Erewash Clinical Commissioning Group

1. Erewash Clinical Commissioning Group Finance Charlotte Allen-Neale 29th September 2011

2. The Financial Priorities • Financial position • QIPP • Looking forward - 2013/14 and beyond

3. Financial Position • As previously stated Erewash CCG is one of the five CCG’s that make up the Cluster Financial Position. • The Cluster must achieve a breakeven financial position over the next two years. • Derbyshire County PCT remains on target to achieve financial balance at M5 by utilising the PCT Risk Reserve in order to balance the PCT’s Financial position in light of the emerging overspend positions in Secondary Care. • The CCG Financial Position is attached using M4 activity information. This shows that the CCG is in an underspend position (916k on Activity and Prescribing). • Whilst this information is a useful snapshot, the FOT of the CCG’s main secondary care providers (Derby FT and NuH) and Prescribing FOT need to be considered. • FOT (forecast outturn position) at M5 (in £000’s) for Derby and NuH for County PCT is an overspend of £1.4m, as detailed below:- • Derby FT: 1,000 • NuH: 400 • Derby FT activity position for Erewash at M4 is underspent on Non-Electives and day-case as consultants have left. However they will catch up. County PCT FOT on this contract is £1m overspent. • NuH is currently £200k under on Non-Electives, this is due to lower than expected A&E activity. • Prescribing FOT for Erewash CCG using M4 data is £330k overspent (an improvement on M3 FOT of £442k). • Practices are able to view M4 actuals against practice level budgets on the CUBE. • The key to achievement of financial balance is the management of referrals, admissions and prescribing as part of the overall QIPP programme.

4. QIPP (Quality, Improvement, Prevention and Productivity) • Erewash share of the 11/12 QIPP is £4m. • QIPP Assurance is being co-ordinated by a Sub-Committee of the Cluster Corporate Governance Board called the QIPP Co-ordination and Assurance Committee, this group serves to assure the Cluster that appropriate measures are being taken by CCG’s to deliver QIPP. • Recent reviews of the QIPP plans by the Cluster have lead to the following summary of schemes which are now considered to be the responsibility of Erewash CCG (some via lead commissioner arrangements). • £2,042k of the £4m is deemed to be consortia led QIPP. The delivery of the £527k MH schemes will be managed under lead commissioner arrangements with Hardwick Health. This leaves £1,515k which is deemed CCG deliverable. Swift implementation of a QIPP delivery plan and appreciation of activity trends is key via use of the CUBE / consultation with Contract Leads. Incentive Schemes will support QIPP achievement. • Link between QIPP achievement and financial balance.

5. 2011/12 QIPP Delivery • Early indications are that there may be some slippage on QIPP schemes. The value of this is to be determined. See below:-

6. 13/14 and beyond – an update • 2013/14 the CCG becomes a Statutory Body and can ‘stand alone’. • The Running Costs for target for the CCG is not known with certainty, but may be between £20 - £25ph. The CCG must ensure that any changes to organisational structure must be affordable and contained within this envelope. • The budgets of aligned / assigned staff are currently being mapped to each CCG. The addition of non-pay budgets and recharges between CCG’s will form the basis of Erewash CCG’s running cost. • Pending the outcome of this exercise, and utilising the DoH Running cost tool, the affordability of new structures and premise plans will be clearer. • Achievement of financial balance and QIPP priorities will cement the financial standing of the CCG. • Demonstration of a ‘financial track record’ is required for ‘Accreditation’