ITEM 13 Financial Monitoring
North Lanarkshire Council · 22 November 2023
Back to Health and Social Care Integration Joint Board — 22 November 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: 13 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 2023 to 30 September 2023. 2. ROUTE TO THE INTEGRATION JOINT BOARD 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 revised projected outturn for 2023/24 is an underspend of £3.640m. 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 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, prior to removal of ring-fenced funding, is an underspend of £2.323m and the projected outturn for 2023/24 is an underspend of £4.313m, assuming the current trajectory of spend continues throughout the financial year. SUBJECT: Financial Monitoring Report 2023/2024 TO: Integration Joint Board Lead Officer for Report: Ross McGuffie Chief Officer NHSCP Author(s) of Report Amanda Kilburn, Chief Finance Officer DATE: 22 November 2023 Yes No N/A
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2 6.2 In line with Scottish Government guidance, unspent ring-fenced funding must be transferred to relevant reserves at the end of each financial year for use in later years. 6.3 Removing this from the current projected outturn gives a revised year to date underspend and projected outturn for 2023/24 of £1.961m and £3.640m respectively. Service 2023/24 Year to Date Position £m 2023/24 Projected Year End Outturn £m Health Care Services 0.006 0.010 Social Care Services 2.317 4.303 Total North Lanarkshire HSCP 2.323 4.313 Ring-Fenced Funding (0.362) (0.673) Revised Outturn Total 2023/2024 1.961 3.640 6.4 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 has been highlighted in the North Lanarkshire IJB Medium-Term Financial Plan 2023-2026. 6.5 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 11.774 There are continuing challenges in terms of recruitment and retention 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 sectors. Work is underway to scrutinise all vacant posts which have been challenging to recruit to, with a view to realign, and create posts for current service need and workforce availability. This projected underspend is currently offsetting the projected overspends below. Payments to Other Bodies (PTOB) (0.849) 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 to fund 1,361 care plans but at present the number of projected care plans is 1,466 resulting in a projected overspend of £0.323m. SDS is similarly overspent due to a budget to fund 2,617 care plans against 3,068 estimated care plans for 23/24. This increase was forecast and reported in the Medium-Term Financial Plan. In line with the IJB strategy to address the demand pressures within the plan, a drawdown of £3.682m from the social care demand reserve is being used to offset the current projection reducing the overspend to £1.356m. Additional work is also underway including investment in a review team to work across home support and SDS.
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3 Prescribing (4.680) The current projection is attributable to the continued increase in costs associated with the number of medicines being prescribed. This projection is based on April data and 2022/23 trends as no current prescribing data is available due to an ongoing problem related to a recent system upgrade. The supplier has informed boards this situation is likely to continue for the next couple of months making current projections extremely difficult to profile. Similar to the increase in SDS demand, the prescribing increase was in part forecast and reported in the Medium-Term Financial Plan and therefore a drawdown of £3.835m from the prescribing reserve is being used to offset the current overspend. North Lanarkshire Hosted Services (2.071) The three main areas of overspend within North Lanarkshire hosted services, relate to continence service, children services and prisoner healthcare: Continence Service overspend is due to an increase in costs relating to continence products. Children Services overspend relates to health and safety requirements and diabetic equipment including diabetic glucose monitoring machines and insulin pumps. Prisoner Healthcare overspend is due to the increase in drug charges similar to the increase seen in prescribing. 