Minutes of the Twenty First Meeting of the Board of NHS Leicester ...

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Paper CNHS Leicester City Board Meeting12 May 2011Acute Commissioning11. Acute commissioning deteriorated by £0.235m. This was due to a deteriorationof acute ‘other’ activity and was made up of movements on out of areacontracts which included antenatal screening; there was also worsening onNon Contract Activity. Whilst the independent sector activity slowed down atthe year end resulting in a favourable movement of £0.107m, this was offset bya modest deterioration on the UHL and EMSCG agreements.Non Acute Commissioning12. The Non acute position deteriorated by £0.498m. This is broken down betweenMental Health and Learning Disabilities (£0.384m) and Ambulance, ECRs and‘Other’ (£0.226m).13. Mental Health and LD worsened due to an increase in overspend of £0.188mon the LD pooled budget hosted by the Leicester City Council. Also impactingon the position was a net decrease in the EMSCG surplus position and a slightincrease in costs of Castlebeck placements.14. Non acute Ambulance, ECRs and ‘Other’ deteriorated due to increased costson continuing care of £0.236m. This included a provision of £0.131m forretrospective claims being made by families of patients seeking reimbursementof costs incurred. In addition one case of £0.045m was settledand paid. This was partially offset by improvements in CAMHS complex care,voluntary sector agreements and prison healthcare, and which also offsetdeterioration on the EMAS contract.Infrastructure15. Favourable movements within Health Informatics Services and Primary andCommunity Care were offset by increased expenditure within Public health (butbroadly still in line with the original plan). Therefore the main contributingfactors to the favourable movement of £0.405m within Infrastructure wereFinance (£0.243m) and Corporate Affairs (£0.251m).16. Finance improved due to a reduction in the bad debt provision of £0.089m andcost of capital movement from budget of £0.197m (this was due to an overallincrease in the net liability on the balance sheet). Corporate Affairs improveddue to slippage on training budgets £0.108m. The remainder was due to anunder-spend on Communications and Public Patient Involvement.Reserves17. Table 4 identifies the flexibilities within reserves that were used to offset theoperational pressure of £4.188m identified in paragraph 7 and appendix 1.Joel Martin 4Head of Corporate Finance
Table 4 – Achievement of £6.192mPaper CNHS Leicester City Board Meeting12 May 2011£m £mInitial Control surplus 5.155Non Elective Levy allocation 0.994Revised Control surplus 6.149In - Year MovementSlippage on Productivity (appendix 2) -3.193Residual operational deficit -0.995Total operational deficit -4.188In year net flexibilities identifiedSlippage on Ear Marked Reserves 0.494Slippage on Developments 2.285Slippage on transformational Fund 0.342Unplanned flexibilities 1.110Total in-year solutions 4.231Net In-year flexibility 0.043Actual surplus 6.19218. The main movement on reserves during the year related to the commissioningreserve which was established at the beginning of the financial year at£4.997m. Table 5 shows how this reserve has been utilised in the year.Table 5 – Commissioning Reserve Utilisation£mManagement Cost RestructureProvision 1.7TCS TUPE Provision 0.8NHS SBS TCS termination provision 0.1EMSCG Pressures 0.4LCCHS SLA 0.3Year End pressures - acute 1.2Increase in dilapidation provision 0.5Total use of Commissioning Reserve 5.0Joel Martin 5Head of Corporate Finance
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Page 11 and 12: NHS LEICESTER CITYMEETING: TRUST BO
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Page 27 and 28: PERFORMANCEPaper DNHS Leicester Cit
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