ITEM 12 Financial Monitoring Report

North Lanarkshire Council · 21 February 2024
Back to IJB Performance, Finance and Audit Committee — 21 February 2024 and its agenda

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REPORT
Item No:12 
SUBJECT: Financial Monitoring Report 2023/2024
TO: Performance, Finance and Audit Committee
Lead Officer for Report: Ross McGuffie, Chief Officer NL HSCP
Author(s) of Report Amanda Kilburn, Chief Finance Officer
DATE: 21st  February 2024 
1. PURPOSE OF REPORT
1.1 This paper is coming to the PFA Committee 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 31
December 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 PFA Committee: 
(1) Acknowledge the contents of the report; and
(2) Acknowledge the projected outturn for 2023/24 is an underspend of £5.796m. 
4. VARIATIONS TO DIRECTIONS 
Yes  No  N/A 
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 projected outturn position, prior to
removal of ring-fenced funding, is an underspend of £5.796m, assuming the
current trajectory of spend continues until the end of this financial year.

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Care Group
Annual
Budget
2023/24
£m
In Year
Drawdown
From Reserves
£m
Revised
Budget
2023/24
£m
Projected Year
End Spend
2023/24
£m
Projected Year
End Variance
2023/24
£m
Health Care Services 528.310 24.895 553.205 550.522 2.683
Social Care Services 247.726 3.176 250.903 247.790 3.112
TOTAL 776.037 28.071 804.108 798.312 5.796 
6.2 Appendices 1 to 3 show a detailed revenue budget position for each care group
above. 
6.3 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.  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 financial plans. 
7. 2023/24 PERFORMANCE
7.1 The current financial forecast for 2023/24 projects a yearly underspend of
£5.796m relating to various under and overspends across the whole integrated
budget.  A summary of the main variances including financial challenges and key
pressures are highlighted below: 
7.1.1 Employee Costs – underspend of £10.518m
There are continuing challenges in terms of recruitment and retention across all
service areas. Recruitment plans continue to be progressed to fill vacancies as
quickly as possible however this is proving challenging in the current market. 
7.1.2 Payments to Other Bodies (PTOB) – overspend of £1.229m
There are two main areas of overspend within PTOB which are independent care
homes and self-directed support (SDS) costs. 
 Independent care homes have a yearly budget to fund 1,361 care plans but at
present the number of projected care plans is 1,501 resulting in a projected
overspend of £0.708m. 
 SDS is similarly overspend due to a budget to fund 2,617 care plans against 2,817
estimated care plans for 23/24.  In line with the IJB strategy to address the
demand pressures within the plan, a drawdown of £2.337m from the social care
demand reserve is being used to offset the current projection.  An action plan is
currently under development which focuses on overdue client reviews and
ensuring outcomes and budgets are aligned. 
7.1.3 Prescribing – overspend of £0.824m
The current overspend is attributable to the continued increase in costs associated
with the number of medicines being prescribed.  This projection is based on actual
prescribing data available to September 2023.  The forecast will be updated as
further data becomes available. 
Similar to the increase in SDS demand, the prescribing increase was in part
forecast and reported in the financial plan and therefore a drawdown of £3.835m

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from the prescribing reserve is being used to offset the current overspend.

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7.1.4 Work continues to mitigate this overspend through the savings program (para 8)
and from a non-recurring allocation being issued to fund the pharmacy tariff
increase amounting to £1.598m for the IJB. 
7.1.5 North Lanarkshire Hosted Services – overspend by £2.641m
The 3 main areas of overspend within the NL hosted services relate to continence
service, children services and prisoner healthcare, due to increases in product
costs and additional expenditure relating to diabetic glucose monitoring machines
and insulin pumps. There is also an increase in costs linked to the delivery of the
new pharmacy contract and drug price associated with prisoner healthcare. 
7.2 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 as at December 2023 £m
Additional Staffing Band 2-4 1.093
Alcohol and Drug Partnership 2.562
Child Death Review 0.024
Dementia Post Diagnostic Support 0.430
Digital Therapy Posts 0.111
Distress Brief Intervention 2.944
District Nursing 0.607
Family Nurse Practitioner Funding 1.196
ICU Bed Capacity Uplift 0.045
Learning Disabilities Health Checks 0.172
Long Covid Support Fund 0.260
Meningitis C 0.106
Mental Health Action 15 3.930
Mental Health Community Perinatal 0.505
Mental Health Infant and Maternity 0.476
Mental Health Outcomes Framework 10.243
Mental Health Support Veterans 0.126
Multi-Disciplinary Teams 1.996
Neonatal Psychological Interventions 0.138
Outcomes Framework 2.770
PCR Prison Care Nursing Roles 0.013
School Nursing Posts 0.840
North Lanarkshire Council Sustainability Payment 0.220
TOTAL 30.807 
7.3 In addition, CORE management team and various sustainability and value
workshops have been meeting on a regular basis to discuss and monitor the
management actions reported in the financial plans to identify potential savings
and redesign of services to help support future years budget planning.  This
includes the following areas of work: 
 Review of financial planning assumptions for 2024/25.
 Review of all current vacancies including length of time left vacant.

