ITEM 9 PFA Financial Monitoring Report May 25
North Lanarkshire Council · 21 May 2025
Back to IJB Performance, Finance and Audit Committee — 21 May 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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REPORT Item No: 9 1. PURPOSE OF REPORT 1.1 This paper is coming to the Performance, Finance and Audit (PFA) Committee for: For approval For endorsement For noting 1.2 This report provides a summary of the North Lanarkshire University Health and Social Care Partnership (UHSCNL) for the period 1 April 2024 to 31 March 2025 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 PFA Committee: (1) Acknowledge the year end financial position of a £10.716m underspend. (2) Refer to the IJB Reserves Strategy report to approve the allocation of this underspend. 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 Chief Officer (Finance). 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 Table 1, the IJB final outturn position, prior to removal of ring-fenced funding, is an underspend of £10.716m. SUBJECT: Financial Monitoring Report 2024/25 TO: Performance, Finance and Audit Committee Lead Officer for Report: Chief Officer Author(s) of Report Chief Finance Officer DATE: 21 May 2025 Yes No N/A
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6.2 Once the ring-fenced balances have been transferred to the relevant reserve in line with Scottish Government guidance, the revised outturn was an underspend of £10.102m. Table 1 6.3 Subject to PFA approval of the Reserves Strategy report, this underspend will be allocated to manage earmarked commitments, any funding gap which has been highlighted in the Medium Term Financial Plan 2025/26 – 2027/28 and to augment the amounts held in contingency. 6.4 Appendices 1 to 3 show a detailed revenue budget position for each care group above. 7. 2024/25 FINANCIAL PERFORMANCE 7.1 Thie final outturn underspend for 2024/25 is an underspend of £10.716m 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 £19.219m As highlighted throughout 2024/25, 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 skill mix required or the competition being offered by other private and public sectors. Included in this underspend is £6.961m relating to a non-recurring reduction in pension contributions within Social Care. 7.1.2 Payments to Other Bodies (PTOB) – overspend of £1.073m This overspend is primarily in relation to anticipated spend in Independent Care Homes and also within ‘Care at Home’ through self-directed support (SDS) plans. These projections are demand led and are based on full year costs for both current clients and those anticipated. 7.1.3 Transport – overspend of £0.418k The overspend is attributed to an increase in running costs associated with the home support additional pool cars that were purchased during 2024/25 along with an increase in staff mileage claims. 7.1.4 Prescribing – overspend of £4.757m This overspend is based on actual prescribing data available to January 2025 and estimated data for February and March 2025. Based on data received to date the cost per item has increased to £10.33, and the number of items being dispensed has reduced by 0.02% based on the same period in 2023-24. Therefore, the overspends is attributable to both the number of medicines being prescribed and dispensed in community pharmacies remaining at high levels alongside higher prices. This is exacerbated by the fact that there hasn’t been an inflationary increase added to 2024-25 annual budget. £m £m £m £m £m £m £m Health Care Services 588.021 (4.978) 583.043 578.509 4.534 (0.614) 3.920 Social Care Services 273.025 (5.708) 267.317 261.135 6.182 0.000 6.182 TOTAL 861.046 (10.686) 850.360 839.644 10.716 (0.614) 10.102 Less Ring- Fenced Underspend Revised Final Outturn Variance 2024/25 Annual Budget 2024/25Care Group Final Outturn Variance 2024/25 Final Outturn 2024/25 In Year Drawdown From Reserves Revised Budget 2024/25
