Finance Report

Month 9 2010-11

Jonathan Wise,

Director of Finance & Performance

222

NHS BRENT FINANCE REPORT 10/11 - CONTENTS

1. Summary [Slides 3-7]2. Year to Date Position [Slides 8-26]3. Forecast Outturn Position [Slides 27-35]

Appendices

A.Detailed finance schedules [Slides 36-45]

33

SECTION 1 – SUMMARY

3

444

FINANCIAL PERFORMANCE SUMMARY (1)

Statutory duties– Underspend against revenue resource

limit– Achievement of capital resource limit– Underspend against cash limit

Achievement of public sector payment policy

Achievement of Operating plan surpluswithin SHA defined tolerances

Underlying recurrent position

Management Cost target

BCS full cost recovery

BCS achievement of plan

Achievement of 10/11 Savings plan Achievement of 10/11 Demand Man. plans

GG

G

YTD FOT From Last Month

Improving

No Change

Worsening

G

GG

G G

A G

R R

A A

R

R

R

R

G G

R R

555

FINANCIAL PERFORMANCE SUMMARY (2)

• At month 9 the year-to-date position is a £0.4m favourable variance against budget. The main elements of this position are underspends within Joint Working (£0.7m), Other Acute (£1.6m), Corporate budgets (£1.5m), Estates (£0.2m), the CSP/Performance budget (£3.6m), Investment / Reserves (£5.7m), Contingency (£0.5m) offset by overspends on Acute contracts (£5.5m), Primary care (£0.3m), BCS (£0.9m) and the pressure year-to date from the contribution to the NW London sector position (£4.1m) and a 10/11 advance on 11/12 Challenged Trust Board contribution (£2.6m).

• The overall forecast outturn position at month 9 is break-even against a plan of £17.2m surplus. There are forecast underspends in Joint Working (£1.6m), Other Acute (£2.0m), Corporate budgets (£2.0m), CSP/Performance (£3.6m), Balance Sheet review (£2.5m), Allocations (£0.5m), Contingency (£0.2m), the benefit from the year-end settlement with NWLHT (£3.4m) and slippage on Investments / Reserves (£7.2m) offset by forecast overspends on Acute contracts (£9.1m), Primary Care (£1.1m), BCS (£0.9m) and the pressure from the contribution to the NW London sector position (£5.4m) and the 10/11 advance on 11/12 Challenged Trust Board contribution (£6.5m).

• The forecast outturn movement is from a £0.2m surplus against plan at month 8 to break-even at month 9. The main movements have been increases in underspends on Investments/Reserves (£2.3m), CSP (£0.3m) and the release of contingency (£0.2m), netted-off by an increased contribution to the 11/12 Challenged Trust Board contribution of £3.0m.

66

RISKS & OPPORTUNITIES TO FORECAST OUTTURN POSITION (1)There are a number of significant variables that could impact on the forecast outturn set out in the table below. These issues are being actively monitored on a monthly basis by EMT.

RISK/OPPORTUNITY Risk = Red Opportunity = Green Potential risk or opportunity =Amber

Likelihood L=Low M= Medium H= High

ESTIMATED RANGE OF IMPACT ON FINANCIAL POSITION

MITIGATING ACTIONS

CSP/Performance agreed investment & non-recurrent spend plan underspends beyond current forecast

M No change to improvement up to £1.0m

Plans have been reviewed with SROs and further underspend reflected in the forecast.

Balance sheet M No change to improvement of up to £1.0m

Initial review concluded and reflected in outturn. Further review to be undertaken post month 9.

Contingency not required M Improvement of up to £1.5m

The acute position outturn forecast is based upon month 8 data. It is possible that the forecast may change in future months.

M Improve by a £1m or deteriorate by £1m

Establish robust early warning mechanisms with ACV. Seasonality built into forecasts. Year-end settlement has been reached with NWLHT; opportunity or risk limited to contract performance with other Trusts. Year-end settlements are sought with other Trusts.

77

RISKS & OPPORTUNITIES TO FORECAST OUTTURN POSITION (2)

During the last few months the balance has shifted towards a reduction in the level of risk. There are now three green-rated risks, four amber-rated risks and no red-rated risks.

RISK/OPPORTUNITY Risk = Red Opportunity = Green Potential risk or opportunity =Amber

Likelihood L=Low M= Medium H= High

ESTIMATED RANGE OF IMPACT ON FINANCIAL POSITION

MITIGATING ACTIONS

Specialist commissioning 10/11 information based upon month 7 data. It is possible that the forecast may change in future months.

M Improve or deteriorate by up to £0.5m

Establish robust early warning mechanisms with LSCG.

Prescribing 10/11 information based upon month 7 position. It is possible that the forecast may change in future months.

M Improve or deteriorate by up to £0.25m

Review information as soon as available. Investigate potential causes of variances already identified.

BCS M Improve by £300k or deteriorate by £200k

Recovery plan included within forecast outturn position.

88

SECTION 2 – YEAR TO DATE POSITION

8

999

OVERVIEW OF BUDGET POSITION AT MONTH 9

Month 8 (£m)

Changes (£m)

Month 9 (£m)

Issued budgets 532.8 1.5 534.3

Contingency 2.0 2.0

Investment & reserves 8.6 (0.5) 8.1

In-Year Plan for sector contribution (5.4) (5.4)

Advance on 11/12 CTB contribution (3.5) (3.5)

10/11 Severance cost funding 1.0 1.0 2.0

Allocation adjustments 0.8 0.8

Total 536.3 2.0 538.3

Surplus for Investment plan in 2011/12 17.2 17.2

Total Allocation 553.5 2.0 555.5

• The £1.5m increase in issued budgets relates to £0.7m pass-through payments to NWLHT, £0.5m revenue funding regarding Peel Road, £0.2m Smoking Pharmacy Performance Bond and £0.1m funding for Clinical Directors.•Of the £0.5m reduction in Investments & Reserves, £0.3m was transferred to issued budgets and £0.2m was reduced from the allocation for London-wide recharges.•An additional £1m funding has been anticipated towards 10/11 severance costs.

