North West London

Month 4 Budget UpdateSaHF & NWL Strategy and Transformation Programmes

August 2014

This paper provides the month 4 budget update for NWL-wide financial strategy/ SaHF including Strategy & Transformation programmes.

It updates the budgets proposed at the previous Collaboration Board, includingreflecting NHSE confirmed contribution.

The Collaboration Board are asked to:

a) agree the proposed budget changes on slides 5 & 6 for recommendation toCCG Governing Bodies

b) note the month 4 budget report and balanced forecast outturn on S&T budgets on slides 7 and 8

2

Purpose / Summary

Contents

Sources of funding

Applications of funding

Budget Analysis

1

2

3

Month 4 S&T budget report4

Forecast outturn S&T spend5

3

Total resource available

Sources of funding

CCGs contribute to the programme from the 2.5% top slice

HENWL contribute for the development of community education networks across NWL

NHS E contribute to the Prime Minister’s challenge fund

£41.7m1

£5.0m

£1.0m

£2.5mBalance of PM match funded locally by CCGs

Initial funding

A

C

E

1 includes Richmond CCG contribution of £1m2 reduced to £15m to reflect NHSE budget and then subsequently to £13.6m as a result of surplus

control total target

NHS E fund equivalent of the 2.5% contribution from services they commissionB £16.3m

£59.0m

F

Additional sources of funding

Revised funding

4

£41.7m1

£1.0m

£56.3m

£5.0m

£2.5m

£13.6m2

Applications of funding

£31.9m

£27.1m£1.95m£3.90m£0.60m

£11.60m£4.70m£1.50m£2.85m

--

Total

£59.0m

- S&T projects (including HENWL contribution)- Provider support

- Ealing- Hillingdon- Imperial (A&E)- NWLHT (CMH plus A&E)- West Mids- West Mids Transaction Related

Costs- NWLHT Transaction Related Costs

- Carried forward to 2015/16- Over commitment

£31.9m

5

£22.75m£1.95m£3.90m£0.60m

£11.60m£4.70m

--

£2.0m(£0.35m

)

£56.3m

Notes• Total funding available reduced by £2.7m• S&T projects budget unchanged• Provider support reduced by £4.35m• £2m carried forward to 15/16 (by Brent CCG) as part of agreeing 14/15 revised plans with

NHSE• Balance of over-commitment of £0.35m

Initial funding Revised funding

In Year Budget Pressures

6

• The following SaHF implementation in year funding pressures have been reviewed by the COs and proposed to fund:-

- Further resilience in respect of A&E closures £0.35m- Maternity transition £0.83m- Imperial emergency surgery £0.25m

• Agreement of these would increase the total over-commitment to £1.75m

• It is proposed that the following approach to balancing the budget is adopted. In priority order:-

a) Seek re instatement from NHSE of £1.5m reduction related to control totals

b) Review S&T budgets to identify in year slippage on plansc) Mid year review of CCG forecast outturns for additional contributiond) CCGs miss control totals agreed with NHSE

7

Breakdown of agreed 2014/15 S&T budget – Unchanged

£3.0m

1 Balance of PM match fund of £2.5m funded locally by CCGs (i.e. total match fund £5m). 2 PM match fund of £5m to be funded by NHS England

£24.7mTotal

Slide 7Primary care transformation

Enhanced integration

2

1

Hub businesscase

development

Informatics strategy

Primary Caredevelopment +PM match fund

£5.0m £3.5m

£2.5m £1.25m £0.3m

£5.5m

£2.1m

Other costs (core team, non-pay, events) £2.8m

SaHFimplementation

5 year strategy

£0.2m

Programme Office

£1.5m

Implementation mngt and

governance

£2.6m

Local H & M.H. business case

delivery

£4.0m3 £13.3m

Hospital BC assurance &

IMBC

£1.0m

Imp. of 2014 changes (A&E,

Maternity)

£1.0m

£31.9m

Transforming Mental Health services

4

Transforming Mental Health

services

£2.0m

£1.0m

PC Co-commissioning

£1.25m

Workforce

Whole systems Whole systems implementation

£2.0m

Communicatio ns

£1.0m

£3.2m

-

£1.0m

-

£7.2m

Inc. £1m HENWL

S&T CCGs

8

Month 4 S&T budget reportCommitted Spend YTD

BUDGET COMMITTED SPEND VARIANCEYTD

YTD YTD

Whole systems £0.7m £0.9m -1 Enhanced Whole systems implementationintegration £0.1m - -

TOTAL £0.8m £0.9m £0.1m

PC co-commissioning £0.2m - -

Primary care GP Development + PM match fund £0.1m - -

2 trans- Hub business case development £0.2m £0.5m £0.3m

formation Primary care IT strategy £0.1m - -

TOTAL £0.6m £0.5m -£0.1m

5 year strategy £0.1m £0.1m -

Programme office £0.4m £0.4m -Implementation planning and governance £0.6m £0.5m -£0.1m

SaHF LH & MH business case delivery £1.2m £1.2m -

3 Implement- Imp. of 2014 changes (A&E, maternity) £0.1m £0.1m -

ation Hospital BC assurance & IMBC £0.7m £0.8m £0.1m

Workforce £0.2m £0.2m -Communications £0.4m £0.3m -£0.1mTOTAL £3.7m £3.6m -£0.1m

Trans-forming

4 mental healthservices TOTAL

£0.3m £0.3m -

Other costs

5 (core team,non-pay,

events) TOTAL £0.8m £0.9m £0.1m

Total £6.2m £6.2m -

Forecast outturn S&T spend

Enhanced integration1

Primary care trans- formation

2

SaHFImplement- ation

3

Trans-forming mental health services

4

Other costs (core team, non-pay, events)

5

Whole systemsWhole systems implementationTOTAL

PC co-commissioningGP Development + PM match fund Hub business case development Primary care IT strategyTOTAL

5 year strategy Programme officeImplementation planning and governance LH & MH business case deliveryImp. of 2014 changes (A&E, maternity) Hospital BC assurance & IMBC WorkforceCommunicationsTOTAL

TOTAL

TOTAL

1 includes £1m HENWL contribution

£5.0m£3.5m£8.5m

£1.3m£2.5m1

£1.3m£0.3m£5.3m

£0.2m£1.5m£2.6m£4.0m£1.0m£1.0m£2.0m£1.0m

£13.3m

£2.0m

£2.8m

Total

9

£31.9m

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-----

---------

-

-

-

BUDGET VARIANCE

£5.0m£3.5m£8.5m

£1.3m£2.5m£1.3m£0.3m£5.3m

£0.2m£1.5m£2.6m£4.0m£1.0m£1.0m£2.0m£1.0m

£13.3m

£2.0m

£2.8m

£31.9m

FORECAST OUTTURN