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7.1.5 North Lanarkshire Hosted Services – projected underspend of £2.865m The main areas reporting an underspend within hosted services include speech and language therapy, children and adolescent mental health services, podiatry services and mental health and learning disability services. The underspends in this area are partially offset by the following areas of concern: • Continence Services – overspend of £0.683m which is related to product costs within both the care home environment and within the community. • Children Services Diabetic Nursing – overspend of £2.221m which is mainly due to additional expenditure relating to diabetic glucose monitoring machines and insulin pumps. • Prisoner Healthcare – overspend of £0.204m due to the increase in costs linked to the delivery of the new pharmacy contract and drug prices associated with prescribing. 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 table 2 shows the current funding allocation received from Scottish Government during 2024/25. Table 2 Scottish Government Allocations as at 31 March 2025 £m Action 15 mental Health Strategy 1.478 Additional Band 2-4 Staffing 1.276 Alcohol and Drug Partnership Funding 3.179 DBI national Pathways 0.075 Mental Health Outcomes Framework 11.592 Multi Disciplinary Teams 2.309 Outcomes Framework (exc Mental Health) 1.865 School Nursing 0.840 Specialist Community Perinatal, Infant and Maternity Mental Health 1.084 District Nursing 0.683 Long Covid Support Fund 0.320 Distress Brief Intervention 2.780 Digital Mental Health Licences 0.120 Band 7 OPAT Post 0.069 Hospital at Home 0.276 V1P & ICU Funding 0.170 Dementia Post 0.441 Meningitis C 0.106 Specialty and Specialist Doctors Contract 0.194 National Diabetes Technology 0.212 Seasonal Vaccines 4.013 Operation Flow 1.871 Other 1.810 TOTAL 36.763
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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 statute 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 closing IJB reserves position for 2024/25 after adjustments for the drawdown of in-year reserves, is a revised balance of £64.386 and is summarised in table 4. Table 4 8.3 A detailed list of all reserve movement during 2024/25 is at appendix 5 including a key guidance table showing how the reserves are aligned to our five ambition statements detailed in the Strategic Commissioning Plan 2023-26. 8.4 The reserves Strategy report for 2025/26 is also being reported to PFA this cycle which requests approval for the allocation of the 2024/25 surplus and also provides a detailed list of the opening reserves should these approvals be granted. 9. SAVINGS 9.1 The saving delivery plan commenced in April 2024 with a target of £29.093m over financial years 2024/25 and 2025/26. 9.2 The Senior Management Team alongside various sustainability and value workshops met on a regular basis to discuss and monitor the management actions reported in the financial plans to progress 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. • Review of discretionary spend and supplementary staffing. • Updates on saving planning in significant areas of budget pressures. • Various service reviews across the partnership. • Collaboration with South UHSCP Management Team primarily to review hosted services and joint working arrangements across Lanarkshire. 9.3 The final IJB savings position show total savings achieved of £15.437m and is summarised in chart 1. Opening Balance As At 1 April 2024 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2025 £m £m £m £m NHSL Ring-Fenced Reserves 24.114 9.060 (11.599) 21.575 NLC/NHSL Earmarked Reserves 20.975 0.000 (5.131) 15.843 NLC/NHSL Risk-Based Reserves 17.045 0.000 (2.731) 14.314 NHSL Contingency Reserves 13.390 0.000 (0.286) 13.104 NLC/NHSL Closed Reserves 0.000 0.000 0.000 0.000 75.524 9.060 (19.748) 64.836Total LEAD SUMMARY
