Kingston Clinical Commissioning Group Report Summary

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Kingston Clinical Commissioning Group Report Summary Meeting Title Governing Body in public Date 7 th November 2017 Report Title Finance Committee Minutes Agenda Item 15 Attachment O1 Purpose (please

1 Kingston Clinical Commissioning Group Report Summary Meeting Title Governing Body in public Date 7 th November 2017 Report Title Finance Committee Minutes Agenda Item 15 Attachment O1 Purpose (please indicate with X) Approval/ Ratification Discussion / Comment Information x Report Author: (name & job title) Presented by: (name & job title) MINUTES OF THE FINANCE COMMITTEE HELD ON MONDAY 24 th JULY rd FLOOR CONFERENCE ROOM, GUILDHALL 1, KINGSTON PRESENT: David Knowles Lay Member & Vice Chair Jim Smyllie Lay Member Phil Moore Governing Body GP Annette Pautz Governing Body GP Naz Jivani Governing Body Chair Jenny Sinnott Head of Finance IN ATTENDANCE: Ben Okoye Dep Director of Finance, NEL CSU Laura Winder NEL CSU Julia Gosden Director of Commissioning Jo Dandridge Business Manager - Minutes APOLOGIES: James Murray Chief Finance Officer, SWL Alliance Tonia Michaelides Managing Director Yarlini Roberts Local Director of Finance, K&R LDU Paul Gallagher Lay Member & Audit Chair 17/147 WELCOME AND APOLOGIES: Those present were welcomed to the meeting. 17/148 DECLARATIONS OF INTEREST: There were no declarations. 17/149 MINUTES OF THE LAST FINANCE COMMITTEE MEETING The minutes of the last meeting held on Monday 26 th June 2017 were agreed as an accurate record. Version: Final O1-1

2 17/150 MATTERS ARISING None. 17/151 FINANCE REPORT MONTH 3 A copy of the Month 3 Finance Report had been circulated. Members noted that the SWL estates and space utilisation strategy is under review, with potential implications for Kingston CCG properties. Members were also presented with a summary of the Month 3 position as follows: CCG expects to meet its planned in year 0.5% surplus of 1,151k Cash targets and Better Payment Practice Code statistics were met in Month 3 Capital PIDs have been approved by NHS England CCG is marginally behind target for QIPP year to date but working towards full delivery in 2017/18 Non-recurrent allocations of 706k and recurrent allocations of 5k were received in Month 3 Acute Commissioning Members were advised that the year to date overspend in acute commissioning was currently 928k however at month 3 this overspend was mitigated through reserve utilisation. Members also noted the variation in elective admissions had reduced in May 2017 due to a marked increase against plan at St George s and a smaller increase against plan at Kingston Hospital. The variation year to date in non-elective admissions had increased in May 2017 mainly due to the delay in set up of locality teams in the Kingston Co-ordinated Care provider alliance and the activity increases relating to the CDU at Kingston Hospital. Non Acute Commissioning Mental Health Members were informed that mental health placements were overspent by 46k due to invoicing for a patient s hospital stay. The invoices are in dispute and additional evidence has been requested from the provider. Continuing Care Members were informed that the year to date continuing care position showed an underspend of 225k however this was not expected to continue throughout the year. The continuing care team will continue to review CHC clients to ensure they still meet the CHC criteria. Primary Care Members noted that prescribing costs were low in April 2017 compared to the previous 2 years spend hence the reported year to date underspend. However it was expected that by year end there will be an overspend of 74k if historic trends are applied. Version: Final O1-2

