20082009 FINANCE AND PERFORMANCE REPORT Month 1

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2008/2009FINANCE AND PERFORMANCE REPORT
Month 1
Jonathan Wise, Director of Finance Performance

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Contents

• Part 1 Finance report (slides 2-13)
• Part 2 Performance report (slides 14 26)
• Part 3 PBC and Acute commissioning report
• ( slide 27)
• Finance Appendices (slides 28 - 35)
• Summary Operating Cost Statement and variances by
  budget heading
• 2. Balance sheet
• 3. Cash flow

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PART 1 FINANCE REPORTFinancial position -
Summary

• Statutory duties
• Forecast underspend against revenue resource
  limit
• Achievement of capital resource limit
• Forecast underspend against cash limit
• Achievement of Operating plan surplus
• Improvement in ALE assessment
• Budget holder responsibilities / training

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Overview of budget position

• Total budgets agreed by Board at March meeting
• 000
• Issued budgets 418,054
• Contingency 4,200
• Investment programme 9,500
• TOTAL 431,754
• Surplus for investment 12,446
• TOTAL 444,200
• All issued budgets have been signed off by
  budget holders
• All budget changes (virements, access to
  contingency and new investment programme) being
  tracked for agreement at appropriate level

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Approval of budget changes

• Virement

• In year contingency all to be agreed by CE,
  as agreed at March Board meeting
• New investment programme all to be agreed
  Board, on advice of Investment
• group (Chaired by CE) as agreed at March Board
  meeting. The following
• investments are put forward for Board
  approval
• 000
• PBC Executive group - 100 (non-recurrent)
• (payments to attendees)
• Primary care strategy - (Project Mgr)
  65 (non-recurrent)
• Health visitors x 4 WTE 92 (recurrent, full
  year 157k)
• Health visitors (agency cover
• for sick leave) 54 (non-recurrent)
• - Project Management 216 (non-recurrent)

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The investment process has 2 phases

• Project selection (portfolio formulation)
• Ensure strategic fit
• Establish priorities
• Project delivery (programme execution)
• Detailed planning(ensure project offers good
  value for money and is deliverable)
• Deliver plans
• Review

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Portfolio Formulation
Programme Execution
Decision
1 Agree to invest
0 Commission analysis
3 Project complete
4 Benefits evaluation
2 Go live
1 Start-up
2 Delivery
3 Closure
4 Review
Stage
Project Brief
Business case project plan
Go/no go report
End project lessons learnt report
Post-implemen-tation review
Document
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Successful schemes at Stage 0

• Have clear outcomes, that make a major
  contribution to our strategic objectives
• Give the Panel confidence that the scheme is
  realistic
• Cost
• Benefit
• Risks
• Next steps

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Successful schemes at Stage 1

• Have the best value for money (cost v benefits)
• Give the Panel confidence that the scheme is
  deliverable
• Stakeholders
• Delivery plans
• Resources
• Risks

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Successful schemes at Stage 2

• Monitor progress to ensure the business case is
  still strong
• Costs
• Benefits
• Risks
• Stakeholders and interfaces
• Milestones
• Re-plan as circumstances change

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Overview of month 1 position

• Aggregate surplus of 1041k largely reflecting
  planned surplus for investment in 09/10
• Variances on issued budgets net to overall
  balance
• Commissioning April activity data not yet
  available so position largely reflects
  contractual agreements
• Primary Care the YTD underspend of 40k is
  likely to increase with slippage on GMS enhanced
  services and additional Dental allocation
• Provider services risks in respect of income
  reflected in YTD overspend of 34k
• HQ net overspend of 31k being investigated
  further
• General a significant element of the Phase 1
  investment programme is profiled later in the
  year and potential slippage (underspend) is
  currently being assessed

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Achievement of Operating Plan surplus

• A full assessment of the overall plan is underway
  and will be presented (with proposed actions) to
  the July Board, building on the risk assessment
  presented to the March Board

Risk Assessment of Overall Financial Position
2008/9
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Other Corporate objectives

• ALE assessment
• Action plan to deliver the Corporate objective of
  achieving adequate or better across all
  dimensions being considered by EMT / Audit
  Committee
• Update on high risk areas will be considered at
  June EMT/Audit Committee
• Budget holder responsibilities / training
• Budget sign-off letter plus Finance guide clearly
  set out responsibilities
• Provider arm training commenced 12/5 (14
  attended)
• Further Provider arm plus Commissioner training
  planned for June

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Part 2 2008-09 Performance Report

• 4 main target areas as set out in the 2008-09
  Operating Plan
• National Requirements (NR) refers to national
  commitments where the requirements are very
  specific at a national level and must be cascaded
  to PCT level.
• National Priorities (NP) - refers to national
  commitments, but where trajectories are set by
  the PCT.
• London Priorities (Lon P) as per national
  commitments but for the London SHA area.
• Local Priorities (LP)- Priorities and any
  corresponding targets agreed locally.
• Existing Commitments (EC)- PCT required to
  continue to achieve targets from prior
  commitments.
• Indicators marked with an asterix () under
  internal monitoring frequency column will be
  subject to local monitoring on a more frequent
  basis than that proposed by the SHA and DoH. This
  will ensure appropriate monitoring of high risk
  target areas where investment has been focused
  for 2008-09. Discussions will take place with
  individual Directors to agree in year reporting
  and timetables for these indicators.

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2008-09 Performance Report(2)

• Actuals against Plan will be available within 6
  weeks of the current reporting month and reported
  to the following EMT and Board meetings.
• Performance against targets will be measured
  using the Red, Amber and Green (RAG) rating as in
  previous years and in accordance with the SHA
  thresholds for each target.
• The targets have been grouped by Directorate and
  the monitoring frequency as shown on the
  following pages.

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Clinical Leadership and Integrated Governance
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Organisational Development Human Resources
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Primary and Community Commissioning Services
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Primary and Community Commissioning Services (2)
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Provider Development and Estates
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Public Health
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Public Health (2)
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Strategic Commissioning
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Strategic Commissioning (2)
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Strategic Commissioning (3)
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Strategic Commissioning (4)
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Part 3 PBC and Acute Commissioning Report

• PBC budgets (PbR services) were issued on 24
  April at the PBC launch event
• Practices are due to confirm acceptance of the
  budget and the Governance and Accountabilities
  arrangements on 27 May
• The PCT is now working on
• PBC reporting arrangements
• In-year acute contract data validation / contract
  management arrangements
• Month 1 reports are expected to be available to
  Practices in June

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Appendix 3 Cash Flow Report to 30/04/08
Cash drawings in April were consistent with plan.
Receipts including Sure Start were higher than
expected and contributed to the cash balance at
month end.