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FINANCE REPORT

2018/19Finance report for the period ending 30th September 2018

Greater Nottingham Finance Report

Consolidated Finance Report for NHS Nottingham City, NHS Nottingham North and East, NHS Nottingham West and NHS Rushcliffe.

1) Summary Finance Performance

The tables below summarise the forecast year end position for key financial duties, targets and internal key

financial indicators for the Clinical Commissioning Groups (CCGs):

Key Financial Duties Nottm City NNE NW Rushcliffe

Remain within the Revenue Resource Limit (£1.04 Bn)

Achieve the ‘Control Total’ (in year breakeven)

Remain within Running Cost Allowance (£14.9 M)

Remain within the Cash Balance Limit

Better Payments Practice Code

Key Internal Financial Indicators Nottm City NNE NW Rushcliffe

QIPP – achievement of overall target

Achieve Underlying Surplus

Risk Reserves – level utilised to balance position

Co-commissioning – spend remains within budget

Acute services – spend remains within budget

Continuing healthcare – spend remains within budget

Prescribing – spend remains within budget

NHSE - CCG Improvement & Assessment Framework Nottm City NNE NW Rushcliffe

Forecast v plan for the year: Red - below plan

Year to date financial position: Amber 0.1% to 2%; Red > 2% over plan

Net risk: Amber 1% to 2%; Red > 2% of planned spend

YTD QIPP: Amber < 80% plan

FOT QIPP: Amber < 90% plan

MHIS achievement: Amber unachieved

I&A OVERALL RATING: Red - any red; Amber - any amber

2) Month 6 Summary

The overall forecast for the Clinical Commissioning Partnership (CCP) is delivery of the key financial duties.

Key area of concern remains Acute spend. This area is £13.7 million over plan to date, with a combination of contract

over performance and savings targets not delivered causing the pressure. The rate of overspend has reduced slightly

from month 5 on acute.

Contingency and risk reserves are brought into the year to date position to form the main mitigation for the Acute

pressure. Underspends on other budgets areas, notably Prescribing, also form part of the mitigations.

The Acute pressure leads to a continued risk of non-delivery of the control totals for Nottingham City, Nottingham

North and East (NNE) and Rushcliffe CCGs. At this stage of the year, however, we are still forecasting delivery of the

control totals for each CCG and the combined CCP control total.

QIPP delivery shows a £7.2 million shortfall against the ytd £24.5 million target. Schemes to the value of £47m are

identified although these are subject to risk rating. It is essential that QIPP schemes are delivered in the remaining

months of the year otherwise the delivery of the financial duties will be at risk.

The reported underlying position at £6.5 million deficit has slightly worsened against month 5. Recurrent acute

pressures noted above are the main driver of the underlying deficit.

3) Summary of Financial Duties/Target

The Year End forecast position is in line with the submitted NHS England annual operational plan.

Indicates that the organisation is forecasting to achieve its target by the financial year-end

Indicates that there is some cause for concern and the organisation may not achieve its target unless action is taken

Indicates that the organisation will not achieve its target by the financial year-end without immediate intervention

Statutory Duties -

Remain within

Revenue Resource

Limit

Year to Date

(£'000)

Forecast Out-

Turn

(£'000)

Risk Rating Comments

Cumulative Surplus

b/f8,062 19,349

The Greater Notts CCGs are reporting delivery of the b/f cumulative

surplus of £19,349k

Running Costs 373 361 The Greater Notts CCGs are forecasting an underspend position of

£361k for Running Costs

Other budget areas

incl reserves(372) (359)

The Greater Notts CCGs are forecasting an overspend position of

£359k for other budget areas

TOTAL 8,063 19,351 Overall forecast of In Year Breakeven / delivery of the b/f surplus

Better Payments

Practice Code

Year to Date

(%)

Target

(%)

By Number:

Non NHS99.4 95.0

By Number:

NHS99.6 95.0

By Value:

Non NHS99.8 95.0

By Value:

NHS99.5 95.0

Comments

All targets are achieved

Green

Green

Green

Green

Amber

Red

4) Revenue Resource Limit

The combined CCP Revenue Resource Limit (RRL) including the latest month allocations is £1.04 billion per below:-