1010

SUMMARY OF YEAR TO DATE VARIANCES£000s+ve = u/spend(-ve) = o/spend

M7 M8 M9Movement M8

to M9

Acute Contracts (3,465) (4,285) (5,538) (1,253)

Other Acute Commissioning 995 1,449 1,604 155

Joint Working 872 737 707 (30)

Primary Care (594) (398) (304) 94

PCT Corporate Costs 1,183 1,336 1,520 184

Estates 155 118 195 77

CSP / Performance 2,627 3,016 3,625 609

BCS over/(under) recovery (656) (815) (881) (66)

Total variances against budgets 1,117 1,158 928 (230)

Contingency 0 0 500 500

Investment slippage & reserves 3,305 4,822 5,679 857

Allocation adjustment 0 0 0 0

In-year plan (Sector) (3,192) (3,648) (4,104) (456)

10/11 advance on 11/12 CTB Sector Contribution

0 (2,333) (2,625) (292)

TOTAL VARIANCE 1,230 0 379 379

Explanations for the main variances are included on the following slide.

111111

SUMMARY OF YEAR TO DATE VARIANCESAcute contracts (£5.5m) unfavourable– Currently 11 out of the 22 acute contracts are showing overspends based upon month 8 data. There are overspends reported at NWLHT £2.6m, Imperial £1.4m, Royal Brompton £1.1m, Royal Free £0.4m, St Georges £0.2m, Barnet & Chase Farm £0.1m, Moorfields Eye £0.1m and Chelsea and Westminster £0.2m. There are underspends at Barts £0.3m, RNOH £0.2m and Guys £0.1m. Our experience is that it is likely that these underspends will reduce over the coming months.

Other Acute (£1.6m) favourable – The suspension of the Clinicenta contract has resulted in a £1.4m underspend to date, High Cost Drugs is underspent by £0.3m, Non-contracted activity is underspent by £0.2m and cost per case overspent by £0.3m.

Joint working (£0.7m) favourable – Underspends on Continuing Care (£0.3m), Children and Families (£0.3m), End of Life £0.3m,Mental Health (£0.3m) and overspend on Learning Disability (£0.5m).

Primary Care (£0.3m) unfavourable – There is an overspend on primary care prescribing (based upon 7 months of data) of £0.4m and an overspend against medical contracts (£0.3m). Other Primary Care Services (Dental, Pharmacy and Ophthalmic) under spend by £0.4m.

Corporate costs (£1.5m) favourable – There are underspends on all directorates, Public Health (£0.3m), Primary Care (£0.4m), CEO (£0.2m), Strategic Commissioning (£0.3m) and Finance & Performance (£0.3m).

Estates (£0.2m) favourable – Due to a refund on business rates and an underspend on minor works.

CSP/Performance (£3.6m) favourable – There is slippage on Primary Care Commissioning schemes (£2m), Public Health Schemes (£1m)and Strategic Commissioning schemes (£0.6m).

BCS (£0.9m) unfavourable – Due to non-achievement of CIP savings targets.

1212

PBC PRESCRIBING POSITION AT MONTH 8

The prescribing position includes a risk pool budget of £330k.

Prescribing budgets are overspent by £160k(1%) to the end of November 10 and are forecast to be overspent by £232k (0.6%) by year-end 2010/11. The forecast outturn has Increased by £29k since October.

N.B. Prescribing information is received from the PPA after month-end financial reports are finalised and therefore there may be a difference between the latest position year-to date shown above and the position shown in the Month 8 report.

Key : Overspend (), Underspend +

Cluster Annual budget YTD Budget YTD Actual YTD Variance YTD VarianceFOT Variance at November

FOT Variance at

October FOT Variance Movement

£'000 £'000 £'000 £'000 % £'000 £'000 £'000Harness Co-operative 7,949 5,380 5,699 (319) (6%) (471) (476) 5Kilburn 8,234 5,573 5,589 (16) (0%) (24) (5) (19)Kingsbury 7,936 5,371 5,234 137 3% 203 220 (17)Wembley 6,916 4,681 4,654 27 1% 40 33 6Willesden 5,374 3,637 3,846 (209) (6%) (309) (304) (5)Risk Pool 330 220 0 220 100% 330 330 0Grand Total 36,739 24,862 25,022 (160) (1%) (232) (202) (29)

1313

ACUTE CONTRACT POSITION – MONTH 8 (1)

The forecast outturn builds in seasonality, slippage on achievement on STARRS and UCC demand management schemes and assumes that there is no improvement in the forecast outturn underspend position reported for Barts, Ealing, Guys and RNOH beyond the position reported at Month 9.

The NWLHT outturn position is shown before the application of a cap on over-performance of £1.25m, agreed with the Trust.

Providers

ANNUAL BUDGET (£'000)

BUDGET YEAR TO DATE (£'000)

ACTUAL TO DATE (£'000)

VARIANCE (£'000)

VARIANCE %

FOT VARIANCE (£'000)

FOT VARIANCE %

IMPERIAL 67,900 45,204 46,451 (1,247) (2.8%) (2,097) (3.1%)NWLH 110,139 74,286 76,566 (2,280) (3.1%) (4,620) (4.2%)NWL Host 2,250 716 716 0 0.0% 0 0.0%RNOH 2,818 1,875 1,734 141 7.5% 158 5.6%NORTH MIDDLESEX 191 128 118 10 7.8% 15 7.7%HILLINGDON HOSPITAL 404 274 253 21 7.6% 30 7.5%EALING HOSPITALS 1,229 817 741 76 9.3% 85 6.9%GUYS & ST THOMAS 2,609 1,766 1,638 128 7.2% 144 5.5%ST GEORGE'S 305 204 309 (106) (51.8%) (159) (52.0%)KING'S HEALTHCARE 688 459 532 (74) (16.1%) (112) (16.3%)WHITTINGTON HOSPITAL 678 452 440 12 2.7% 17 2.5%BARTS 1,554 1,041 772 269 25.8% 302 19.5%GOSH 2,314 1,522 1,578 (56) (3.7%) (87) (3.8%)MOORFIELDS 2,684 1,789 1,897 (108) (6.1%) (167) (6.2%)ROYAL MARSDEN 374 240 204 36 15.1% 54 14.4%CHELSEA & WESTMINSTER 3,554 2,389 2,586 (197) (8.2%) (301) (8.5%)HOMERTON 130 85 52 33 39.0% 50 38.0%UCLH 9,401 6,267 6,462 (194) (3.1%) (309) (3.3%)ROYAL BROMPTON 3,400 2,267 3,238 (971) (42.9%) (1,463) (43.0%)BARNET & CHASE FARM 4,352 2,907 3,025 (118) (4.0%) (184) (4.2%)WEST HERTS HOSPITALS 376 253 243 10 4.0% 14 3.8%EAST & NORTH HERTS 1,371 914 839 75 8.2% 110 8.0%ROYAL FREE 15,364 10,242 10,623 (381) (3.7%) (598) (3.9%)