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Chart 1 9.4 Appendix 6 shows a detailed list, including target value, of all IJB approved saving plans. Directors should note the unachieved savings from this 2 year plan have been absorbed into the Medium Term Financial Plan 2025/26 and form part of the new savings plan for 2025/26. 10. VACANCY POSITION 2024/25 10.1 Table 5 shows the full time equivalent (FTE) vacancy numbers at 31 March 2025 within each service compared against their budgeted establishment. Table 5 10.2 To help cover the vacant posts throughout the year, agency staff, bankaide, overtime and excess part time hours is used, the cost of which is included within the financial position reported. A detailed analysis of these costs is at appendix 7 and summarised in Table 6. Establishment Actual Vacancies FTE FTE FTE North West Locality 393.28 373.55 19.73 North East Locality 331.46 315.87 15.59 Adult Services 295.44 267.42 28.02 Children Services 602.67 544.70 57.97 Mental Health 1,196.62 1,246.28 -49.66 Social Care Services 989.30 838.24 151.06 Home Support 996.57 927.23 69.34 Other 233.36 231.96 1.40 TOTAL 5,038.70 4,745.25 293.45 Position as at 31 March 2025 Service
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Table 6 11. DIGITAL FINANCE POSITION 2024/25 11.1 Below is a summary of the current North Lanarkshire IJB digital programmes of work and the agreed funding associated with each: Overtime Excess Part Time Bankaide Agency TOTAL £m £m £m £m £m North West Locality 0.080 0.031 0.696 0.013 0.820 North East Locality 0.043 0.017 0.434 0.000 0.494 Adult Services 0.056 0.073 0.322 0.007 0.459 Children Services 0.122 0.045 0.735 0.268 1.170 Mental Health 0.336 0.077 4.266 4.453 9.132 Social Care Services 0.777 - - 0.111 0.888 Home Support 4.437 - - - 4.437 Other 0.014 0.014 0.051 - 0.078 TOTAL 5.864 0.257 6.504 4.853 17.478 SERVICE Costs As At 31 March 2025 Home Support Scheduling System (ACCESS) COST £m FUNDING £m Year 1 (23/24) 0.521 Year 2 (24/25) 0.610 Year 3 (25/26) 0.547 Year 4 (26/27) 0.312 Year 5 (27/28) 0.326 Year 6 (28/29) 0.340 TOTAL COST OF PROGRAMME 2.656 Recurring Revenue Budget (0.224) Earmarked Reserve (2.432) TOTAL FUNDING AVAILABLE (2.656) Community Alarms Analogue to Digital COST £m FUNDING £m Year 1 (24/25) 0.399 Year 2 (25/26) 0.229 Year 3 (26/27) 0.279 TOTAL COST OF PROGRAMME 0.907 Capital Budget (0.087) Recurring Revenue Budget (0.135) Earmarked Reserve (0.465) TOTAL FUNDING AVAILABLE (0.687) Recurring Funding Gap From Year 3 (26/27) 0.220
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11.2 Currently two of the three programmes are progressing within their allocated funding however, Community Alarms envisage a gap in recurring funding from 2026/27 onwards. To ensure future financial transparency, the Medium Term Financial Plan has been updated to reflect this additional pressure. 12. IMPLICATIONS 12.1 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 ☒ 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 Social Work Case Management System (MOSAIC COST £m FUNDING £m Year 1 (23/24) 0.213 Year 2 (24/25) 0.174 Year 3 (25/26) 0.114 Year 4 (26/27) 0.114 Year 5 (27/28) 0.114 Year 6 (28/29) 0.114 Year 7 (29/30) 0.114 TOTAL COST OF PROGRAMME 0.957 Capital Budget (0.157) Non-Recurring Funding (0.100) Earmarked Reserve (0.700) TOTAL FUNDING AVAILABLE (0.957)
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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 Very High Nicola Scott Prevention and Detection of Fraud, Bribery and/or Corruption Low Claire Rae National Set-Aside Budget High Claire Rae Hosted Services Medium Claire Rae Prescribing Activity and Costs Very High Claire Rae Pharmacy Pressures within Prison Service Very High Claire Rae Third and Voluntary Sector Low Claire Rae Ineffective Governance Arrangements Low Claire Rae 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 Chief Officer (Finance) within 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.
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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 IJB 2024/25 Budget Appendix 2 - Hosted Services Led by North Lanarkshire Appendix 3 - Hosted Services Led by South Lanarkshire Appendix 4 - North Lanarkshire IJB Budget Reconciliation 2024/25 Appendix 5 – North Lanarkshire IJB Movement on Reserves Appendix 6 – North Lanarkshire IJB 2 Year Savings Delivery Plan Appendix 7 - Analysis of Additional Employee Costs 2024/25 Chief Finance Officer Members seeking further information about any aspect of this report, please contact Nicola Scott on telephone number 07816 126362.
