RCCG/GB/17/104 FINANCE 2017/18 REPORT. Governing Body report. Finance report for the period ending 31 May 2017

Transcription

1 RCCG/GB/17/104 FINANCE 2017/18 REPORT Finance report for the period ending 31 May 2017 Governing Body report 1

2 Summary Finance Performance The tables below summarises the key financial duties and targets and internal key financial indicators for the CCG: Key Financial Duties YTD RAG Rating Forecast RAG Rating Remain within the Revenue Resource Limit ( 160,451k full year) Achieve the Control Total (in year breakeven) Remain within Running Cost Allowance ( 2,719k full year) Remain within the Cash Balance Limit Better Payments Practice Code Key Internal Financial Indicators YTD RAG Rating Forecast RAG Rating QIPP achievement of overall target ( 7,972k full year) QIPP achievement of recurrent target ( 7,972k) Achieve Underlying Surplus ( 888k full year) Risk Reserves level utilised to balance position Co-commissioning spend remains within budget Acute Contract spend remains within budget Continuing healthcare spend remains within budget Prescribing spend remains within budget 2

3 Month 2 Summary Month 2 position spend has remained with budget for all areas, with 489k phased back into reserves to deliver a balanced position There are a number of risks / issues to be noted with regards to the reported position: o QIPP phasing is back-loaded o Acute based on one month data o Month 1 acute adjustments for Major Trauma and IR rules may be inaccurate o HRG4+ coding pressures increase through year o Locally priced services take effect from 15 July o Estates market rent anticipated allocation differs to assumptions o Prescribing currently breakeven as no 17/18 data o CHC activity may be understated ytd o Mental Health investments made in excess of the agreed MH QIPP As a result the CCG is reporting that we still face a net risk of 464k in terms of delivering in year breakeven 3

4 Resource Limit The table below shows the current RL:- M2 opening Revenue Resource Limit (RRL) Month 2 changes Return of 2016/17 surplus Annual Resource Limit Recurrent 000 Non Recurrent 000 Total , ,514 2,937 2,937 Total RRL 158,419 2, ,451 Summary Financial Position Year to Date 489k of reserves generated by position to date Acute 239k under plan Continuing Care 42k under plan Prescribing 43k under plan Running Costs 37k under plan Mental Health 7k under plan Community Services 69k under plan See Appendix 1 for full Operating Cost Statement and Appendix 2 for Variance summary charts 4

5 AREAS Key Areas Risk, Over and Underspend Areas YTD Variance k Commentary Nottingham University Hospital NHS Trust 372k over plan Circle 531k under plan NUHT position is a combination of contract position ( 164k over plan) and untransacted QIPP ( 208k). The contract position is amended for anticipated adjustments in relation to services charged to the CCG that are NHSE responsibility. Due to the anticipated adjustments it is not possible to report precise POD variances, however, Elective is significantly below plan and NEL & A&E PODs above plan. Circle is under plan on elective and daycase ( 80k in month 1) and also shows a 71k favourable m1 variance on outpatient PODs. High cost drugs is 24k over plan. As with all acute contracts, m2 position is based on m1 contract data plus an estimate for m2. The m2 Circle position also includes a large fall out from the 2016/17 position. Free Choice Network - FCN Continuing Health Care - CHC 15k under plan 42k under plan Ramsay and BMI are under plan, with Elective and Daycase the key drivers Package costs are on plan for the period. Key risk for the year is the ramp up of QIPP/savings targets through the financial year. CHC service provider costs are the driver of the underspend, this is a non recurrent saving. Prescribing 43k under plan The position reflects a small favourable fall out from 2016/17 plus a small underspend on oxygen costs. No prescribing data has yet been received for 2017/18 therefore the main costs are assumed on plan. 5