6.6 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 allocation received from Scottish Government: Scottish Government Allocations 2023/24 £m Additional Staffing Band 2-4 1.093 Alcohol and Drug Partnership 8.149 Child Death Review 0.024 Digital Therapy Posts 0.111 Distress Brief Intervention 3.070 District Nursing 0.608 Family Nurse Practitioner Funding 1.150 ICU Bed Capacity Uplift 0.045 Learning Disabilities Health Checks 0.172 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 4.753 Mental Health Support Veterans 0.126 Multi-Disciplinary Teams 1.996 Neonatal Psychological Interventions 0.138 Outcomes Framework 2.770 School Nursing Posts 0.840 North Lanarkshire Council Sustainability Payment 0.220 TOTAL 30.400
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4 7. SAVINGS 7.1 Within 2023/24 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 to changing prescribing practices and culture. The impact of this work has recorded savings at the end of September totalling £0.669m and if this continues the forecast annual savings expected by March 2024 is £1.590m. 7.3 The table below shows the volatility in cost per item within prescribing as at May 2023, average cost per item was £10.43 compared to April 2022 when the average cost was £9.38: 7.4 The following two tables give additional information on the cost of prescribing from April 2022 to May 2023 and number of items dispended for the same period. These tables will be refreshed once current data on prescribing is made available: 2.700 1.590 0.509 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 £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 - May 2023
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5 7.5 It should be noted that due to the volatility within this area and the time lag in receiving up to date information from the recording systems, 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 The current IJB reserves position for 2023/24 after adjustment for the drawdown of reserves, is a revised balance of £70.631m and is summarised in the table below: 8.2 Appendix 5 shows a detailed list of all reserve movement during 2023/24. 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 - May 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 - May 2023 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 23.397 (0.224) (8.860) 14.313 NHSL & NLC Earmarked Reserves 44.497 0.084 (3.672) 40.909 NHSL & NLC Risk-Based Reserves 14.901 (0.253) (7.517) 7.131 NHSL Contingency Reserves 8.060 0.218 0.000 8.278 NHSL & NLC Closed Reserves 7.091 0.175 (7.266) 0.000 97.946 0.000 (27.315) 70.631 LEAD SUMMARY Total
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6 8.3 Regular updates will be provided to the IJB throughout the year 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 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. 10. DELEGATED SERVICES 2023/2024 10.1 The following table shows the costs of other North Lanarkshire Council services delegated to the IJB during 2023/24. The projected outturn position at 31 March 2024 is breakeven for both services. Service Expenditure £m Income £m Housing 2.095 (2.095) Breakeven Transport 0.551 (0.551) Breakeven Total 2.646 (2.646) Breakeven Establishment Actual Vacancies FTE FTE FTE North West Locality 394.12 338.99 55.13 North East Locality 332.48 292.83 39.65 Adult Services 287.24 275.41 11.83 Children Services 599.72 554.98 44.74 Mental Health 1,189.52 1,139.33 50.19 Social Care Services 986.81 758.57 228.24 Home Support 1,000.17 1,008.70 -8.53 Other 200.13 218.53 -18.40 TOTAL 4,990.19 4,587.34 402.85 Service Overtime Excess Part Time Bankaide Agency TOTAL £m £m £m £m £m North West Locality 0.084 0.025 0.439 0.154 0.702 North East Locality 0.033 0.016 0.238 0.032 0.319 Adult Services 0.038 0.045 0.208 0.069 0.361 Children Services 0.136 0.035 0.337 0.063 0.570 Mental Health 0.266 0.040 1.772 2.391 4.469 Social Care Services 0.550 - - 0.200 0.750 Home Support 2.079 - - - 2.079 Other 0.022 0.012 0.050 0.043 0.128 TOTAL 3.208 0.174 3.044 2.953 9.378 SERVICE Year to Date Cost
