Item 5 - IJB Reserves Strategy
North Lanarkshire Council · 22 March 2023
Back to Health and Social Care Integration Joint Board — 22 March 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 REPORT Item No: 5 SUBJECT: IJB Reserves Strategy 2022/2023 TO: Integration Joint Board Lead Officer for Report: Ross McGuffie, Chief Officer Author(s) of Report Amanda Kilburn, Chief Finance Officer DATE: 22nd March 2023 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integration Joint Board (IJB) For approval For endorsement For noting 1.2 This report provides an update on the review of the North Lanarkshire Integration Joint Board (IJB) reserves and seeks approval to establish new reserves in line with the planned commitments and Scottish Government guidance. 2. ROUTE TO THE INTEGRATION JOINT BOARD 2.1 This paper has been: Prepared By; Chief Finance Officer Reviewed By; Chief Officer 3. RECOMMENDATIONS 3.1 The IJB is asked to agree the following recommendations: (1) Note the contents of the report; (2) Approve the proposed transfers to earmarked reserves in section 7.5 and (3) Approve the proposed realignment of reserves in appendix 1. 4. VARIATIONS TO DIRECTIONS 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 Consistent with a number of other Health and Social Care Partnerships, an underspend was reported to the IJB on 22 June 22 totalling £74.67m and was transferred to reserves. This 2021/2022 underspend included funding received to meet the ongoing cost and recovery to the Covid-19 pandemic and also funding made available by the Scottish Government to progress policy commitments and national priorities. 6. CONCLUSIONS 6.1 The IJB Reserves Strategy 2022/2023 provides an opportunity to strengthen long- term financial sustainability by considering the allocation of the 2021/2022 underspend to the strategic priorities of the IJB and both partners. The IJB Reserves Strategy 2022/2023 will enable the IJB to balance current commitments whilst planning and addressing financial risks. Yes No N/A
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2 6.2 It is essential for the long-term financial stability and the sustainability of the IJB that sufficient funds are held in reserve to manage unanticipated pressures from year to year. The requirement for financial reserves is acknowledged in statute and is part of a range of measures in place to ensure that section 106 public bodies do not over- commit themselves financially. 7. IJB RESERVES STRATEGY 2022/2023 7.1 As detailed in the summary table below, the reserves balances at 31 March 2022 were £119.452m. This figure comprised of £70.05m earmarked reserves to support the delivery of projects which span financial years and £45.718m ring-fenced monies to enable the IJB to deliver on specific Scottish Government funded programmes. The remaining balance of £3.684m, is contingency reserves which are not held to meet any specific liability and offer the IJB some flexibility to deal with unforeseen events or emergencies. 7.2 A further in-year analysis and review was carried out with both partners in respect of all reserves to ensure the reserves held in 2022/2023 were still required and sufficient to meet on-going pressures. 7.3 As a result of this review, it was evident that some of the reserves were no longer required for their original purpose. This has been driven by two key factors; (i) due to the pandemic, delay to specific projects has resulted in changes and redesign to services, making the held reserve no longer fit for purpose; and (ii) the need to consider the utilisation of reserves in the context of the IJB Strategic Commissioning Plan 2023-2026 and the range of uncertainties that remain as a result of the National Care Service proposals and December emergency budget. 7.4 Following on from the above, a proposed realignment of reserves has been determined, as summarised in Appendix 1. The revised structure of the reserves will continue to enable the IJB to meet its agreed strategic objectives, and Scottish Government policy requirements. 7.5 In particular, it is proposed that new earmark reserves are created for the following purposes: £3.498m home support resilience reserve to support the effective recruitment and retention of home support staff by maintaining and increasing the number of pool cars available to the service and offering home support worker incentives. £2.4m staff training academy reserve to assist the development of staff by offering apprenticeships and support to implement a HSCP ‘Grow our Own’ initiative in recognition of the ongoing challenges in recruitment and retention and a national shortage of key skills. Balance As At 31 March 2022 £m Ring-Fenced Reserves 45.718 Earmarked Reserves 70.050 Contingency Reserves 3.684 Total 119.452 SUMMARY