234,085 156,096 161,018 (4,922) (3.2%) (9,117) (3.9%)

14

ACUTE CONTRACT POSITION – MONTH 8 - NWLH (2)

Bottom-line £2,280k 3.1% over (M7 £1,861k 2.9% over)

PbR £1,442k over 3% Of which:Elective £331k over 3%Non–elective non-emergency £420k over 8%Outpatients £949k over 8%A&E £23k over 0%Non-elective £281k under 1%

Non-PbR £839k over 5%Of which:Direct Access £662k over 16%High Cost Drugs £292k over 17%Non-elective £78k over 27%Outpatients £257k over 13%Critical care £99k over 2%Elective Day Cases £277k under 15%HASU/Stroke £298k under 32%

14

15

Bottom-line £1,247k 2.8% over (M8 £934 2% over )

PbR £343k over 1.5%Of which:Non-elective £547k over 5%Outpatients £200k over 4%Elective £544k under 10%

Non-PbR £905k over 4.1%Of which:Adult critical care £87k over 3%Outpatients £140k over 8%Direct Access £50k over 9%High Cost Drugs £590k over 7%Of which:

– Renal £337k 6% over– Drug-Anti TNF £142k 4% over– Neonatal £112k 25% over

ACUTE CONTRACT POSITION – MONTH 8 - IMPERIAL (3)

15

16

Chelsea & Westminster £196k 8.2% over Paediatric High Dependency Unit £46k 429% over Non Elective Excess Bed Days £44k 57% over PbR Elective £58k 13% over

Royal Brompton £971k 43% over Intensive Unit £237k 107% over NEL PAG £79k 68% over PAT £141k 49% over PbR Non-elective £29k 15% over PbR Elective inpatients £318k 43% over Non-PbR Inpatients £121k 89%

Royal Free £381k 4%over Non-elective Excess Bed days £153k 141% over Critical Care £295k 64% over Therapies £56k 44 % under Chronic Hepatitis Disease £43k 27% under

Barnet & Chase Farm £118k 4% overPbR

Non-Elective £137k 27% under Elective £98k 23% over NELNE £52k 17% over

Non-PbR SCBU £21k 81% over Elderly Rehab £22k 147% Chemotherapy £17k 164%over

ACUTE CONTRACT POSITION – MONTH 8 – OTHER TRUSTS (4)

16

1717

ACUTE CONTRACT POSITION - MONTH 8 (5)The overspend of £4,922k at month 8 is analysed as follows:

It should be noted that the benefit from the marginal rate adjustment is transferred to the SHA towards a London-risk pooling scheme. Therefore the gross YTD overspend for the PCT is £4.9m + £1.1m = £6.0m.

The variances above are based upon November planned activity being eighth-twelfths of the 10/11 annual activity (based upon forecast 09/10 outturn adjusted for population growth and trend growth) and not adjusted for seasonality. For this reason the above do not match the variances shown in the following acute activity graphs which compare activity on a seasonal basis (slides 18-22).

PbR £'000 Non PbR £'000Electives (240) Inpatients 57Outpatients (1,462) Outpatients (373)Non Electives (1,935) Critical Care (706)Excess Bed Days 138 Direct Access (727)A&E (72) Excluded Drugs & Devices (568)GUM 5 Renal (429)

Marginal rate adjustment 1,048Other 342

Total PbR Overspend (3,566) Total Non PbR Overspend (1,356)

Key: Overspend (), Underspend +

18

ACUTE ACTIVITY ANALYSIS (1) - OUTPATIENTS

Against the comparative period of April- November 09 , there is an increase in activity of 0.8%.Figures include Outpatient Procedures.

18

1st OP attends GP referred G&A specs (excl Audiology) - All providers

0

1000

2000

3000

4000

5000

6000

2008-09

2009-10

2010-11

2008-09 4414 3969 4245 4403 3530 4479 4391 3996 3682 4228 3655 4645

2009-10 4127 4093 5056 4849 4006 4736 4626 4670 4274 4185 4058 4659

2010-11 4276 4245 4945 4810 4345 4406 4569 4848

April May June July AugustSeptembe

rOctober November December January February March

19

ACUTE ACTIVITY ANALYSIS (2) - ELECTIVE

Against the comparative period of April- November 09, there is a decrease in activity of 1.7%N.B.- Figures include Day cases 19

Elective FFCEs G&A specs only - All providers

0

500

1000

1500

2000

2500

3000

3500

2008-09

2009-10

2010-11

2008-09 2821 2651 2703 2827 2502 2903 3251 2717 2368 2635 2541 2913

2009-10 2706 2594 3025 3142 2592 2896 2998 2851 2542 2526 2627 3020

2010-11 2515 2618 3045 2794 2884 2838 2748 2981

April May June July AugustSeptembe

rOctober November December January February March

20

ACUTE ACTIVITY ANALYSIS (3) – NON-ELECTIVE

For the comparative period of April – November 09, there is an increase in activity of 6.4% 20

Non elective FFCEs G&A Specs only

0

500

1000

1500

2000

2500

3000

2008-09

2009-10

2010-11

2008-09 2091 2180 2138 2062 2031 2149 2209 2135 2272 2166 1916 2146

2009-10 2100 2171 2147 2197 2039 2136 2357 2171 2327 2220 2041 2436

2010-11 2267 2330 2294 2318 2214 2367 2359 2284

April May June July AugustSeptembe

rOctober November December January February March

21

ACUTE ACTIVITY ANALYSIS (4) - MATERNITY

Against the comparative period of April – November ’09, there is an increase in activity of 11.9%. 21

Maternity Spells (Source: SUS)

0

100

200

300

400

500

600

700

800

900

1000

2008/09

2009/10

2010/11

2008/09 656 729 683 719 621 664 670 712 765 762 581 710

2009/10 822 831 784 739 774 781 838 803 805 773 712 758

2010/11 795 945 891 941 911 895 911 839

April May June July August Sept Oct Nov Dec Jan Feb March

22

ACUTE ACTIVITY ANALYSIS (5) - BIRTHS

Against the comparative period of April – November ’09, there is an increase in activity of 7.7%. 22

Births (all providers) (Source: SUS)

0

100

200

300

400

500

600

2008/09

2009/10

2010/11

2008/09 385 413 362 440 379 369 326 386 420 426 347 423

2009/10 415 413 403 392 431 422 440 415 428 421 325 378

2010/11 377 461 448 487 475 461 474 405

April May June July August Sept Oct Nov Dec Jan Feb March

23

CLAIMS MANAGEMENT

Further to the year-end settlement agreed with NWLHT, the potential further benefit through claims management is dependent upon the level of success from the £4.3m of issues not yet resolved with Other Trusts.

