Agenda Item: 4.4 Finance Report

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Sharon Neal
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1 Agenda Item: 4.4 Finance Report For the period to 31 January 213 and Forecast Outturn for 212/13

2 CONTENTS 1. Introduction and Background 2. Performance against statutory duties 3. Available Resources 4. Operating Cost Statement Including performance against plan charts 1. Locality Position 2. Directorate Performance Exception Report 3. Risks / Overall Financial Position 4. Statement of Financial Position 5. Capital Investment Programme 6. Working Capital & Treasury Management 7. Recommendations

3 1. Introduction and Background 1. Introduction 1.1 This report details the PCT s year to date position and the forecast outturn for 212/ Background 2.1 The statutory duty of each PCT remains to deliver a breakeven position. However, the DOH has maintained the requirement for organisations to deliver a minimum 1% surplus control total and to hold a 2% recurrent surplus which should be invested on non-recurrent schemes to lever transformation change and support the delivery of QIPP schemes. For 212/13 and thinking ahead to 213/14 and the likely financial challenges to face the Clinical Commissioning Group, the PCT has planned to deliver a 2% control total. As previously, this has been split between lodgement and forecast operating surplus. The details of which are: 212/13 Control Total ' Lodgement with SHA 1,271 Forecast Surplus 3,424 Total SHA Control Total 13, For 212/13, NHS East Lancashire will be producing financial reports and performance managing its financial position against the delivery of the 3,424k surplus as the lodgement has already been topsliced from the PCT s available resources reported in section 3.

4 2. Performance Against Statutory Duties Duty Commentary Year to Date Rating Forecast Year End Rating Revenue At month 1, the PCT is on track to deliver the control total surplus. Performance against the ELHT contract continues to be worsen and an over performance forecast of 1,k is included in the current position. In order to support the delivery of the control total, the PCT has lodged a further 2,k with the SHA. This will be returned to the CCG in 213/14 As more robust activity data becomes available, other contract performance variances are emerging which have contributed on acute and specialist services net forecast overspend of 9,393k. These are discussed in more detail in section 7. Capital The capital resource of 7,1k has formally been transferred to the PCT, This includes the additional 5k revenue to capital transfer requested at month 6. All three of the major capital developments have now been approved and work is underway. As at 31/1/213, 2,292k has been expended. Cash The PCT is forecasting to live within its cash limit. Better Payment Practice Code Performance against the BPPC target on both NHS and private suppliers is in excess of the 95% Target

5 3. Available Resources Opening Recurrent Baseline 664,98 212/13 Growth 19,793 Confirmed Allocation Adjustments 3,296 Anticipated Allocation adjustments (by SHA and PCT) TOTAL AVAILABLE RESOURCES 715,69 No further allocations are anticipted

6 4. Operating Cost Statement Corporate Services Board Performance, Intelligence & Development Corporate Finance, Information & Estates Clinical Public Health HR, OD and Workforce TOTAL CORPORATE SERVICES Commissioning Services Acute & Specialist NHS Acute & Specialist - Non NHS Priority Care NHS Priority Care Non NHS Public Health - NHS Public Health - Non NHS Childrens Services - NHS Childrens Services - Non NHS Mental Health & Older People - NHS Mental Health & Older People - Non NHS Community Healthcare - NHS Community Healthcare - Non NHS Non NHS Service Agreements PPA Prescribing GMS / PMS GDS / PDS Pharmacy Ophthalmology Other Primary Care Annual Budget ' 1,254 4,137 2,527 11,11 3,536 1, ,94 343,547 1,245 2,987 33, , (442) 35, ,443 8,55 Budget ' 1,56 3,194 2,16 8,791 2,919 1, ,9 286,819 6,836 2,491 32, , , ,567 5,911 Year to Date Actual Variance ' ' 1,23 2,773 1,615 7,752 2,56 1, , ,734 6,978 2,489 33, ,657 29, , (421) (41) (1,39) (412) (41) 43 (2,98) 7, (2) 89 (1) 1 (145) () Forecast Outturn Variance ' budget %. (2) (4.83) (2) (7.91) (5) (4.54) (2) (5.66).. (1,1) (22.95) 9, Percentage Variance on Annual (2) (.7) 2, (71) (23.73). Practice Based Commissioning Choosing Health Commissioner Reserves TOTAL COMMISSIONED SERVICES Provider Services TOTAL PROVIDER SERVICES (For detailed breakdown, refer to provider position) TOTAL NET OPERATING COST Financed By Notified Revenue Resource Limit 67,59 52,27 17,35 14,54 4, ,573 24,519 69,165 55,782 41,273 13,63 12,116 3, , ,758 5,92 53,783 41,384 12,95 11,819 3, ,2 (37) 9 (1,998) 111 (698) (297) (62) (6) 712 (159) (6,368) 7.2 (1) (.12)... (3,) (4.47) (8) (4.7) (1).. (755) (329) (2.92) Anticipated Allocations APPROVED EXPENDITURE LIMIT. 715,69 (717,12) 577, ,914 (2,853) (11,832) (2,324) (48.26) (84.37) OPERATIONAL FINANCIAL BALANCE Favourable variances are shown as negative numbers I.e. n 2,111 (597,984) (597,984) (714,991) (597,984) (597,984) (3,424) (.48) 78 (2,217) (23,7) (2,853). (3,424) (.48)

