2013/005. Subject: Author: Lead Clinician KCCG): Purpose:

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213/5 Subject: Author: Lead Clinician KCCG): Purpose: Date of meeting: Finance, Performance & Quality Simon Bolitho, Deputy Director of Finance Katherine Paddock, Finance and Performance Manager

1 213/5 Subject: Author: Lead Clinician KCCG): Purpose: Date of meeting: Finance, Performance & Quality Simon Bolitho, Deputy Director of Finance Katherine Paddock, Finance and Performance Manager Natalie Jones, Deputy Director of Professional Practice & Quality To update the Board on the finance and performance position at 28 February April 213 Summary of initiative and benefits: The Board paper indicates the position on Finance, Performance and Quality of the PCT during as at 28 th February 213 (Month 11) Stakeholder engagement: who has been involved? Incorporated in performance report What are the equality and human rights implications? Incorporated in performance report Quality and patient experience impact Incorporated in performance report Finance implications/costs Incorporated in performance report Key risks and mitigating actions Finance o Delivery of QIPP savings and Continuing Healthcare costs Improving care for our patients with long term conditions o Stroke services most providers Improving our patients safety and experience o Same Sex Accommodation Improving urgent care service for our patients o A&E clinical indicators and A&E 4 hour waits o Ambulance response and handover times Improving our population s mental health o CAMHS Decision required The Board is recommended to resolve to note the contents of this report. 1

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3 CORNWALL AND ISLES OF SCILLY PRIMARY CARE TRUST Finance Schedules REPORT ON FINANCIAL PERFORMANCE - 212/13 MONTH 11 Schedule 1 KEY OUTCOMES RISK ASSESSMENT OBJECTIVE CURRENT FORECAST COMMENTARY POSITION POSITION A Deliver agreed operating surplus of 8.822million Close to Plan Underlying pressures continuing at Month 11. Overall delivery position remains close overall but not without risks. B Deliver agreed net 'standard' capital spend of 3.7million Capital funding has been adjusted to reflect slippage on some schemes. Firm plans are in place to utilise revised allocation. C Manage within agreed cash allocations Month 11 cash utilisation is now within the 'straight line' share of the cash limit to date. We remain confident of year-end delivery. D1 Deliver Better Payment Practice Code 95% commitment: Number of invoices paid in time 92.11% Month 11 position continues to be a little below the 95% target. Work continues with budgetholders to clear invoices promptly as we approach 31 March. D2 Deliver Better Payment Practice Code 95% commitment: Value of invoices paid in time 98.61% Month 11 position continues to be well ahead of the target. 3

4 CORNWALL AND ISLES OF SCILLY PRIMARY CARE TRUST Finance Schedules REPORT ON FINANCIAL PERFORMANCE - 212/13 MONTH 11 Schedule 2 NET REVENUE EXPENDITURE POSITION FULL-YEAR YEAR TO DATE (MONTH 11) BUDGET BUDGET SPEND VARIANCE ' ' ' ' KERNOW CCG DELEGATED BUDGETS Royal Cornwall Hospitals Trust 258,13 236, , Plymouth Hospitals Trust 59,283 54,343 54,343 Northern Devon Healthcare Trust 6,11 5,51 5,51 Royal Devon and Exeter Foundation Trust 2,493 2,286 2, Independent Sector Treatment Centres 7,244 6,64 6, Duchy Hospital 1,634 9,748 11,892 2,144 South Western Ambulance Service Foundation Trust 22,431 2,562 2, Peninsula Community Health (formerly Community Health Services) 78,695 72,136 72,136 Continuing Healthcare & Funded Nursing Care 47,296 43,495 5,97 6,62 Cornwall Partnership Foundation Trust 39,254 35,983 35,983 Mental Health Pooled Fund 29,378 26,93 26,93 Other Commissioning Budgets 68,457 63,482 66,839 3,357 COMMISSIONING SUB-TOTAL 629,36 577, ,958 12,224 PRESCRIBING AND OXYGEN COSTS 91,315 84,197 79,869-4,328 POSITION ON DEFINED KERNOW CCG DELEGATED BUDGETS 72, , ,827 7,896 PCT RETAINED BUDGETS SPECIALIST COMMISSIONING 68,458 62,753 62, PRIMARY CARE MEDICAL CONTRACTS 8,655 73,934 75,528 1,594 PHARMACY CONTRACTS 19,63 17,969 18, DENTAL CARE CONTRACTS 18,63 15,978 14,482-1,496 OPHTHALMIC COSTS 5,377 4,929 4, POSITION ON DEFINED PCT RETAINED BUDGETS 192, , , AREAS REQUIRING FURTHER WORK TO ALLOCATE ADMIN & TECHNICAL BUDGETS 24,871 22,75 23, RESERVES 2,346 8,584-8,584 POSITION ON UNALLOCATED BUDGETS 45,217 31,289 23,369-7,92 SUMMARY POSITION POSITION ON DEFINED KERNOW CCG DELEGATED BUDGETS 72, , ,827 7,896 POSITION ON DEFINED PCT RETAINED BUDGETS 192, , , POSITION ON UNALLOCATED BUDGETS 45,217 31,289 23,369-7,92 TOTAL PCT NET EXPENDITURE POSITION 957, , ,793 1 REVENUE RESOURCES: CONFIRMED ALLOCATIONS 963,265 ANTICIPATED ALLOCATIONS 3,551 PROJECTED REVENUE RESOURCE LIMIT 966, ,87 876,87 SURPLUS 8,822 8,87 8,77 1 4

