOTAL
Communications and Engagement
5 Year Strategy
Core Team, non-pay, events
Informatics
TOTAL
Total
BUDGET
YTD
£m
ACTUAL
YTD
£m
VARIANCE
YTD
£m
-
(1.3)
(0.7)
(2.0)
-
0.4
(0.3)
0.1
0.7
0.1
-
(1.0)
(0.2)
-
0.2
-
0.2
0.4
1.1
0.2
0.2
1.9
0.0
6.8
1.2
-
8.0
2.0
1.4
1.0
4.4
4.4
1.4
0.8
-
6.6
-
1.7
1.0
2.7
1.4
1.6
4.4
0.9
8.3
30.0
6.8
2.5
0.7
10.0
2.0
1.0
1.3
4.3
3.7
1.3
0.8
1.0
6.8
-
1.5
1.0
2.5
1.0
0.5
4.2
0.7
6.4
30.0
BUDGET
ANNUAL
£m
2
8
6.8
2.5
0.7
10.0
2.0
1.0
1.3
4.3
3.7
1.3
0.8
1.0
6.8
-
1.5
1.0
2.5
1.0
0.5
4.2
0.7
6.4
30.0
M12 S&T budget report
Variances
1. Whole systems Integrated Support (£2m underspend):
• Change academy contract Phase 1 contract was not approved, thus preventing investment
in Phase 2;
• Planned investment in consultancy support was halted due to NHSE restrictions.
2. Primary Care transformation (£0.1m overspend):
• Underspend on Hub business cases due to length of time taken to get Business Case
approval was used to support CCGs in development of Primary Care Model of Care.
3. Acute reconfiguration (£0.2m underspend):
• System wide support budget was used to support the ImBC and OBC development costs.
4. Mental Health Transformation (£0.2m overspend):
• Overspend due to unaccrued costs from previous years.
5. Cross cutting and Core team (£1.9m overspend);
• Communications overspend due to initial high rate of interim staff, substantive recruitment
largely complete by March 2016;
• 5 year strategy overspend due to the increase in support required for 7 day services, both
within the central team and in provider Trusts. Also includes cost for support to the
Sustainability and Transformation Plan, Urgent and emergency care, and Community
Paediatric services;
• Core team costs overspend due to an increase in accommodation costs; and
• Informatics overspend due to increase in contract with SECSU to support the Whole
Systems Data Warehouse project.
North West London
Appendix A
Month 12 Budget Update Consultancy Contracts Let
SaHF & NWL Strategy and Transformation Programmes
April 2016
10
Contract
Let
Contract Value Provider Decision-making panel NHSE Contract Summary
Jun 2015 WSIC Early
Adopters Go
Live
£206,985
McKinsey
Single Tender Waiver1
Signed by C Parker (AO) and R O’Hare
(Chair)
Approved
Contract to support handover
of Data Warehouse from
McKinsey to CCG/Strategy
and Transformation team;
Jun 2015 SaHF ImBC
Development
- Joint PMOb
£190,500
Moorhouse
Single Tender Waiver2
Signed by C Parker (AO) and R O’Hare
(Chair)
Approved
Contracts to support the
ImBC refresh in July/August;
Jun 2015 SaHF ImBC
Development
- Productivity
Analysis
£791,778
McKinsey
Single Tender Waiver2
Signed by C Parker (AO) and R O’Hare
(Chair)
Approved
Contracts to support the
ImBC refresh in July/August;
Jun 2015 SaHF ImBC
Development
- Financials
£203,145
NEL CSU
(Deloitte)
Single Tender Waiver2
Signed by C Parker (AO) and R O’Hare
(Chair) – SLA signed by C Parker plus
Finance Director NELCSU
Approved
Contracts to support the
ImBC refresh in July/August;
Jun 2015 SaHF ImBC
Development
- Re-write
£17,351
Carnall
Farrar
Signed by C Parker (AO)
N/A as
below £50k
threshold
Contracts to support the
ImBC refresh in July/August;
Aug 2015 Portfolio and
PMO
Support for
S&T
Directorate
£863,604 PA
Consulting
Evaluation panel: Director of S&T
(acting), Deputy Director S&T, Deputy
Director Reconfiguration (S&T),
Programme Director Reconfiguration
(S&T), Deputy CFO CWHHE, and two
Lay Members
Approved Contract to support Portfolio
Management Office in
Strategy & Transformation to
March 16, to allow time for
recruitment to substantive
roles;
S&T consultancy contracts let since 1st April 2015 (1/6)
Contract
Let
Contract Value Provider Decision-making panel NHSE Contract Summary
Aug 2015
SaHF ImBC
Development
- Joint PMO
(extension to
Jun 2015
letting)
£35,200
Moorhouse
Single Tender Waiver1
Signed by C Parker (AO)
N/A as below
£50k threshold
Contracts to support the
ImBC refresh in
July/August;
Aug 2015 Delivery
Architecture
£549,828
McKinsey
Evaluation panel: Director of S&T
(acting), Deputy Director Strategic
Financial Planning (S&T), Deputy
Director S&T (WSIC), Deputy Director
Reconfiguration (S&T), Lay Member.