The NHS Brent share of the Specialist Commissioning accepted claims amounts to a year to date saving of £50k.

NHS Brent has also had the following success with its own claims management covering months 1-6 on Non-Contracted Activities (£139k), Walk-in Centres contracts (£31k) and Cost per Case contracts (£10k). 23

Acute Commissioning Vehicle BRENT PCT

Not resolved

Resolved in Trust favour

Resolved in PCT favour Total

£000 £000 £000 £000

NWLHT 2,248 424 627 3,299Other Trusts 3,273 334 739 4,346Total 5,521 758 1,366 7,645

Specialist Commissioning LONDON WIDE

Not resolved

Resolved in Trust favour

Resolved in PCT favour Total

£000 £000 £000 £000Total 1,050 418 1,607 3,075

2424

BALANCE SHEET FOR 9 MONTHS ENDING 31st DECEMBER 2010Opening Year To DateBalance Change Balance

Notes £000s £000s £000s

Non Current Assets

Property, Plant & Equipment 64,815 (1,369) 63,446

Intangible Assets 69 (8) 61

Other Financial Assets 196 (5) 191

Trade & Other Receivables 4 2 6

Total Non Current Assets 65,084 (1,380) 63,704

Current Assets

Trade and Other Receivables 2,753 2,380 5,133

Cash & Cash Equivalents 16 48 64Total Current Assets 2,769 2,428 5,197

TOTAL ASSETS 67,853 1,048 68,901

Current Liabilities

Trade and Other Payables (40,713) 4,567 (36,146)

Provisions (368) 123 (245)

Other Financial Liabilities (781) 546 (235)

Total Current Liabilities (41,862) 5,236 (36,626)

NET CURRENT ASSETS \ (LIABILITIES) (39,093) 7,664 (31,429)

TOTAL ASSETS LESS CURRENT LIABILITIES 25,991 6,284 32,275

Non Current Liabilities

Trade and Other Payables (170) 0 (170)

Provisions (3,538) 201 (3,337)

Borrowings (30,420) 0 (30,420)

Total Non Current Liabilities (34,128) 201 (33,927)

TOTAL ASSETS EMPLOYED (8,137) 6,485 (1,652)

FINANCED BY:

General Fund (18,887) 6,485 (12,402)

Revaluation Reserve 10,750 (0) 10,750

Donated Asset Reserve 0 0 0

TOTAL CAPITAL AND RESERVES (8,137) 6,485 (1,652)

2525

BETTER PAYMENT PRACTICE CODE (BPPC)

The target is to achieve 95% in all categories. This is being achieved in consolidated position in three out of the four categories. In the category where the target is not being achieved the performance is close to target.

The target on NHS invoices for BCS has deteriorated compared to last month. This month only 13% invoices (£) were paid within the target period. This is due to 5 invoices totalling to £425k, which were not approved within the target period.

Better Payment Practice CodeApr 10 -Dec 10

Apr 10 -Dec 10

Apr 10 -Dec 10

Apr 10 -Dec 10

Apr 10 -Dec 10

Apr 10 -Dec 10

Number £000s Number £000s Number £000s% of Non- NHS bills paid within Target 95.9% 96.1% 96.6% 96.1% 94.7% 95.9%% of NHS bills paid within Target 93.9% 99.7% 94.1% 99.8% 92.7% 91.0%

Key : 95% & aboveBetween 90 to 95%90% & below

consolidated PCT BCS

2626

Month 9 Actual drawings are in line with the Revised Plan.

CASH POSITION

£’000

30,000

40,000

50,000

1 2 3 4 5 6 7 8 9 10 11 12

FIMS PLANNED DRAWINGS

REVISED PLAN

ACTUAL DRAWINGS

2727

SECTION 3 – FORECAST OUTTURN POSITION

27

282828

SUMMARY FORECAST OUTTURN

£000s+ve = u/spend-ve = o/spend

Month 7 Month 8 Month 9 Movement M8 to M9

Acute Contracts (8,184) (8,623) (9,118) (495)

Other Acute Commissioning 1,136 1,572 1,988 416

Joint Working 1,445 1,682 1,554 (128)

Primary Care (1,082) (970) (1,075) (105)

PCT Corporate Costs 1,978 2,010 2,037 27

Estates 14 (3) 61 64

CSP / Performance 2,762 3,311 3,639 328

BCS over/(under) recovery (900) (900) (900) 0

Sub Total variance against budgets (2,831) (1,921) (1,815) 106

Contingency 0 0 240 240

Investment Slippage and reserves 6,425 4,837 7,177 2,340

Allocation Adjustments 500 500 500 0

Balance Sheet 1,500 2,500 2,500 0

Benefit from year-end settlement with NWLHT 2,378 3,234 3,370 136

In-year plan (Sector) (5,472) (5,472) (5,472) 0

10/11 advance on 11/12 CTB Sector Contribution

0 (3,500) (6,500) (3,000)

TOTAL VARIANCE AGAINST PLAN 2,500 (1) 178 0 (178)The plan is for a £17.2m surplus.

(1) At the request of NHS London and NWL Sector at M7 we have submitted a FIMS return which reports a forecast a break-even position against plan, pending further discussions

Explanations for the main variances are included on the following slide.

292929

SUMMARY FORECAST OUTTURNAcute contracts (£9.1m) unfavourable – Adjusting for seasonality, slippage in demand management schemes and for underspends at some Trusts currently which are unlikely to continue across the remainder of the financial year, we are forecasting an overspend of £9.1m by year-end (3.9%).

Other Acute (£2.0m) favourable – Forecast under spend of £1.9m on the Clinicenta contract, £0.2m on UCC Budgets and a forecast overspend of £0.1m on Specialist consortia-led commissioning.

Joint working (£1.6m) favourable – Forecast underspends on End of Life £0.4m, Continuing Care £0.3m, Children and families budget £0.5m, £0.6m on Investments, £0.3m Mental Health and a forecast overspend of £0.6m on Learning Disabilities.

Primary Care (£1.1m) unfavourable - There are overspends forecast on prescribing £0.2m, Community Trusts £0.1m and on medical contracts of £0.8m due to anticipated non-achievement of PMS and enhanced services savings targets.

Corporate costs (£2.0m) favourable – Break-even or underspends are forecast in line with measures taken to achieve 10/11 management cost reductions.