6 QIPP QIPP trajectory for the year shows an increasing challenge through the financial year 6

7 Other Key Areas Running cost The CCG running costs are forecast to be within the 2,719k allowance for the year. The CCG has spent 408k on running costs for the reporting period, against a budget of 445k. Better Payment Practice Code (BPPC) NHS Organisations have a target of paying 95% of invoices from both NHS providers and external (non-nhs) organisations within 30 days by number and value. The CCG is forecasting to achieve these targets. The CCG s BPPC performance for the year to date is shown in the table below: Non-NHS (%) NHS (%) Volume 99.97% 100% Value 99.29% 100% Statement of Financial Position and Cash The Statement of Financial Position can be found in Appendix 3. The Cash Management regime requires the CCG to have a balance at the end of the month, of not more than 1.25% of that month s drawdown. This equates to 166k for the reporting period. The actual cash balance the end of the reporting period is 114k. The CCG is on target to remain within the Maximum Cash Drawdown for 2016/17. Primary Care Co-Commissioning The Primary Care Co-commissioning position has shown a small over spend for the reporting period and the forecast for the year is in line with plan. Better Care Fund (BCF) BCF spend is currently on plan. 7

8 Key Messages The year to date financial position is within plan The reported position carries a number of risks particularly as it is based on 1 month of acute data and no prescribing data is available at this stage of the year QIPP saving challenge increases throughout the financial year Net risk of 464k has been reported to NHSE in terms of our outturn financial position Recommendations The CCG Governing Body is recommended to: NOTE the financial position of the CCG for the reporting period. NOTE the continued risks faced in delivering 2017/18 control total and for the requirement of FRP savings to be delivered. APPROVE the Finance Report for the reporting period. Jonathan Bemrose Chief Finance Officer Date 13 June

9 APPENDIX 1 Operating Cost Statement 04N Rushcliffe CCG Operating Cost Statement Annual budget ( '000) 9 YTD budget ( '000) YTD Actual ( '000) YTD Variance ( '000) For the Period Ending: 31st May 2017 Co-Commissioning GMS/PMS Payments 11,813 1,969 1,974 5 Property Costs 1, Enhanced Services QoF 1, Other Co-Commissioning Total 15,806 2,588 2, Acute Services NUHT 54,278 9,162 9, SFHFT 2, EMAS 2, Circle - Nottingham Treatment Centre 11,508 1,918 1, FCN/Independent 1, Other 2, Acute Services Total 75,361 12,676 12, Mental Health Services NHT 8,914 1,506 1,506 0 Low Secure/Other 3, IAPT Mental Health Services Total 13,107 2,202 2,195-7 Better Care Fund Better Care Fund 5, Better Care Fund 5, Community Services CHP 7,585 1,264 1,256-8 Other 1, Community Services Total 9,180 1,453 1, Commissioning - Other Other 2, Commissioning - Other Total 2, CHC / FNC CHC/FNC 12,020 1,976 1, CHC / FNC Total 12,020 1,976 1, Primary Care Prescribing 16,589 2,765 2, LES Pathways 1, GP IT Meds Management Clinical 1, Other Primary Care Total 19,747 3,291 3, Programme Corporate Costs Programme Corporate Costs Programme Corporate Costs Mgt & Admin PAY 1, NON-PAY Mgt & Admin Total 2, Provisions Provisions Provisions Total Developments & Reserves Developments/Risk % TF National Reserve Contingency Reserves Total 2, Planned Surplus Budget Planned Surplus 2, Planned Surplus Total 2, TOTAL AVAILABLE RESOURCE 160,449 25,498 25,

10 APPENDIX 2 trend graphs (blue line = 2016/17 actuals, red line = 2017/18) 10

11 APPENDIX 3 Balance Sheet STATEMENT OF FINANCIAL POSITION AS AT 31st May 2017 Audite d Closing Ne t Open Bal at Balance Change Apr-17 for period '000s '000s '000s Non-current assets T otal non-current assets Current assets Inventories Trade and other receivables 4,372 14,517 10,145 Other Financial Assets Other Current Assets Cash and cash equivalents 27-1,579-1,606 T otal Current Assets 4,399 12,938 8,539 Non Current Assets classified as "Held for Sale" T otal assets 4,399 12,938 8,539 Current Liabilities Trade and other payables -18,378-17, Other Financial Liabilities Other Liabilities Borrowings Provisions T otal current liabilities -18,454-17, T otal assets less current liabilities -14,055-5,011 9,044 Non-current liabilities Trade and other payables Other Financial Liabilities Other Liabilities Borrowings Provisions T otal assets employed -14,055-5,011 9,044 Financed By T axpayers' equity General Fund -14,055-5,011 9,044 Revaluation reserve Donation reserve Charitable Reserve T otal taxpayer's equity -14,055-5,011 9,044 11