Approved
Contracts to support the
creation of the NWL
Delivery Architecture to
allow the delivery of pan-
NWL savings across
agreed areas of joint
working;
Sept 2015 SaHF ImBC -
Additional
Support for
Finance Plans
for 8 NWL
CCGs
£50,000
Deloitte LLP
Single Tender Waiver2
Signed by Clare Parker
N/A as below
£50k threshold
Contract to create model
required to allow
consolidation of 8 CCG
5-year financial plans;
Oct 2015 Supporting
SaHF
Programme –
CCG QIPP
Plan for
CWHHE and
BHH
£208,733 GE
Healthcare
Finnamore
Single Tender Waiver1
Signed by Clare Parker, CFO, and
Chair, CLCCG
Approved Contract to support
consolidation of QIPP
plans and benefits
realised to support ImBC
process;
S&T consultancy contracts let since 1st April 2015 (2/6)
Contract
Let
Contract Value Provider Decision-making panel NHSE Contract Summary
Oct 2015 Delivery Architecture -
Bridging to
Implementation
£263,250
McKinsey &
Company
Single Tender Waiver1
Signed by Clare Parker
Approved
Contracts to support the creation of
the NWL Delivery Architecture to
allow the delivery of pan-NWL
savings across agreed areas of joint
working;
Oct 2015 Change Academy £690,921
GE
Healthcare
Finnamore
Contract - Evaluation panel:
Director of S&T (acting),
Deputy Director S&T, Work
Force Lead S&T, Head of
Education Transformation
ICH, Clinical lead HENWL
and one Lay Member
Not
approved
Contract to support Organisational
Development for new ways of working
in an Whole Systems environment.
(NOT AWARDED)
Oct 2015 New Models of
Primary Care
£471,645 PA
Consulting
Contract – Evaluation Panel:
Director of S&T (acting),
Deputy Director Strategic
Financial Planning, Deputy
Director S&T, MD, West
London CCG, 2 Lay members
Not
approved
Contract to support development of
locally-designed primary care offer
initially taking forward the work of 3
NWL CCGs focusing on the design
and roll-out of new models of primary
care, aligned to the Strategic
Commissioning Framework
(NOT AWARDED)
Nov 2015 Support to ImBC Out
of Hospital Plans
£49,900 GE
Healthcare
Finnamore
Single Tender Waiver2 N/A as
below £50k
threshold
Contract to Support the development
of Strategic Outline Case level
models for OOH delivery
Nov 2015 Review of the 2015
Maternity Services
Transition in North
West London
£49,750 GE
Healthcare
Finnamore
Contract - Evaluation panel:
Director of S&T (acting),
Programme Director
Reconfiguration, Deputy
Director Reconfiguration.
N/A as
below £50k
threshold
Contract to conduct a review of the
changes as a result of the planned
closure of birthing services at Ealing
Hospital.
Nov 2015 Support to S&T-
Supporting SaHF
programme
£49,000 GE
Healthcare
Finnamore
Contract - Evaluation panel:
Director of S&T (acting),
Programme Director
Reconfiguration, Deputy
Director Reconfiguration.
N/A as
below £50k
threshold
Contract to provide strategic support
to the reconfiguration programme by
K. Atkin
S&T consultancy contracts let since 1st April 2015 (3/6)
Contract
Let
Contract Value Provider Decision-making panel NHSE Contract Summary
Nov 2015 Support to S&T-
Supporting SaHF
programme
£49,000 GE
Healthcare
Finnamore
Contract - Evaluation
panel: Director of S&T
(acting), Programme
Director Reconfiguration,
Deputy Director
Reconfiguration.
N/A as
below £50k
threshold
Contract to provide strategic support
to the reconfiguration programme by
K. Atkin
Nov 2015 Equalities Review for
Paediatric Transition
£29,918 Deloitte LLP Contract – Evaluation
Panel:
Director of S&T (acting),
Assistant Director
Communications and
Engagement
N/A, as
below £50k
threshold
Contract to provide support for the
transition of paediatric in-patient
services from Ealing Hospital,
specifically with regard to the impact
on protected characteristics,
inequality of access and inequality of
outcomes.