CSP/Performance (£3.6m) favourable - All schemes have been reviewed. The main underspends are on Public Health schemes £1.0m including Smoking Cessation £0.9m, Primary Care schemes £2.0m and Strategic Commissioning Schemes £0.6m.

BCS (£0.9m) unfavourable – BCS reporting a deficit of £0.6m against a planned £0.3m (1%) surplus.

Balance Sheet (£2.5m) favourable – A review of prior year balances has concluded that there is a benefit of £2.5m.

Year-end settlement with NWLHT (£3.4m) favourable – This is the benefit derived from the difference between the forecast outturn position based upon the M8 figures and the agreed year-end settlement.

Allocation adjustments (£0.5m) favourable – Forecast value of allocations received not required to be released into budgets

Contingency (£0.2m) favourable – Release of contingency reserve

In-year plan (£5.5m) unfavourable– this relates to the savings target required to fund the contribution to the NWL sector position of £5.5m.

10/11 advance on 11/12 CTB sector contribution (£6.5m) unfavourable – An opportunity has been taken to fund this in advance. A further £3.0m has been agreed at M9.

Investment / Reserves (£7.2m) favourable – see following slide.

3030

INVESTMENT & RESERVES

The table above identifies where the underspend of £7.2m has been identified.

Investment Category

Schemes not yet approved /

Business Case Pending

Forecast Spend

Forecast Underspend

£'000 £'000 £'000Children & Young People 155 - 155Planned Care - Primary Care Transformation 1,878 238 1,640Staying Healthy 221 100 121Long Term Conditions 325 - 325Mental Health 970 100 870Market Management 90 - 90Polyststem Development 1,812 100 1,712Workforce Development 200 100 100Behavioural Change / Stakeholder involvement 300 - 300Performance Improvement 250 150 100ICT 264 114 150Other Investment & Reserves 1,614 - 1,614

Total 8,079 902 7,177

3131

SAVINGS PROGRAMME (1)

31

( ) Overspend, +Underspend

Budget area Scheme / Initiative Start Date RAG rating

Initial Plan

(£000)

Year to Date

Budget (£000)

Year to date

Actual (£000)

Year to date

Variance (£000)

Forecast Outturn Variance

Acute Intermediate care Oct-10

Agreement has been reached with preferred provider, ramp-up plan underway - however unlikely to achieve planned savings in 10/11. (2,556) (1,278) (633) (645) (855)

A&E Attendance avoidance Oct-10Access investment plans should impact on A&E attendance figure estimated (350) (175) 0 (175) (234)

Gynaecology Jul-10Service in place since July. Target being exceeded July - Sept. (182) (121) (157) 36 55

Ophthalmology Jul-10 Service will now not begin in 10/11. (121) (81) 0 (81) (121)

MSK Jan-10Service in place - cumulative data to Sept indicates no achievement (248) (186) 0 (186) (248)

ENT Apr-10Protocol in place - data cumulative to Sept indicates partial achievement (60) (45) (33) (12) (16)

Gastroenterology Apr-10Protocol in place - cumulative data to Sept indicates no achievement (31) (23) 0 (23) (31)

PBC - referral management Apr-10Referral management review in place - cumulative data to Sept indicates no achievement (560) (420) 0 (420) (560)

UCC Dec-10

Contract signed with provider Care UK 2nd Dec. Go-live confirmed as 28th March 2010. Recruitment and TUPE transfer underway. (382) (96) 0 (96) (382)

Community midwifery Apr-10 In contract baseline (278) (209) (209) 0 0Contract terms (OP 1st to F/U rates) Apr-10

In contract baseline, reduction due to allowance for exceptions (1,727) (1,295) (971) (324) (432)

09/10 successful contract challenges Apr-10 In contract baseline (1,202) (902) (902) 0 0

Other Acute Specialist commissioning In contract baselines (765) (574) (574) 0 0Joint Working Intermediate care Ramp-up plan agreed 1,274 637 470 167 334

Urgent Care Centre Set-up costs below budget 675 169 0 169 214Continuing Care Apr-10 Currently underspending -in contract baseline (400) (300) (300) 0 0Other commissioned services Apr-10 In contract baseline (125) (94) (94) 0 0CNWL - reduced inpatient costs Apr-10 In contract baseline (100) (75) (75) 0 0CNWL - 2% efficiency Apr-10 In contract baseline (375) (281) (281) 0 0CNWL - Balance (525) (394) 0 (394) (525)CNWL - LD bed Apr-10 In contract baseline (180) (135) (135) 0 0

Enhanced reablementStrategy document to be written by end of Feb - funded by Local Authority 250 188 0 188 250

End of lifeInvestment in training in 10/11 to achieve savings in 11/12 250 188 0 188 186

3232

SAVINGS PROGRAMME (2)

32

( ) Overspend, +Underspend

Budget area Scheme / Initiative Start Date RAG rating

Initial Plan

(£000)

Year to Date

Budget (£000)

Year to date

Actual (£000)

Year to date

Variance (£000)

Forecast Outturn Variance

There is a forecast £3.3m shortfall against the savings plan of £11.7m at Month 9. At Month 8 the shortfall was reported as £3.1m. The £0.2m net deterioration is due to updated estimate of UCC set up costs £0.1k and list validation savings £0.1k.

Primary& Community Care PMS stretch targets Jan-11 No contract changes in 10/11 (214) 0 0 0 (214)

Enhanced services Apr-10 Some planned savings not being achieved (352) (264) (225) (39) (106)List validation savings Jan-11 Savings will not take effect until 11/12 (268) 0 0 0 (268)Prescribing Apr-10 Savings not being made YTD (730) (548) 0 (548) (730)Barnet Community Trust Apr-10 In contract baseline (100) (75) (219) 144 192BCS - MFF efficiency reduction Apr-10 In contract baseline (800) (600) (600) 0 0

BCS - efficiency Apr-10In contract baseline - some non-recurrent support has been agreed (531) (398) (343) (56) (74)

BCS - Community Paediatrics Apr-10 In contract baseline (250) (188) (188) 0 0Health visiting Programme director in place 300 225 60 165 220Pathway redesign - reprovision

Covers Opthalmology/Gynae - Ophthalmology under review 180 90 13 77 160

HQ / Estates Budgets BCS - Infrastructure In contract baseline (286) (215) (215) 0 0

Management cost efficiencies (>3.5%) Apr-10 In budget baseline (626) (470) (470) 0 0CSL savings (10%) Apr-10 In budget baseline (99) (74) (74) 0 0Maintenance/utilities Apr-10 In budget baseline (87) (65) (65) 0 0

21 Building SLA Apr-10 Discussions to take place re future service provision (125) (94) 0 (94) (125)(11,706) (8,176) (6,218) (1,958) (3,310)

333333

MANAGEMENT COSTS (1)

The table above shows that there is a requirement to save 67% of our 10/11 budgeted management costs by the end of March 2013. NHS London have brought forward the requirement to achieve the 12/13 target and PCTs in London are now required to plan to achieve the original 12/13 target by the end of March 2012.

