GOVERNING BODY LEAD: Paul Gallagher, Finance Committee Chair ATTACHMENT: K ACTION: For Information MEETING DATE: 24 th May 2016 MINUTES OF THE FINANCE COMMITTEE HELD ON MONDAY 22 FEBRUARY 2016 GUILDHALL 1, KINGSTON PRESENT: Paul Gallagher Lay Member & Audit Chair Naz Jivani Governing Body Chair Phil Moore Governing Body Deputy Chair Clinical Tonia Michaelides Chief Officer Yarlini Roberts Chief Finance Officer Jenny Sinnott Head of Finance IN ATTENDANCE: Julia Gosden Director of Commissioning Jo Dandridge Business Manager (Minutes) APOLOGIES: David Knowles Lay Member Shaun Stoneham Rachel Bartlett Director Integrating Care Michael Mulligan Ben Okoye 16/01 WELCOME AND APOLOGIES: Those present were welcomed to the meeting. 16/02 DECLARATIONS OF INTEREST: None. 16/03 MINUTES OF THE LAST FINANCE COMMITTEE SEMINAR The minutes of the last meeting held on 25 th January 2016 were agreed as an accurate record. 16/04 MATTERS ARISING: 04.1 Acute Commissioning Action remained outstanding: Jenny Sinnott to ask Shaun Stoneham to provide details on the increase in births at Chelsea & Westminster Hospital. Version: Final K - 1
04.2 Tender Waiver Action remained outstanding: Yarlini Roberts to ask Sylvie Ford to provide agreement from Richmond CCG of their agreed 50% contribution of 203k. 16/05 FINANCE REPORT MONTH 10 Jenny Sinnott presented the key messages from the Month 10 financial scorecard. In 2015/16, the CCG is on target to meet all key financial targets Including delivery of the required 1% surplus of 2,178k To enable the delivery of the year end 1% surplus, the CCG has had to utilize its reserves The CCG did not achieve its cash target in Month 10, due to a banking error at SBS. All Better Payment Practice Code targets were achieved in Month 10, which has improved the cumulative position The CCG expects to over-achieve its QIPP target saving by 114k In month 10, the CCG received a non-recurrent allocation for Healthy London Partnership of 156k, which is a reallocation of the London underspend and contingency. 245k of resource was transferred from the CCG into the SWL Risk Pool. Members noted the following financial risks for Kingston CCG to meet its financial targets: Many local acute providers predict deficit budgets in 2015/16 which is likely to impact on CCG acute budgets Performance issues at Kingston Hospital may have financial consequences for the CCG If the CCG accepts delegated primary care commissioning, responsibilities will transfer to the CCG on 1 st April 2016. Acute Commissioning Members noted the year to date position reflects the month 9 reported contract variances, adjusted for challenges. Over performances have been fully reflected in forecasts. Under performances have not been shown in full. Members noted the following: Kingston Hospital reported a slightly worsening position of 57k Epsom & St Helier s forecast position has improved by 125k since month 9, as consultant vacancies have been filled and the Trust is working through the RTT backlog. The run rate in month 10 has increased in acute but decreased in orthopaedics Under performance is reported at St George s position at month 9/10. The forecast has been adjusted to reflect the RTT backlog work planned over the coming months Ashtead Hospital continues to under perform significantly and this pattern is seen across South West London. We have assumed that Kingston and St George s will reinvest the contract penalties in Qtr 4 but not the readmissions. This is in line with recent guidance. Version: Final K - 2
Focus on Other Acute Contracts Royal Brompton & Harefield NHS Foundation Trust Members queried the under performance reported at Month 10 for Royal Brompton as concerns around over performance had previously been reported. ACTION: Jenny Sinnott agreed to check the data and report back to members. Epsom & St Helier NHS Foundation Trust Members asked for details of the final forecast outturn agreement for Epsom & St Helier. ACTION: Yarlini Roberts agreed to confirm the final figure on email to Finance Committee members. Kingston Hospital Position Yarlini Roberts reported on the latest year end financial settlement position for 2015/16 with Kingston Hospital. The outcomes of the mediation meetings between the CCG and Kingston Hospital were discussed and it was noted that control totals had to be delivered by both organisations.. Draft specifications were being developed and would be discussed with the Hospital by the end of the week. ACTION: Yarlini Roberts agreed to update the Finance Committee Chair on any further discussions. Non Acute Commissioning Mental Health The mental health placements costs have increased by 16k due to an extended stay. The overspent budget will be funded by underspend in other mental health areas (not including the Parity of Esteem investments). Mental Health Parity of Esteem investment schemes are forecast to be fully spent in 2015/16. Continuing Care The continuing care forecast has improved by 119k since Month 9. Primary Care Members noted the prescribing forecast position has improved by 220k since month 9. QIPP Members noted an over achievement Version: Final K - 3
16/06 TERMS OF REFERENCE A revised copy of the Terms of Reference for the Finance Committee had been circulated to members prior to the meeting. Members were asked to approve the additional section on Declaration of Interests which had been included on recommendation by the LCFS following their recent audit. Members also made a request for the chair of the Council of Members to be invited as a GP representative member of the Finance Committee. The Finance Committee APPROVED the revised Terms of Reference. 16/07 FINANCIAL PLANNING FOR 2016/17 The 2016/17 Financial Planning Report had been circulated to members prior to the meeting. Members were informed that on 8 th February 2016, the CCG submitted a breakeven plan for the 2015/16 budget after taking advice from NHS England. Members noted that the next draft plan submission was due on 2 nd March 2016. Members were advised that since the February submission, further planning requirements had come to light and the following changes were being made: Acute inflation increased by 0.6% to account for CNST, with a cost of 690k Permission given for continuing care retrospectives to be funded from the 1% nonrecurrent requirement which would reduce the budget requirement by 366k. Discussion followed on the option of remaining with a breakeven plan submission vs the plan for the CCG to meet its business rules. Members noted the progress made with the identified QIPP savings schemes and recognised that although there was further work to be done it was agreed in principle that the way forward was to submit the budget as a 1% surplus. ACTION: The March submission would be reported as the CCG meeting its business rules. 16/08 KINGSTON CO-ORDINATED CARE A verbal update was provided. Members noted that the pilot schemes were currently in the process of being assessed.. ACTION: Rachel Bartlett to provide a more detailed update for the next meeting. Version: Final K - 4
16/09 RE-PROCUREMENT OF SWL 111 & OUT OF HOURS A verbal update was provided. 16/10 TENDERS WAIVERS None received. 16/11 ANY OTHER BUSINESS None. 16/12 DATE OF NEXT MEETING: Monday, 21 st March 2016 (1.30-3.00pm). Version: Final K - 5