Recurrent

£'000

Non Recurrent

£'000

Total

£'000

Monthly opening Revenue Resource Limit (RRL) 1,009,870 27,596 1,037,466

In Month changesRetained Doctors Scheme Qtr 1 Payment 29 29

MOCH Funding Year 1 Qtr 3 61 61

LTBI Qtr 2 Allocations 19 19

Agreed UEC Allocations - 2018/19 390 390

Elective Care Transformation Funding for STP 76 76

IAT Adjustment for IR Changes - Made Recurrent (6) (6)

NDPP Funding 2018/19 - Qtr 1 and Qtr 2 25 25

BCF Funding from Region 25 25

GP OOH Services Funding Allocation 5 5

0

Total RRL 1,009,864 28,226 1,038,090

Annual Resource Limit

5) Summary Financial Position Year to Date

Acute £13,698k over plan (this includes £8,944k of savings requirement that is yet to be realised).

Continuing Care £293k over plan

Prescribing £2,281k under plan

Running Costs £373k under plan

Mental Health £178k over plan

Community Services £290k over plan

See Appendix 1 for Individual CCG Operating Cost Statements.

6) Revenue Expenditure Position

The Revenue Expenditure Position is required to match the Cross Provider Report. The reconciliation from the Month 5 cross provider

report to the reported Month 6 ledger position below is detailed in Appendix 3.

Annual Budget Budget to Date Actual to Date Variance under/

(overspend)

£000 £000 £000 £000

Commissioned Services

Acute Care 451,228 226,319 240,018 (13,698)

Mental Health Care 105,361 53,121 53,299 (178)

Community Care 97,525 49,178 49,468 (290)

Continuing Care 70,677 35,420 35,713 (293)

Primary Care 33,503 16,202 16,006 196

Prescribing 85,226 42,473 40,076 2,397

Delegated Co-Commissioning 97,215 45,139 44,671 468

Other Programme Services 26,009 12,043 11,881 162

Contingency, Reserves and Developments 37,003 10,864 0 10,864

Total Programme Costs 1,003,747 490,759 491,131 (372)

CCG Running Costs 14,994 7,455 7,082 373

Total Expenditure 1,018,741 498,214 498,213 1

Planned Historic Surplus 19,349 9,674 0 9,674

Total Revenue Position 1,038,090 507,888 498,213 9,676

7) Key Areas – Risk, Over and Underspend Areas

AREAS YTD Variance Commentary

Prescribing £2,397k Underspend

The underspend on Prescribing mainly relates to a change in the Budget Profiles that have been

received from the NHS Business Services Authority in order to bring the budgets more in line with

the expected spend in order to take account of any seasonal variation, there is also a favourable

fall out from the prior year position. Additional costs are anticipated in the second half of the

year due to Category M drugs pricing pressures (national issue). This risk has been factored in to

the overall forecast position

Community £290k Overspend

Community services contracts are broadly on plan although continence charges are showing a

pressure year to date and for the full year forecast, as well as an element of savings target that is

required.

Mental Health £178k OverspendThe YTD overspend relates to an increase in high cost S117 patients, as well as pressures within

Locked Rehab and Improved Access to Psychological Therapies (IAPT).

Acute Services £13,698k Overspend

Continuing Health Care - CHC £293k Overspend

Key drivers are activity levels at NUHT in Nottingham City & Rushcliffe CCGs and to a lesser extent

Nottingham West. The key Service lines over plan include Daycase, Non elective and Stroke Rehab.

The NUHT contract is c £5.7 million over plan to date.

The Circle contract overall for the CCP is c £1.5million below plan.

Acute savings requirement not reflected in individual contracts are the other key risk area

together with NUHT contract giving a ytd pressure of £8.3 million

YTD Continuing Care shows an Overspend. Risks are starting to be realised around the

volume/price of new packages commencing within Continuing Care.

8) Forecast Outturn and Underlying Position

The forecast outturn position across the Partnership and for each of the four CCGs is breakeven. As noted above, pressures on acute services and savings delivery are emerging. At this stage it is anticipated that the CCGs hold sufficient reserves and other mitigations to cover the pressures/risks. However, the majority of mitigations are non-recurrent, therefore there is a deterioration reported in the 2018/19 exit underlying position.

