ITEM 11 Financial Monitoring Report
North Lanarkshire Council · 27 September 2023
Back to Health and Social Care Integration Joint Board — 27 September 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: 11 SUBJECT: Financial Monitoring Report 2023 2024 TO: Integration Joint Board Lead Officer for Report: Ross McGuffie, Chief Officer North HSCP Author(s) of Report Amanda Kilburn, Chief Finance Officer DATE: 27 September 2023 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integration Joint Board (IJB) for: For approval For endorsement For noting 1.2 This report provides a summary of the financial position of the North Lanarkshire Health and Social Care Partnership (HSCP) for the period 1 April 2024 to 30 June 2023. 2. ROUTE TO THE PERFORMANCE, FINANCE AND AUDIT COMMITTEE 2.1 This paper has been: Prepared By: Chief Finance Officer ☒ Reviewed By: Chief Officer ☒ Endorsed By: ☐ 3. RECOMMENDATIONS 3.1 It is recommended that the IJB: (1) Acknowledge the contents of the report; and (2) Acknowledge the projected outturn for 2023/24 is an underspend of £3.182m. 4. VARIATIONS TO DIRECTIONS 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 This report is based on the financial monitoring reports received from NHS Lanarkshire Director of Finance and North Lanarkshire Council Head of Financial Solutions. The position detailed in these reports is therefore based on the Yes No N/A
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2 information contained in each partner’s respective financial systems and includes accruals and adjustments in-line with their financial policies. 6. CONCLUSIONS 6.1 As detailed in the following table, the IJB year to date position is an underspend of £0.969m and the projected outturn for 2023/24 is an underspend of £3.182m, assuming the current trajectory of spend continues throughout the financial year. There is no ring-fenced funding included in this reported projected outturn. Service Year to Date Position £m Projected Year End Outturn £m Health Care Services 0.042 0.169 Social Care Services 0.927 3.014 Total North Lanarkshire HSCP 0.969 3.182 Ring-Fenced Funding - - Revised Outturn Total 2023/2024 0.969 3.182 6.2 Subject to IJB approval, in-year underspends will be allocated to manage, on a non-recurring basis, ring-fenced commitments, additional commitments relating to the Strategic Commissioning Plan and any funding gap which is highlighted in the North Lanarkshire IJB Medium-Term Financial Plan 2023-2026. 6.3 A summary of the current financial challenges and key pressures are highlighted in the table below: Area Projected Outturn under/(over) £m Main Factors Employee Costs 10.439 As highlighted through 2022/2023, there are ongoing challenges in terms of recruitment and retention issues across all service areas. For a wide range of posts recruitment has been unsuccessful due to the availability of the skills mix required or the competition being offered by other private and public sectors. During this financial year, various planning groups will work to address and provide solutions to help mitigate shortages in line with staffing availability. Payments to Other Bodies (PTOB) (1.930) There are two main areas of overspend within PTOB which are independent care homes and self-directed support (SDS) costs. The independent care homes have a yearly budget of 1,361 care plans but at present the number of projected care plans is 1,440 resulting in a projected overspend of £1.014m. SDS is similarly overspent due to a budget of 2,312 care plans against 2,860 estimated care plans for 23/24. This increase in demand was forecast and reported in the Medium-Term Financial Plan. As per the IJB strategy to address the demand pressures within the plan, a drawdown of £3m from the social care demand reserve is being used to offset the current projection reducing the overspend to £1.356m.