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 Review of all earmarked reserves.

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 Updates on saving planning in significant areas of budget pressures.
 Service reviews including home support and self-directed support.
 Collaboration with South HSCP Management Team primarily to review hosted
services and joint working arrangements across Lanarkshire. 
7.4 As recommended by Audit Scotland in their audit annual report, a Long Term
Financial Plan (LTFP) will be presented to the IJB in March 2024 which includes
an update on planning assumptions for 2024/25. 
8. SAVINGS
8.1 Within 2023/24 prescribing budget, the HSCP has an action plan that includes our
contribution to the health board-wide efficiency measures, including drug switches
and prescribing improvement projects with a savings target of £2.7m. 
8.2 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 December totalling £1.212m and if this continues the
forecast annual savings expected by March 2024 is £1.942m. 
8.3 These measures will only contribute in a small way to easing the pressure on our
budget and at this stage are being outstripped by global price increases.  The only
way to deliver a significant improvement on pressure in this budget area will be
through a reduction in drug price inflation and items being dispensed, additional
Scottish Government funding, or a policy decision at a national level to restrict the
scope of drugs that can be provided by the NHS. 
8.4 The following tables give additional information on the cost of prescribing and
number of items dispensed for this financial year, in comparison to 2022/23.
These tables will be refreshed once current data on prescribing is made available:
1.942
2023/24 Prescribing Savings (£m)
Savings Achieved 1.212
Savings Expected
Savings Target 2.700
0.000 0.500 1.000 1.500
£m
2.000 2.500 3.000

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8.5 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. 
9. GENERAL RESERVES
9.1 The current IJB reserves position for 2023/24 after adjustment for the drawdown of
reserves, is a revised balance of £67.538m and is summarised in the table below: 
LEAD  SUMMARY
Opening
Balance As At
1 April 2023
Proposed
Transfers
To / From
Reserves
Pending
Drawdown
from
Reserves
Revised
Balance As At
31 December
2023
£m £m £m £m
NHSL Ring-Fenced Reserves 19.191 (0.224) (8.473) 10.494
NLC/NHSL Earmarked Reserves 33.324 0.326 (2.676) 30.974
NLC/NHSL Risk-Based Reserves 12.952 8.237 (6.172) 15.017
NHSL Contingency Reserves 8.060 2.993 0.000 11.053
NLC/NHSL Closed Reserves 24.419 (11.332) (13.087) 0.000
Table 1: Prescribing Cost (£m)
8.000
7.000
6.000
5.000
4.000
3.000
2.000
1.000
0.000
2022/23 2023/24
Table 2: Prescribing Items Dispensed
720,000
700,000
680,000
660,000
640,000
620,000
600,000
580,000
560,000
540,000
2022/23 2023/24
£m
No. of Items Dispensed

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Total 97.946 0.000 (30.408) 67.538

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9.2 A detailed list of all reserve movement during 2023/24 and the relationship to our
ambitions statement and performance within the Strategic Commissioning Plan
has been included within the PFA reserves strategy paper. 
9.3 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. 
10. CURRENT VACANCY POSITION
10.1 As highlighted throughout this report, employee costs are projecting a significant
underspend within all services. 
10.2 The table below shows the full time equivalent (FTE) vacancy numbers within
each service against their budgeted establishment: 
Service Establishment Actual Vacancies
FTE FTE FTE
North West Locality 394.02 343.54 50.48
North East Locality 332.48 297.00 35.48
Adult Services 286.73 281.74 4.99
Children Services 593.20 557.30 35.90
Mental Health 1,194.55 1,148.84 45.71
Social Care Services 986.90 788.25 198.65
Home Support 1,000.17 981.58 18.59
Other 205.78 205.01 0.77
TOTAL 4,993.83 4,603.26 390.57 
10.3 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. 
SERVICE
Costs As At 31 December 2023
Overtime Excess
Part Time Bankaide Agency TOTAL
£m £m £m £m £m
North West Locality 0.121 0.034 0.621 0.216 0.992
North East Locality 0.051 0.019 0.366 0.047 0.484
Adult Services 0.055 0.077 0.289 0.136 0.556
Children Services 0.178 0.059 0.485 0.085 0.807
Mental Health 0.397 0.058 2.545 3.491 6.490
Social Care Services 0.844 - - 0.315 1.159
Home Support 3.277 - - - 3.277
Other 0.024 0.016 0.070 - 0.110
TOTAL 4.948 0.262 4.376 4.290 13.877 
12. IMPLICATIONS
12.1 NATIONAL OUTCOMES

