Croydon Attachment D1 2012/13 Financial Position and Recovery Plan Month 12 Outturn Performance April 2013 0
Index 1. Financial Position Summary 2. QIPP Recovery Performance 1
1. Executive Summary • Final outturn is a £63k surplus, following the release of funds from the SWL Risk Sharing Arrangement (£9.0m) and additional resource limit released for continuing care restitution payments (£2.6m) and Croydon share of transition costs. • Year-end agreement was reached with Croydon Healthcare Services (CHS) and South London & the Maudsley • Key estimates include: continuing care, premises severance, review of provisions for old clinical negligence settlements 2
1.1 Financial Outturn Financial Performance Performance Measure Target Forecast Status Trend Target/ Indicator Statutory Break Even Duties £620.2m Revenue Resource (incl. £9m Stay within RRL £620.1m Green Limit (RRL) from risk share) Capital Resource Stay within CRL £1.0m £0.7m Green Limit £619.4m Stay within Cash (incl £9m Cash Resource Limit £619.4m Green Limit from risk share) Administration Duties Payment of valid Better Practice Between 78% invoices within 30 90% Amber Payment Policy and 93% days. Other Significant Financial Targets Delivery of Green (see QIPP £25m £21.1m Programme Savings Appendix 12/13) 3
1.2 Financial Outturn – Key Estimates Key estimates included in the outturn position include: • Prescribing accrual (£3.4m) • Provision for continuing care restitution claims (£4.5m) • Severance costs on premises (Leon House and Windsor House) (£0.8m) • Bad Debt and Bad Debt Provisions (£1.1m) • Partially completed acute inpatient spells (£3.1m) • Review of old clinical negligence provisions (£0.7m) 4
1.3 Financial Performance By Receiver Organisation 5
1.4 Financial Performance CCG: ACUTE (10 months) 6
1.5 Financial Performance CCG: Out of Hospital Services 7
1.6 Financial Performance NCB: Primary Care / Specialist 8
1.7 YTD/FOT QIPP Performance Graph (M11) 9
1.8 RAG Rating of QIPP Schemes PMO RAG Number of Annual Plan Forecast Variance Rating Projects (£000) Saving (£000) (£000) Green 20 13,608 19,142 5,534 Amber 6 2,564 1,742 (822) Red 17 6,341 223 (6,109) Unidentified 2,487 - (2,487) Total (M11) 43 25,000 21,107 (3,893) Total (M10) 43 25,000 21,220 (3,780) 10
2. Recovery/QIPP Performance • £25m recovery target (net after investment) • £22.5m Net Savings Plans Agreed (90%) • Risks on Forecast outturn: • Non-delivery on agreed schemes (£1.4m) • Non-delivery to be identified (£2.5m) 11
2.1 Year to date performance • Based on 11 months actual acute data • Achieved net savings of £18.9m against plan of £22.5m (84%) • Key areas of adverse performance: • Primary Care • Shift of Care: Intermediate Services / Demand Management • Mental Health Efficiency • LTC and GP Support for Care Homes initiatives • Direct Access Diagnostics • Key areas of favourable performance: • Continuing Care: Mental Health, Children and LD • Prescribing • Corporate/Public Health • Community Efficiency • Acute KPIs/underperformance in outpatient activity 12
2.2 2012/13 Programme Overview 2012/13 Planned Net Savings 2011/12 QIPP Category Work in Outturn Confirmed Total Progress Mental Health 1,465 3,083 3,083 Acute Sector 1,977 9,939 9,939 Primary Care 1,294 824 824 Community Support Services - 1,416 1,416 Activity Shifts - 1,167 1,167 Long Term Conditions 480 2,156 2,156 Urgent Care 2,365 104 104 Planned Care 3,547 1,407 1,407 End of Life 350 877 877 Staying Healthy - 325 325 Back office 2,965 177 177 Staffing - 240 240 Prescribing 2,325 800 800 Total 16,769 22,513 0 22,513 Unidentified 2,487 Target savings for 2012/13 22,513 0 25,000 RED HIGHLIGHT: Delivering shifts of activity, but not seeing underperformance on acute SLAs 13
2.3 Top Ten QIPP Schemes PMO £’000 Project Status Description Rating Acute KPI/CQUINs – CUH Savings from agreed contract levers with CUH 8,145 G New Reduction in acute MH contract value, activity Mental Health Efficiency 2,030 R New reductions and shifts into primary care CCHS (Community) Efficiency 1,416 G New Reduction in agreed value of CCHS contract COPD ‘hot clinic’ to avoid emergency COPD Community Service 874 R Exp. admissions, doors opened in March Reduction in GP prescribing spend. Limited Prescribing Efficiency 800 G New data YTD. Principally reduced pricing for SCG services LSCG Efficiencies 778 G New Savings from agreed contract levers with other Acute KPI/CQUINs – Other Trusts 746 G New Acute Providers National efficiency adjustment Mental Health National Efficiency 735 G New Savings agreed with CUH through service Urology Service Redesign 600 G New redesign Community triage service established to reduce Intermediate Ophthalmology Pathway 575 R FYE activity flow into Secondary Care Total (67% of total target) 16,699 14
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