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North Lanarkshire IJB Revenue Budget Position 1 April 2024 to 31 March 2025 Appendix 1 Annual Final Year End Actual Final Year End Variance Budget Total Total 2024/25 2024/25 2024/25 £m £m £m Health Care Services Locality and Other Services 70.116 64.937 5.179 Addiction Services 4.317 4.073 0.244 Medical and Nursing Directorate 4.607 4.105 0.502 Prescribing 76.952 81.709 (4.757) Out of Area Services 4.318 4.220 0.098 Area Wide Services 8.823 8.420 0.403 Hosted Services 203.408 200.543 2.865 Family Health Services 135.965 135.965 0.000 Set-Aside Budget 74.537 74.537 0.000 Total Expenditure - NHSL 583.043 578.509 4.534 Social Care Services Social Care Services Gross Expenditure 272.233 265.631 6.602 Social Care Services Gross Income (7.146) (6.942) (0.204) Social Care Services Net Expenditure 265.087 258.689 6.398 Housing Revenue Account 2.229 2.445 (0.216) Social Care, Housing and Transport Services Net Expenditure 267.316 261.134 6.182 Total Expenditure - NHSL and NLC 850.360 839.643 10.716 Annual Budget 2024/25 £m NHS Lanarkshire Funding (578.065) Social Care Funding (23.417) Resource Transfer (23.975) Commissioned Services (6.965) Transfer from Reserves (Approved) (4.978) Total Funding - NHSL (637.401) NLC Funding - Social Care Services (208.024) NLC Funding - Housing Services (2.229) Transfer from Reserves (Approved) (2.706) Total Funding - NLC (212.959) Total Funding - NHSL and NLC (850.360) Care Group Funded By:
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Hosted Services Appendix 2 March 2025 March 2025 March 2025 March 2025 March 2025 March 2025 March 2025 March 2025 March 2025 Budget Actual Variance Budget Actual Variance Budget Actual Variance £m £m £m £m £m £m £m £m £m £m £m £m Sexual Health Services 3.852 3.852 3.819 0.033 2.003 2.003 1.970 0.033 1.849 1.849 1.849 0.000 Continence Services 2.527 2.527 3.210 (0.683) 1.314 1.314 1.997 (0.683) 1.213 1.213 1.213 0.000 Immunisation Services 6.231 6.231 4.925 1.306 3.240 3.240 1.934 1.306 2.991 2.991 2.991 0.000 Speech and Language Therapy Services 7.514 7.514 6.678 0.837 3.907 3.907 3.071 0.837 3.607 3.607 3.607 0.000 Children and Adolescents Mental Health Services 14.376 14.376 13.683 0.694 7.476 7.476 6.782 0.694 6.901 6.901 6.901 0.000 Childrens Services 14.336 14.336 16.556 (2.221) 7.455 7.455 9.675 (2.221) 6.881 6.881 6.881 0.000 Integrated Equipment and Adaptations Store 0.817 0.817 0.817 0.000 0.425 0.425 0.425 0.000 0.392 0.392 0.392 0.000 Dietetics Services 4.609 4.609 4.339 0.269 2.396 2.396 2.127 0.269 2.212 2.212 2.212 0.000 Podiatry Services 5.167 5.167 4.627 0.540 2.687 2.687 2.147 0.540 2.480 2.480 2.480 0.000 Prisoner Healthcare Services 2.122 2.122 2.327 (0.204) 1.104 1.104 1.308 (0.204) 1.019 1.019 1.019 0.000 Blood Borne Viruses Services 1.830 1.830 1.667 0.163 0.952 0.952 0.789 0.163 0.879 0.879 0.879 0.000 Hospital at Home 3.048 3.048 3.048 0.001 1.585 1.585 1.584 0.001 1.463 1.463 1.463 0.000 Mental Health and Learning Disability Services 93.071 93.071 90.942 2.130 48.397 48.397 46.267 2.130 44.674 44.674 44.674 0.000 TOTAL 