Primary Care Finance 2017/18. Finance Report on the Primary Care Budgets 30 September 2017 Produced by Finance

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Colleen Randall
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1 Primary Care Finance 2017/18 Finance Report on the Primary Care Budgets 30 September 2017 Produced by Finance

2 Contents 1. Background 2. Month 6 Financial Position 3. Risks 4. Recommendations 2

3 Background Primary Care Delegated Commissioning was introduced 1 st April The financial accounting for this area is done with NHS England staff working exclusively for South West London CCGs. Given that this team are now based locally this should address some of the communication and detail issues experienced in the first year of operation. This paper reflects information available to the CCG to support the financial position in the period ending 30 th September It should be noted that this position includes general primary care commissioning that has always been the responsibility of the CCG as well as picking up prescribing information. 3

4 Contents 1. Background 2. Month 6 Financial Position 3. Risks 4. Recommendations 4

5 Month 6 Financial Position (1 of 3) Year To Date Full Year Forecast Outturn Merton CCG - PRIMARY CARE & PRESCRIBING Budget Actual Variance Budget Forecast Variance 000's 000's 000's 000's 000's 000's PRESCRIBING 11,685 11,685 (0) 23,369 23, MEDICINES OPTIMISATION (3) (6) CENTRAL DRUGS TOTAL PRESCRIBING 12,067 12, ,134 23, PRIMARY CARE CONTRACT VALUE AND KPI'S 5,059 4, ,498 20, PRIMARY CARE OTHER DELEGATED BUDGET 9,023 9,210 (187) 8,097 8,305 (208) TOTAL PRIMARY CARE DELEGATED BUDGET 14,082 14,165 (83) 28,595 28,595 0 LES - NEAR PATIENT TESTING 2 2 (0) LES - ATRIAL FIBRILATION LES - ANTI COAG (3) (7) LES - PHLEBOTOMY (1) (2) LES - POST OPERATIVE WOUND CARE (2) (4) LES - MENORRAGHIA (0) LES - GYNAECOLOGY (0) LES - UROLOGY (0) LES - DIABETES 2 2 (0) LES - OTHER 0 0 (0) LOCAL ENHANCED SERVICES (8) (13) TOTAL OUT OF HOURS 1, ,024 1, GP - STATUTORY MEDICAL FEES (8) PRIMARY CARE OTHER PRIMARY CARE TRANSFORMATION FUND ,606 1,606 0 WALK IN CENTRE (UNREGISTERED PATIENTS) TOTAL PRIMARY CARE OTHER ,559 2, TOTAL PRIMARY CARE & PRESCRIBING 28,182 28, ,786 57,

6 Month 6 Financial Position (2 of 3) Overview For all primary care an under spend of 36,000 is showing at month 6 (YTD). The forecast year-end underspend is 374,000. Prescribing Prescribing is currently showing an overall underspend of 32,000 based on currently available data which is always two month out of date. We have become aware that expected savings to come through later in the year may not materialise due to certain generic drugs not being available in which case more expensive branded drugs will be used instead. This will be kept under review and may affect the forecasts moving forward. For this reason, although at month 6 our forecast outturn is an underspend of 217,000, There is a risk that this will be eroded by the end of the financial year. Other Primary Care The other significant underspend forecast in the Primary Care and Prescribing budgets is in the Out of Hours Services where the budget is reporting a year to date surplus of 71,000 with a forecast outturn underspend of 142,000. 6

7 Month 6 Financial Position (3 of 3) Delegated Primary Care 6 months results to 30th September are showing an over-spend of 83k on the budget to date, but the full year forecast remains on plan. There has been a reduction in the monthly run rate over spend because last month we had to account for a shortfall in accruals for enhanced services and QOF along with unexpected costs related to a contract transfer. However this was a one off adjustment and the actuals have moved more in line with the plan. The PMS core contract costs include 132k for additional caretaking and short term contract payments incurred. To note that this has now ended a new contract holder has been appointed. The results to date include a 32k under-spend on personally administered medicines budget, but this under-spend will erode later in the year when the flu season kicks in. QOF expenditure is 40k below budget which is due to the level of aspiration payments being paid as a result of 2016/17 final achievement. The budget was based on a higher achievement when the results of 16/17 were unknown. The year to date and forecast for DES costs now reflect the latest position in sign-up, and record a saving of 11k on budget in the year to date. 7

8 Contents 1. Background 2. Month 6 Financial Position 3. Risks 4. Recommendations 8

9 Risks/Mitigations Risk Finance team not embedded within Merton CCG. Unforeseen costs emerge such as premises or growth above forecast. Prescribing savings do not materialise. Prescribing pressures emerge that are beyond the control of the CCG NHS 111 activity increases above current forecast. Mitigation The team is now located within the Sector and has regular meetings with SWL CCG finance teams Other expected costs do not emerge/overall CCG financial position Overall CCG financial position Apply to access the NHSE risk pool Overall CCG position Overall CCG financial position 9

10 Contents 1. Background 2. Month 6 Financial Position 3. Risks 4. Recommendations 10

11 Recommendations The Primary Care Committee are asked to: 1. Note the financial position as reported in this paper for the period ending 30 th September Note that the CCG is reliant upon NHSE for supporting information. 3. Acknowledge the further risks outlined in this paper. 11

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

Primary Care Finance Report Month 4 (July 2016), 2016/17 Att. 13 Primary Care Commissioning Summary - NHS Kingston received an allocation of 24,576k for 2016/17, which represents growth of 3.57%. - There