Actual Monthly Variance 'v' Plan 286. 285.5 ' 285. Forecast Surplus Actual Surplus 284.5 284.

7 Actual Monthly Variance 'v' Plan ' 285. Forecast Surplus Actual Surplus April May June July August September October November December January February March Months 4, 3,5 3, 2,5 2, 1,5 1, 5 Cumulative Out-turn 'v' Plan Cumulative Planned Position Cumulative Reported Position 4.1 Monthly variance against plan is on track to deliver the required control total surplus April MayJune July August September October November DecemberJanuary February March Months

8 5. Locality Position The locality position will be tabled as an addition to this report

9 6. Directorate Performance Exception Report 6.1 The Commissioning dashboards presented to the Local Delivery Group gives more detailed indications as to the reason for forecast variances. The purpose here is to provide a high level summary. Corporate Services Corporate services are forecasting an underspend of 1,1k by year end. This is after the required running cost contribution of 8k has been made to the QIPP programme. As posts from the PCT structure become vacant, they are not being replaced, as contracts come to an end they are not being renewed and non-pay expenditure is being critically scrutinized before it is incurred. Acute & Specialist The overall forecast in this area based on activity data as at month 1 is for an over spend / over performance of 9,831k. The majority of this ( 1,k) is forecast against the ELHT. Other contracts which are indicating significant over-performance are:- North West Ambulance Service 31 Lancashire Teaching 368 Leeds Teaching 347 Airedale 255 Counter-acting those over performances is a forecast under performance at Pennine Acute of 2,4k. The PCT has also been made aware that specialist commissioning is forecasting and overspend of between 8,k and 9,k. This will need to be shared out amongst member PCTs in accordance with the agreed risk share, and whilst specific information for the PCT has not been received, prudently, an anticipated over-performance for East Lancashire of 1,k has been included in the forecast.

10 Priority Care A number of large packages of care have been agreed through both continuing healthcare and complex packages. This has resulted in the significant swing in this area to an over performance of 1,5k. An analysis of CHC restitution claims has been made, and provision included within the PCT accounts. The calculation for the basis of the provision has been agreed in principle with the external auditors. The current forecast is calculated thus:- Public Health Nothing to report at this stage Children s Services Nothing to report at this stage Mental Health & Older People Community Healthcare PPA Prescribing Primary Care Commissioner Reserves Nothing to report at this stage Nothing to report at this stage Nursing Home Month 1 has seen a continued to see an increase in the forecast underspend on prescribing. At present, the PPA forecast is showing and underspend of 3,k. This relates in the main to the benefit from the in year category M drugs adjustment Residential Hom Nothing to report at this stage. There is still 24,519k still held within reserves. Of this 3,424k will deliver the PCT control total surplus and 8,126k will be required to cover anticipated overspends within budgets. Claims