159.501 159.501 156.637 2.864 82.941 82.941 80.076 2.864 76.561 76.561 76.561 0.000 Led by the North Partnership South Lanarkshire IJB - 48% Share Final OutturnAnnual Budget 2024/25 Annual Budget 2024/25 Final Outturn North Lanarkshire IJB - 52% ShareFinal OutturnAnnual Budget 2024/25 Hosted Services Appendix 3 March 25 March 25 March 25 March 25 March 25 March 25 March 25 March 25 March 25 Budget Actual Variance Budget Actual Variance Budget Actual Variance £m £m £m £m £m £m £m £m £m £m £m £m Community Dental Services 8.710 8.710 7.687 1.023 4.529 4.529 4.529 0.000 4.181 4.181 3.158 1.023 Brain Injury Unit 2.504 2.504 2.455 0.049 1.302 1.302 1.302 0.000 1.202 1.202 1.153 0.049 Out of Hours Services 10.703 10.703 10.103 0.600 5.565 5.565 5.565 0.000 5.137 5.137 4.537 0.600 Palliative Care Services 9.801 9.801 7.707 2.094 5.097 5.097 5.097 0.000 4.705 4.705 2.611 2.094 Physiotherapy Services 12.320 12.320 10.959 1.361 6.407 6.407 6.407 0.000 5.914 5.914 4.553 1.361 Primary Care Services 0.916 0.916 0.762 0.154 0.476 0.476 0.476 0.000 0.440 0.440 0.286 0.154 South Improving Cancer Journey 0.470 0.470 0.638 (0.168) 0.244 0.244 0.244 0.000 0.226 0.226 0.394 (0.168) Occupational Therapy Services 9.061 9.061 8.460 0.601 4.712 4.712 4.712 0.000 4.349 4.349 3.748 0.601 Diabetic Services 5.024 5.024 6.200 (1.176) 2.613 2.613 2.613 0.000 2.412 2.412 3.588 (1.176) Primary Care Improvement Fund 24.928 24.928 24.927 0.001 12.962 12.962 12.962 0.000 11.965 11.965 11.965 0.001 TOTAL 84.436 84.436 79.899 4.537 43.907 43.907 43.907 0.000 40.529 40.529 35.993 4.537 Annual Budget 2024/25 Year to Date South Lanarkshire IJB - 48% Share Led by the South Partnership Annual Budget 2024/25 Final Outturn Annual Budget 2024/25 Year to Date North Lanarkshire IJB - 52% Share
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North Lanarkshire IJB Budget Reconciliation 2024/25 Appendix 4 2024/25 NHSL Financial Allocation to North Lanarkshire HSCP £m 2024/25 NLC Financial Allocation to North Lanarkshire HSCP £m 2024/25 North Lanarkshire HSCP Financial Allocation 338.816 2024/25 North Lanarkshire HSCP Financial Allocation 206.811 Set-Aside Budget 74.537 NLC Funding - Housing Services 2.229 South Hosted @ 52% 39.188 NLC Financial Allocation at 11 October 2024 209.040 Family Health Service South @ 52% 124.475 Budget Adjustments Posted in Month 5 NHSL Financial Allocation at 31 May 2024 577.016 Transfer Scottish Living Wage budget to Housing -0.023 NLC Financial Allocation at 23 August 2024 209.017 Budget Adjustments Posted in Month 3 Budget Adjustments Posted in Month 6 Draw Down From Reserves 1.747 Scottish Living Wage for Childrens Services 0.500 Increase in ERS Usage 1.943 NLC Financial Allocation at 11 October 2024 209.517 Long Covid, ADP, Men C Funding 0.387 Budget Adjustments Posted in Month xx Budget Realignment 0.981 0.736 Increase in Hosted Services Led by South 1.358 Budgeted Use of Rserves 2.706 Increase in Area Wide Services 0.072 NLC Financial Allocation at 31 March 2025 212.959 Other Budget Adjustments 0.273 NHSL Financial Allocation at 30 June 2024 583.777 Budget Adjustments