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People are able to look after and improve their own health and wellbeing
and live in good health for longer
☐

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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
☒
12.2 ASSOCIATED MEASURE(S)
Each partner is required to remain within their approved budgetary provision. 
12.3 FINANCIAL
This paper has been reviewed by Finance:
Yes  No  N/A 
12.4 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
National Set-Aside Budget High Ross McGuffie
Hosted Services Medium Ross McGuffie
Prescribing Activity and Costs Very High Ross McGuffie
Third and Voluntary Sector Low Ross McGuffie
Ineffective Governance Arrangements Medium Ross McGuffie 
12.5 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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□ 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. 
12.6 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 
13. BACKGROUND PAPERS
None. 
14. 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 - 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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Direction from North Lanarkshire Integration Joint Board (IJB) 
1 Reference Number  
2 Report Title  
3 Date direction issued by IJB 
4 Date from which direction
takes effect 
5 Direction to: 
6 Does this direction supersede,
revise or revoke a previous
direction – if yes, include
reference number(s) 
7 Functions covered by direction 
8 Full text of direction 
9 Budget allocated by Integration
Joint Board to carry out
direction 
10 Performance Management /
Governance arrangements 
11 Date direction will be reviewed

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Appendix 1 
North Lanarkshire IJB Revenue Budget Position 1 April 2023 to 31 December 2023 
Funded By:
Annual
Budget
2023/24
£m 
NHS Lanarkshire Funding  (528.311)
Social Care Funding (23.417)
Resource Transfer (23.975)
Commissioned Services (6.961)
Transfer from Reserves (Approved) (24.895)
Total Funding - NHSL (607.559) 
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  (804.108)
Projected Year
End Outturn
Total
2023/24
£m 
3.670
(0.019)
0.212
(0.824)
0.103
0.319
(0.777)
0.000
0.000
2.683 
3.070
0.042
3.112 
0.000
0.000 
3.112 
5.796 
Year To Date Year To Date
Variance
Budget
December 2023
£m
Actual
December 2023
£m
Total
December 2023
£m 
46.205  43.453  2.752
2.984 2.998 (0.014)
3.259 3.100 0.159
57.358 57.976 (0.618)
3.238 3.161 0.077
5.401 5.162 0.239
140.258 140.840 (0.583)
90.777 90.777 0.000
52.877 52.877 0.000
402.356 400.344 2.013 
193.772  191.410  2.362
(2.805) (2.838) 0.033
190.967 188.573 2.394
1.612 1.612 0.000
0.424 0.424 0.000
193.002 190.608 2.394 
595.358  590.952  4.407 
Care Group 
Annual
Budget
2023/24
£m
Health Care Services
Locality and Other Services
Addiction Services
Medical and Nursing Directorate
Prescribing
Out of Area Services
Area Wide Services
Hosted Services
Family Health Services
Set-Aside Budget
Total Expenditure - NHSL 
65.292
6.941
4.398
76.406
4.318
7.803
193.324
124.223
70.502
553.206 
Social Care Services 
251.903 Social Care Services Gross Expenditure
Social Care Services Gross Income (3.647)
Social Care Services Net Expenditure 248.257
Housing Revenue Account 2.095
Transport Services Account 0.551
Social Care, Housing and Transport Services Net Expenditure 250.902 
Total Expenditure - NHSL and NLC  804.108 
Appendix 1