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3 Current projections do not take account of any slippage to start dates or cancelled packages which will reduce costs further as the year progresses. Additional work is underway within the service and the finance team to further analyse this projection. Prescribing (5.399) This overspend is attributable to the number of medicines being prescribed and dispensed in community pharmacies resulting in an increase in costs. The current projection is based on April data and 2022/2023 trends due to the 2-month time lag in receiving current data. Additional information on the on-going prescribing saving plan is at para 7. North Lanarkshire Hosted Services (0.428) The two main areas of overspends within North Lanarkshire hosted services, relate to continence service and children services. Continence Service overspend is due to an increase in costs relating to continence products. Children Services overspend relates to diabetic equipment including diabetic glucose monitoring machines and insulin pumps. 6.4 Throughout the year, adjustments are made to the original budget due to additional budget allocations and budget transfers. Appendix 4 provides a reconciliation of the main budget adjustments applied this financial year and the table below shows the current funding allocations received from Scottish Government: Scottish Government Allocations 2023/24 £m Additional Staffing Band 2-4 1.093 Alcohol and Drug Partnership 2.800 Child Death Review 0.024 Distress Brief Intervention 3.070 District Nursing 0.610 Family Nurse Practitioner Funding 1.150 Long Covid Support Fund 0.224 Mental Health Action 15 3.930 Mental Health Community Perinatal 0.505 Mental Health Infant and Maternity 0.476 Mental Health Outcomes Framework 3.380 Multi-Disciplinary Teams 1.740 Neonatal Psychological Interventions 0.138 Outcomes Framework 2.770 School Nursing Posts 0.730 TOTAL 22.640 7. SAVINGS
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4 7.1 Within 2023/2024 prescribing budget, a savings target of £2.7m has been set by NHS Lanarkshire to help reduce the continuing increasing overspend. 7.2 A wide range of work has commenced from March to ensure the balance of the savings target is achieved, ranging from reducing waste and inefficiencies and changing prescribing practices and culture. The impact of this work has recorded savings at the end of June totalling £0.239m and if this continues the forecast annual savings expected by March 2024 is £1.170m. 7.3 Work on savings programmes for Scriptswitch and medicine reviews continues from last financial year along with a wide variety of other work which has commenced from March 2023. Allowing a period of time for communication and implementation of changes to practice and efficiency programmes to embed, the impact of this work is expected to achieve the required savings target by March 2024. 7.4 The table below shows the volatility in cost per item within prescribing. As at April 2023, average cost per item was £10.23 compared to April 2022 when the average cost was £9.38: 7.5 Table 1 below shows the cost of prescribing from April 2022 to April 2023 and table 2 shows the data by items dispended for the same period: 2.700 1.170 0.239 Savings Target Savings Expected Savings Achieved 0.000 0.500 1.000 1.500 2.000 2.500 3.000 £m 2023/24 Prescribing Savings £m 2023/2024 £8.80 £9.00 £9.20 £9.40 £9.60 £9.80 £10.00 £10.20 £10.40 £10.60 Cost Per Item Cost Per Item April 2022 - March 2023
