Estimates Memorandum for the Main Estimate for the Department of Health

Transcription

1 Estimates Memorandum for the Main Estimate for the Department of Health Introduction 1. The Department of Health s Main Estimate for seeks the necessary resources and cash to support the functions of the Department of Health, NHS and associated non- departmental public bodies. The structure of the Estimate reflects the health and social care system and organisations as set out below: The NHS Commissioning Board (known as NHS England); Provision of Healthcare (NHS Trusts and NHS Foundation Trusts); Department of Health Administration and Programme Local Authorities (Public Health) Public Health England (Executive Agency) Health Education England Other Special Health Authorities; and Other Non Departmental Public Bodies; 2. The total resources and capital contained within this Estimate are as follows: TABLE 1: BUDGETARY LIMITS RESOURCE CAPITAL DEL, of which: 116, ,810.0 Ring-fenced depreciation & impairments Administration 3,021.0 AME 7, TOTAL 123, , An explanation of key terms used in the memorandum is provided below. Key Points Main Areas of Expenditure 4. The main activities for the Department of Health in are as follows: Expenditure of The NHS Commissioning Board (known as NHS England), special health authorities, NHS trusts and NHS Foundation Trusts, Non Departmental Public Bodies and Public Health England. Central budget expenditure through departmental programmes (including vaccines, research and development, EEA medical costs, healthy start, etc). 1

2 Administration for the core department, non-departmental public bodies and special health authorities. Local Authority Public Health A proportion of health expenditure financed by income from National Insurance Contributions. This is recorded as non-voted expenditure in Estimates as it has already been approved by the Social Security Act Annually Managed Expenditure (AME) for the bodies mentioned above, this includes expenditure on provisions for future liabilities and certain types of asset impairments. Changes to budgetary limits The table below provides a comparison of budgetary limits between the Main Estimate and the Spending Round 15 (Published 25 November 2015) : TABLE 2: COMPARISON OF BUDGETARY LIMITS WITH SR RESOURCE CAPITAL Spending Round SR15 DEL - SR , ,810.0 AME 7, TOTAL 124, Main Estimate DEL 116, Of which Non Voted DEL 18,898.8 AME 7, TOTAL 123, ,825.0 Difference DEL ,000.0 AME TOTAL ,015.0 Differences from SR to ME (DEL), comprising: ,000.0 Budget Transfers between Other Government Departments Transfer of research budgets to CDEL following introduction of European system of accounts reclassification Differences from SR to ME (AME), comprising: Increase in financial assets that score to AME

3 5. A comparison of the final Estimate and the Main Estimate is set out in Appendix A (1). Format of the Estimate: 6. The Main Estimate takes account of the health and social care system and organisations it follows the estimate structure. 7. The Estimate is presented on a consolidated income and expenditure basis, which is after the elimination of forecast transactions between bodies within the Departmental Group. 8. The Estimate contains details of the net expenditure of the NHS Commissioning Board (known as NHS England) - that is after the elimination of forecast transactions with other bodies within the Departmental Group. Funding issued to the Board was set out in the Finance Directions issued at the same time as The Mandate. A reconciliation between the financial directions and the figures contained within the Estimate is provided at Appendix A (1). 9. For planning purposes, the figures in the Main Estimate for the NHS assume financial balance in both the Commissioning and Provider Sectors. The DH continues to work with the NHS to clarify the financial position and options to address this. An update will be provided to the sectors if required at the Supplementary Estimate. Detailed breakdown 10. A detailed breakdown of planned and actual expenditure figures are included in Appendix A (attached as a separate document): a. Appendix A (1) compares the Main Estimate DEL to the final Estimate DEL provision; b. Appendix A (2) compares the Main Estimate AME to the final Estimate AME provision; c. Appendix A (3) compares Plans and Outturn by DEL/ AME Budget for the period to ; and d. Appendix A (4) Reconciliation to the financial directions to the NHS Commissioning Board (known as NHS England). Supplementary information Machinery of government changes 11. There have been no machinery of Government changes. Other changes- reclassification 12. Following the change announced to the European System of Accounts we have now 3

4 reclassified research and development expenditure to Capital DEL. Contingent Liabilities 13. A list of Contingent Liabilities is shown in the notes to the Estimate and has been updated since Main Estimate. Approval of Memorandum 14. This memorandum has been prepared with reference to HM Treasury s Supply Estimates: a guidance manual. The information in this memorandum has been approved by Andrew Baigent, Director of Group Financial Management. Glossary of Key Terms Annually Managed Expenditure (AME) a Treasury budgetary control for spending that is generally difficult to control, large as a proportion of the department s budget, and volatile in nature Departmental Expenditure Limits (DEL) - a Treasury budgetary control for spending that is within the department s direct control and which can therefore be planned over an extended (Spending Review) period (such as the costs of its own administration, payments to third parties, etc). Administration (DEL) - a Treasury budgetary control for spending within the overall DEL that relates specifically to administration of the department, NDPBs (including the NHS Commissioning Board) set out in the Spending Review. 4

