2014/15 FINANCIAL OUTLOOK AND CHALLENGES
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2014/15 FINANCIAL OUTLOOK AND CHALLENGES. Overview. Financial Context Summary of 2014/15 position: Key pressures/service developments Savings opportunities 2015/16 and future outlook Implications for 2014/15 and Choices. Scale of Financial Challenge in 2014/15.

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2014/15 FINANCIAL OUTLOOK AND CHALLENGES

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2014/15 FINANCIAL OUTLOOK AND CHALLENGES


Overview

  • Financial Context

  • Summary of 2014/15 position:

    • Key pressures/service developments

    • Savings opportunities

  • 2015/16 and future outlook

  • Implications for 2014/15 and Choices


Scale of Financial Challenge in 2014/15

Additional funding of £420m needed to meet all identified costs of meeting existing policies and expectations

Savings of £170m have been identified by DHSSPS

DHSSPS budget due to increase by £90m

A funding gap of £160m still needs to be resolved


DHSSPS Budget 2010 Profile


Efficiencies Already Delivered


Efficiency Indicator Trends


Opening position for 2014/15

Significant

unresolved

challenges experienced in 2013/14

The HSC is carrying deficits of £115m into 2014/15

  • Reliance on non-recurrent measures in 2013/14:

    • In Year Monitoring

    • Managed slippage/deferral of expenditure


Latest Assessment of 2014/15


Key Pressures in 2014/15

Pay & non-pay inflation

£52m

NICE Drugs

£19m

Demography

£35m

MH and LD Resettlement

£17m

Service Developments

£76m

Specialist Hospital Services

£7m

Family Health Services

£37m

Transforming Your Care

£21m

Public Health Agency

£4m

Revenue Costs of Capital

£7m


Service Developments in 2014/15

Psychological Therapies

£2.5m

NICE Drugs

£19m

Cath labs

£4.5m

Elective

Care

£15m

ED Capacity Planning

£5m

Normative Nursing

£12m

Family and Child Care

£7m


Savings Opportunities 2014/15


Savings Opportunities at Trusts – 2014/15

  • ACUTE

  • REFORM

  • Reduce Excess Bed Days

  • Increase in day case rates

  • Reduce Did Not Attends

  • Improve theatre utilisation

  • Reduce level of cancellations

  • SOCIAL CARE REFORM

  • Reablement

  • Shift to lower cost provision

  • Reform of Social Care

  • STAFF PRODUCTIVITY

  • Review of skill mix

  • Reduction in backfill (whilst maintaining safe staffing levels)

  • Reduce sickness absence

  • Unit cost management

  • OTHER PRODUCTIVITY

  • Rationalisation of the estate

  • Procurement

  • Management costs/shared services


2015/16 Outlook

  • Total additional pressures are estimated at £317m

  • There is a growing trend of cost pressures:


Population

The 2011 Census, indicates that 20% of the resident population were aged 60+.

By 2021 it is projected that this will increase to 23.2% and by 2051 almost one third (32.6%) of the population will be aged 60+.

Between 2011 and 2051, the proportion of the population aged 85+ is expected to increase from 1.7% to 6.7% .


Unplanned Admissions to HSC Hospitals in Northern Ireland with a Long Term Condition for those aged 65 and Over by HSC Trust, 2010/11

By 2020: Number of adults with LTC will increase 40% in RoI, 30% in Northern Ireland

80% of GP consultations & 60% of hospital bed days relate to LTC and complications.*

* Source: Making Chronic Conditions Count IPHI


Key Reform Initiatives Under TYC

Shifting 5% of hospital expenditure with reinvestment in primary, community

and social care services

Improving integration of care through the development of integrated care partnerships – reducing need for unnecessary hospital visits

Maximising the potential of technology

Building a model of care which is focused on

the individual rather than the institutions


Impact of budget allocation – 2014/15

  • Deterioration in waiting times for elective services – which would exacerbate the health inequalities we are committed to addressing

  • Compromising the safety and quality of services provided to patients and clients

  • Compromising the delivery of statutory requirements, Programme of Government commitments and key Ministerial priorities and commitments

  • A growing parity gap between Northern Ireland and the rest of the UK by not funding all demand led pressures


Choices For Executive

1

Increase even further the extent of savings required across the HSC

2

Constraining pay for HSC staff

3

Reducing the range and/or standard of services offered

4

Impose additional charges or co-payments for services

5

Provide additional recurrent resources to DHSSPS


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