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5 7.6 It should however be noted that due to the volatility within this area and the time lag in receiving up to date information from the recording system, the current projection is likely to change month on month. Additional monitoring is in place with the data being analysed by a dedicated working group and regular updates on progress will be reported to the IJB throughout the year. 8. GENERAL RESERVES 8.1 It is important 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 statue and is part of a range of measures in place to ensure that s106 public bodies do not over-commit themselves financially. 8.2 The current IJB reserves position for 2023/2024 after adjustment for the drawdown of reserves, is a revised balance of £84.211m and is summarised in the table below: 0.000 1.000 2.000 3.000 4.000 5.000 6.000 7.000 8.000 £m Table 1: Prescribing Cost £m April 2023 - April 2024 540,000 560,000 580,000 600,000 620,000 640,000 660,000 680,000 700,000 720,000 No. of Items Dispensed Table 2: Prescribing Items Dispensed April 2022 - April 2023
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6 8.3 The IJB risk-based and contingency reserves currently equate to 2.6% of the financial envelope. Appendix 5 shows a detailed list of all reserve movement during 2023/24. 8.4 Regular updates will be provided to the IJB throughout 2023/24 as analysis and reviews of all reserves are monitored to ensure they continue to meet on-going pressures and remain fit for purpose. 9. CURRENT VACANCY POSITION 9.1 As highlighted throughout this report, employee costs are projecting a significant underspend within all services. Recruitment continues to be progressed for vacant posts in all areas. 9.2 The table below shows the current full time equivalent (FTE) vacancy numbers within each service against their budgeted establishment: 9.3 To help cover the vacant posts, agency staff, bankaide, overtime and excess part time hours are used, the cost of which is included within the financial position reported. A detailed analysis of these costs is at appendix 6. Opening Balance As At 1 April 2023 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Ring-Fenced Reserves 23.936 0.000 (2.760) 21.176 NHSL & NLC Earmarked Reserves 44.497 0.084 (1.248) 43.333 NHSL & NLC Risk-Based Reserves 14.901 (0.253) (3.000) 11.648 NHSL Contingency Reserves 8.060 (0.006) 0.000 8.054 NHSL & NLC Closed Reserves 6.552 0.175 (6.727) 0.000 97.946 0.000 (13.735) 84.211 LEAD SUMMARY Total Establishment Actual Vacancies FTE FTE FTE North West Locality 384.46 336.88 47.58 North East Locality 323.88 285.52 38.36 Adult Services 273.75 268.87 4.88 Children Services 570.49 529.42 41.07 Mental Health 1,127.15 1,121.32 5.83 Social Care Services 972.60 736.70 235.90 Home Support 1,000.17 1,008.84 -8.67 Other 85.01 207.57 -122.56 TOTAL 4,737.51 4,495.12 242.39 Service
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7 10. DELEGATED SERVICES 2023/2024 10.1 The following table shows the costs of other North Lanarkshire Council services delegated to the IJB during 2023/2024. The projected outturn position for 2023/2024 is breakeven: Service Expenditure £m Income £m Projected Year End Outturn £m Housing 1.945 (1.945) Breakeven Transport 0.551 (0.551) Breakeven Total 2.496 (2.496) Breakeven 11. IMPLICATIONS 11.1 NATIONAL OUTCOMES People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care, and treatment they provide ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 11.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. 11.3 FINANCIAL Overtime Excess Part Time Bankaide Agency TOTAL £m £m £m £m £m North West Locality 0.043 0.014 0.198 0.133 0.387 North East Locality 0.017 0.009 0.067 0.005 0.099 Adult Services 0.022 0.021 0.081 0.037 0.161 Children Services 0.073 0.018 0.163 0.008 0.262 Mental Health 0.129 0.024 0.723 1.201 2.078 Social Care Services 0.283 - - 0.109 0.393 Home Support 1.015 - - - 1.015 Other 0.012 0.006 0.015 - 0.033 TOTAL 1.595 0.092 1.247 1.493 4.428 SERVICE Year to Date Cost