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7 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 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
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8 ☐ 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: 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 2023/24 Appendix 5 - North Lanarkshire IJB General Reserves 2023/24 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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9 North Lanarkshire Revenue Budget Position 1 April 2023 to 30 September 2023 Appendix 1 Annual Year To Date Variance Projected Year End Outturn Budget Budget Actual Total Total 2023/2024 September 2023 September 2023 September 2023 2023/2024 £m £m £m £m £m Health Care Services Locality and Other Services 66.248 30.465 28.586 1.879 3.758 Addiction Services 6.941 2.056 2.070 (0.014) (0.028) Medical and Nursing Directorate 4.261 2.165 2.109 0.056 0.112 Prescribing 74.808 36.903 39.243 (2.340) (4.680) Out of Area Services 4.641 3.040 2.620 0.420 0.840 Area Wide Services 7.657 3.543 3.314 0.229 0.456 Hosted Services 188.639 92.329 92.552 (0.224) (0.447) Family Health Services 120.561 58.767 58.767 0.000 0.000 Set-Aside Budget 70.502 35.251 35.251 0.000 0.000 Total Expenditure - NHSL 544.258 264.518 264.512 0.006 0.010 Social Care Services Social Care Services Gross Expenditure 251.856 135.615 133.300 2.315 4.299 Social Care Services Gross Income (3.909) (2.105) (2.108) 0.002 0.005 Social Care Services Net Expenditure 247.946 133.510 131.192 2.317 4.304 Housing Revenue Account 2.095 1.128 1.128 0.000 0.000 Transport Services Account 0.551 0.297 0.297 0.000 0.000 Social Care, Housing and Transport Services Net Expenditure 250.592 134.934 132.617 2.317 4.304 Total Expenditure - NHSL and NLC 794.851 399.452 397.129 2.323 4.313 Annual Budget 2023/2024 £m NHS Lanarkshire Funding (523.801) Social Care Funding (23.417) Resource Transfer (23.887) Commissioned Services (6.740) Transfer from Reserves (Approved) (20.457) Total Funding - NHSL (598.302) NLC Funding - Social Care Services (190.727) NLC Funding - Housing Services (2.095) NLC Funding - Transport Services (0.551) Transfer from Reserves (Approved) (3.176) Total Funding - NLC (196.549) Total Funding - NHSL and NLC (794.851) Year To Date Care Group Funded By:
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10 Hosted Services Appendix 2 September 2023 September 2023 September 2023 September 2023 September 2023 September 2023 September 2023 September 2023 September 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 3.346 1.678 1.745 (0.067) 1.740 0.873 0.940 (0.067) 1.606 0.806 0.806 0.000 Continence Services 2.466 1.237 1.678 (0.441) 1.283 0.643 1.084 (0.441) 1.184 0.594 0.594 0.000 Immunisation Services 3.119 2.141 2.162 (0.021) 1.622 1.113 1.134 (0.021) 1.497 1.028 1.028 0.000 Speech and Language Therapy Services 7.082 3.590 3.512 0.078 3.682 1.867 1.789 0.078 3.399 1.723 1.723 0.000 Children and Adolescents Mental Health Services 15.150 6.691 6.623 0.068 7.878 3.479 3.411 0.068 7.272 3.212 3.212 0.000 Childrens Services 12.911 6.428 6.871 (0.443) 6.714 3.342 3.786 (0.443) 6.197 3.085 3.085 0.000 Integrated Equipment and Adaptations Store 0.567 0.284 0.275 0.009 0.295 0.148 0.139 0.009 0.272 0.136 0.136 0.000 Dietetics Services 4.250 2.173 2.052 0.121 2.210 1.130 1.009 0.121 2.040 1.043 1.043 0.000 Podiatry Services 4.938 2.523 2.444 0.079 2.568 1.312 1.233 0.079 2.370 1.211 1.211 0.000 Prisoner Healthcare Services 