5 CORNWALL AND ISLES OF SCILLY PRIMARY CARE TRUST REPORT ON FINANCIAL PERFORMANCE - 212/13 MONTH 11 POTENTIAL OUTTURN RANGES Finance Schedules Schedule 2a FULL-YEAR FORECAST RANGE ASSESSMENTS BUDGET LIKELY BETTER WORSE CASE ' ' ' ' KERNOW CCG DELEGATED BUDGETS Royal Cornwall Hospitals Trust 258, Plymouth Hospitals Trust 59, Northern Devon Healthcare Trust 6, Royal Devon and Exeter Foundation Trust 2, Independent Sector Treatment Centres 7, Duchy Hospital 1,634 2,45 2,1 2,7 South Western Ambulance Service Foundation Trust 22, Peninsula Community Health (formerly Community Health Services) 78, Continuing Healthcare & Funded Nursing Care 47,296 7,15 6,65 7,75 Cornwall Partnership Foundation Trust 39, Mental Health Pooled Fund 29, Other Commissioning Budgets 68,457 3,685 3,3 4,3 COMMISSIONING SUB-TOTAL 629,36 13,45 1,625 16, PRESCRIBING AND OXYGEN COSTS 91,315-4,4-4,8-4,1 POSITION ON DEFINED KERNOW CCG DELEGATED BUDGETS 72,621 9,5 5,825 11,9 PCT RETAINED BUDGETS SPECIALIST COMMISSIONING 68, PRIMARY CARE MEDICAL CONTRACTS 8,655 1,85 1,725 1,975 PHARMACY CONTRACTS 19, DENTAL CARE CONTRACTS 18,63-1,425-1,6-1,1 OPHTHALMIC COSTS 5, POSITION ON DEFINED PCT RETAINED BUDGETS 192, ,275 AREAS REQUIRING FURTHER WORK TO ALLOCATE ADMIN & TECHNICAL BUDGETS 24,871 1, ,25 RESERVES 2,346-1,425-1,95-9,85 POSITION ON UNALLOCATED BUDGETS 45,217-9,383-1,2-8,6 SUMMARY POSITION POSITION ON DEFINED KERNOW CCG DELEGATED BUDGETS 72,621 9,5 5,825 11,9 POSITION ON DEFINED PCT RETAINED BUDGETS 192, ,275 POSITION ON UNALLOCATED BUDGETS 45,217-9,383-1,2-8,6 TOTAL PCT NET EXPENDITURE POSITION 957, ,7 4,575 ADDITIONAL MITIGATIONS/QIPP ACCELERATION TO DELIVER PLAN (LIKELY CASE ONLY) n/a 5