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8 This paper has been reviewed by Finance: Yes No N/A 11.4 RISK ASSESSMENT/RISK MANAGEMENT The strategic financial risks detailed in the IJB Risk Register has been updated where necessary and are included in a separate report to the IJB. Relevant Risk Register Details Current Risk Level Risk Owner Financial Challenges High Amanda Kilburn Prescribing Activity and Costs Very High Ross McGuffie 11.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Objectives Further details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes The Director of Finance of NHSL and the Head of Financial Solutions of NLC both continue to be consulted on the financial position of the NL IJB. ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design, and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery Financial information is shared with stakeholders on a regular basis and is provided to the PFA and IJB on a quarterly basis. ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership IJB Financial Plan and Reserves Strategy aligns and supports the IJB Strategic Commissioning Plan to ensure robust financial monitoring and scrutiny. 11.6 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed and EQIA added to website:
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9 Yes No N/A 12. BACKGROUND PAPERS None. 13. APPENDICES Appendix 1- North Lanarkshire Health and Social Care Partnership Budget Appendix 2 - Hosted Services Led by North Lanarkshire Appendix 3- Hosted Services Led by South Lanarkshire Appendix 4- North Lanarkshire IJB Budget Reconciliation 2023/2024 Appendix 5- North Lanarkshire IJB General Reserves 2023/2024 Appendix 6- Analysis of Additional Employee Costs 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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10 Appendix 1 North Lanarkshire Revenue Budget Position 1 April 2023 to 30 June 2023 Appendix 1 Annual Year To Date Variance Projected Year End Outturn Budget Budget Actual Total Total 2023/2024 June 2023 June 2023 June 2023 2023/2024 £m £m £m £m £m Health Care Services Locality and Other Services 58.031 15.032 14.233 0.799 3.196 Addiction Services 7.054 0.534 0.536 (0.002) (0.008) Medical and Nursing Directorate 4.982 1.414 1.337 0.078 0.311 Prescribing 70.973 17.743 19.093 (1.350) (5.399) Out of Area Services 4.571 1.144 1.012 0.131 0.526 Area Wide Services 7.064 1.841 1.750 0.091 0.364 Hosted Services 165.185 45.904 45.609 0.295 1.179 Family Health Services 116.617 28.041 28.041 0.000 0.000 Set-Aside Budget 70.502 17.626 17.626 0.000 0.000 Total Expenditure - NHSL 504.978 129.279 129.236 0.042 0.169 Social Care Services Social Care Services Gross Expenditure 251.389 77.350 76.363 0.988 3.061 Social Care Services Gross Income (4.379) (1.348) (1.287) (0.061) (0.197) Social Care Services Net Expenditure 247.009 76.003 75.076 0.927 2.864 Housing Revenue Account 1.945 0.598 0.598 0.000 0.150 Transport Services Account 0.551 0.169 0.169 0.000 0.000 Social Care, Housing and Transport Services Net Expenditure 249.505 76.771 75.844 0.927 3.014 Total Expenditure - NHSL and NLC 754.483 206.049 205.080 0.969 3.182 Annual Budget 2023/2024 £m NHS Lanarkshire Funding (497.419) Social Care Funding (22.964) Resource Transfer (23.421) Commissioned Services (6.721) Transfer from Reserves (Approved) (7.559) Total Funding - NHSL (558.084) NLC Funding - Social Care Services (190.727) NLC Funding - Housing Services (1.945) NLC Funding - Transport Services (0.551) Transfer from Reserves (Approved) (3.176) Total Funding - NLC (196.399) Total Funding - NHSL and NLC (754.483) Year To Date Care Group Funded By:
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11 Appendix 2 Appendix 3 Hosted Services Appendix 2 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 Budget Actual Variance Budget Actual Variance Budget Actual Variance 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 £m £m £m £m £m £m £m £m £m £m £m £m Sexual Health Services 2.949 0.778 0.768 0.010 1.533 0.404 0.395 0.010 1.415 0.373 0.373 0.000 Continence Services 2.402 0.617 0.835 (0.218) 1.249 0.321 0.539 (0.218) 1.153 0.296 0.296 0.000 Immunisation Services 1.918 0.502 0.554 (0.052) 0.997 0.261 0.313 (0.052) 0.920 0.241 0.241 0.000 Speech and Language Therapy Services 6.454 1.802 1.835 (0.032) 3.356 0.937 0.970 (0.032) 3.098 0.865 0.865 0.000 