Posted in Month 4 Draw Down From Reserves 1.626 Non Recurring Funding Hospital at Home 0.442 Other Budget Adjustments 0.084 NHSL Financial Allocation at 31 July 2024 585.929 Budget Adjustments Posted in Month 5 Draw Down From Reserves 2.935 Increase in Hosted Services Led by South 0.087 Veterans 1st Point Funding 0.126 Other Budget Adjustments 0.886 NHSL Financial Allocation at 31 August 2024 589.963 Budget Adjustments Posted in Month 6 Draw Down From Reserves 0.846 Increased income 0.099 Increase in Hosted Services Led by South 5.734 Prescribing adjustments 1.144 Other budget adjustments 0.187 NHSL Financial Allocation at 31 September 2024 597.973 Budget Adjustments Posted in Month 7 Draw Down From Reserves 0.691 Increased income 0.554 Increase in Hosted Services Led by South 1.727 Prescribing adjustments 0.400 AW 0.354 Other budget adjustments 8.019 NHSL Financial Allocation at 31 October 2024 609.718 Budget Adjustments Posted in Month 8 Draw Down From Reserves 0.886 Increased income 0.654 Increase in Hosted Services Led by South 0.465 AW 0.163 Prescribing adjustments 0.520 Other budget adjustments 0.342 NHSL Financial Allocation at 30 November 2024 612.748 Budget Adjustments Posted in Month 9 SG Allocations/PC Reserves 6.965 Medical Pay Award 2.132 Income 1.693 Prescribing adjustments 0.250 AW 0.397 NHSL Financial Allocation at 30 December 2024 624.185 Budget Adjustments Posted in Month 10 Prescribing 1.973 SG Allocations/PC Reserves 2.310 IJB Reserves hand back -10.881 Income 1.240 AW -0.144 South Hosted Serv 4.508 NHSL Financial Allocation at 31 January 2025 623.191 Budget Adjustments Posted in Month 11 SG Allocations/PC Reserves 2.104 IJB Reserves 2.430 Income 0.833 Prescribing 0.206 AW 0.029 South Hosted Serv 2.974 NHSL Financial Allocation at 28 February 2025 631.767 Budget Adjustments Posted in Month 12 SG Allocations/PC Reserves 0.741 IJB Reserves 4.996 Income 0.892 Prescribing 0.164 AW 0.073 South Hosted Serv -1.232 NHSL Financial Allocation at 31 March 2025 637.401
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North Lanarkshire IJB Movement on Reserves Audit Trail NHSL & NCL Opening Balance As At 1 April 2024 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2025 Movement in Reserves 2024/25 £m £m £m £m £m NHSL Alcohol and Drug Partnership Funding 3.597 0.860 (1.021) 3.436 (0.161) 1, 2, 4, 5 NHSL Area Wide Services - Refugees and Dis 0.106 (0.029) 0.077 (0.029) 1, 2, 4, 5 NHSL Blood-Borne Viruses Services 0.194 (0.039) 0.155 (0.039) 1, 2, 4, 5 NHSL Children and Adolescent Mental Health 2.849 (0.075) 2.774 (0.075) 1, 2, 4, 5 NHSL Community Living Change Fund 1.164 (1.110) 0.055 (1.110) 1, 4, 5 NHSL District Nursing 0.292 0.373 (0.292) 0.373 0.081 1, 2, 3, 4, 5 NHSL Family Nurse Practitioner Funding 0.072 0.072 0.000 1, 2, 3, 4, 5 NHSL Frailty Nursing 0.401 (0.400) 0.001 (0.400) 1, 2, 3, 4, 5 NHSL Hospital at Home Services 0.962 0.276 (0.322) 0.915 (0.046) 1, 2, 4, 5 NHSL Learning Disabilities Health Checks 0.491 0.491 0.000 2, 3 NHSL Long Covid Pathways 0.234 0.289 (0.233) 0.289 0.056 2, 3, 4, 5 NHSL Mental Health Action 15 0.729 0.730 (0.730) 