Summary Sheet: Governing Body
Date / Tuesday 9 Sept 2014Title of paper / Shaping a Healthier Future M4 budget update
Presenter & Organisation / Clare Parker, CFO, CWHHE
Author / Jonathan Wise, CFO BHH
Responsible Director / Clare Parker, CFO, CWHHE
Clinical Lead / Dr Tim Spicer, Chair H&F CCG
Confidential / Yes No x (items are only confidential if it is in the public interest for them to be so)
The Governing Body is asked to:
Approve the proposed budget changes on slides 5 and 6, including the proposed approaches to ensuring a balanced budget
Notethe month 4 budget report and balanced forecast outturn on S&T budgets on slides 7 and 8
Summary of purpose and scope of report
The purpose of this report is to set out the budget position at month 4 and to highlight to the governing body an identified risk of overspend of £1.75m, with recommendations to the governing body about how this should be managed.
The original SAHF budget totalled £59m. This budget has reduced by £2.7m as a result of a reduced contribution from NHS England, relating to a lower original budget than we had previously assumed and a further reduction as a result of discussions about changes in the CCG’s control totals. Planned expenditure has reduced as CCGs do not now need to contribute to the transaction related costs for the two mergers at NWLH/Ealing and West Middlesex/Chelsea & Westminster, but additional risks relating to A&E closures, maternity transition and emergency surgery at Charing Cross have been identified which need to be funded. This gives a £350k shortfall against the budget based on the current approved expenditure, and £1.75m once the additional risks are factored in.
The Collaboration Board has considered the paper and has endorsed the need to fund the additional expenditure, giving an overcommitment of £1.75m. It is proposed that the following approach to balancing the budget is adopted. In priority order:
a)Seek reinstatement for NHSE of £1.5m reduction related to control totals
b)Review Strategy and Transformation budgets to identify in year slippage on plans
c)Mid year review of CCG forecast outturns for additional contribution and / or utilization of funds currently earmarked for carry forward to 15/16
d)One or more CCGs miss surplus control totals agreed with NHSE.
The Collaboration Board endorsed this approach for managing the budget.
The remainder of the paper sets out the budget position at month 4. There are no forecast overspends against the budget other than the overcommitment set out above.
Quality & Safety/ Patient Engagement/ Impact on patient services:
No issues.
Financial and resource implications
There is a risk of a £1.75m overspend across the 8 CCGs if the above mitigations are not successful.
Equality / Human Rights / Privacy impact analysis
No issues.
Risk
As per financial implications
Supporting documents
-Month 4 budget update, SAHF & NWL Strategy and Transformation Programmes
Governance and reporting(list committees, groups, or other bodies that have discussed the paper)
Committee name / Date discussed / Outcome
NWL Collaboration Board / 28/08/2014 / Recommended for Governing Body approval