Depending upon the balance to full year of in year 2018/19 QIPP/savings schemes that may impact in the next financial year, the opening 2019/20 underlying position may show an improvement on the 2018/19 exit. This will become evident during the year as saving schemes are implemented and the balance to full year quantified.

The exit underlying position currently reported shows £12.7 million deterioration to £6.5 million deficit.

CCG

Recurrent Planned

Surplus / (Deficit)

£'000

Recurrent Benefits

/ (Pressures)

£'000

Forecast Exit

Surplus / (Deficit)

£'000

Nottingham City 4,418 (7,410) (2,992)

Nottingham, North & East 725 (4,158) (3,433)

Nottingham West 461 1,839 2,300

Rushcliffe 569 (2,939) (2,370)

Total 6,173 (12,668) (6,495)

9) Other Key Areas

Running costs (RC)

The CCG running costs are within the RC allowance up to Reporting Period Mth 6.

The CCGs have spent £7,082k on running costs for the reporting period, against a year to date budget of

£7,455k.

Statement of Financial Position and Cash

The Statement of Financial Position can be found in Appendix 2.

The Cash Management regime requires CCGs to have a balance at the end of the month, of not more

than 1.25% of that month’s drawdown. This equates to a combined limit £875k for the reporting period

for the Partnership. The actual cash balance the end of the reporting period is £325k.

Primary Care Co-Commissioning

The Primary Care Co-commissioning position shows a slight underspend position for Nottingham West

and Rushcliffe for the reporting period with a small underspend of circa £138k on both Nottingham City

and Nottingham, North and East due to prior year overpayment reclaims, however, the forecast for the

year remains at breakeven.

Better Care Fund (BCF)

BCF spend is on plan.

10) Financial Recovery Plan – Month 6 position The tables below summarises current FRP delivery forecast:

The value of the schemes identified is £4.49m under target, but risk assessed gives a £17.79m shortfall. The forecast delivery by programme area is shown in the table below:

The year to date QIPP delivery is £17.5m against a plan of £24.3m (month 6). The CCP is working to realise additional savings that would give a total QIPP savings of £43.5m.

Current Position Overall Risk Adjusted

Full Year Effect of 17/18 Schemes £21.35m £18.69m

18/19 New Schemes £26.69m £16.04m

Total £48.03m £34.73m

Target £52.52m £52.52m

Shortfall / Surplus (£4.49m) (£17.79m)

Primary Care £0.00m - - - - - £0.00m

Community Care £4.71m £0.42m £2.99m - £1.30m £4.74m (£0.03m)

Urgent Care £3.58m - £0.24m £0.34m £3.00m £7.75m (£4.17m)

Prescribing £7.49m - £7.49m - - £6.40m £1.09m

Planned Care £22.45m £11.35m £9.00m - £2.10m £27.75m (£5.30m)

Continuing Health Care £3.35m - £3.33m £0.01m - £3.44m (£0.09m)

Mental Health £0.29m £0.28m - - - £0.29m £0.00m

Internal Efficiencies £0.51m - £0.51m - - £0.52m (£0.01m)

Estates £0.01m £0.01m - - - £0.06m (£0.05m)

Pipeline Schemes £5.65m £0.05m - - £5.60m - £5.65m

Sub Totals £48.04m £12.11m £23.56m £0.35m £12.01m £50.95m (£2.91m)

NHSE Risk Adjusted Sub Totals £34.73m £12.11m £21.21m £0.21m £1.20m £43.05m (£8.32m)

No RiskMovement

from FRPFRPLow Risk

Medium

RiskHigh RiskProgramme Areas

Current

Position

11) Key Messages

The Partnership is forecasting delivery of the Financial targets and duties.

There is significant risk to this position. Acute spend is over plan year to date and forecast to be

significantly over plan by the end of the year due to the NUHT contract position and acute savings targets.

QIPP delivery is below target year to date. It is imperative that QIPP schemes deliver for the rest of the

year to ensure that Control Totals are delivered

12) Recommendations

The CCP Joint Committee is recommended to:

NOTE the financial position of the Partnership and the individual CCGs for the reporting period.

NOTE the financial recovery position of the Partnership at Month 6.

APPROVE the Finance Report for the reporting period.