11 7. Risks/Overall Financial Position 7.1 There are a number of risks to the PCTs forecast financial position, the magnitude and certainty of which vary. The table below lists the continuing major risks with potential best and worst case scenarios. Currently, the most likely position is included in the forecast outturn. Risk Worst Best Most Likely Prescribing new drug prescribing pressures (3,) PBR activity not contained within planned levels 12, 9,5 CRES programme does not deliver 3, Non-PBR ELHT 2, 1, Specialist commissioning pressures 2, 1, CPOC, IFRs and CHC 1, 1, GP consortia delegation of commissioning budgets 1,6 8 Continuing Healthcare Restitution Cases 12,1 12,1 All non-recurrent resource is not deployed (1,) Total adverse revenue risks 24,9 22,4

12 8. Statement of Financial Position NON-CURRENT ASSETS Property, Plant & Equipment Intangible Assets Other Financial Assets Trade and Other Recevables Total Non Current Assets CURRENT ASSETS Inventories Trade and Other Receivables Other Financial Assets Other Current Assets Cash and Cash Equivalents Sub Total Current Assets Non Current Assets Held for Sale TOTAL ASSETS CURRENT LIABILITIES Trade & Other Payables Opening Balance Closing Balance as at 1/4/12 as at 31/1/13 ' ' Movement ' 14,584 11,98 (3,486) 3 3 (27) (6) 15,324 11,85 (3,519) Other Liabilities Provisions Borrowings Other Financial Liabilities Total Current Liabilities NET CURRENT ASSETS / (LIABILITIES) TOTAL ASSETS LESS CURRENT LIABILITIES NON-CURRENT LIABILITIES Trade and Other Payables Provisions Borrowings Other Financial Liabilities Other Liabilities Total Non-Current Liabilities TAXPAYERS EQUITY General Fund Revaluation Reserve Other Reserves ASSETS LESS LIABILITIES (Total Assets Employed) TOTAL TAXPAYERES EQUITY 3,618 (2,84) 5,72 7,422 7,422 5,72 11,4 5,338 5,72 11,4 (49,196) (4,282) (39,482) 5,338 9,714 (4,282) (765) (765) (54,243) (44,529) 9,714 (48,541) (33,489) 15,52 56,783 68,316 11,533 (136) (12,99) (12,854) (47,8) (46,27) 738 (47,144) (59,26) (12,116) 9,639 9,56 (583) (5,192) (5,689) (497) 14,831 14,745 (86) 9,639 9,56 (583)

13 9. Capital Investment Programme Balance to be Capital Plan Expenditure to 31/1/13 spent by 31/3/13 ' ' ' GP IT Haslingden Health Centre 1,3 1,2 298 Energy Saving Schemes Accrington Victoria (HAC / MIU / Physio) Clitheroe Community Hospital 2, ,71 Great Harwood Health Centre Colne Health Centre 1, Retinal Screening Backlog Maintenance (131) Totals 7,1 2,292 4,88 Capital Resource Limit Confirmed capital resource limit 6,6 Return of Brokerage Anticipated resource limit adjustment 5 Sale of Meadowview 9.1 The PCT has received the allocation through it s capital resource limit. 9.2 All three capital schemes have been approved and work is under way. 9.2 To support the front-loading of expenditure on the new schemes, the PCT requested that an additional 5k be transferred from revenue to capital. Resources available 7,1 ANTICIPATED VARIANCE (underspend)/overspend

14 1. Working Capital & Treasury Management Plan Actual Risk Comments Debtors (Percentage greater than 9 days) No data available at this stage BPPC NHS % by Volume % by Value 95% 95% 99.96% 99.69% On target BPPC Non NHS % by Volume % by Value 95% 97.42%98. 95% 46% On target Indicates unchanged from previous period Indicates an improved position Indicates a worsening position

15 11. Recommendations The Board is recommended to: note the year to date position; note the forecast out-turn for the financial year ; note each directorates performance as shown in the summary and exception report; note the risks to the delivery of the in year financial position; note the performance against statutory duties and the control total; await monthly updates on the delivery of the capital programme approve the proposed reporting of the charitable funds position await monthly updates on the PCT s financial position. M Youlton Locality Director of Finance

0.1% > variance < 0.5% 0.1% > variance < 0.5% <95% but >= 50% of plan

0.1% > variance < 0.5% 0.1% > variance < 0.5% <95% but >= 50% of plan Commentary Template The commentary template will need to be completed when either; a) An organisation is red rated in any of the criteria set out below Indicator Green Amber Red Comments Surplus -(variance