Finance Report Month 11 2010-11

1. Finance ReportMonth 11 2010-11

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

3. 3 SECTION 1 � SUMMARY

4. FINANCIAL PERFORMANCE SUMMARY (1)

5. 5 FINANCIAL PERFORMANCE SUMMARY (2) At month 11 the year-to-date position is a breakeven against budget. The main elements of this position are underspends within Joint Working (�1.9m), Other Acute (�1.1m), Corporate budgets (�1.7m), Estates (�0.2m), the CSP/Performance budget (�4.4m), Investment / Reserves (�8.1m), Benefit from year-end settlement with NWLHT (�2.2m) and Allocation Adjustments (�0.8m) offset by overspends on Acute contracts (�7.8m), Primary care (�0.6m), BCS (�1.0m) and the pressure year-to date from the contribution to the NW London sector position (�5.0m) and a 10/11 advance on 11/12 Challenged Trust Board contribution (�6.0m). The overall forecast outturn position at month 11 is break-even against a plan of �17.2m surplus. There are forecast underspends in Joint Working (�1.9m), Other Acute (�1.4m), Corporate budgets (�2.0m), Estates (�0.2m), CSP/Performance (�3.8m), Balance Sheet review (�2.5m), Allocations (�0.7m), Benefit from the year-end settlement with NWLHT (�2.9m) and slippage on Investments / Reserves (�7.5m) offset by forecast overspends on Acute contracts (�8.9m), Primary Care (�1.0m), BCS (�1.0m) and the pressure from the contribution to the NW London sector position (�5.5m) and the 10/11 advance on 11/12 Challenged Trust Board contribution (�6.5m). The forecast outturn net movement is neutral from Month 10 to Month 11 i.e. breakeven in both months.

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

7. 7 SECTION 2 � YEAR TO DATE POSITION

9. SUMMARY OF YEAR TO DATE VARIANCES

10. 10 PBC PRESCRIBING POSITION AT MONTH 10

11. 11 ACUTE CONTRACT POSITION � MONTH 10 (1)

12. ACUTE CONTRACT POSITION � MONTH 10 - NWLH (2)

13. Bottom-line �2,364 4.2% over (M9 �1,715k 3.4% over) PbR �957k 2.7% over Of which: Non-elective �1,262k over 7.9% Outpatients �366k over 4.4% Elective �708k under 7% Non-PbR �1,407k 5.2% over Of which: Adult critical care �407k over 11.6% Outpatients �187k over 8.6% Direct Access �48k over 6.9% Radiotherapy �97k under 11.2% RDA �82k under 12.4% High Cost Drugs �873k over 7.9% Of which: Renal �452k 6.9% over Drug-Anti TNF �205k 5.2% over Neonatal �216k 38.3% over ACUTE CONTRACT POSITION � MONTH 10 - IMPERIAL (3)

14. Chelsea & Westminster �246k 8% over Paediatric High Dependency Unit �68k 518% over Day Cases PbR �111k 30% over Outpatient First �86k over 25% over Royal Brompton �1030k 36% over Intensive Unit �224k 81% over Drugs �127k 35% over PbR Elective inpatients �335k 36% over PbR NEL �135k 56% over PbR NENE �61k 37% over Non Pbr Inpatient �128k 75% Royal Free �596k 5%over Non-elective Excess Bed days �149k 110% over EL �141k 7% over Critical Care �280k 48% over Renal �116k 16% over Chronic Hepatitis Disease �59k 29% under OPMSFUP �49k 96% under Barnet & Chase Farm �136k 4% over Non-Elective �117k 18% under Elective �98k 18% over NELNE �38k 10% over NEL/NENE Excess Bed Days �37k 36% over SCBU �18k 54% over Drugs exclusion �21k 35% over O ACUTE CONTRACT POSITION � MONTH 10 � OTHER TRUSTS (4)

15. 15 ACUTE CONTRACT POSITION - MONTH 10 (5)

16. 16 ACUTE ACTIVITY ANALYSIS (1) - OUTPATIENTS

17. 17 ACUTE ACTIVITY ANALYSIS (2) - ELECTIVE

18. 18 ACUTE ACTIVITY ANALYSIS (3) � NON-ELECTIVE

19. 19

20. 20

21. 21 CLAIMS MANAGEMENT Further to the year-end settlement agreed with NWLHT and Imperial, the potential further benefit through claims management is dependent upon the level of success from the �2.0m 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 �85k. NHS Brent has also had the following success with its own claims management covering months1-11 on Non-Contracted Activities (�141k), Walk-in Centres contracts (�58k) and Cost per Case contracts (�19k).

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23. 23

24. 24

25. 25 SECTION 3 � FORECAST OUTTURN POSITION

28. 28 INVESTMENT & RESERVES The table above identifies where the underspend of �7.5m has been identified.

29. 29 SAVINGS PROGRAMME (1)

30. 30 SAVINGS PROGRAMME (2)

31. 31 MANAGEMENT COSTS (1)

32. 32 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: �1.76m (included in forecast outturn) Target �2.27m Shortfall �0.51m Reclassification of spend � CSL and FHS services (�0.35m) Forecast shortfall at Month 11 �0.16m 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 �2.5m) will be accounted for in 10/11. 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.

33. 33 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.

34. 34 APPENDIX A � FINANCIAL SCHEDULES

35. SUMMARY OPERATING COST STATEMENTFOR 11 MONTHS ENDING 28TH FEBRUARY 2011

36. COMMISSIONING OF HEALTHCAREFOR 11 MONTHS ENDING 28TH FEBRUARY 2011

37. COMMISSIONING OF HEALTHCAREFOR 11 MONTHS ENDING 28TH FEBRUARY 2011

38. COMMISSIONING OF HEALTHCAREFOR 11 MONTHS ENDING 28TH FEBRUARY 2011

39. PRIMARY CARE SERVICESFOR 11 MONTHS ENDING 28TH FEBRUARY 2011

40. PRIMARY CARE SERVICESFOR 11 MONTHS ENDING 28TH FEBRUARY 2011

41. PCT CORPORATE COSTSFOR 11 MONTHS ENDING 28TH FEBRUARY 2011

42. PCT CSP & PERFORMANCE FOR 11 MONTHS ENDING 28TH FEBRUARY 2011

43. PCT CSP & PERFORMANCE FOR 11 MONTHS ENDING 28TH FEBRUARY 2011