Jonathan Bemrose Chief Finance Officer Date – 17 October 2018

APPENDIX 1a – Operating Cost Statement (Greater Nottingham CCGs)

OCS Area OCS Description Annual budget YTD Budget YTD Actual YTD Variance In Month

Movement

Acute Services (AS) Circle Indep. Sect Treatment Ctr 51,379 26,249 24,712 1,537 700

East Midlands Ambulance Service 23,858 11,684 11,472 211 211

AS - Nottingham CityCare 394 197 197 0 14

Nottingham University Hospitals 356,928 179,132 184,205 (5,074) (1,089)

AS - Savings Requirement (18,205) (9,276) (332) (8,944) (1,506)

AS - Other NHS 13,583 6,704 7,174 (470) (205)

AS - Other Non NHS 12,529 6,250 6,341 (91) 156

AS - Sherwood Forest Hospitals (SFHFT) 8,537 4,259 4,623 (364) (151)

AS - Vanguard 52 52 52 0 (0)

Urgent Care Centre 0 0 0 0 (0)

Collaborative Commissioning 18 9 9 0 0

Clinical Assessment Serivce Team 272 136 136 0 0

AS - Resilience 1,882 924 1,429 (505) (255)

Acute Services (AS) 451,228 226,319 240,018 (13,698) (2,125)

Delegated Co-Commissioning (DCC) DCC - Enhanced Services 1,868 928 987 (59) 1

GMS/PMS Payments 67,698 33,948 33,670 278 163

Other 5,312 95 91 4 (31)

Property Costs 13,032 6,508 6,421 87 (96)

QOF 8,349 2,487 2,493 (6) (14)

Delegated Co-Commissioning (DCC) 96,260 43,966 43,662 305 23

Community Health Services (CHS) Local Partnerships 37,929 18,910 18,854 56 7

Integrated Comm Equip Loan Service 2,724 1,362 1,415 (53) (12)

CHS - Nottingham CityCare 30,520 15,260 15,260 0 (0)

CHS - Other NHS 1,920 1,042 979 64 9

CHS - Other Non NHS 22,489 11,632 11,788 (156) 104

CHS - Sherwood Forest Hospitals (SFHFT) 2,343 1,172 1,172 0 0

CHS - Vanguard 0 0 0 0 0

CHS - Savings Requirement (400) (200) 0 (200) (33)

Community Health Services (CHS) 97,525 49,178 49,468 (290) 74

Continuing Care Serivces Continuing Care 61,789 30,975 31,547 (572) (691)

CHC Assessment Service 866 434 427 6 (42)

Funded Nursing Care 8,022 4,011 3,738 273 393

Continuing Care Serivces 70,677 35,420 35,713 (293) (340)

Mental Health Services (MHS) Improv. Access to Psych. Therapies 6,512 3,256 2,954 302 174

Locked Rehab 7,083 3,604 3,252 351 447

Section 117 13,834 7,223 8,071 (848) (794)

MHS - Non Contracted Activity 1,864 932 936 (4) 344

Nottinghamshire Healthcare Trust 72,060 36,020 36,011 9 (22)

MHS - Other NHS 613 307 279 27 (315)

MHS - Other Non NHS 3,395 1,780 1,796 (16) 366

Mental Health Services (MHS) 105,361 53,121 53,299 (178) 199

Corporate Costs Non-Pay 4,218 2,038 1,784 255 18

Pay 10,776 5,416 5,298 118 68

Corporate Costs 14,994 7,455 7,082 373 86

Other Programme Services (OPS) Corporate Costs (75) (1,007) (1,160) 153 37

OPS - Medicines Management 423 211 240 (28) (29)

OPS - GP IT 2,261 1,130 1,112 19 16

NHS Property Services 6,721 3,361 3,392 (31) (44)

OPS - Other NHS 31 15 44 (29) (2)

OPS - Other Non NHS 12,454 6,227 6,102 124 101

Patient Transport 4,194 2,105 2,151 (46) (11)

Other Programme Services (OPS) 26,009 12,043 11,881 162 68

Primary Care Services (PCS) PCS - Enhanced Services 6,548 3,274 3,182 92 115

GP Forward View 4,349 2,322 2,322 (0) (0)