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Appendix 2
Hosted Services 
Appendix 3
Hosted Services 
Annual
Budget
2023/24
£m
Year to Date
South Lanarkshire IJB - 48% Share
December 2023
Budget
£m
December 2023
Actual
£m
December 2023
Variance
£m 
3.910  2.916  2.322  0.595
1.652 0.889 1.123 (0.234)
4.790 3.486 3.347 0.139
3.632 2.717 2.658 0.060
5.631 4.242 4.237 0.005
0.424 0.322 0.269 0.053
4.296 3.241 3.066 0.175
2.211 1.706 1.703 0.003
10.527 7.924 7.634 0.290
37.074 27.444 26.359 1.085 
Annual
Budget
2023/24
£m
Year to Date
North Lanarkshire IJB - 52% Share
December 2023
Budget
£m
December 2023
Actual
£m
December 2023
Variance
£m 
4.236  3.159  3.159  0.000
1.789 0.963 0.963 0.000
5.190 3.777 3.777 0.000
3.935 2.944 2.944 0.000
6.100 4.595 4.595 0.000
0.459 0.349 0.349 0.000
4.654 3.511 3.511 0.000
2.395 1.848 1.848 0.000
11.404 8.584 8.584 0.000
40.163 29.731 29.731 0.000 
Led by the South Partnership
Annual
Budget
2023/24
£m
Year to Date
December 2023
Budget
£m
December 2023
Actual
£m
December 2023
Variance
£m 
Community Dental Services  8.147  6.076  5.481  0.595
Brain Injury Unit 3.441 1.852 2.085 (0.234)
Out of Hours Services 9.980 7.263 7.124 0.139
Palliative Care Services 7.567 5.661 5.602 0.060
Physiotherapy Services 11.731 8.837 8.833 0.005
Primary Care Services 0.883 0.671 0.618 0.053
Occupational Therapy Services 8.950 6.752 6.577 0.175
Diabetic Services 4.606 3.555 3.551 0.003
Primary Care Improvement Fund 21.931 16.508 16.218 0.290
TOTAL 77.237 57.175 56.089 1.085 
Annual
Budget
2023/24
£m
Year to Date
South Lanarkshire IJB - 48% Share
December 2023
Budget
£m
December 2023
Actual
£m
December 2023
Variance
£m 
1.633  1.240  1.240  0.000
1.184 0.889 0.889 0.000
1.623 1.340 1.340 0.000
3.399 2.561 2.561 0.000
7.465 4.947 4.947 0.000
6.353 4.810 4.810 0.000
0.272 0.204 0.204 0.000
2.077 1.578 1.578 0.000
2.388 1.808 1.808 0.000
0.976 0.733 0.733 0.000
0.769 0.582 0.582 0.000
1.348 1.038 1.038 0.000
44.030 31.324 31.324 0.000
73.517 53.053 53.053 0.000 
Annual
Budget
2023/24
£m
Year to Date
North Lanarkshire IJB - 52% Share
December 2023
Budget
£m
December 2023
Actual
£m
December 2023
Variance
£m 
1.770  1.343  1.472  (0.129)
1.283 0.963 1.618 (0.656)
1.759 1.451 2.123 (0.672)
3.683 2.775 2.551 0.223
8.087 5.359 4.885 0.474
6.882 5.211 5.958 (0.747)
0.295 0.221 0.396 (0.174)
2.250 1.710 1.488 0.222
2.587 1.959 1.858 0.101
1.057 0.794 1.360 (0.566)
0.833 0.630 0.733 (0.103)
1.460 1.124 1.152 (0.028)
47.699 33.934 32.464 1.471
79.644 57.474 58.057 (0.583) 
Led by the North Partnership
Annual
Budget
2023/24
£m
Year to Date
December 2023
Budget
£m
December 2023
Actual
£m
December 2023
Variance
£m 
Sexual Health Services  3.403  2.583  2.712  (0.129)
Continence Services 2.466 1.852 2.507 (0.656)
Immunisation Services 3.382 2.791 3.463 (0.672)
Speech and Language Therapy Services 7.082 5.336 5.113 0.223
Children and Adolescents Mental Health Services 15.553 10.306 9.832 0.474
Childrens Services 13.235 10.021 10.768 (0.747)
Integrated Equipment and Adaptations Store 0.567 0.426 0.600 (0.174)
Dietetics Services 4.327 3.288 3.066 0.222
Podiatry Services 4.974 3.766 3.666 0.101
Prisoner Healthcare Services 2.032 1.527 2.093 (0.566)
Blood Borne Viruses Services 1.602 1.212 1.314 (0.103)
Hospital at Home 2.808 2.162 2.189 (0.028)
Mental Health and Learning Disability Services 91.730 65.258 63.787 1.471
TOTAL 153.161 110.527 111.110 (0.583) 
Appendix 2
Appendix 3