Children and Adolescents Mental Health Services 8.504 3.594 3.182 0.412 4.422 1.869 1.457 0.412 4.082 1.725 1.725 0.000 Childrens Services 12.099 3.233 3.383 (0.149) 6.291 1.681 1.831 (0.149) 5.807 1.552 1.552 0.000 Integrated Equipment and Adaptations Store 0.567 0.142 0.137 0.004 0.295 0.074 0.069 0.004 0.272 0.068 0.068 0.000 Dietetics Services 3.930 1.074 1.052 0.023 2.044 0.559 0.536 0.023 1.887 0.516 0.516 0.000 Podiatry Services 4.552 1.274 1.244 0.031 2.367 0.663 0.632 0.031 2.185 0.612 0.612 0.000 Prisoner Healthcare Services 1.781 0.475 0.524 (0.049) 0.926 0.247 0.296 (0.049) 0.855 0.228 0.228 0.000 Blood Borne Viruses Services 1.560 0.409 0.482 (0.072) 0.811 0.213 0.285 (0.072) 0.749 0.196 0.196 0.000 Hospital at Home 2.326 0.640 0.654 (0.014) 1.210 0.333 0.347 (0.014) 1.117 0.307 0.307 0.000 Mental Health and Learning Disability Services 78.242 21.137 20.735 0.402 40.686 10.991 10.589 0.402 37.556 10.146 10.146 0.000 TOTAL 127.284 35.678 35.383 0.295 66.188 18.553 18.258 0.295 61.096 17.125 17.125 0.000 Led by the North Partnership South Lanarkshire IJB - 48% Share Year to Date Annual Budget 2023/2024 Annual Budget 2023/2024 Year to Date North Lanarkshire IJB - 52% ShareYear to DateAnnual Budget 2023/2024 Hosted Services Appendix 3 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 Budget Actual Variance Budget Actual Variance Budget Actual Variance 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 £m £m £m £m £m £m £m £m £m £m £m £m Community Dental Services 7.204 2.051 1.826 0.224 3.746 1.066 1.066 0.000 3.458 0.984 0.760 0.224 Brain Injury Unit 1.220 0.545 0.540 0.005 0.635 0.283 0.283 0.000 0.586 0.261 0.257 0.005 Out of Hours Services 9.079 2.362 2.346 0.017 4.721 1.228 1.228 0.000 4.358 1.134 1.117 0.017 Palliative Care Services 7.133 1.902 1.836 0.067 3.709 0.989 0.989 0.000 3.424 0.913 0.846 0.067 Physiotherapy Services 10.845 3.037 3.205 (0.168) 5.639 1.579 1.579 0.000 5.206 1.458 1.626 (0.168) Primary Care Services 0.804 0.229 0.207 0.021 0.418 0.119 0.119 0.000 0.386 0.110 0.089 0.021 Occupational Therapy Services 8.381 2.354 2.283 0.072 4.358 1.224 1.224 0.000 4.023 1.130 1.058 0.072 Diabetic Services 3.999 1.130 1.150 (0.020) 2.079 0.588 0.588 0.000 1.919 0.543 0.563 (0.020) Telehealth 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Sub Total 48.666 13.610 13.393 0.217 25.307 7.077 7.077 0.000 23.360 6.533 6.316 0.217 Ring Fenced Funding Primary Care Improvement Fund 24.220 6.055 5.243 0.813 12.595 3.149 3.149 0.000 11.626 2.907 2.094 0.813 Primary Care Transformation Fund 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Sub Total 24.220 6.055 5.243 0.813 12.595 3.149 3.149 0.000 11.626 2.907 2.094 0.813 TOTAL 72.887 19.665 18.636 1.029 37.901 10.226 10.226 0.000 34.986 9.439 8.410 1.029 Annual Budget 2023/2024 Year to Date South Lanarkshire IJB - 48% Share Led by the South Partnership Annual Budget 2023/2024 Year to Date Annual Budget 2023/2024 Year to Date North Lanarkshire IJB - 52% Share
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12 Appendix 4 North Lanarkshire IJB Budget Reconciliation 2023/24 Appendix 4 2023/24 NHSL Financial Allocation to North Lanarkshire HSCP £m 2023/24 NLC Financial Allocation to North Lanarkshire HSCP £m 2023/24 North Lanarkshire HSCP Financial Allocation 333.065 2023/24 North Lanarkshire HSCP Financial Allocation 190.727 Set-Aside Budget 70.502 NLC Funding - Housing Services 1.945 South Hosted @ 52% 37.901 NLC Funding - Transport Services 0.551 Family Health Service South @ 52% 116.616 Pay Award Drawdown from Reserves 3.176 NHSL Financial Allocation at 30 June 2023 558.084 NLC Financial Allocation at 21 July 2023 196.399
