NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY 30 th April 2013

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1 Agenda Item No. 8.0 Part 1 X Part 2 NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY 30 th April 2013 Title of Report Purpose of the Report 2013/14 Financial Plan To provide members of the CCG Governing Body with an update of the progress to date and latest position on the financial plan for 2013/14 and the PCT financial position for the year-ending 31 st March Actions Requested Decision X Discussion X Information X Strategic Objectives Supported by the Report Recommendations 1. Consistently achieving local and national quality standards. 2. Delivering an increasing proportion of services from primary care and community services from primary care and community services in an integrated way. 3. Reduce the gap in health outcomes between the most and least deprived communities in Trafford. 4. To be a financial sustainable economy. The members are asked to note the contents of this report and subject to any suggested changes, note approve the revised financial plan for 2013/14 as at April and note that the final plan will be presented in May Discussion history prior to the Governing Body Financial Implications Risk Implications Impact Assessment Previously discussed at the QFP Committee and CCG Board in February and March Discussed in detail at the QFP Committee 19 th March and with the LAT Director of Finance 20 th March. As described within the paper. There is a risk that the CCG will not deliver its statutory financial duties, which may in turn impact upon its plans to deliver integrated care within Trafford. Investments and disinvestments will be given due consideration under the impact assessments framework, where appropriate

2 Communications Issues Public Engagement Summary Prepared by Responsible Director NA NA Joe McGuigan, Deputy Chief Finance Officer Tim Barlow, Chief Operating Officer/Chief Finance Officer Page 2

3 FINANCIAL PLAN /14 To: CCG Governing Body, 30 th April Introduction The members will be aware that the CCG has submitted initial plans to the GM LAT in line with the financial planning framework for 2013/14. At the time of submission, work was ongoing in regards to the un-weaving of specialised services and this had delayed the signing of Acute service contracts. As a consequence, the financial plan signed of by the CCG Committee in March was considered to be a draft and subject to further changes. As discussions are still ongoing, primarily in regards to specialised services, primary care baselines and the use of the monies for non-recurrent purposes, the financial plan attached with this report is still likely to change although any further changes will be reflected within a final financial plan that will be presented for consideration and approval at the May CCG Governing Body. Members will also be aware that it was imperative that the PCT delivered its agreed final year-end target surplus so as to ensure that the CCG did not inherit any legacy debt and this report also provides an update on the final year-end position for the PCT /13 Outturn Trafford PCT (Pre-Audit) It is pleasing to report that as detailed in Appendix 1 the pre-audit surplus as at 31 st March is 501k. The Governing Body will be aware that the target surplus for Trafford PCT was revised to 500k with agreement from GM Cluster and NHS North and accordingly this will mean that the CCG does not inherit any legacy debt from the PCT. In regards to financial performance, the members will see that the NHS Acute Providers over-spending for 2012/13 was 4,737k which was 53k lower than the month 11 position and 263k lower than the month 11 forecast outturn. 2.1 Trafford Division of CMFT 1,025k over-spent at m11 The PCT through the CCG agreed a full and final settlement with CMFT of 1,119k for the year which included the full deduction for readmissions of 1,071k. As reported in previous months, CMFT also agreed to waive the net charge between critical care and rehabilitation costs at the year-end resulted in a net saving of 526k. Page 3

4 Further savings as a result of monthly data validation and clinical coding challenges were factored into the final agreement. 2.2 Central Manchester Trust - 1,195k over-spent at m11 The PCT through the CCG agreed a full and final settlement with CMFT of 1,304k for the year that includes the full deduction for readmissions of 279k. Further savings were factored into the final agreement as a result of monthly data validation and clinical coding challenges. 2.3 University Hospital of South Manchester - 688k under-spent at m11 The PCT through the CCG agreed a full and final settlement with UHSM of 750k under contract which includes the full deduction for readmissions of 933k. Further savings were factored into the final agreement as a result of monthly data validation, clinical coding and EUR challenges. 2.4 It should be noted that actions taken in the latter part of 2012/13 have enabled the PCT to balance and will continue to have a positive effect upon the activity and finances in 2013/14. Further details of performance against individual contracts and points of delivery are provided in Appendix 2 and Cash Releasing Efficiency Savings 2012/13 It is pleasing to report that the actual CRES delivered in 2012/13 was 10,984k, 68k greater than the plan set at the start of the year. It can be seen from Appendix 4 that savings from prescribing have offset other areas of slippage although in part this is due to a later than planned commencement of some of the schemes. It should be noted that this represents savings of 2.8% of the total resource and should enable the CCG to move forward in a strong position with the target for 2013/14 of 6m representing a savings target of 2.2%. 4.0 Principles for 2013/14 Plan As reported previously, the CCG has been working to the following key principles:- a) A target 1% net surplus after setting aside 2% for non-recurrent schemes. In exceptional cases, this can be varied by Area Teams and a target surplus of 1m for 2013/14 has been agreed subject to Page 4

5 the CCG being able to provide assurance that it would be able to deliver a 1% surplus in 2014/15. b) The CCG has also been required to set aside 2% for non-recurrent purposes. c) The CCG Governing Body has agreed a target CRES of 6.0m for 2013/14 providing a contingency sum of 0.6m for further investments in integrated care. d) 5.3m has also been set aside within the plan as part of a risk sharing agreement to meet the costs of specialised services. 5.0 Financial Plan 2013/14 The attached financial plan (Appendix 5) has not changed significantly from the previous plan approved in March and has been compiled based upon the principles above and best estimates of cost pressures, pre-commitments and contractual requirements for 2013/14. As reported within the introduction, discussions are still ongoing and further changes may be required and a final plan will be presented to the Governing Body in May. 6.0 CRES 2013/14 Good progress is being made to identify and agree the schemes that will deliver the savings requirement of 6m for 2013/14. Appendix 6 provides a summary of the schemes agreed to date and the ones still in development. As part of the AT assurance process, the CRES plans have been discussed in detail with the GM LAT Director of Finance. The LAT have requested a more detailed review of Trafford plans after 2013/14 Qtr 1 where implementation plans and delivery of key outcome measures will be reviewed and subject to challenge. 7.0 Summary The CCG Governing Body is requested to note that the PCT delivered a preaudit surplus of 500k in 2012/13 and exceeded the 2012/13 CRES target. The attached financial plan may be subject to further changes and it is envisaged that a final plan will be presented to the May Governing Body. Members will note that the 13/14 draft plan provides for a surplus of 1m and this should still be treated as provisional until final confirmation has been received from the Area Team Director of Finance. Page 5

6 8.0 Recommendation The members are asked to note the contents of this report and subject to any suggested changes, note approve the revised financial plan for 2013/14 as at April and note that the final plan will be presented in May. Tim Barlow Chief Operating Officer/Chief Finance Officer 23 rd April 2013 Page 6

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