09/10 Outturn

10/11 Budget (1) (2)

10/11 Target

10/11 Savings

vs budget

10/11 Savings

vs budget11/12

Savings11/12

Savings11/12 Target

12/13 Savings

12/13 Savings

12/13 Target

£m £m £m £m % £m % £m % £m

NHS BrentCorporate (non-def'n) 5.0Management costs 10.2 10.9 8.7 (2.2) (20%) (3.3) (38%) 5.4 (1.8) (33%) 3.6

Sub-total 10.2 15.9 8.7 (2.2) (3.3) 5.4 (1.8) 3.6

BCS Management 4.9 4.9 4.2 (0.7) (14%) (1.6) (38%) 2.6 (0.9) (33%) 1.8

TOTAL Management 15.1 15.8 12.9 (2.9) (4.9) 8.0 (2.7) 5.4

Note:(1) Reflects FYE of 09/10 new structures plus Sector increase, less £662k savings incorporated in budgets(2) Baseline £10.9m includes £3.3m 'bought-in' services (£0.9m NW Sector, £0.9m CSL, £0.9m FHS,

£0.6m finance audit/SBS/procurement)

3434

MANAGEMENT COSTS (2) – 10/11 AND 11/12 PLANS

A)NHS Brent

• There has been further clarification from NWL Sector on the application of the management costs guidance, particularly in relation to FHS services, and also information from CSL on the percentage of their costs which fall within management cost. As a result, the forecast achievement against the management cost savings target has improved and is as follows:

Saving through freezing vacancies and ceasing interim cover: £1.74m (included in forecast outturn)Target £2.27mShortfall £0.53mReclassification of spend – CSL and FHS services (£0.35m)Forecast shortfall at Month 9 £0.18m

• The restructuring of posts taking place in the last quarter of the year will not lead to any material in-year saving, it will ensure the PCT achieves the 11/12 savings targets. Potential redundancy costs arising from the restructuring (estimated at £1.5m-£2.5m) will not impact the management costs target but may need to be accounted for in 10/11. It is anticipated that funding will be made available to cover 10/11 severance costs.

• The 11/12 operating framework has signalled a move away from the separation of management and corporate costs, and has indicated that PCTs will be expected to monitor “running costs” instead. The guidance and accompanying targets for this have yet to be issued.

3535

MANAGEMENT COSTS (3) – 10/11 PLAN

B) BCS

Plans to address the target 15% reduction of £0.75m in 10/11 are as follows:

Reduction in WTE management posts £0.12mReduction in interim spend £0.08mReduction in management consultancy spend (non-recurrent in 09/10) £0.20mCorporate saving / back office functions £0.35m

Total £0.75m

This plan has been signed off by the BCS Board and is on course to be delivered.

3636

APPENDIX A – FINANCIAL SCHEDULES

36

37

SUMMARY OPERATING COST STATEMENTFOR 9 MONTHS ENDING 31ST DECEMBER 2010

Annual Year to Date Most Likely FOTBudget Budget Actual Variance Variance

£000s £000s £000s £000s %

Commissioning Services

Commissioning of Healthcare

Acute Contracts 234,794 174,592 180,130 (5,538) (3)%

Other Acute Commissioning 38,376 27,847 26,243 1,604 6%

Joint Working Commissioning 84,087 61,786 61,078 707 1%

Sub-total: 357,257 264,225 267,451 (3,227) (1)%

Primary Care

Medical Contract 45,675 33,020 33,264 (244) (1)%

Dental Contract 14,560 10,923 10,658 266 2%

Pharmacy Contract 7,253 5,440 5,402 38 1%

Prescribing 37,609 28,254 28,681 (427) (2)%

Opthalmic 2,547 1,910 1,987 (77) (4)%

Community Trusts (including Brent Community Services) 29,873 22,678 22,538 140 1%