5 Appendix A (1) Explanation of changes in Main Estimate from the Supplementary (Final) Estimate - Departmental Expenditure Limits Table 1: Summary of changes Subhead 1,803,363 17,109,793 18,913, ,000 1,765,363 21,935,893 23,701, ,825-38,000 4,826,100 4,788,100 3,825 A: NHS Commissioning Board (known as NHS England) net expenditure B: NHS Trust net expenditure 0 27,461,648 27,461,648 1,221,580 26,183,655 26,183,655 1,047,991-1,277,993-1,277, ,589 C: NHS Foundation Trusts net expenditure 0 38,923,998 38,923,998 1,453,420 37,646,004 37,646,004 1,681,087-1,277,994-1,277, ,667 D: DH Programme and admin expenditure 627,439 2,242,450 2,869, , ,623 1,486,234 2,090,857 2,616,526-22, , ,032 2,212,065 E: DH Payments to Local Authorities 0 3,082,405 3,082, ,074 3,388,400 3,388, , , ,074 F: Public Health England (Executive Agency) 144, , , , , , ,134 92,500-5,221 24,649 19,428-14,900 G: Health Education England 75,868 1,893,978 1,969,845 2,829 70,482 1,968,710 2,039,192 2,000-5,386 74,733 69, H: Special Health Authorities expenditure 159,077 1,354,940 1,514,017 31, ,418 1,303,709 1,451,127 30,684-11,659-51,231-62,890-1,002 I: NDPB net expenditure 308, , ,024 34, , , ,631 35,388-14,988 18,595 3,607 1,163 J: NHS Commissioning Board (known as NHS England) 0 18,898,759 18,898, ,898,759 18,898, net expenditure financed from National Insurance Contributions DEL 3,119, ,404, ,523,446 3,689,675 3,021, ,291, ,312,015 5,810,000-98,070 1,886,639 1,788,569 2,120, s HSCMEMO - 1. DEL Changes Table 2: Summary of changes, Line A - NHS Commissioning Board - known as NHS England Initial allocations ,824, ,012, ,836, , Subtotal - As per NHS Mandate Financial Directions 0 1,824, ,012, ,836, , Plus Estimates and Consolidation adjustments - National Insurance Contributions financing ,898,759-18,898,759 0 Latest available forecast Intra-group eliminations ,637-63,177,348-63,235,985 The level of intra group transactions with other NHS bodies has been re-modelled using more up to date data. Total 1,803,363 17,109,793 18,913, ,000 1,765,363 21,935,893 23,701, ,825-38,000 4,826,100 4,788,100 3,825 Table 3: Summary of changes, Line B - NHS Trust net expenditure Initial allocations ,047, Intra-group eliminations ,183,655 26,183, The level of intra group transactions with other NHS bodies has been re-modelled using more up to date data. Total 0 27,461,648 27,461,648 1,221, ,183,655 26,183,655 1,047, ,277,993-1,277, ,589 Table 4: Summary of changes, Line C - NHS Foundation Trusts net expenditure RDEL RDEL RDEL CDEL RDEL RDEL RDEL CDEL RDEL RDEL RDEL CDEL Initial allocations ,681, Intra-group eliminations ,646,004 37,646, The level of intra group transactions with other NHS bodies has been re-modelled using more up to date data. Total 0 38,923,998 38,923,998 1,453, ,646,004 37,646,004 1,681, ,277,994-1,277, ,667

6 Table 5: Summary of changes, Line D - DH Programme and Administration expenditure Initial allocations 532,911 1,214,961 1,747,872 1,616, HSCMEMO - 1. DEL Changes Intra group distribution Transfer between Capital DEL and Revenue DEL -998, , ,000 Reclassification of research budgets to Capital DEL 0 Transfers from / to other government departments 108, ,941 From Home Office for immigration centres and migrant surcharge income 51,000 51,000 2,000 From Department for International Development - Overseas development assistance budgets agreed in the spending review. 21,000 21,000 From Department for Education contribution towards the school fruit and vegetables scheme From Ministry of Defence for out of hours services To Department of Business Innovation and Skills for business information modelling HMT Budget 16 addition 6,450 6,450 HMT contribution to charities announced in the 2016 Budget Intra-group eliminations 71,712 1,081,258 1,152,970 The level of intra group transactions with other NHS bodies has been re-modelled using more up to date data. Total 627,439 2,242,450 2,869, , ,623 1,486,234 2,090,857 2,616,526-22, , ,032 2,212,065 CHECK Table 6: Summary of changes, Line E - Local Authority (Public Health) Opening budgets ,388,400 3,388, Intra group distribution Total 0 3,082,405 3,082, , ,388,400 3,388, , , ,074 Table 7: Summary of changes, Line F - Public Health England (Executive Agency) Opening budgets , , ,600 92, Intra-group eliminations ,443-11,023-17, The level of intra group transactions with other NHS bodies has been revised. Total 144, , , , , , ,134 92,500-5,221 24,649 19,428-14,900 Table 8: Summary of changes, Line G - Health Education England Main Estimates Increase/(Decrease) from Opening budgets ,414 4,891,000 4,963,414 2, Intra-group eliminations ,932-2,922,290-2,924, The level of intra group transactions with other NHS bodies has been revised. Total 75,868 1,893,977 1,969,845 2,829 70,482 1,968,710 2,039,192 2,000-5,386 74,733 69, Total Table 9: Summary of changes, Line H - Special Health authorities Opening budgets , , ,003 30, Intra-group eliminations ,145,640 1,146, The level of intra group transactions with other NHS bodies has been revised. Total 159,077 1,354,940 1,514,017 31, ,418 1,303,709 1,451,127 30,684-11,659-51,231-62,890-1,002 CHECK