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3 £2.653m Local Government pay award reserve to assist with the on-going staffing pay pressure. This will cover 2023/24 financial year only and will be replaced by a recurring budget in 2024/25. £1.208m vulnerable and complex cases reserve to provide co-ordinated, person- centred, care managed approach with individuals who have often become disengaged and need assistance to be re-directed and reconnected to appropriate services within the Health and Social Care settings or the community. £828k breast feeding team reserve to introduce a peer support model to improve breastfeeding initiation and reduce attrition and to introduce a seven-day support provision to deliver person centred care through the mother’s postnatal journey from hospital discharge to one year post birth. £600k IJB cost-of-living helpline reserve to maintain and enhance the existing single point of contact for advice on a range of impacts from the cost-of-living crisis. This would provide one gateway for residents to receive direct advice and where required a direct route to follow up appointments for support. £550k three-year investment within the neonatal unit to provide dietetic support to preterm and sick infants. This earmarked reserve will provide premature babies with dietetic intervention aimed at reducing morbidity and mortality rates, reducing length of hospital stays, improving short and long-term neurodevelopment and growth outcomes and providing support to parents/carers. £450k Stigma Free Lanarkshire reserve to continue investment in addressing challenging mental health stigma and discrimination in line with the outcomes in the Lanarkshire Mental Health Strategy. £444k long covid pathways reserve to support people with long term effects of Covid- 19 where their physical and mental wellbeing has suffered. This earmarked reserve will allow continued investment in recruitment to deliver improved care and support for people living with long Covid and will ensure it remains a priority. £212k Chryston Community Health Clinic reserve to fund the repatriation of services under ‘The Plan for North Lanarkshire’ which sets out an estates strategy to develop community hubs and campuses. £187k HR employability staffing reserve to fund a dedicated HR team within health with the cost split 50:50 between North and South Lanarkshire partnerships. £260k organisational development reserve to support the 2023/24 organisational development plan focussing heavily on sector and unit management team development. £98k funding for additional posts within Psychology to help with the substantial waiting lists by extending trainee contracts until March 2023. £90k assistive technology reserve which will fund a 12-month contract that provides a service to the council in assessing, recommending, and procuring assistive technologies to enable our employees with a disability or impairment to maximise their ability to work effectively. 7.6 The IJB is therefore asked to approve the realignment of reserves as summarised in the table at appendix 1.
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4 7.7 Following approval from the IJB the revised summary position is below with a detailed analysis at appendix 2. 8. COVID-19 RESERVE 8.1 Scottish Government have processed the return of uncommitted North Lanarkshire Covid-19 reserves totalling £24.051m. 8.2 The table below shows the current position: 9. RISK 9.1 As part of the development of the financial plan and in line with the North Lanarkshire IJB Medium to Long Term Financial Plan 2020/21 to 2029/30, if possible, it is recommended that the risk-based and contingency reserves are established as a percentage of the financial envelope as follows: Year 2022/2023 2023 to 2030 Contingency Reserve % 3% 5% 9.2 The IJB contingency reserves currently equate to 2% of the financial envelope, however, following completion of the 2022/2023 financial year end, it is anticipated this percentage may increase. 10. IMPLICATIONS 10.1 NATIONAL OUTCOMES The effective management of financial resources contributes to the achievement of the national outcomes. 10.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. 10.3 FINANCIAL This paper has been reviewed by Finance: Opening Balance After Review Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NHSL Ring-Fenced Reserves 49.903 (24.116) (14.353) 11.434 NHSL & NLC Earmarked Reserves 31.661 17.186 (6.494) 42.353 NHSL & NLC Risk-Based Reserves 13.478 (2.130) (0.796) 10.552 NHSL Contingency Reserves 4.167 1.032 (0.301) 4.898 NHSL & NLC Closed Reserves 20.244 (15.916) (4.327) - 119.453 (23.944) (26.271) 69.237 LEAD SUMMARY Total Opening Balance As At 1 April 2022 Drawdown from Reserves Return of Covid-19 Reserves to Scottish Government Revised Balance As At 31 March 2023 £m £m £m £m Covid-19 Funding 29.677 (2.957) (24.051) 2.669 Covid-19 Funding - Unscheduled Care 1.944 (1.620) 0.324 TOTAL 31.621 (4.577) (24.051) 2.993 Ring-Fenced Covid-19 Reserve
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5 Yes No N/A 10.4 RISK ASSESSMENT/RISK MANAGEMENT The financial risks are detailed at section 8. 10.5 PEOPLE None 10.6 STAKEHOLDER ENGAGEMENT The Director of Finance of NHSL and the Head of Financial Solutions of NLC have both been consulted on the proposed IJB Reserves Strategy 2021/2022 for the North Lanarkshire IJB. 10.7 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed: Yes No N/A 10.8 CARBON MANAGEMENT IMPLICATIONS Yes No N/A 11. BACKGROUND PAPERS None. 12. APPENDICES HSCP Reserves Realignment Appendix 1 Movement of Reserves Year to Date Appendix 2 Chief Finance Officer Members seeking further information about any aspect of this report, please contact Amanda Kilburn on telephone number 07816 126362.