PCS - GP IT 1,025 512 467 45 1

PCS - Medicines Management 1,142 571 558 13 (5)

Out of Hours 6,260 3,131 3,161 (29) (16)

Pathways 5,369 2,685 2,329 356 38

Prescribing 94,991 47,352 45,072 2,281 349

Primary Care Services (PCS) 119,684 59,848 57,092 2,756 483

Developments and Reserves Contingency 4,588 4,588 0 4,588 157

Investments / Other 20,993 6,276 0 6,276 2,044

Committed 11,422 0 0 0 (669)

Developments and Reserves 37,003 10,864 0 10,864 1,532

Planned Historic Surplus Planned Historic Surplus 19,349 9,674 0 9,674 1,612

Planned Historic Surplus 19,349 9,674 0 9,674 1,612

TOTAL 1,038,090 507,888 498,213 9,676 1,612

Greater Nottingham CCP Operating Cost Statement Ledger Position £'000. Variance: Favourable / (Adverse)

APPENDIX 1b – Operating Cost Statement (Nottingham City CCG)

OCS Area OCS Description Annual Budget YTD Budget YTD Actual YTD VarianceIn Month

Movement

Acute Services (AS) Circle Indep. Sect Treatment Ctr 24,610 12,579 11,353 1,225 390



Nottingham University Hospitals 175,161 88,014 89,490 (1,476) (373)

AS - Savings Requirement (9,362) (4,681) 0 (4,681) (780)

AS - Other NHS 6,538 3,187 3,569 (382) (334)

AS - Other Non NHS 6,556 3,278 3,204 74 30

AS - Sherwood Forest Hospitals (SFHFT) 861 430 407 23 (3)

AS - Vanguard 52 52 52 0 (0)

Urgent Care Centre 0 0 0 0 (0)



AS - Resilience 1,782 891 1,191 (300) (50)

Acute Services (AS) 219,557 110,310 115,711 (5,400) (1,005)

Delegated Co-Commissioning (DCC) DCC - Enhanced Services 794 387 412 (25) (18)

GMS/PMS Payments 33,934 17,029 16,838 191 205

Other 2,144 72 72 0 (35)

Property Costs 7,853 3,897 3,924 (27) (17)

QOF 3,611 1,048 1,048 0 0

Delegated Co-Commissioning (DCC) 48,336 22,434 22,295 139 135


Integrated Comm Equip Loan Service 1,254 627 627 (0) (0)

CHS - Nottingham CityCare 30,520 15,260 15,260 0 (0)

CHS - Other NHS 354 260 272 (12) (3)

CHS - Other Non NHS 19,311 10,043 10,020 23 88

CHS - Sherwood Forest Hospitals (SFHFT) 0 0 0 0 0


CHS - Savings Requirement (400) (200) 0 (200) (33)



CHC Assessment Service 38 19 16 3 (43)

Funded Nursing Care 2,797 1,399 1,221 178 392

Continuing Care Serivces 30,112 15,056 15,360 (304) 283

Mental Health Services (MHS) Improv. Access to Psych. Therapies 3,054 1,527 1,606 (79) (59)

Locked Rehab 5,658 2,829 2,249 580 580

Section 117 8,548 4,274 5,077 (802) (802)

MHS - Non Contracted Activity 605 302 306 (4) 344

Nottinghamshire Healthcare Trust 41,413 20,799 20,790 9 15

MHS - Other NHS 216 108 108 0 (341)

MHS - Other Non NHS 2,565 1,377 1,446 (70) 314

Mental Health Services (MHS) 62,059 31,217 31,583 (366) 50

Corporate Costs Non-Pay 1,985 992 994 (2) (44)

Pay 5,227 2,642 2,496 146 94

Corporate Costs 7,212 3,635 3,491 144 50

Other Programme Services (OPS) Corporate Costs 1,031 541 467 74 22

OPS - Medicines Management 423 211 240 (28) (29)

OPS - GP IT 2,261 1,130 1,112 19 16


OPS - Other NHS 0 0 16 (16) 0

OPS - Other Non NHS 725 362 281 82 79

Patient Transport 1,980 990 990 0 0


Primary Care Services (PCS) PCS - Enhanced Services 4,293 2,147 2,133 14 38

GP Forward View 2,471 1,235 1,235 (0) (0)