2.009 1.019 1.306 (0.287) 1.045 0.530 0.817 (0.287) 0.964 0.489 0.489 0.000 Blood Borne Viruses Services 1.596 0.816 0.904 (0.088) 0.830 0.424 0.513 (0.088) 0.766 0.392 0.392 0.000 Hospital at Home 2.631 1.351 1.396 (0.044) 1.368 0.703 0.747 (0.044) 1.263 0.649 0.649 0.000 Mental Health and Learning Disability Services 87.914 42.102 41.290 0.812 45.715 21.893 21.081 0.812 42.199 20.209 20.209 0.000 TOTAL 147.980 72.033 72.256 (0.224) 76.949 37.457 37.681 (0.224) 71.030 34.576 34.576 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 September 2023 September 2023 September 2023 September 2023 September 2023 September 2023 September 2023 September 2023 September 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 8.107 4.032 3.650 0.381 4.216 2.097 2.097 0.000 3.891 1.935 1.554 0.381 Brain Injury Unit 2.954 1.144 1.353 (0.209) 1.536 0.595 0.595 0.000 1.418 0.549 0.758 (0.209) Out of Hours Services 9.980 4.891 4.803 0.088 5.190 2.543 2.543 0.000 4.790 2.348 2.260 0.088 Palliative Care Services 7.544 3.775 3.748 0.026 3.923 1.963 1.963 0.000 3.621 1.812 1.786 0.026 Physiotherapy Services 11.731 5.944 6.100 (0.156) 6.100 3.091 3.091 0.000 5.631 2.853 3.009 (0.156) Primary Care Services 0.876 0.452 0.413 0.039 0.455 0.235 0.235 0.000 0.420 0.217 0.178 0.039 Occupational Therapy Services 8.940 4.543 4.432 0.111 4.649 2.362 2.362 0.000 4.291 2.181 2.070 0.111 Diabetic Services 4.416 2.311 2.304 0.007 2.296 1.202 1.202 0.000 2.120 1.109 1.102 0.007 Sub Total 54.547 27.092 26.804 0.288 28.365 14.088 14.088 0.000 26.183 13.004 12.716 0.288 Ring Fenced Funding Primary Care Improvement Fund 23.644 11.940 10.412 1.527 12.295 6.209 6.209 0.000 11.349 5.731 4.204 1.527 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 23.644 11.940 10.412 1.527 12.295 6.209 6.209 0.000 11.349 5.731 4.204 1.527 TOTAL 78.191 39.031 37.216 1.815 40.660 20.296 20.296 0.000 37.532 18.735 16.920 1.815 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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11 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 2.095 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 196.549 Budget Adjustments Posted in Month 4 Draw Down From Reserves 1.845 Pay Award Uplift Including One-Off Payments 14.592 Scottish Government 2% Uplift to Resource Transfer and Contracts 1.135 Scottish Government Non Recurring Ring Fenced Monies 7.073 Increase in Hosted Services Led by South 1.843 Increase in Area Wide Services 0.571 Other Budget Adjustments 0.185 NHSL Financial Allocation at 31 July 2023 585.328 Budget Adjustments Posted in Month 5 Draw Down From Reserves 4.985 NHS Lanarkshire Unscheduled Care Reserve -2.790 North Lanarkshire Council Provider Sustainability Payment 0.220 Scottish Government Non Recurring Ring Fenced Monies 0.125 Increase in Hosted Services Led by South 1.058 Other Budget Adjustments 0.200 NHSL Financial Allocation at 31 August 2023 589.126 Budget Adjustments Posted in Month 6 Draw Down From Reserves 3.276 Increase in Family Health Services 3.944 Medical Pay Award 1.705 Funding from NES and Digitial Therapy Posts 0.366 Decrease in Hosted Services Led by South -0.142 Other Budget Adjustments 0.027 NHSL Financial Allocation at 30 September 2023 598.302
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12 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 23.397 (0.224) (8.860) 14.313 NHSL & NLC Earmarked Reserves 44.497 0.084 (3.672) 40.909 NHSL & NLC Risk-Based Reserves 14.901 (0.253) (7.517) 7.131 NHSL Contingency Reserves 8.060 0.218 0.000 8.278 NHSL & NLC Closed Reserves 7.091 0.175 (7.266) 0.000 97.946 0.000 (27.315) 70.631 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 0.000 0.000 0.255 NHSL Area Wide Services - Refugees and Displaced Persons 0.250 0.000 (0.131) 0.119 NHSL Blood-Borne Viruses Services 0.171 0.000 (0.028) 0.143 NHSL Children and Adolescent Mental Health Services 4.101 0.000 (1.146) 2.955 NHSL Community Living Change Fund 1.298 0.000 0.000 1.298 NHSL