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6 Opening Balance As At 1 April 2022 Transfers / Drawdown From Reserves New Reserves Awaiting IJB Approval Proposed Realignment Revised Balance As At 31 March 2023 £m £m £m £m £m Advocacy Services 0.123 (0.045) - 0.061 0.139 Business Case - Non-Recurring NLC Costs 5.380 (1.941) - 0.537 3.976 Covid-19 Funding 29.742 (27.008) - (0.065) 2.669 Digital and IT Strategy Technology Improvements - Home Support Scheduling System 1.000 - - 2.776 3.776 Integrated Authority Support 6.076 - - (1.150) 4.926 Kylepark Works 1.000 - - 0.608 1.608 Planned Date of Discharge - Discharge To Assess 0.200 (0.074) - 0.241 0.367 Planned Date of Discharge - Locality Social Work Manager Post 0.055 (0.051) - 0.096 0.100 Regrading of Posts Including Backpay 0.125 - - 0.125 0.250 Sexual Health Services - Long-Acting Reversible Contraception (LARC) 0.109 (0.004) - 0.386 0.491 Social Care Contracting Staff within Quality Assurance Services 0.047 (0.052) - 0.028 0.023 Social Care Demand 6.117 (0.069) - (2.130) 3.918 Contingency Fund Reserve 4.167 (0.194) - 0.925 4.898 Closed Reserves 20.244 (4.328) - (15.916) 0.000 Existing Reserves 74.385 (33.766) 0.000 (13.478) 27.141 Assistive Technology Contract x 12 months (ATC) - (0.062) 0.090 - 0.028 Breast Feeding Team (2 year funding) - - 0.828 - 0.828 Development of Chryston Community Health Clinic - - 0.212 - 0.212 Home Support Resilience (2 year funding) - - 3.498 - 3.498 HR Employability Team (2 year funding, 50:50 split between North and South) - - 0.187 - 0.187 IJB Helpline (2 years funding) - - 0.600 - 0.600 Local Government Pay Award 23/24 - - 2.653 - 2.653 Long Covid Pathways - - 0.444 - 0.444 Neonatal & Paediatrics Dieteics Intervention (3 year funding) - - 0.550 - 0.550 Organisational Development Fund - - 0.260 - 0.260 Psychology Posts 2 x Band 6 - - 0.098 - 0.098 Staff Training Academy - - 2.400 - 2.400 Stigma Free Lanarkshire (3 year funding) - - 0.450 - 0.450 Vulnerable and Complex Cases - Test of Change - - 1.208 - 1.208 New Reserves 0.000 (0.062) 13.478 0.000 13.416 TOTAL REALIGNMENT 13.478 (13.478) APPENDIX 1 HSCP Reserves Realignment
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7 North Lanarkshire IJB APPENDIX 2 Movement on Reserves Audit Trail NHSL & NCL Opening Balance After Review Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NHSL Ring-Fenced Reserves 49.903 (24.116) (14.353) 11.434 NHSL & NLC Earmarked Reserves 31.661 17.186 (6.494) 42.353 NHSL & NLC Risk-Based Reserves 13.478 (2.130) (0.796) 10.552 NHSL Contingency Reserves 4.167 1.032 (0.301) 4.898 NHSL & NLC Closed Reserves 20.244 (15.916) (4.327) - 119.453 (23.944) (26.271) 69.237 Opening Balance After Review Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NHSL Alcohol and Drug Partnership Funding 3.154 (2.800) 0.354 NHSL Alcohol and Drug Partnership - Local Implementation Plan 0.167 0.167 NHSL Alcohol and Drug Partnership - Long Acting Buprenorphine 0.255 0.255 NHSL Blood-Borne Viruses Services 0.146 0.146 NHSL Children and Adolescent Mental Health Services 5.333 (3.082) 2.251 NHSL Community Living Change Fund 1.298 1.298 NHSL Covid-19 Funding 29.742 (24.116) (2.957) 2.669 NHSL Covid-19 Funding - Unscheduled Care 1.944 (1.620) 0.324 NHSL Mental Health and Learning Disability Services - Action 15 3.019 (3.016) 0.003 NHSL Mental Health and Learning Disability Services - Veteran's First Point 0.026 0.026 NHSL Mental Health - Diagnostic Support Service Dementia Post 0.429 0.429 NHSL