6 CORNWALL AND ISLES OF SCILLY PRIMARY CARE TRUST REPORT ON FINANCIAL PERFORMANCE - 212/13 MONTH 11 REVENUE RESOURCE LIMIT ANALYSIS Fina Memo: Revenue Revenue Revenue Resource Resource Cash Limit Limit Allocation ' ' ' Status PCT OPENING BASELINE 941, ,848 Confirmed in National Allocations CONFIRMED ADJUSTMENTS Cancer Drugs topslice School Fruit Topslice DAAT Pooled Treatment Budget -1, ,461-1, ,461 HPV funding Cash adjustment re: depreciation -4,221 Headroom topslice Return of headroom to PCT -17,985 14,985-17,985 14,985 Central Budgets Adjustments 3,92 3,92 Central Budgets Adjustment - RCHT passthrough Family Nurse Partnership -1,8 3-1,8 3 Liaison & Diversion Funding National top-slice for Specialist Commissioning Public Health Transition Funding -5, , Adjustment for depreciation -5 CCG Development funding Return of 211/12 Cancer Drugs underspend to SHA ISFE project funding Dementia funding Pertussis outbreak control programme for pregnant women 1 1 Technical cash amendments: Movement in year to year surplus -252 Return of prior year surplus to PCT 8,57 National top-slice for Overseas Visitors & Gibraltar Dental Access Funding Transfer in respect of planned capital grants - Local Authority 1,865 1,865 Transfer in respect of planned capital grants - 3rd Party 1,67 1,67 CCG Development Fund Investment in Technology - RCHT 3 3 Investment in Technology - CPFT 8 8 FT development adjustment - RCHT Central Budgets - RCHT 1, 1, Liaison & Diversion Funding Funding transfer: transition 1,3 1,3 Winter Funding - LA 1,96 1,96 Winter Funding - NHS 1,14 1,14 Pass-through funding: RCHT 6, 6, Return of remaining PCT Headroom to PCT 3, 3, Technical adjustment: cash funding adjustment 7,163 21,417 Sub Total : Confirmed Adjustments 21,417 15,532 TOTAL CONFIRMED RESOURCE LIMIT AS AT MONTH , ,38 ANTICIPATED ADJUSTMENTS Technical resource amendments: Impairment funding 2,5 Technical resource amendments: IFRIC 12 funding 1,1 Technical resource amendments: Cost of Capital -115 Technical resource amendments: Donated assets 66 3,551 Sub Total : Anticipated Adjustments 3,551 PROJECTED REVENUE RESOURCE LIMIT 966, ,38 RECONCILIATION OF MOVEMENT ON REVENUE RESOURCE LIMIT PROJECTED REVENUE RESOURCE LIMIT (MONTH 1) 966,65 Technical resource amendments: Donated assets 66 Adjustment to top-slice for Guernsey and Crown Depencies 1 PROJECTED REVENUE RESOURCE LIMIT (MONTH 11) 966,

7 Improving Care for our Patients with Long Term Conditions Cancer 1 Table 1 below shows performance against our cancer targets from 1 to 31 January 213. Table 1: NHS Cornwall & Isles of Scilly Performance against cancer targets during the month of January 213 NHS Cornwall & Isles of Scilly as a commissioner Target (%) Actual (%) Maintain cancer waiting time targets 62 day wait %ile 85% 75.7% Maintain cancer waiting time targets 31 day wait %ile 96% 97.1% Direction of travel (distance from target) compared to previous month Maintain cancer waiting time targets 2 week wait %ile Percentage of patients referred with 'breast symptoms' who are seen within 14 days subsequent treatment within 31 days (chemo) subsequent treatment within 31 days (surgery) subsequent treatment within 31 days (radiotherapy) treatment within 62 days of referral from NHS cancer screening services treatment within 62 days of consultant deciding to upgrade their priority 93% 95.6% 93% 94.7% 98% 1..% 94% 92.5% 94% 98.% 9% 92.6% 9% 75.% 7

8 2 Table 2 shows performance against stroke targets from 1 to 31 January 213. Stroke Table 2: Stroke Targets 1 to 31 January 213 Percentage of people who have a TIA and are scanned and treated within 24 hours Percentage of people who have a CT scan in 24 hours Percentage of people who spend 9% of their time on a stroke ward Target CIOS Provider PCT RCHT PHNT NDHCT 6% 63.6% % % 88.% 97.% 8% % 62.5% 69.% Improving Urgent Care Service for our Patients Accident and Emergency Table 3: The percentage of patients spending less than 4 hours in A&E Provider Royal Cornwall Hospitals NHS Trust Plymouth Hospitals NHS Trust Northern Devon Healthcare Trust Target January 213 February 213 Year to date 95% 94.23% 88.63% 93.98% 95% 95.4% 95.16% 95.8% 95% 97.95% 97.96% 98.57% Fractured Neck of Femur Table 4: Fractured Neck of Femur (aged 75+), operated on within 36 hours as at 31 January 213 Provider Local target Actual % and numbers of patients Variance Direction of travel (distance from target) Compared to previous month Royal Cornwall Hospitals NHS Trust 75% 76.27% (45/59) 1.27% Plymouth Hospitals NHS Trust 7% 7.97% (44/62).97% 8

9 Improving Elective Care service for our Patients Referral to Treatment Table 5: Proportion of Patients Treated within 18 Weeks from GP Referral to Treatment for period 1 to 31 January 213 Target Percentage Full Provider View NHS Cornwall & Isles of Scilly as a commissioner RCHT PHNT R,D & E NDHT Admitted Pathways Non- Admitted Pathways Incomplete Pathways 9% 94.8% 94.3% 92.3% 9.2% 94.8% 95% 98.6% 98.9% 96.5% 97.8% 99.3% 92% N/A 96.4% 92.1% 92.9% 98.1% 9

NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY 24 April 2018

Part 1 Part 2 NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY 24 April 2018 Title of report Finance Report for 12 months 2017/18 Purpose of the report and key highlights To provide members with