Primary Care Finance Report Month 4 (July 2016), 2016/17

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1 Primary Care Finance Report Month 4 (July 2016), 2016/17 Att. 13

2 Primary Care Commissioning Summary - NHS Kingston received an allocation of 24,576k for 2016/17, which represents growth of 3.57%. - There is a shortfall in allocation, see details on page 3 - There have been changes to admin functions following delegation and primary care support service functions have been transferred from the current provider to Capita, with a phased transfer of service. - Following the closure of Primary Care Support England (PCSE), details of changes to governance and CCG policies are being worked through - GP IT Capital has been approved by the CCG delivery group, details are on page 9 2

3 Delegated Primary Care Allocation - NHS England finance teams have calculated budgeted expenditure for 2016/17 as 24,980k, the CCG is required as part of its business rules to hold a 1% non-recurrent reserve and a 0.5% contingency reserve, therefore the total requirement is 25,349k this is a total shortfall in allocation of 773k. - 1% non-recurrent reserve and 0.5% contingency reserve have been funded from the CCG baseline. This leaves the CCG with shortfall of 404k, primary care investment funds have been used to support this. MEMORANDUM '000 Primary Care Delegated Comissioning Allocation 24, /17 Budget Requirement 24,980 1% Non-recurrent Reserve % Contingency 123 Total Requirement 25,349 Shortfall in allocation (773) Less QIPP (Est 0.5% Transactional) (125) Shortfall in allocation after QIPP (648) 3

4 Delegated Primary Care Commissioning - NHS England have applied QIPP targets to primary care budgets. However, as no QIPP schemes have been identified, the CCG has not reflected any QIPP savings in delegated budgets or the forecast position - At month 4, NHS England teams reported a year to date underspend of 133k, which assumes the QIPP target will be met. - As access to detailed financial information is limited, Kingston CCG has prudently forecasted to budget. However at month 4, year to date overspends are reported for premises costs. See page 5 for details /16 spend is paid by KCCG, however a transfer will be made to pass these costs on to NHS England. 4

5 Delegated Primary Care Commissioning Description of Budget Budget Year To Date Annual July 2016 March 2017 Estimated Spend Annual Budget Forecast Outturn APMS Core Contract 396, ,887 6,629 1,189,546 1,189,546 0 PMS Core Contract 3,205,504 3,109,599 95,905 9,616,564 9,616,564 0 GMS Core Contract 2,399,754 2,362,994 36,760 7,199,268 7,199,268 0 GMS MPIG 81,092 81,102 (10) 243, ,307 0 QOF Achievement 186, ,787 (2,581) 558, ,749 0 QOF Aspiration 438, ,294 2,581 1,316,736 1,316,736 0 DES 373, ,973 22,378 1,120,432 1,120,432 0 Premises costs 1,076,823 1,107,359 (30,536) 3,230,784 3,230,784 0 Seniority 124, ,922 1, , ,257 0 Personally Administered Drugs 43,742 43, , ,329 0 Total - Delegated Commissioning 8,326,245 8,193, ,585 24,979,973 24,979,

6 Other Primary Care Budgets Description of Budget Budget Year To Date Annual July 2016 March 2017 Estimated Spend Annual Budget Forecast Outturn The CCG continues to commission the following primary care services, with no change to arrangements. Delegated Commissioning 8,326,245 8,193, ,585 24,979,973 24,979,973 0 Local Commissioned Services 556, ,530 88,809 1,668,848 1,668,848 0 Kingston Medical Services 202, , , ,027 0 Primary Care IT (Revenue) 174, ,508 8, , ,000 0 PRIMARY CARE GRAND TOTAL 9,259,460 9,038, ,858 27,779,848 27,779,848 0 Locally Commissioned Services Quarter 1 activity and expenditure data was available in July and this has been used to report the year to date position. At month 4 overspends have been reflected in ABPM, phlebotomy, leg ulcers and wound management. The forecast position is reported to budget at this early stage, we expect to manage the overspends by introducing caps to some of the LCS as discussed at the LCS meeting in July. 6

7 Other Primary Care Budgets Kingston Medical Service This is non-recurrent funding for investment in transformation, primarily to be used for the equalisation of primary care contracts. The primary care investment pot has been reduced in month 4 to support the 404k shortfall in the primary care delegated commissioning budget. Fortnightly KPI Task and Finish Groups are being held to agree and complete local KPI s Primary Care IT The CCG expects to spend the budget in full. Funds are used for routine IT spend i.e. licencing, support, replacement of equipment. Investment in Kinesis and DXS is also funded from this budget. The total primary care budget in 16/17 is 27,780k, however there is also additional GP expenditure in other CCG commissioning budgets details are shown on page 8. 7

8 Other GP Expenditure Description of Budget OTHER GP EXPENDITURE WITHIN OTHER COMMISSIONING BUDGETS Budget Year To Date GPs in A&E extension This has been extended to the end of September and is funded via the (SRG) systems resilience monies. Annual July 2016 March 2017 Estimated Spend Annual Budget Forecast Outturn GP s with special interests (GPSWIs) These include dermatology, diabetes tier 3, neurology, urology and vasectomy services. Other GP expenditure This relates to shockwave therapy, the forecasted reflects maximum capacity for 16/17. GPs in A&E 73,438 73, , ,157 0 GP with Special Interests 115, ,688 13, , ,364 31,233 Other GP Expenditure 6,667 5, ,000 17,490 2,510 GP Collaborative Fees 32,908 28,070 4,838 98,735 84,209 14,526 OTHER GP EXPENDITURE GRAND TOTAL 228, ,025 18, , ,220 48,269 Collaborative Fees This relates to GP claims for various assessments e.g. Mental Heath & Looked after Children. The reported position is based on Quarter 1 data. 8

9 Primary Care Capital Funds Capital Investments - GP IT Capital investments of 373k have been approved in principle by NHS England and by the CCG delivery Group - 5.4m of bids were made via the ETTF (Estates and Technology Transformation Fund), some of our bids have been accepted onto the first gateway and further due diligence is taking place. SUMMARY TOTAL no of schemes Estimated Total Capital Costs TOTAL OF ESTATES BIDS 14 4,613,482 TOTAL OF TECHNOLOGY BIDS 7 793,410 GRAND TOTAL 21 5,406,892 - NHS England are accepting expressions of interest from practices for Improvement Grants, it is the intention that practices who were unsuccessful in reaching the first gateway for ETTF estates bids will submit through this route. 9

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