Mental Health Improvement Fund - Psychology 0.553 (0.448) 0.105 NHSL Mental Health Psychology Services Capacity Building 0.117 0.117 NHSL Mental Health Psychology Services - Recovery and Renewal Phase 1 & 2 0.614 (0.430) 0.184 NHSL Mental Health Recovery Renewal - Facilities Projects 1.840 1.840 NHSL Mental Health Wellbeing in Primary Care Services 0.148 0.148 NHSL Shielding - Social Care Support Fund 0.038 0.038 NHSL Staff Wellbeing 0.254 0.254 NHSL Test and Protect Funding 0.520 0.520 NHSL Third Sector Initiatives To Improve Health 0.306 0.306 49.903 (24.116) (14.353) 11.434 Opening Balance After Review Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NHSL Adult Social Care Winter Preparedness Fund 1.941 (0.001) 1.940 NLC Adaptations Fund 0.289 (0.200) 0.089 NLC Adult Protection (share with C&F and NHSL) 0.050 (0.017) 0.033 NLC Advocacy Services 0.123 0.061 (0.045) 0.139 NHSL Area Wide Services - Health Promotion - North Lanarkshire Leisure agreement 0.123 0.123 NHSL Area Wide Services - NES Training 0.132 0.132 NHSL Area Wide Services - Pre School Vision Screening 0.075 0.075 NHSL Area Wide Services - Primary Care Corporate (iHUB Project - NES funding) 0.034 0.034 NHSL Area Wide Services - Refugees and Displaced Persons 0.400 (0.132) 0.268 NLC Assistive Technology Contract x 12 months (ATC) 0.090 (0.062) 0.028 NHSL Breast Feeding Team (2 year funding) 0.828 0.828 NHSL Business Case - Health Care Support Workers, Multi-Disciplinary Teams 1.794 (1.213) 0.581 NLC Business Case - Non-Recurring NLC Costs 5.380 0.537 (1.941) 3.976 NHSL Care Homes Allocation 0.318 0.318 NLC Carers Act 2018 - Support 0.852 0.852 NHSL Champions Board Funding 0.172 0.172 NHSL Children and Adolescent Mental Health Services - Udston Top Up Funding 0.346 0.346 NHSL Childrens Services - Paediatric Band 7, Band 6 x 4.12 WTE, Band 2 x 9.59 WTE 0.645 (0.231) 0.414 NHSL Development of Chryston Community Health Clinic 0.212 0.212 NHSL Dietetics Services - Double Running Costs 0.110 0.110 NLC Digital and IT Strategy Technology Improvements - Community Alarms 0.694 (0.064) 0.630 NLC Digital and IT Strategy Technology Improvements - Home Support Scheduling System 1.000 2.776 3.776 NLC Digital and IT Strategy Technology Improvements - Other 0.566 0.566 NLC Digital and IT Strategy Technology Improvements - SWIS 0.700 (0.173) 0.527 NHSL Discharge Support Workers Band 4 x 2 WTE 0.107 0.107 NHSL Distinction Awards 0.036 0.036 NLC Financial Strategy - Changes to LA Services Muirpark 2.973 (1.242) 1.731 NHSL Forensic Band 3 x 5 WTE 0.147 0.147 NHSL GPIT Reprovisioning Gap 0.181 0.181 NHSL Health Inequalities - Screening 0.098 (0.024) 0.074 NHSL Health Visiting Students/Trainees 0.840 (0.356) 0.484 NLC Home Support Resilience (2 year funding) 0.000 3.498 3.498 NHSL Hospital at Home Services - Support Development 0.414 (0.043) 0.371 NHSL HR Employability Team (2 year funding, 50:50 split between North and South) 0.187 0.187 NLC IJB Helpline (2 years funding) 0.600 0.600 NHSL Integrated Authority Support 6.076 (1.150) 4.926 NHSL Kylepark Works 1.000 0.608 1.608 NHSL Learning Disabilities Band 3 x 4 FTE 0.118 0.118 NLC Local Government Pay Award 23/24 2.653 2.653 NHSL Long Covid Pathways 0.444 0.444 NLC Mental Health Social Workers 2 x NL10 x 24 months 0.107 (0.074) 0.033 NHSL Minor Capital Works 1.387 (0.209) 1.178 NHSL Neonatal & Paediatrics Dieteics Intervention (3 year funding) 0.550 0.550 NHSL Organisational Development Fund 0.260 0.260 NHSL Paediatric Diabetes Insulin Pumps