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13 Appendix 5 Opening Balance As At 1 April 2023 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NLC Long Covid Contingency 1.949 (1.199) 0.750 NHSL Prescribing Fund 4.361 4.361 NLC Social Care Demand 8.591 0.946 (3.000) 6.537 14.901 (0.253) (3.000) 11.648 Opening Balance As At 1 April 2023 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Contingency Balance Held By NHSL 8.060 (0.006) 8.054 8.060 (0.006) 0.000 8.054 LEAD RISK-BASED RESERVES TOTAL RISK-BASED RESERVES LEAD CONTINGENCY FUND RESERVES TOTAL CONTINGENCY FUND RESERVES North Lanarkshire IJB APPENDIX 5 Movement on Reserves Audit Trail NHSL & NCL Opening Balance As At 1 April 2023 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Ring-Fenced Reserves 23.936 0.000 (2.760) 21.176 NHSL & NLC Earmarked Reserves 44.497 0.084 (1.248) 43.333 NHSL & NLC Risk-Based Reserves 14.901 (0.253) (3.000) 11.648 NHSL Contingency Reserves 8.060 (0.006) 0.000 8.054 NHSL & NLC Closed Reserves 6.552 0.175 (6.727) 0.000 97.946 0.000 (13.735) 84.211 Opening Balance As At 1 April 2023 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Alcohol and Drug Partnership - Long Acting Buprenorphine 0.255 0.255 NHSL Area Wide Services - Refugees and Displaced Persons 0.250 0.250 NHSL Blood-Borne Viruses Services 0.171 0.171 NHSL Children and Adolescent Mental Health Services 4.101 (0.108) 3.993 NHSL Community Living Change Fund 1.298 1.298 NHSL Covid-19 Funding 0.007 0.007 NHSL District Nursing - Scottish Government Funded 0.376 (0.164) 0.212 NHSL Hospital at Home Services - Support Development 0.621 (0.012) 0.609 NHSL Learning Disabilities Health Checks 0.246 0.246 NHSL Long Covid Pathways 0.764 (0.155) 0.609 NHSL Medical Director - Child Death Review Funding 0.012 (0.010) 0.002 NHSL Mental Health and Learning Disability Services - Action 15 3.930 (0.930) 3.000 NHSL Mental Health and Learning Disability Services - Distress Brief Intervention 3.155 (0.570) 2.585 NHSL Mental Health - Diagnostic Support Service Dementia Post 0.751 0.751 NHSL Mental Health Eating Disorders 0.070 0.070 NHSL Mental Health Neurodevelopmental Pathways 0.100 0.100 NHSL Mental Health Perinatal, Infant, Maternity and Neonatal 0.005 0.005 NHSL Mental Health Psychology Posts 0.670 (0.432) 0.238 NHSL Mental Health Recovery Renewal - Facilities Projects 1.840 1.840 NHSL Mental Health Wellbeing in Primary Care Services 0.148 0.148 NHSL North Planning Band 2-4 Posts 0.933 (0.377) 0.556 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 NHSL Unscheduled Care Funding 3.120 3.120 NHSL Upper GI Dietetics Band 4 0.033 0.033 23.936 0.000 (2.760) 21.176 LEAD SUMMARY 2023/24 TOTAL RING-FENCED RESERVES LEAD RING-FENCED RESERVES Total
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14 Opening Balance As At 1 April 2023 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Adult Social Care Winter Preparedness Fund 1.941 1.941 NLC Adaptations Fund 0.289 0.099 0.388 NLC Adult Protection (share with C&F and NHSL) 0.050 0.050 NLC Advocacy Services 0.118 0.118 NHSL Area Wide Services - Health Promotion - North Lanarkshire Leisure agreement 0.123 0.123 NHSL Area Wide Services - Primary Care Corporate (iHUB Project - NES funding) 0.034 0.034 NHSL Breast Feeding Team (2 year funding) 0.828 0.828 NHSL Business Case - Health Care Support Workers, Multi-Disciplinary Teams 1.797 (0.595) 1.202 NLC Business Case - Non-Recurring NLC Costs 3.811 0.001 3.812 NHSL Care Homes Allocation 0.318 0.318 NLC Carers Act 2018 - Support 2.643 0.058 2.701 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 0.414 (0.045) 0.369 NHSL Development of Chryston Community Health Clinic 0.212 0.212 NHSL Dietetics Services - Double Running Costs 0.110 (0.005) 0.105 NLC Digital and IT Strategy Technology Improvements - Community Alarms 0.588 0.588 NLC Digital and IT Strategy Technology Improvements - Home Support Scheduling System 3.776 3.776 NLC Digital and IT Strategy Technology Improvements - Other 0.566 0.566 NLC Digital and IT Strategy Technology Improvements - SWIS 0.700 0.700 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 1.099 (0.499) 0.600 NHSL Forensic Band 3 x 5 WTE 0.147 (0.030) 0.117 NHSL GPIT Reprovisioning Gap 0.181 0.181 NHSL Health Inequalities - Screening 0.071 (0.007) 0.064 NHSL Health