District Nursing - Scottish Government Funded 0.376 0.000 (0.369) 0.007 NHSL Hospital at Home Services - Support Development 0.621 0.000 (0.105) 0.516 NHSL Learning Disabilities Health Checks 0.246 0.000 0.000 0.246 NHSL Long Covid Pathways 0.764 (0.224) (0.300) 0.240 NHSL Mental Health and Learning Disability Services - Action 15 3.930 0.000 (1.764) 2.166 NHSL Mental Health and Learning Disability Services - Distress Brief Intervention 3.155 0.000 (1.262) 1.893 NHSL Mental Health - Diagnostic Support Service Dementia Post 0.751 0.000 (0.051) 0.700 NHSL Mental Health Eating Disorders 0.070 0.000 (0.034) 0.036 NHSL Mental Health Neurodevelopmental Pathways 0.100 0.000 (0.004) 0.096 NHSL Mental Health Perinatal, Infant, Maternity and Neonatal 0.005 0.000 0.000 0.005 NHSL Mental Health Psychology Posts 0.670 0.000 (0.497) 0.173 NHSL Mental Health Recovery Renewal - Facilities Projects 1.840 0.000 0.000 1.840 NHSL Mental Health Wellbeing in Primary Care Services 0.148 0.000 0.000 0.148 NHSL North Planning Band 2-4 Posts 0.933 0.000 (0.377) 0.556 NHSL Staff Wellbeing 0.254 0.000 0.000 0.254 NHSL Third Sector Initiatives To Improve Health 0.306 0.000 0.000 0.306 NHSL Unscheduled Care Funding 3.120 0.000 (2.790) 0.330 NHSL Upper GI Dietetics Band 4 0.033 0.000 0.000 0.033 23.397 (0.224) (8.860) 14.313 LEAD SUMMARY 2023/24 TOTAL RING-FENCED RESERVES LEAD RING-FENCED RESERVES Total 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) 0.000 0.750 NHSL Prescribing Fund 4.361 0.000 (3.835) 0.526 NLC Social Care Demand 8.591 0.946 (3.682) 5.855 14.901 (0.253) (7.517) 7.131 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 0.218 0.000 8.278 8.060 0.218 0.000 8.278 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 Covid-19 Funding 0.007 (0.007) 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 Medical Director - Child Death Review Funding 0.012 (0.012) 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 NHSL Test and Protect Funding 0.520 (0.520) 0.000 7.091 0.175 (7.266) 0.000 CLOSED RESERVES TOTAL CLOSED RESERVES LEAD RISK-BASED RESERVES TOTAL RISK-BASED RESERVES LEAD CONTINGENCY FUND RESERVES TOTAL CONTINGENCY FUND RESERVES LEAD
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13 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 0.000 (0.941) 1.000 NLC Adaptations Fund 0.289 0.099 0.000 0.388 NLC Adult Protection (share with C&F and NHSL) 0.050 0.000 0.000 0.050 NLC Advocacy Services 0.118 0.000 0.000 0.118 NHSL Area Wide Services - Health Promotion - North Lanarkshire Leisure agreement 0.123 0.000 0.000 0.123 NHSL Area Wide Services - Primary Care Corporate (iHUB Project - NES funding) 0.034 0.000 0.000 0.034 NHSL Breast Feeding Team (2 year funding) 0.828 0.000 (0.019) 0.809 NHSL Business Case - Health Care Support Workers, Multi-Disciplinary Teams 1.797 0.000 (1.486) 0.311 NLC Business Case - Non-Recurring NLC Costs 3.811 0.001 0.000 3.812 NHSL Care Homes Allocation 0.318 0.000 0.000 0.318 NLC Carers Act 2018 - Support 2.643 0.058 0.000 2.701 NHSL Champions Board Funding 0.172 0.000 0.000 0.172 NHSL Children and Adolescent Mental Health Services - Udston Top Up Funding 0.346 0.000 0.000 0.346 NHSL Childrens Services - Paediatric Band 7, Band 6 x 4.12 WTE, Band 2 x 9.59 WTE 0.414 0.000 (0.144) 0.270 NHSL Development of Chryston Community Health Clinic 0.212 0.000 0.000 0.212 NHSL Dietetics Services - Double Running Costs 0.110 0.000 (0.030) 0.080 NLC Digital and IT Strategy Technology Improvements - Community Alarms 0.588 0.000 0.000 0.588 NLC Digital and IT Strategy Technology Improvements - Home Support Scheduling System 3.776 0.000 0.000 3.776 NLC Digital and IT Strategy Technology Improvements - Other 0.566 0.000 0.000 0.566 NLC Digital and IT Strategy Technology Improvements - SWIS 0.700 0.000 0.000 0.700 NHSL Discharge Support Workers Band 4 x 2 WTE 0.107 0.000 0.000 0.107 NHSL Distinction Awards 0.036 0.000 0.000 0.036 NLC Financial Strategy - Changes to LA Services Muirpark 1.099 (0.499) 0.000 0.600 NHSL Forensic Band 3 x 5 WTE 0.147 (0.035) 0.000 0.112 NHSL GPIT Reprovisioning Gap 0.181 0.000 0.000 0.181 NHSL Health Inequalities - Screening 0.071 0.000 (0.013) 0.058 NHSL Health Visiting Students/Trainees 0.484 0.000 (0.161) 0.323 NLC Home Support Resilience (2 year funding) 3.498 0.148 0.000 3.646 NHSL HR Employability Team (2 year funding, 50:50 split between North and South) 0.187 0.000 (0.101) 0.087 NLC IJB Helpline (2 years funding) 0.575 0.000 0.000 0.575 NHSL Integrated Authority Support 4.926 0.000 0.000 4.926 NHSL Kylepark Works 1.578 0.000 0.000 1.578 NLC Mental Health Social Workers 2 x NL10 x 24 months 0.069 0.120 0.000 0.189 NHSL Mental Health Wards Window Replacement 0.650 0.000 0.000 0.650 NHSL Minor Capital Works 1.162 0.000 (0.088) 1.074 NHSL Neonatal & Paediatrics Dieteics Intervention (3 year funding) 0.550 0.000 (0.011) 0.539 NHSL Organisational Development Fund 0.260 0.000 0.000 0.260 NHSL Paediatric Diabetes Insulin Pumps and Additional Staff 0.881 0.000 (0.050) 0.831 NLC Planned Date of Discharge - Discharge To Assess 0.304 0.000 0.000 0.304 NLC Planned Date of Discharge - Locality Social Work Manager Post 0.077 0.000 0.000 0.077 NHSL Podiatry Services - Foot Screening 0.426 0.000 (0.035) 0.391 NHSL Prisioner Healthcare - Transitional Project Band 8A 0.070 0.000 (0.027) 0.043 NHSL Psychology Posts 2 x Band 6 0.098 0.000 0.000 0.098 NHSL Regrading of Posts Including Backpay 0.250 0.000 0.000 0.250 NHSL Scottish Clinical Leadership Fellowship 0.100 0.000 (0.011) 0.089 NHSL Sexual Health Services - Forensic Medical 0.175 0.035 (0.035) 0.175 NHSL Sexual Health Services - Long-Acting Reversible Contraception (LARC) 0.491 0.000 (0.037) 0.454 NLC Social Care Contracting Staff within Quality Assurance Services 0.003 0.157 0.000 0.160 NLC Social Care Regrading of Staff (SSW, SP, SW, OT, TL and TM) 3.169 0.000 (0.346) 2.823 NLC/NHSL Staff Training Academy 2.400 0.000 (0.038) 2.362 NHSL Stigma Free Lanarkshire (3 year funding) 0.450 0.000 0.000 0.450 NHSL Supervisor Training 0.065 0.000 0.000 0.065 NLC Violence Against Women (Joint Initiative with SLC and C&F) 0.030 0.000 0.000 0.030 NHSL Vulnerable and Complex Cases - Test of Change 1.092 0.000 (0.099) 0.993 44.497 0.084 (3.672) 40.909 LEAD EARMARKED RESERVES TOTAL EARMARKED RESERVES
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14 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 93,591 83,893 50,097 77,392 412,888 19,046 736,907 5 73,672 36,830 42,883 48,749 315,568 8,740 526,442 6 73,699 50,064 34,182 47,520 320,258 7,555 533,278 7 0 8 0 9 0 10 0 11 0 TOTAL 438,962 237,515 208,162 336,661 1,771,912 50,341 3,043,553 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Other £ Social Care Services £ TOTAL £ 1 42,416 - 2,717 1,571 406,062 - -13,522 439,244 2 62,289 2,876 25,213 5,520 389,942 - 32,744 518,584 3 27,805 2,262 9,143 18,437 405,161 - 36,290 499,098 4 5,197 16,099 14,458 18,437 410,166 - 53,866 518,223 5 6,542 734 11,784 18,438 382,959 - 44,091 464,548 6 9,846 10,346 5,834 309 396,614 43,125 5,887 471,961 7 40,989 40,989 8 0 9 0 10 0 11 0 12 0 TOTAL 154,095 32,317 69,149 62,712 2,390,904 43,125 200,345 2,952,647 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Social Care Service s £ 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 40,838 105,859 304,161 2,651 502,689 4 11,666 3,537 6,890 19,867 38,083 85,974 314,146 2,718 482,881 5 18,101 4,007 4,757 20,670 53,362 87,461 355,153 3,486 546,997 6 10,892 7,970 4,565 22,477 44,961 92,742 358,190 3,201 544,998 7 86,480 350,687 437,167 8 0 9 0 10 0 11 0 12 0 TOTAL 83,741 33,012 38,321 136,085 265,734 550,054 2,078,994 21,771 3,207,712 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 3,944 2,268 6,222 5,946 5,735 2,039 26,154 5 3,958 2,798 8,666 7,518 5,736 2,723 31,399 6 3,725 1,451 9,861 3,175 4,302 2,020 24,534 7 0 8 0 9 0 10 0 11 0 TOTAL 25,155 15,951 45,453 34,870 40,114 12,473 174,016 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