Primary Care Investments 0 0 0 0 0%

Sub-total: 137,516 102,225 102,529 (304) (0)%

Estates 6,714 5,056 4,861 195 4%

Corporate Costs 15,808 11,856 10,336 1,520 13%

C S P / Performance 17,299 7,566 3,941 3,625 48%

COMMISSIONING Total: 534,594 390,928 389,118 1,810 0%`

Brent Community Services

Expenditure 36,177 27,194 28,991 (1,797) (7)%

Income - Brent (31,520) (23,838) (23,950) 112 (0)%

Income - Other (4,957) (3,580) (4,384) 804 22%

BRENT COMMUNITY SERVICES Total (300) (225) 656 (881) 15%

TOTAL (Before Reserves): 534,294 390,703 389,775 928 0%

Reserves and Commitments

Contingency 2,000 500 500 0%

Investments / Reserves 8,079 5,679 5,679 0%

In Year Plan (5,472) (4,104) (4,104) 0%

Allocation Adjustments 865 0 0 0%

10/11 advance on CTB sector contribution (3,500) (2,625) (2,625) 100%

Benefit from year-end settlement with NWLHT

Balance Sheet Flexibilities net of 10/11 severance costs 2,000 0 0 0%

Surplus for investment 2011-12 17,226 15,626 15,626 100%

RESERVES Total: 21,198 15,076 0 15,076 100%

TOTAL for Brent tPCT: 555,492 405,779 389,775 16,005 4%

38

COMMISSIONING OF HEALTHCAREFOR 9 MONTHS ENDING 31ST DECEMBER 2010

Annual Year to Date Most Likely FOTBudget Budget Actual Variance Variance

£000s £000s £000s £000s %

Acute Commissioning

Acute and Foundation Trusts

North West London 110,139 82,603 85,169 (2,566) (3.11)%

Imperial College Healthcare 67,900 50,924 52,328 (1,404) (2.76)%

Royal Free 15,364 11,523 11,950 (427) (3.71)%

Other Acute Trusts 41,391 29,542 30,683 (1,141) (3.86)%

Sub-total - Acute and Foundation Trusts 234,794 174,592 180,130 (5,538) (3.17)%

Other Service Level Agreements

Consortia Led Commissioning 19,769 14,644 14,695 (51) (0.35)%

High Cost Drugs 569 427 183 244 57.14%

Non Contracted Activity 2,380 1,658 1,521 137 8.26%

UCC Budgets 675 0 0 0 0.00%

PCTs 1,577 1,183 1,092 91 7.69%

ISTC - Clinicentre 1,688 1,266 (180) 1,446 114.22%

ISTC - In Health 806 605 671 (66) (10.91)%

Cost per Case 639 479 744 (265) (55.32)%

Sub-total - Other Service Level Agreements 28,103 20,262 18,726 1,536 7.58%

HIV / AIDS and Sexual Health

Consortia Led HIV and AIDS Commissioning 8,311 6,113 6,121 (8) (0.13)%

Local HIV/ Treatment and Care 415 311 234 77 24.76%

Sexual Health 1,547 1,161 1,162 (1) (0.09)%

Sub-total - HIV / AIDS & Sexual Health 10,273 7,585 7,517 68 0.90%

Total Acute Commissioning 273,170 202,439 206,373 (3,934) (1.94)%

39

COMMISSIONING OF HEALTHCAREFOR 9 MONTHS ENDING DECEMBER 2010

Annual Year to Date Most Likely FOTBudget Budget Actual Variance Variance

£000s £000s £000s £000s %

Joint Commissioning & PartnershipChlldren & Families Long Term Bedded Services

Continuing Care - Children 2,211 1,658 1,585 73 4.40%

Continuing Care - Income (144) (108) 0 (108) 100.00%

Sub-total - Long Term Bedded Services 2,067 1,550 1,585 (35) (2.26)%

Chlldren & Families Other

Consortia Led Children's Commissioning 489 355 534 (179) (50.42)%

Other Budgets (includes Sexual Health and CAMH) 1,287 946 510 436 46.09%

Cost per Case 490 388 416 (28) (7.22)%

Barnet, Enfield and Haringey Mental Health Trust 399 299 149 150 50.17%

Sub-total - Other 2,665 1,988 1,609 379 19.06%

Sub-total - Children & Families 4,732 3,538 3,194 344 9.72%

Mental Health

Central and North West London Mental Health 35,168 26,376 26,376 0 0.00%

Consortia Led Mental Health Commissioning 6,767 4,922 4,881 41 0.83%

Mental Health Trusts 3,528 2,483 2,279 204 8.22%

Sub-total - Mental Health 45,463 33,781 33,536 245 0.73%

Long Term Bedded Services

Continue Care - Elderly 1,069 801 761 40 4.99%

Continue Care - Physical Disability 1,044 783 1,006 (223) (28.48)%

Continue Care - Learning Disability- CHC 2,813 2,110 2,248 (138) (6.55)%

Continue Care - Learning Disability- VPN-LBB Transfer 7,361 5,520 5,520 0 0.00%

Continue Care - Older Adults Over 65 874 656 946 (290) (44.21)%

Continue Care - Mental Health (Younger Adults) 6,050 4,538 4,071 467 10.29%

Continue Care - Palliative Care 78 59 47 12 20.34%

Continue Care - Section 28A 186 139 138 1 0.72%

Registered Free Nursing Care 3,328 2,497 2,102 395 15.82%

Sub-total - Long Term Bedded Services 22,803 17,103 16,839 264 1.54%

40

COMMISSIONING OF HEALTHCAREFOR 9 MONTHS ENDING 31ST DECEMBER 2010

Annual Year to Date Most Likely FOTBudget Budget Actual Variance Variance

£000s £000s £000s £000s %

Rehabilitation/ Physically Disabilities

Consortia Led Rehabilitation and PD Commissioning 784 577 586 (9) (1.56)%

Other Budgets 449 337 279 58 17.21%

Brent Equipment Budgets 824 618 618 (0) (0.00)%

Sub-total - Rehabilitation/ Physical Disabilities 2,057 1,532 1,483 49 3.20%

End of Life Care

Pembridge- NHS K&C 1,201 901 901 0 0.00%

Other Hospices 1,192 901 608 293 32.52%

Sub-total - End of Life Care 2,393 1,802 1,509 293 16.26%

Older People / Carers

Brent Carers 59 44 44 0 0.00%

Brent Carers- LBB 0 0 0 0 0.00%

Sub-total - Older People Carers 59 44 44 0 0.00%

Other Joint Commissioning

Substance Misuse 4,804 3,604 3,579 25 0.69%

Substance Misuse Income (1,067) (800) (780) (20) 2.53%

Learning Disabilities 893 670 1,157 (487) (72.69)%

Strategic and Investment Budgets(Includes Carers, End of Life Care) 1,950 512 517 (5) (0.98)%

Sub-total - Other Joint Commissioning 6,580 3,986 4,473 (487) (12.22)%

Total Joint Commissioning and Partnership 84,087 61,786 61,078 707 1.15%

41

PRIMARY CARE SERVICESFOR 9 MONTHS ENDING 31ST DECEMBER 2010

Annual Year to DateBudget Budget Actual Variance Variance

£000s £000s £000s £000s %

Medical ContractGMS Baseline Contracts 17,598 13,399 13,429 (30) (0.22)%

GMS QOF 4,852 2,547 2,547 (0) (0.00)%

GMS Enhanced Services 2,529 1,906 2,055 (149) (7.82)%

PCO Managed Budgets 5,963 4,206 4,277 (70) (1.67)%

Out of Hours 743 557 592 (35) (6.31)%

GMS Premises 3,079 2,390 2,413 (23) (0.94)%

PMS Baseline 7,639 5,890 5,890 (0) (0.00)%PMS QOF 1,425 748 748 (0) (0.00)%PMS Enhanced Services & Premises 1,911 1,434 1,360 75 5.20%APMS Contract Payments 1,538 1,144 1,219 (75) (6.54)%Medical Income -1,602 (1,201) (1,265) 64 (5.29)%Total Medical Contract 45,675 33,020 33,264 (244) (0.74)%

Dental ContractDental Services 16,985 12,742 12,475 267 2.09%Patient Charge Income (2,425) (1,818) (1,817) (1) 0.06%Total Dental Contract 14,560 10,923 10,658 266 2.43%

Pharmacy ContractPharmacy Services 7,253 5,440 5,402 38 0.70%Total Pharmacy Contract 7,253 5,440 5,402 38 0.70%

PrescribingPractice Costs 36,739 27,602 28,005 (404) (1.46)%Central Drugs Bill Charges 767 575 617 (42) (7.28)%Other 103 77 59 19 23.94%Total Prescribing 37,609 28,254 28,681 (427) (1.51)%