Dec 2015
Development of PIDs,
Option Appraisal and
OBC’s for OOH Hubs
£499,999
PA Consulting Contract (Signing in
process) – Evaluation
Panel:
Deputy Director of
Reconfiguration (S&T),
Head of Strategic Estates
Development CLCCG,
Deputy Director of Strategic
Financial Planning
Approved Contract to improve condition of OOH
estates, expand hospital capacity,
maximise benefits of co-location of
health and social care services and
continue consistency of care and
improved clinical standards
Dec 2015 PTS Survey £35,544 365Response Contract – Evaluation
Panel:
Assistant Director
Communications &
Engagement, Travel &
Transport Lead, Travel
Adviser
N/A, as
below the
threshold of
£50k
Contract to provide survey In the area
of patient travel services, data
capture, handling of patients, collate
and analyse patient travel
experiences.
S&T consultancy contracts let since 1st April 2015 (4/6)
Contract
Let
Contract Value Provider Decision-making panel NHSE Contract Summary
Dec 2015 Finance and
Activity work
stream for the
SaHF ImBC
(through
Hammersmith
& Fulham
CCG)
£585,000 Deloitte Contract – Evaluation Panel:
CFO for BHH, Lay Member,
Financial Adviser SaHF, Director of
Financial Strategy NHSE
Approved Contract to provide services in
the following key activities:
• preparation/planning phase
• collection and analysis to feed
into the ImBC
• support to post-ImBC
submission response to
queries etc.
Dec 2015 Like Minded –
Children and
Young People
(through West
London CCG)
£352,687 The Anna
Freud
Centre
Contract – Evaluation Panel:
Senior Children’s Joint
Commissioning Manager (West,
Central H&F CCGs), CAMHS
Project Lead, Assistant Director,
WSIC, Lead CYP, Central London
GP Clinical Lead, Deputy Head
Teacher Cannon’s High School,
Headteacher Roxeth Primary
School, Children’s Commissioner
Harrow LA.
Submitted to
NHSE on
18/02/2015 –
decision
awaited
Contract to provide services for:
• Children and Young People’s
Mental Health and Wellbeing
needs assessment, supporting
co-production, workforce
development & training,
redesigning pathways,
support for learning
disabilities, crisis and urgent
care pathways
• children and young people’s
workforce training and
development needs analysis
Feb 2016 Health
Coaching –
Training
Existing
Trainers and
Coaches
£36,990 Osca
Agency
Contract Evaluation Panel:
Assistant Director Workforce and
OD (S&T), Workstream Lead (Darzi
Fellow) S&T, Lay Partner, Clinical
Lead for Self Care CLCCG
N/A, as below
the threshold
of £50k
Training programme to ‘convert’
current clinicians who have
Coach Trainer qualifications to
become Health Coach Trainers
able to train people to become
Health Coaches and Health
Coaches Trainers
S&T consultancy contracts let since 1st April 2015 (5/6)
Contract
Let
Contract Value Provid
er
Decision-making panel NHSE Contract Summary
Feb 2016 Health Coaching –
Training the Clinicians
£49,840 Osca
Agency
Contract Evaluation Panel:
Assistant Director Workforce
and OD (S&T), Workstream
Lead (Darzi Fellow) S&T, Lay
Partner, Clinical Lead for Self
Care CLCCG
N/A, as
below the
threshold of
£50k
To create a sustainable programme
that equips our front line clinicians
with coaching skills so they can
have better conversations with their
patients to empower them to make
more meaningful changes to their
health related behaviours and
lifestyle to lead to better health
outcomes
March
2016
Support for
Paediatric Transition
Activity Model Review
£19,999 Deloitte
LLP
Deputy Director
Reconfiguration, Programme
Director, Assurance Lead,
Head of Reconfiguration
NHSE
N/A – below
the
threshold of
50K
Changes, as part of the SaHF
programme, were agreed relating to
maternity, paediatrics and
gynaecology services. The
proposals included:
Consolidation of maternity and
neonatal services from seven to six
sites to provide comprehensive
obstetric and midwife-led delivery
care and neonatal care.
Consolidation of paediatric inpatient
services from six sites to five sites
to incorporate paediatric
emergency care, inpatients and
short stay /ambulatory facilities.
TOTAL (including
awarded contracts
only)
£5,188,001
S&T consultancy contracts let since 1st April 2015 (6/6)
Single Tender Waivers have been agreed in line with the CLCCG Prime Financial Policies section 14 for the following
reasons: 1 When the task is essential to complete the project, and arises as a consequence of a recently completed
assignment and engaging different consultants for the new task would be inappropriate (Para 14.8.7);
2 Where the timescale genuinely precludes competitive tendering (Para 14.8.5).