PCS - GP IT 0 0 0 0 0

PCS - Medicines Management 0 0 0 0 0

Out of Hours 3,160 1,582 1,572 10 (17)

Pathways 0 0 0 0 0

Prescribing 43,048 21,480 20,134 1,346 340

Primary Care Services (PCS) 52,972 26,444 25,074 1,370 361

Developments and Reserves Contingency 2,254 2,254 0 2,254 0

Investments / Other 11,921 2,253 0 2,253 700

Committed 2,046 0 0 0 (669)

Developments and Reserves 16,221 4,507 0 4,507 31

Planned Historic Surplus Planned Historic Surplus 9,526 4,763 0 4,763 794

Planned Historic Surplus 9,526 4,763 0 4,763 794

Overall Total 513,807 252,767 248,003 4,763 794

Nottingham City CCG Operating Cost Statement Ledger Position £'000. Variance: Favourable / (Adverse)

APPENDIX 1c – Operating Cost Statement (Nottingham North & East CCG)


Movement

Acute Services (AS) Circle Indep. Sect Treatment Ctr 8,812 4,499 4,414 85 66



Nottingham University Hospitals 79,626 39,896 40,374 (478) (333)


AS - Other NHS 1,819 908 994 (85) 96

AS - Other Non NHS 3,384 1,688 1,722 (34) 56

AS - Sherwood Forest Hospitals (SFHFT) 4,997 2,492 2,759 (267) (114)

AS - Vanguard 0 0 0 0 0

Urgent Care Centre 0 0 0 0 0



AS - Resilience 62 21 145 (125) (125)

Acute Services (AS) 99,912 50,054 52,683 (2,629) (600)

Delegated Co-Commissioning (DCC) DCC - Enhanced Services 401 199 190 8 16

GMS/PMS Payments 13,796 6,913 6,837 76 47

Other 1,578 7 3 4 4

Property Costs 1,694 736 686 49 (118)

QOF 1,928 613 613 0 0

Delegated Co-Commissioning (DCC) 19,396 8,468 8,331 138 (51)


Integrated Comm Equip Loan Service 642 321 334 (13) 4

CHS - Nottingham CityCare 0 0 0 0 0

CHS - Other NHS 343 172 202 (30) 2

CHS - Other Non NHS 1,701 851 862 (12) (1)

CHS - Sherwood Forest Hospitals (SFHFT) 1,012 506 506 0 0


CHS - Savings Requirement 0 0 0 0 0



CHC Assessment Service 355 178 173 5 1

Funded Nursing Care 2,024 1,002 956 46 2

Continuing Care Serivces 16,360 8,318 8,544 (226) (412)

Mental Health Services (MHS) Improv. Access to Psych. Therapies 1,258 629 491 138 64

Locked Rehab 827 403 453 (49) 27

Section 117 2,046 1,186 1,015 171 139

MHS - Non Contracted Activity 348 174 174 0 (0)


MHS - Other NHS 86 43 64 (21) (3)

MHS - Other Non NHS 329 160 134 26 (103)

Mental Health Services (MHS) 18,390 9,201 8,936 265 102

Corporate Costs Non-Pay 938 392 243 149 23

Pay 2,277 1,138 1,126 12 11

Corporate Costs 3,215 1,530 1,370 161 34

Other Programme Services (OPS) Corporate Costs (430) (623) (670) 47 (12)

OPS - Medicines Management 0 0 0 0 0

OPS - GP IT 0 0 0 0 0

NHS Property Services 870 435 435 (0) (0)

OPS - Other NHS 0 0 0 0 0

OPS - Other Non NHS 4,810 2,405 2,348 57 17

Patient Transport 911 466 494 (29) (8)

Other Programme Services (OPS) 6,162 2,683 2,608 75 (4)

Primary Care Services (PCS) PCS - Enhanced Services 837 418 404 14 13

GP Forward View 669 281 281 0 0

PCS - GP IT 406 203 223 (20) (1)

PCS - Medicines Management 361 181 192 (11) (7)

Out of Hours 1,309 654 671 (16) 0

Pathways 2,194 1,097 931 166 39

Prescribing 21,961 10,948 10,538 410 (14)

