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Finance Report Month 9 2010-11

2. 2. 2. NHS BRENT FINANCE REPORT 10/11 - CONTENTS. Summary [Slides 3-7]Year to Date Position [Slides 8-26]Forecast Outturn Position [Slides 27-35]AppendicesDetailed finance schedules [Slides 36-45]. 3. 3. SECTION 1

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Finance Report Month 9 2010-11

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    1. Finance Report Month 9 2010-11

    2. 2 NHS BRENT FINANCE REPORT 10/11 - CONTENTS

    3. 3 SECTION 1 – SUMMARY

    4. 4 FINANCIAL PERFORMANCE SUMMARY (1)

    5. 5 FINANCIAL PERFORMANCE SUMMARY (2) At month 9 the year-to-date position is a £0.4m favourable variance against budget. The main elements of this position are underspends within Joint Working (£0.7m), Other Acute (£1.6m), Corporate budgets (£1.5m), Estates (£0.2m), the CSP/Performance budget (£3.6m), Investment / Reserves (£5.7m), Contingency (£0.5m) offset by overspends on Acute contracts (£5.5m), Primary care (£0.3m), BCS (£0.9m) and the pressure year-to date from the contribution to the NW London sector position (£4.1m) and a 10/11 advance on 11/12 Challenged Trust Board contribution (£2.6m). The overall forecast outturn position at month 9 is break-even against a plan of £17.2m surplus. There are forecast underspends in Joint Working (£1.6m), Other Acute (£2.0m), Corporate budgets (£2.0m), CSP/Performance (£3.6m), Balance Sheet review (£2.5m), Allocations (£0.5m), Contingency (£0.2m), the benefit from the year-end settlement with NWLHT (£3.4m) and slippage on Investments / Reserves (£7.2m) offset by forecast overspends on Acute contracts (£9.1m), Primary Care (£1.1m), BCS (£0.9m) and the pressure from the contribution to the NW London sector position (£5.4m) and the 10/11 advance on 11/12 Challenged Trust Board contribution (£6.5m). The forecast outturn movement is from a £0.2m surplus against plan at month 8 to break-even at month 9. The main movements have been increases in underspends on Investments/Reserves (£2.3m), CSP (£0.3m) and the release of contingency (£0.2m), netted-off by an increased contribution to the 11/12 Challenged Trust Board contribution of £3.0m.

    6. 6 RISKS & OPPORTUNITIES TO FORECAST OUTTURN POSITION (1)

    7. 7 RISKS & OPPORTUNITIES TO FORECAST OUTTURN POSITION (2)

    8. 8 SECTION 2 – YEAR TO DATE POSITION

    9. 9

    10. 10

    11. 11 SUMMARY OF YEAR TO DATE VARIANCES

    12. 12 PBC PRESCRIBING POSITION AT MONTH 8

    13. 13 ACUTE CONTRACT POSITION – MONTH 8 (1)

    14. 14 ACUTE CONTRACT POSITION – MONTH 8 - NWLH (2)

    15. 15 Bottom-line £1,247k 2.8% over (M8 £934 2% over ) PbR £343k over 1.5% Of which: Non-elective £547k over 5% Outpatients £200k over 4% Elective £544k under 10% Non-PbR £905k over 4.1% Of which: Adult critical care £87k over 3% Outpatients £140k over 8% Direct Access £50k over 9% High Cost Drugs £590k over 7% Of which: Renal £337k 6% over Drug-Anti TNF £142k 4% over Neonatal £112k 25% over ACUTE CONTRACT POSITION – MONTH 8 - IMPERIAL (3)

    16. 16 Chelsea & Westminster £196k 8.2% over Paediatric High Dependency Unit £46k 429% over Non Elective Excess Bed Days £44k 57% over PbR Elective £58k 13% over Royal Brompton £971k 43% over Intensive Unit £237k 107% over NEL PAG £79k 68% over PAT £141k 49% over PbR Non-elective £29k 15% over PbR Elective inpatients £318k 43% over Non-PbR Inpatients £121k 89% Royal Free £381k 4%over Non-elective Excess Bed days £153k 141% over Critical Care £295k 64% over Therapies £56k 44 % under Chronic Hepatitis Disease £43k 27% under Barnet & Chase Farm £118k 4% over PbR Non-Elective £137k 27% under Elective £98k 23% over NELNE £52k 17% over Non-PbR SCBU £21k 81% over Elderly Rehab £22k 147% Chemotherapy £17k 164%over ACUTE CONTRACT POSITION – MONTH 8 – OTHER TRUSTS (4)