Ophthalmic Ophthalmic Contracts 2,547 1,910 1,987 (77) (4.03)%Total Ophthalmic 2,547 1,910 1,987 (77) (4.03)%

Community TrustsBrent Provider Services 28,531 21,670 21,587 84 0.39%Other Community Trusts 1,343 1,007 951 56 5.56%Total Community Trusts 29,874 22,678 22,538 140 0.62%

Primary Care InvestmentsPrimary Care Investments 0 0 0 0 0.00%Total Primary Care Investments 0 0 0 0 0.00%

TOTAL PRIMARY CARE 137,517 102,225 102,529 (304) (0.30)%

42

PRIMARY CARE SERVICESFOR 9 MONTHS ENDING 31ST DECEMBER 2010

Annual Year to DateBudget Budget Actual Variance Variance

£000s £000s £000s £000s %

EstatesStaff Pay 1,004 747 688 59 7.90%PFI / LIFT / Lease Costs 5,052 3,801 3,878 (77) (2.03)%Depreciation 2,033 1,524 1,509 15 0.98%Cost of Capital 520 390 390 0 0.00%Estates Management Contract (K&C) 829 622 623 (1) (0.16)%Utilities 636 486 490 (4) (0.82)%Rates 543 407 276 131 32.19%Maintenance 355 266 56 210 78.95%Insurance 122 92 50 42 45.65%Catering 40 30 31 (1) (3.33)%Other 662 502 566 (64) (12.75)%Capital Related Movements 0 171 (171) 0.00%

Income from BCS / GPs / Others (5,082) (3,811) (3,867) 56 (1.47)%

Total Estates 6,714 5,056 4,861 195 3.86%

43

PCT CORPORATE COSTSFOR 9 MONTHS ENDING 31ST DECEMBER 2010

Annual Year to Date

Budget Budget Actual Variance Variance

£000s £000s £000s £000s %

PCT Corporate Costs

Chief Executive Office - expenditure 3,941 2,928 2,811 117 4.00%

Chief Executive Office - income 0 0 (114) 114 0.00%

Public Health - expenditure 2,468 1,850 1,371 479 25.89%

Public Health - income (563) (422) (280) (142) 33.69%

Strategic Commissioning - expenditure 2,782 2,086 1,782 304 14.57%

Strategic Commissioning - income (161) (121) (95) (26) 21.33%

Primary Care Commissioning - expenditure 3,334 2,516 2,121 395 15.70%

Primary Care Commissioning - income 0 0 0 0.00%

Human Resources - expenditure 640 478 466 12 2.51%

Human Resources - income 0 0 0 0.00%

Finance and Performance - expenditure 3,432 2,590 2,323 267 10.31%

Finance and Performance - income (65) (49) (49) 0 (0.51)%

Total Corporate Costs 15,808 11,856 10,336 1,520 12.82%

Of which :Management Costs 10,923 8,192 6,814 1,378 16.82%

44

PCT CSP & PERFORMANCEFOR 9 MONTHS ENDING 31ST DECEMBER 2010

Annual Year to Date

Budget Budget Actual Variance Variance

£000s £000s £000s £000s %

Strategic Commissioning

Acute Care - UCC and STARRS CSP 130 130 155 (25) (19.23)%

Acute Care - UCC Project Costs CSP 108 0 0.00%

Acute Care - UCC Transition Payments CSP 2,000 0 0.00%

End of Life CSP 119 119 43 76 63.87%

Intermediate Care Strategy CSP 2,050 169 133 36 21.30%

ICS- Enhanced Re-ablement CSP 652 0 0 0.00%

Market Management & Procurement CSP 63 63 31 32 50.79%

Planned care - Outpatients and Elective CSP 108 108 82 26 24.07%

Strategic Programme Delivery Team CSP 53 53 53 0 0.00%

Delivery of CSP Project Team CSP 100 71 116 (45) (63.38)%

Children and Young People CSP 101 101 90 11 10.89%

Increase Breast Screening uptake PERF 136 102 10 92 90.20%

Improving Breastfeeding Rates PERF 101 76 73 3 3.63%

Breastfeeding & Access to Maternity PERF 280 196 74 122 62.24%

Internet and Web Development CSP 80 53 48 5 9.43%

Chlamydia - 09/10 baseline PERF 379 284 260 24 8.53%

Chlamydia - 10/11 investment PERF 539 377 233 144 38.20%

DAAT Schemes NTA Refurb CSP 30 12 12 100.00%

45

PCT CSP & PERFORMANCE FOR 9 MONTHS ENDING 31ST DECEMBER 2010Annual Year to Date

Budget Budget Actual Variance Variance

£000s £000s £000s £000s %Finance & IMT

Interim Staffing PERF 106 26 25 1 3.85%

ERP Project CSP 38 28 28 100.00%

Public Health

Smoking Cessation PERF 1,793 1,386 500 886 63.92%

Social Marketing PERF 379 217 103 114 52.53%

CEO

BCS CSP 150 0 0.00%

Primary Care Commissioning

Long Term Conditions CSP 250 250 47 203 81.21%

MSK Pilot CSP 194 145 256 (111) (76.55)%

MSK BCS Recharge CSP (65) 65 0.00%

Planned care - Primary Care Transformation CSP 376 376 162 214 56.91%

Polysystems CSP 382 282 63 219 77.66%

IT, Information and Analytics CSP 63 63 38 25 40.11%

Physio / Podiatry CSP 124 93 0 93 100.00%

Health Visiting CSP 300 225 21 204 90.67%

Immunisation CSP 912 183 165 18 9.84%

Vascular Health CSP 603 302 52 250 82.78%

Pathway Reprovision CSP 180 90 18 72 80.00%

VRA Project Manager CSP 56 56 36 20 36.17%

EPS / SCR CSP 464 440 70 370 84.09%

GP ICT CSP 65 40 13 27 67.50%

Social Enterprise / Right to Request CSP 97 55 47 8 14.55%

RIO Implementation CSP 530 265 0 265 100.00%

BCS- Wheelchairs CSP 50 38 0 38 100.00%

GP Access Project PERF 810 558 512 46 8.24%

Interim Staffing PERF 169 169 146 23 13.61%

List Validation Costs PERF 300 0 0 0.00%

Performance Bond PCT Clusters PERF 1,445 328 328 0 0.00%

Dental Access PERF 395 0 0 0.00%

Human Resources

Workforce Advice CSP 27 27 27 100.00%

OD Plan (New ways of Working) CSP 9 9 3 6 66.67%

Total PCT Investments 17,299 7,566 3,941 3,625 47.91%