Primary Care Services (PCS) 27,736 13,783 13,240 543 31

Developments and Reserves Contingency 973 973 0 973 157

Investments / Other 1,058 733 0 733 733

Committed 4,167 0 0 0 0




Grand Total 217,168 105,614 103,579 2,035 339

Nottingham North & East CCG Operating Cost Statement Ledger Position £'000. Variance: Favourable / (Adverse)

APPENDIX 1d – Operating Cost Statement (Nottingham West CCG)


Movement





AS - Savings Requirement (2,583) (1,460) (332) (1,128) (193)

AS - Other NHS 2,581 1,288 1,374 (86) 54

AS - Other Non NHS 1,011 505 418 87 67

AS - Sherwood Forest Hospitals (SFHFT) 1,338 668 724 (57) (23)





AS - Resilience 38 13 93 (80) (80)


Delegated Co-Commissioning (DCC) DCC - Enhanced Services 301 149 183 (34) (4)

GMS/PMS Payments 8,385 4,240 4,229 12 (20)

Other 1,024 0 0 0 0

Property Costs 1,586 791 753 38 5

QOF 1,262 374 380 (6) (6)


Community Health Services (CHS) Local Partnerships 9,337 4,651 4,647 3 (3)

Integrated Comm Equip Loan Service 384 192 210 (19) (8)


CHS - Other NHS 904 452 445 7 9

CHS - Other Non NHS 1,065 533 526 6 10





Continuing Care Serivces Continuing Care 7,854 4,173 4,051 122 (105)

CHC Assessment Service 210 105 109 (4) (1)

Funded Nursing Care 1,668 804 763 42 12

Continuing Care Serivces 9,733 5,083 4,923 160 (93)

Mental Health Services (MHS) Improv. Access to Psych. Therapies 1,259 629 419 210 104

Locked Rehab 341 193 223 (29) (18)

Section 117 1,385 778 710 69 87

MHS - Non Contracted Activity 303 151 151 (0) (0)


MHS - Other NHS 146 73 74 (2) 1

MHS - Other Non NHS 211 102 82 20 (45)

Mental Health Services (MHS) 11,598 5,939 5,671 268 118


Pay 1,301 651 652 (2) (36)

Corporate Costs 1,924 967 901 66 1

Other Programme Services (OPS) Corporate Costs (328) (430) (453) 22 11


OPS - GP IT 0 0 0 0 0

NHS Property Services 747 373 373 (0) (0)

OPS - Other NHS 31 15 29 (13) (2)

OPS - Other Non NHS 3,391 1,695 1,688 8 10

Patient Transport 643 314 309 5 4




PCS - GP IT 263 132 133 (1) 1

PCS - Medicines Management 413 207 138 68 11

Out of Hours 829 415 425 (10) 0

Pathways 1,215 607 426 181 30

Prescribing 13,512 6,727 6,554 174 32

Primary Care Services (PCS) 17,259 8,575 8,112 463 127


Investments / Other 4,543 649 0 649 7

Committed 2,136 0 0 0 0




Overall Total 138,469 66,054 64,725 1,329 221

Nottingham West CCG Operating Cost Statement Ledger Position £'000. Variance: Favourable / (Adverse)

APPENDIX 1e – Operating Cost Statement (Rushcliffe CCG)


Movement






AS - Other NHS 2,646 1,321 1,237 84 (21)

AS - Other Non NHS 1,577 779 997 (218) 2

AS - Sherwood Forest Hospitals (SFHFT) 1,341 669 732 (63) (10)





AS - Resilience 0 0 0 0 0


Delegated Co-Commissioning (DCC) DCC - Enhanced Services 373 193 201 (8) 7

GMS/PMS Payments 11,584 5,766 5,766 (0) (69)

Other 565 16 16 0 0

Property Costs 1,900 1,084 1,057 26 35

QOF 1,548 451 451 0 (8)



Integrated Comm Equip Loan Service 444 222 243 (21) (9)


CHS - Other NHS 318 159 60 99 1

CHS - Other Non NHS 411 205 380 (174) 8





Continuing Care Serivces Continuing Care 12,678 6,025 5,958 68 (106)

CHC Assessment Service 263 132 129 3 0

Funded Nursing Care 1,532 806 799 7 (14)