7 HSCMEMO - 1. DEL Changes Table 10: Summary of changes, Line I - NDPBs Section Opening budgets , , ,711 35, Intra-group eliminations ,184 54,104 48, The level of intra group transactions with other NHS bodies has been revised. Total 308, , ,024 34, , , ,631 35,388-14,988 18,595 3,607 1,163 Table 11: Summary of changes, Line J - NHS Commissioning Board expenditure financed by NI Contributions Section Opening budgets ,898,759 18,898, Latest available forecast from HMRC Total 0 18,898,759 18,898, ,898,759 18,898,

8 Appendix A (2) Explanation of changes in Main Estimate from the Supplementary (Final) Estimate - Annually Managed Expenditure HSCMEMO - 2. AME Changes Table 1: Summary of changes Section Supplementary Estimate Resource AME Main Estimate Increase/ (Decrease) from Main Estimates Supplementa ry Estimate Capital AME Main Estimate s Increase/ (Decrease) from Main Estimates K: NHS Commissioning Board (known as NHS England) 300, , The large reduction from is due to the impact of net expenditure a change in the discount rate for provisions - this is a L: NHS Trust net expenditure 862, ,070 88, non recurrent change and does not impact on M: NHS Foundation Trusts net expenditure 1,003, ,092-79, budgets, which are broadly similar to previous years. N: DH Programme and admin expenditure 1,164, , ,642 15,000 15,000 0 O: Public Health England 0 22,928 22, P: Non Departmental Public Bodies 4,679 4,679 Q: Special Health Authorities expenditure 27,941,369 4,737,000-23,204, AME 31,271,800 7,589,594-23,682,206 15,000 15,000 0

9 Appendix A (3) DEL/AME - Plan and Outturn comparisons HSCMEMO - 3. PlanvOT Revenue DEL Plan Voted DEL Plan Nonvoted DEL Plan Total Outturn Variance % Programme Admin , , , , , % , , , , , % (1) 85, , , , , % (1) 87, , , , , % , , , , (2) 113, , , (2) 116, , , (2) 119, , , (2) 121, , , (2) 125, , ,664.0 (1) Takes account of transfer to Department for Communities and Local Government for Learning Disabilities and Health Reform Grant. (2)Takes account of the change to Research budgets now part of the Capital DEL Capital DEL Plan Total Outturn Variance % , , % , , % , , % , , % , (2) 5, (2) 5, (2) 5, (2) 5, (2) 5,918.0 (2)Takes account of the change to Research budgets now part of the Capital DEL AME AME Plan Total Outturn Variance % , , % , , % , , % , , % , (2) 7, (2) 8, (2) 8, (2) 9, (2) 10,016.9

10 Appendix A (4) NHS COMMISSIONING BOARD (known as NHS England) - FINANCIAL DIRECTIONS - RECONCILIATION TO ESTIMATE LINES / ALLOCATIONS HSCMEMO - 4. NHS E ESTIMATE NHS ENGLAND FINANCIAL DIRECTIONS RDEL RDEL RDEL CDEL RDEL RDEL RDEL CDEL Section Admin Prog Total Total Admin Prog Total Total A: NHS Commissioning Board (known as NHS England) net expe 1,765 21,936 23, , , , J: NHS Commissioning Board (known as NHS England) net expenditure financed from NICS 18,899 18,899 0 Transactions with other bodies within the group 59 63,177 63,236 0 Total Administration Limit - column 1 above 1,703 1,703 Total Administration Limit - column 2 above Total revenue Resource Limit - column 1(less admin) 103, ,967 Total revenue Resource Limit - column 2(less admin) Total DEL 1, , , , , ,