3 Members were informed that GP IT is forecast to overspend by 11k, the cost pressure due to NHS England transferring Health & Social Care Network portal costs to the CCG which exceeds the allocation received in Month 3. Members were also advised that Primary Care Delegated commissioning budgets in Month 3 is reporting a cost pressure for QOF and Seniority. However overall costs are still forecast to be within budget/allocation. Risks and Mitigations A list of risks and mitigations of the 2017/18 reported position updated as at Month 3 had been submitted to NHS England. The risk adjusted control total is a surplus of 1.17m, the CCG is still able to deliver the 0.5% planned in year surplus. QIPP Performance Members were informed that of the 26 QIPP schemes identified for 2017/18, there were 8 of these schemes rated as red. The end of life care QIPP scheme is still being worked up, there had been an issue with project resource that had caused some delays to this starting. Neurology community shifts QIPP scheme is still in progress and a SWL wide project for neurology services that is being looked at by the planned care team. Ophthalmology increased community position is not expected to start until later in the year, limited project resource has been an issue on this project. The Finance Committee NOTED the Month 3 Finance Report. 17/152 NEL CSU INTEGRATED REPORT Members received the Month 2 consolidated view of Kingston s CCG contracting performance for information 17/ FINANCIAL PLAN Members received details of the financial plan for approval. Members noted the final version of the financial plan had been submitted to NHS England on 30 th March A copy of the assurance feedback from NHS England recently received confirming that our financial plans were assured was tabled for information. The plan submitted reported meeting all business rules in both and as follows: Delivery of an in-year 0.5% surplus in 2017/18 and in year breakeven in 2018/19; Maintaining the 0.5% mandatory contingency reserve in both years; Maintaining the 1% non-recurrent reserve, with half remaining uncommitted; Meeting of the Mental Health Investment Standard requirement; Providing for the non-recurrent investment of 1.50/head for primary care in both years; and QIPP savings required of 11.5m in 2017/18 and 8.7m in 2018/19. Members of the Finance Committee expressed their thanks to the finance team for their hard work preparing the financial plan for Version: Final O1-3

4 The Finance Committee APPROVED the Financial Plan. 17/154 QIPP A copy of the 2017/18 QIPP dashboard for Month 3 had been circulated to members for information. The following red rated QIPP areas were highlighted: End of life care Medicines Management new models of care and meds optimisation Neurology community shifts Ophthalmology increased community provision Planned care transformation Reduction in outpatient follow up rates Respiratory KPI 17/155 BUSINESS CASE Improving Access to Psychological Therapies (IAPT) Services in Kingston A copy of an outline Business Case for the Kingston IAPT service requesting additional funding to meet the NHS England increased access performance targets was presented to members for approval. Members noted that the business case had been approved by the Delivery Group at its meeting on 20 th June 2017 and they had requested a detailed implementation/action plan and data on the number of self-referrals both of which would be presented to the next Delivery Group meeting. Members discussed the issues with recruitment of staff for the service with the national drive that was underway and also requested that further work be done around interlinking long term conditions with the Expert Patient Programme. Members also raised the issue of needing a mechanism to ensure oversight of those patients that choose to self-refer into the service and this question would be raised at the next CQRG meeting. The Finance Committee RATIFIED the business case and noted that the contract variation detail would be prepared separately for sign off by the Managing Director and Local Director of Finance. 17/156 CAPITAL PIDs Members noted that as part of the financial planning process, the CCG submitted capital plans and bids to NHS England for approval by the London Capital Committee on 11 th July Members received copies of the following 3 PIDS that had previously been reviewed and approved by the Delivery Group at their meeting on 20 th June 2017: Version: Final O1-4

5 Your Healthcare CIC IT rolling replacements Members noted that as a CIC, Your Healthcare cannot bid for capital directly. Therefore the CCG would pass the capital grant to them on the understanding that there would be no financial consequences for commissioners resulting from the capital expenditure. GP IT Members noted that GP IT are assets held by NHS England. The CCG will procure the assets and recharge NHS England. CCG IT rolling requirements Members noted that CCG IT rolling replacements are in line with the SWL IT strategic plans for integrated working. Depreciation costs are outlined in the PID. Support and maintenance costs would be covered under the current support contract until the end of the 3 year licensing agreement. the The Finance Committee APPROVED the planned capital expenditure as outlined in above three PIDs. 17/157 TENDER WAIVER Kingston Care Record Members received details of a tender waiver for retrospective approval by members and they were informed that due to capital approval received by the CCG late in December 2016 for the Kingston Care Record (KCR), and due to timescales quotes were not obtained even though the purchase was above 15k as per procurement and financial policies. The value of the tender waiver was 215k. Members were not comfortable with a retrospective tender waiver. However, it was reported that the money spent with the software suppliers had enabled considerable progress with the programme over the last six months. The Finance Committee APPROVED the Kingston Care Record Tender Waiver subject to a view from the Auditors that there could be no legal challenge. 17/158 ANY OTHER BUSINESS None. 17/159 DATE OF NEXT MEETING Tuesday, 26 th September 2017 ( pm) Future Meeting Dates: Tues 24 th October 2017 Tues 28 th November 2017 Tues 19 th December 2017 Version: Final O1-5

Kingston Clinical Commissioning Group Report Summary

Kingston Clinical Commissioning Group Report Summary Meeting Title Governing Body in public Date 6 th March 2018 Report Title Finance Committee Minutes Agenda Item 12 Attachment J1 Purpose (please indicate