Continuing Care Serivces 14,473 6,963 6,886 78 (119)

Mental Health Services (MHS) Improv. Access to Psych. Therapies 941 471 437 33 65

Locked Rehab 257 178 328 (150) (142)

Section 117 1,854 984 1,270 (286) (217)

MHS - Non Contracted Activity 608 304 304 0 (0)


MHS - Other NHS 165 83 33 50 29

MHS - Other Non NHS 291 142 134 8 201

Mental Health Services (MHS) 13,314 6,765 7,109 (345) (71)


Pay 1,971 985 1,023 (38) (2)

Corporate Costs 2,644 1,323 1,321 2 1

Other Programme Services (OPS) Corporate Costs (348) (494) (505) 10 16


OPS - GP IT 0 0 0 0 0


OPS - Other NHS 0 0 0 0 0

OPS - Other Non NHS 3,528 1,764 1,786 (22) (4)

Patient Transport 661 335 358 (23) (6)

Other Programme Services (OPS) 6,040 2,704 2,738 (34) 5



PCS - GP IT 356 178 112 66 1

PCS - Medicines Management 367 184 228 (45) (9)

Out of Hours 962 481 494 (13) (0)

Pathways 1,961 980 971 9 (31)

Prescribing 16,471 8,197 7,847 350 (10)

Primary Care Services (PCS) 21,717 11,046 10,666 380 (36)


Investments / Other 3,471 2,641 0 2,641 604

Committed 3,073 0 0 0 0




Overall Total 168,646 83,454 81,905 1,549 258

Rushcliffe CCG Operating Cost Statement Ledger Position £'000. Variance: Favourable / (Adverse)

APPENDIX 2 – Balance Sheet

STATEMENT OF FINANCIAL POSITION

As at 30th September 2018

Audited Closing Net

Open Bal at Balance Change

Apr-18 for period

£'000s £'000s £'000s

Non-current assets

Property, plant and equipment 0 0 0

Intangible assets 0 0 0

Investment Property 0 0 0

Trade & Other Receivables 0 0 0

Other Financial Assets 0 0 0

Total non-current assets 0 0 0

Current assets

Inventories 0 0 0

Trade and other receivables 4,093 23,473 19,380

Other Financial Assets 0 0 0

Other Current Assets 0 0 0

Cash and cash equivalents 159 115 (44)

Total Current Assets 4,252 23,588 19,336

Non Current Assets classified as "Held for Sale"

Total assets 4,252 23,588 19,336

Current Liabilities

Trade and other payables (38,028) (74,691) (36,663)

Other Financial Liabilities 0 0 0

Other Liabilities 0 0 0

Borrowings 0 0 0

Provisions (238) (317) (79)

Total current liabilities (38,266) (75,008) (36,742)

Total assets less current liabilities (34,014) (51,420) (17,406)

Non-current liabilities

Trade and other payables 0 0 0

Other Financial Liabilities 0 0 0

Other Liabilities 0 0 0

Borrowings 0 0 0

Provisions (508) (459) 49

Total assets employed (34,522) (51,878) (17,356)

Financed By Taxpayers' equity

General Fund (34,522) (51,878) (17,357)

Revaluation reserve 0 0 0

Donation reserve 0 0 0

Charitable Reserve 0 0 0

Total taxpayer's equity (34,522) (51,878) (17,357)

APPENDIX 3 – Cross Provider report to Ledger – Expenditure to date reconciliation

Category / £000 Finance Cube M5Accrued Month(s) /

Prior Year Fall out

Providers/Spend

not in cubeLedger M6

Acute Care £185,663 £34,668 £19,687 £240,018

Mental Health Care £29,830 £6,181 £17,288 £53,299

Community Care £28,373 £5,741 £15,354 £49,468

Continuing Care £29,087 £6,627 £0 £35,713

Primary Care 0 £0 £13,148 £13,148

Prescribing £34,226 £6,786 £2,931 £43,943

Delegated Co-Commissioning £0 £0 £43,662 £43,662

Other Programme Services £0 £0 £11,881 £11,881

CCG Running Costs £0 £0 £7,082 £7,082

Reserves £0 £0 £0 £0

Total £307,179 £60,002 £131,032 £498,213

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