and Additional Staff 0.908 (0.027) 0.881 NLC Planned Date of Discharge - Discharge To Assess 0.200 0.241 (0.074) 0.367 NLC Planned Date of Discharge - Locality Social Work Manager Post 0.055 0.096 (0.051) 0.100 NHSL Podiatry Services - Foot Screening 0.459 (0.033) 0.426 NHSL Prisioner Healthcare - Transitional Project Band 8A 0.070 0.070 NHSL Psychology Posts 2 x Band 6 0.098 0.098 NHSL Regrading of Posts Including Backpay 0.125 0.125 0.250 NHSL Scottish Clinical Leadership Fellowship 0.045 (0.011) 0.034 NHSL Sexual Health Services - Forensic Medical 0.222 (0.047) 0.175 NHSL Sexual Health Services - Long-Acting Reversible Contraception (LARC) 0.109 0.386 (0.004) 0.491 NLC Social Care Contracting Staff within Quality Assurance Services 0.047 0.028 (0.052) 0.023 NLC/NHSL Staff Training Academy 2.400 2.400 NHSL Stigma Free Lanarkshire (3 year funding) 0.450 0.450 NHSL Supervisor Training 0.077 (0.012) 0.065 NLC Unmet Saving 21/22 - IDS/LSS (merging building Coatbridge & Cumbernauld) 0.086 (0.068) 0.018 NLC Violence Against Women (Joint Initiative with SLC and C&F) 0.030 0.030 NHSL Vulnerable and Complex Cases - Test of Change 1.208 (0.088) 1.120 31.661 17.186 (6.494) 42.353 LEAD SUMMARY TOTAL EARMARKED RESERVES LEAD RING-FENCED RESERVES TOTAL RING-FENCED RESERVES LEAD EARMARKED RESERVES Total
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8 Opening Balance After Review Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NLC Long Covid Contingency 3.000 (0.727) 2.273 NHSL Prescribing Fund 4.361 4.361 NLC Social Care Demand 6.117 (2.130) (0.069) 3.918 13.478 (2.130) (0.796) 10.552 Opening Balance After Review Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NHSL Contingency Balance Held By NHSL 4.167 1.032 (0.301) 4.898 4.167 1.032 (0.301) 4.898 Opening Balance After Review Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NHSL Administration Support Services 0.240 (0.239) (0.001) - NHSL Area Wide Services - Admin 0.080 (0.080) - NHSL Area Wide Services - Audiology Equipment 0.011 (0.011) - NHSL Area Wide Services - Locality Funding 0.432 (0.432) - NHSL Area Wide Services - Mental Health Pharmacy, PCIP and NES SLA with GPs 1.048 (1.048) - NHSL Area Wide Services - Update Consolidated Health Information (CHI) 0.015 (0.015) - NHSL Assistant Support Worker - Promise 0.026 (0.026) - NLC Carers Act 2018 - Waving of Charges 0.580 (0.580) - NHSL Children and Adolescent Mental Health Services - Choice and Partnership Approach (CAPA) Team 0.717 (0.717) - NHSL Children and Adolescent Mental Health Services - Service Improvement Post (Band 7 - 18 months) 0.088 (0.088) - NHSL Children and Adolescent Mental Health Services - Waiting List Co-ordinator (Band 5) 0.038 (0.038) - NHSL Childrens Services - Childrens Inspection Senior Nurse (3 months) 0.017 (0.017) - NHSL Childrens Services - Manager Post (1WTE) 0.040 (0.040) - NHSL CLAN Cancer Support Funding 0.095 (0.095) - NHSL Clinical Fellow Funding 0.080 (0.080) - NHSL Clinical Guidelines Post 0.023 (0.023) - NHSL Clinical Pharmacist - Additions 0.035 (0.035) - NHSL Community Assessment and Rehabilitation Service - Rehabilitation Pilot 0.023 (0.023) - NHSL Community WIFI 0.342 (0.342) - NHSL Development of Health Promoting Culture 0.141 (0.141) - NHSL Dietetics Services 0.046 (0.046) - NHSL Dietetics Services - Band 6 0.114 (0.016) (0.098) - NHSL Dietetics Services - Diabetes Type 2 and Adult Weight Management 0.024 (0.024) - NHSL Dietetics Services - Oral Nutrition 0.038 (0.038) - NHSL Dietetics