    17. 17 ACUTE CONTRACT POSITION - MONTH 8 (5)

    18. 18 ACUTE ACTIVITY ANALYSIS (1) - OUTPATIENTS

    19. 19 ACUTE ACTIVITY ANALYSIS (2) - ELECTIVE

    20. 20 ACUTE ACTIVITY ANALYSIS (3) – NON-ELECTIVE

    21. 21

    22. 22

    23. 23 CLAIMS MANAGEMENT Further to the year-end settlement agreed with NWLHT, the potential further benefit through claims management is dependent upon the level of success from the £4.3m of issues not yet resolved with Other Trusts. The NHS Brent share of the Specialist Commissioning accepted claims amounts to a year to date saving of £50k. NHS Brent has also had the following success with its own claims management covering months 1-6 on Non-Contracted Activities (£139k), Walk-in Centres contracts (£31k) and Cost per Case contracts (£10k).

    24. 24

    25. 25

    26. 26

    27. 27 SECTION 3 – FORECAST OUTTURN POSITION

    28. 28

    29. 29

    30. 30 INVESTMENT & RESERVES The table above identifies where the underspend of £7.2m has been identified.

    31. 31 SAVINGS PROGRAMME (1)

    32. 32 SAVINGS PROGRAMME (2)

    33. 33 MANAGEMENT COSTS (1)

    34. 34 MANAGEMENT COSTS (2) – 10/11 AND 11/12 PLANS NHS Brent There has been further clarification from NWL Sector on the application of the management costs guidance, particularly in relation to FHS services, and also information from CSL on the percentage of their costs which fall within management cost. As a result, the forecast achievement against the management cost savings target has improved and is as follows: Saving through freezing vacancies and ceasing interim cover: £1.74m (included in forecast outturn) Target £2.27m Shortfall £0.53m Reclassification of spend – CSL and FHS services (£0.35m) Forecast shortfall at Month 9 £0.18m The restructuring of posts taking place in the last quarter of the year will not lead to any material in-year saving, it will ensure the PCT achieves the 11/12 savings targets. Potential redundancy costs arising from the restructuring (estimated at £1.5m-£2.5m) will not impact the management costs target but may need to be accounted for in 10/11. It is anticipated that funding will be made available to cover 10/11 severance costs. The 11/12 operating framework has signalled a move away from the separation of management and corporate costs, and has indicated that PCTs will be expected to monitor “running costs” instead. The guidance and accompanying targets for this have yet to be issued.

    35. 35 MANAGEMENT COSTS (3) – 10/11 PLAN B) BCS Plans to address the target 15% reduction of £0.75m in 10/11 are as follows: Reduction in WTE management posts £0.12m Reduction in interim spend £0.08m Reduction in management consultancy spend (non-recurrent in 09/10) £0.20m Corporate saving / back office functions £0.35m Total £0.75m This plan has been signed off by the BCS Board and is on course to be delivered.

    36. 36 APPENDIX A – FINANCIAL SCHEDULES

    37. 37 SUMMARY OPERATING COST STATEMENT FOR 9 MONTHS ENDING 31ST DECEMBER 2010

    38. 38 COMMISSIONING OF HEALTHCARE FOR 9 MONTHS ENDING 31ST DECEMBER 2010

    39. 39 COMMISSIONING OF HEALTHCARE FOR 9 MONTHS ENDING DECEMBER 2010

    40. 40 COMMISSIONING OF HEALTHCARE FOR 9 MONTHS ENDING 31ST DECEMBER 2010

    41. 41 PRIMARY CARE SERVICES FOR 9 MONTHS ENDING 31ST DECEMBER 2010

    42. 42 PRIMARY CARE SERVICES FOR 9 MONTHS ENDING 31ST DECEMBER 2010

    43. 43 PCT CORPORATE COSTS FOR 9 MONTHS ENDING 31ST DECEMBER 2010

    44. 44 PCT CSP & PERFORMANCE FOR 9 MONTHS ENDING 31ST DECEMBER 2010

    45. 45 PCT CSP & PERFORMANCE FOR 9 MONTHS ENDING 31ST DECEMBER 2010

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