Visiting Students/Trainees 0.484 (0.079) 0.405 NLC Home Support Resilience (2 year funding) 3.498 0.148 3.646 NHSL HR Employability Team (2 year funding, 50:50 split between North and South) 0.187 0.187 NLC IJB Helpline (2 years funding) 0.575 0.575 NHSL Integrated Authority Support 4.926 4.926 NHSL Kylepark Works 1.578 1.578 NLC Mental Health Social Workers 2 x NL10 x 24 months 0.069 0.120 0.189 NHSL Mental Health Wards Window Replacement 0.650 0.650 NHSL Minor Capital Works 1.162 (0.088) 1.074 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 0.881 (0.021) 0.860 NLC Planned Date of Discharge - Discharge To Assess 0.304 0.304 NLC Planned Date of Discharge - Locality Social Work Manager Post 0.077 0.077 NHSL Podiatry Services - Foot Screening 0.426 (0.023) 0.403 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 0.250 0.250 NHSL Scottish Clinical Leadership Fellowship 0.100 (0.005) 0.095 NHSL Sexual Health Services - Forensic Medical 0.175 0.030 0.205 NHSL Sexual Health Services - Long-Acting Reversible Contraception (LARC) 0.491 0.491 NLC Social Care Contracting Staff within Quality Assurance Services 0.003 0.157 0.160 NLC Social Care Regrading of Staff (SSW, SP, SW, OT, TL and TM) 3.169 (0.346) 2.823 NLC/NHSL Staff Training Academy 2.400 2.400 NHSL Stigma Free Lanarkshire (3 year funding) 0.450 0.450 NHSL Supervisor Training 0.065 0.065 NLC Violence Against Women (Joint Initiative with SLC and C&F) 0.030 0.030 NHSL Vulnerable and Complex Cases - Test of Change 1.092 (0.035) 1.057 44.497 0.084 (1.248) 43.333 LEAD EARMARKED RESERVES TOTAL EARMARKED RESERVES Opening Balance As At 1 April 2023 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Alcohol and Drug Partnership Funding 2.926 (2.926) 0.000 NHSL Alcohol and Drug Partnership - Local Implementation Plan 0.167 (0.167) 0.000 NHSL Area Wide Services - NES Training 0.132 0.006 (0.138) 0.000 NHSL Assistive Technology Contract x 12 months (ATC) 0.008 (0.008) 0.000 NHSL Learning Disabilities Band 3 x 4 FTE 0.118 (0.118) 0.000 NLC Local Government Pay Award 23/24 2.653 0.177 (2.830) 0.000 NHSL Mental Health Covid Clinicians (Cossette) 0.200 (0.200) 0.000 NHSL Mental Health Pharmacy Recovery Plan 0.175 (0.175) 0.000 NHSL NES SLA Pharmacy Training 0.173 (0.173) 0.000 6.552 0.175 (6.727) 0.000 CLOSED RESERVES TOTAL CLOSED RESERVES LEAD
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15 Analysis of Additional Employee Costs 2023/2024 Appendix 6 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Other £ TOTAL £ 1 63,500 21,000 29,000 54,500 250,000 5,000 423,000 2 63,500 21,000 29,000 54,500 250,000 5,000 423,000 3 71,000 24,728 23,000 54,000 223,198 5,000 400,926 4 0 5 0 6 0 7 0 8 0 9 0 10 0 11 0 TOTAL 198,000 66,728 81,000 163,000 723,198 15,000 1,246,926 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Social Care Services £ TOTAL £ 1 42,416 - 2,717 1,571 406,062 -13,522 439,244 2 62,289 2,876 25,213 6,576 389,942 32,744 519,640 3 27,805 2,262 9,143 - 405,161 36,290 480,661 4 53,866 53,866 5 0 6 0 7 0 8 0 9 0 10 0 11 0 12 0 TOTAL 132,510 5,138 37,073 8,147 1,201,165 109,378 1,493,411 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Social Care Services £ Home Support £ Other £ TOTAL £ 1 15,591 5,617 9,055 25,740 47,690 4,691 87,355 5,664 201,403 2 13,874 6,412 7,221 23,070 40,800 86,847 309,302 4,051 491,577 3 13,617 5,469 5,833 24,261 40,383 105,859 304,161 2,651 502,234 4 85,974 314,146 400,120 5 0 6 0 7 0 8 0 9 0 10 0 11 0 12 0 TOTAL 43,082 17,498 22,109 73,071 128,873 283,371 1,014,964 12,366 1,595,334 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Other £ TOTAL £ 1 6,273 4,839 7,436 7,174 11,599 2,093 39,414 2 3,055 1,717 5,869 5,494 6,373 2,626 25,134 3 4,200 2,878 7,399 5,563 6,369 972 27,381 4 0 5 0 6 0 7 0 8 0 9 0 10 0 11 0 TOTAL 13,528 9,434 20,704 18,231 24,341 5,691 91,929 BANKAIDE COSTS YEAR TO DATE OVERTIME COSTS YEAR TO DATE EXCESS PART TIME COSTS YEAR TO DATE Period Period Period Period AGENCY COSTS YEAR TO DATE Appendix 6