Services - Weight Management 0.049 (0.049) - NHSL Eating Disorders Funding 0.111 (0.111) - NLC Financial & Strategic Planning 2023/2026 5.416 (5.416) - NHSL Health Inequalities - Health Promotion Posts 0.006 (0.006) - NHSL Health Inequalities Funding 0.024 (0.024) - NHSL High Resource User Posts 0.025 (0.025) - NLC Home Support Development 0.217 (0.217) - NHSL Hospital at Home Services - Shortfall 0.110 (0.110) - NLC IJB Financial Plan Contingency - Allocated to NLC 3.000 (3.000) - NLC Impact of Covid-19 Pandemic Review 0.100 (0.100) - NHSL Integrated Support Worker 0.153 (0.153) - NHSL IT Federated Trust Environment Strategy 0.214 (0.214) - NHSL Joint Equipment Store 0.554 (0.554) - NHSL Kings Fund Organisational Development 0.014 (0.014) - NHSL Long Term Conditions (LTC) Lead Clinician 0.010 (0.010) - NHSL Maternity and Neonatal Psychological Interventions 0.044 (0.044) - NHSL Medical Director - Associate Medical Director (MR) 0.074 (0.074) - NHSL Medical Director - Child Death Review Funding 0.021 (0.021) - NHSL Mental Health and Learning Disability Services - Distress Brief Intervention 1.552 (1.552) - NHSL Mental Health Infant - NES Funding 0.013 (0.013) - NHSL Mental Health PDN 0.2wte for 20/21 spend previously approved 0.011 (0.011) - NLC Mental Health Practice Assessor 0.006 (0.006) - NHSL Mental Health Perinatal and Infant 0.532 (0.532) - NHSL Mental Health Practice Development (HF) 0.047 (0.047) - NHSL Mental Health Support for Those Hospitalised with Covid-19 0.172 (0.172) - NHSL Motherwell Rehabilitation Team Leadership 0.058 (0.058) - NHSL Neurodevelopmental Pathway OT 0.095 (0.095) - NHSL Nursing Appointments 0.119 (0.119) - NHSL Nursing Services 0.125 (0.125) - NHSL Nursing Services - District Nurse 0.292 (0.292) - NHSL Nursing Services - Extend Health Improvement Unit posts to March 2020 0.075 (0.075) - NHSL Nursing Services - Family Nurse Partnership 0.033 (0.033) - NHSL Nursing Services - Nursing Assoicate Post Band 7 x 0.2 WTE 0.011 (0.011) - NHSL Nursing Services - Queens Nursing Institute Grants 0.004 (0.004) - NHSL Nursing Services - Quest Patient Safety Posts 0.003 (0.003) - NHSL Nursing Services - School Nursing 0.162 (0.162) - NHSL Nursing Services - Solihull Training 0.018 (0.018) - NLC Payment to Voluntary Org - Glenboig 0.006 (0.006) - NHSL Pre School Screening Exclusion Incident Audit 0.025 (0.025) - NHSL Project Manager - Adverse Events 0.036 (0.036) - NHSL Public Health Intelligence Data Analysts 0.061 (0.061) - NHSL Return to Nursing Students 0.107 (0.107) - NLC SDS Transformational Team 0.025 (0.025) - NHSL Sexual Health Services - Health & Homeless Post 0.004 (0.004) - NHSL Sexual Health Services - Long-Acting Reversible Contraception (LARC) (2 clinics for 2 years) 0.386 (0.386) - NHSL Sexual Health Services - Sexually Transmitted Infections 0.122 (0.010) (0.112) - NHSL Speech, Language and Therapy Services 0.807 (0.807) - NHSL Speech, Language and Therapy Services - Contract 0.250 (0.250) - NHSL Test of Change - High Intensity Service Users 0.027 (0.027) - NHSL Training Fund 0.246 (0.246) - NHSL Vulnerable Population Post - Health Improvement Funding 0.068 (0.068) - NLC Winter Plan 0.300 (0.300) - NHSL Winter Plan - Discharge To Assess 0.010 (0.010) - 20.244 (15.916) (4.327) 0.000 119.453 (23.944) (26.271) 69.237TOTAL RESERVES LEAD RISK-BASED RESERVES TOTAL RISK-BASED RESERVES LEAD CONTINGENCY FUND RESERVES APPENDIX 2 CONT. TOTAL CONTINGENCY FUND RESERVES LEAD CLOSED RESERVES TOTAL CLOSED RESERVES