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Appendix 4
North Lanarkshire IJB Budget Reconciliation 2023/24 
2023/24 NLC Financial Allocation to North Lanarkshire HSCP £m
2023/24 North Lanarkshire HSCP Financial Allocation 190.727
NLC Funding - Housing Services 2.095
NLC Funding - Transport Services 0.551
Pay Award Drawdown from Reserves 3.176
NLC Financial Allocation at 21 July 2023 196.549 
2023/24 NHSL Financial Allocation to North Lanarkshire HSCP £m
2023/24 North Lanarkshire HSCP Financial Allocation 333.065
Set-Aside Budget 70.502
South Hosted @ 52% 37.901
Family Health Service South @ 52% 116.616
NHSL Financial Allocation at 30 June 2023 558.084 
Budget Adjustments Posted in Month 4 
1.845 Draw Down From Reserves
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 
4.985 Draw Down From Reserves
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 
3.276 Draw Down From Reserves
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 
Budget Adjustments Posted in Month 7 
1.653 Draw Down From Reserves
Funding from NES & Glasgow 0.419
Increase in Hosted Services Led by South 0.059
Other Budget Adjustments 0.127
NHSL Financial Allocation at 31 October 2023 600.560 
Budget Adjustments Posted in Month 8 
0.999 Draw Down From Reserves
Non-Recurring Pay Award -2.329
Service Level Agreements Uplifts 0.728
Funding for Dementia Post 0.430
Increase in Hosted Services Led by South 3.060
NHSL Financial Allocation at 30 November 2023 603.448 
Budget Adjustments Posted in Month 9 
1.788 Draw Down From Reserves
Non-Recurring Taskforce Funding 0.258
Non-Recurring Hospital @ Home 0.188
Non-Recurring Pharmacy Tariff Increase 1.598
Funding from NES 0.162
Other Budget Adjustments 0.117
NHSL Financial Allocation at 31 December 2023 607.559 
Appendix 4

Page 17

17 
Appendix 5
Analysis of Additional Employee Costs 2023/24 
Period 
BANKAIDE COSTS YEAR TO DATE
North West
Locality
£
North East
Locality
£
Adult
Services
£
Children
Services
£
Mental
Health
£
Other
£
TOTAL
£
1 74,898 36,739 35,561 69,550 331,019 10,506 558,273
2 67,549 30,009 34,077 52,510 234,588 8,215 426,948
3 71,996 33,984 29,543 55,338 233,159 7,164 431,184
4 77,147 49,890 31,916 62,994 337,320 8,162 567,429
5 73,672 36,828 42,883 48,749 315,567 8,740 526,439
6 73,701 50,064 34,181 47,520 320,258 7,555 533,279
7 64,435 42,627 29,527 43,917 240,358 6,547 427,411
8 55,201 42,019 24,288 45,014 240,941 6,029 413,492
9 62,864 44,132 26,592 59,452 291,603 7,046 491,689
10       0
11       0
TOTAL 621,463 366,292 288,568 485,044 2,544,813 69,964 4,376,144 
Period
AGENCY COSTS YEAR TO DATE
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 5,197 16,099 14,458 25,834 377,191 53,866 492,645
5 6,542 734 11,784 28,422 415,155 44,091 506,728
6 9,846 10,346 19,352 21,284 438,512 5,887 505,227
7 6,662 3,251 17,960 1,609 355,250 40,989 425,721
8 17,479 - 21,870 - 367,171 47,998 454,518
9 37,811 11,091 13,317 - 336,741 41,651 440,611
10      24,639 24,639
11       0
12       0
TOTAL 216,047 46,659 135,814 85,296 3,491,185 314,633 4,289,634 
Period
OVERTIME COSTS YEAR TO DATE
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 40,838 105,859 304,161 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 14,033 5,262 4,075 12,600 46,278 86,480 350,687 1,162 520,577
8 10,831 6,048 8,322 13,901 45,513 88,577 364,293 589 538,074
9 12,467 7,133 4,360 15,899 39,353 105,900 514,029 699 699,840
10      99,595 319,748  419,343
11         0
12         0
TOTAL 121,072 51,455 55,078 178,485 396,878 844,126 3,277,064 24,221 4,948,379 
Period
EXCESS PART TIME COSTS YEAR TO DATE
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 4,084 2,024 12,318 7,358 5,005 1,370 32,159
8 2,121 910 9,672 8,200 5,730 1,289 27,922
9 2,468 289 9,507 8,144 6,745 1,135 28,288
10       0
11       0
Appendix 5

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18 
TOTAL 33,828 19,174 76,950 58,572 57,594 16,267 262,385