0.730 0.000 1, 2, 4, 5 NHSL Mental Health Covid Clinicians 0.052 0.052 0.000 1, 2, 4, 5 NHSL Mental Health Diagnostic Support Service Dementia Post 0.972 0.359 (0.274) 1.057 0.086 1, 2, 3, 4, 5 NHSL Mental Health Digital Therapy Post 0.111 0.110 0.221 0.110 1, 2, 3, 4, 5 NHSL Mental Health Distress Brief Intervention 3.396 2.704 (3.396) 2.704 (0.692) 1, 2, 4, 5 NHSL Mental Health Eating Disorders 0.036 0.036 0.000 1, 2, 4, 5 NHSL Mental Health Neurodevelopmental Pathways 0.074 (0.074) 0.000 (0.074) 1, 2, 4, 5 NHSL Mental Health Recovery Renewal - Facilities Projects 1.029 1.029 0.000 1, 2, 4, 5 NHSL Mental Health Wellbeing in Primary 0.148 0.148 0.000 1, 2, 4, 5 NHSL North Planning Band 2-4 Posts & Multi-D 2.719 2.719 (2.719) 2.719 0.000 1, 2, 3, 4, 5 NHSL PCR Prison Care Network Transforming 0.013 (0.012) 0.001 (0.012) 1, 2, 3, 4, 5 NHSL Pharmacy Mental Health Recovery & NE 0.341 0.640 (0.341) 0.640 0.299 1, 2, 3, 4, 5 NHSL School Nursing 0.622 (0.348) 0.274 (0.348) 1, 2, 3, 4, 5 NHSL Specialist Doctor Contracts 0.194 0.194 0.000 1, 2, 3, 4, 5 NHSL Staff Wellbeing 0.254 0.254 0.000 3 NHSL Third Sector Initiatives To Improve 0.247 (0.172) 0.075 (0.172) 1, 2, 3, 4, 5 NHSL Unscheduled Care Funding 2.790 2.790 0.000 1, 2, 3, 4, 5 NHSL Upper GI Dietetics Band 4 0.027 (0.013) 0.014 (0.013) 3 24.114 9.060 (11.599) 21.575 (2.539) Opening Balance As At 1 April 2024 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2025 Movement in Reserves 2024/25 £m £m £m £m £m NHSL Adult Social Care Winter Preparedness F 1.000 1.000 0.000 1, 2, 3, 4, 5 NLC Adaptations Fund 0.308 (0.185) 0.123 (0.185) 2, 4 NLC Adult Protection (share with C&F and 0.050 (0.040) 0.010 (0.040) 1, 2, 4, 5 NLC Advocacy Services 0.065 (0.046) 0.019 (0.046) 1, 2, 4, 5 NHSL Breast Feeding Team (2 year funding) 0.705 (0.360) 0.345 (0.360) 1, 2, 5 NLC Business Case - Non-Recurring NLC 1.319 (1.010) 0.309 (1.010) 1, 2, 3, 4, 5 NLC Carers Act 2018 - Support 2.596 (0.170) 2.426 (0.170) 1, 2, 4, 5 NHSL Children and Adolescent Mental Health 0.268 0.268 0.000 4 NHSL Childrens Services - Paediatric Band 7, 0.107 (0.107) 0.000 (0.107) 3 NHSL Development of Chryston Community 0.212 0.212 0.000 1, 5 NHSL Dietetics Services - Double Running 0.064 (0.009) 0.055 (0.009) NLC Digital and IT Strategy Technology 0.465 (0.235) 0.230 (0.235) 2, 3 NLC Digital and IT Strategy Technology 3.699 (0.367) 3.332 (0.367) 2, 3 NLC Digital and IT Strategy Technology 0.389 (0.075) 0.314 (0.075) 2, 3 NLC Digital and IT Strategy Technology 0.700 (0.045) 0.655 (0.045) 2, 3 NLC Financial Strategy - Changes to LA 0.027 (0.009) 0.018 (0.009) NHSL Health Inequalities - Screening 0.044 (0.028) 0.016 (0.028) 2 NHSL Health Visiting Students/Trainees 0.311 (0.282) 0.029 (0.282) 3 NLC Home Support Resilience (2 year 0.656 (0.079) 0.577 (0.079) 3, 4 NHSL HR Employability Team (2 year funding, 50:50 split between North and South) 0.087 0.087 0.000 3 NLC IJB Helpline (2 years funding) 0.360 (0.223) 0.137 (0.223) 1, 4, 5 NHSL Kylepark Works 0.134 0.134 0.000 4, 5 NLC Mental Health Social Workers 2 x NL10 0.162 (0.013) 0.149 (0.013) 3, 4 NHSL Mental Health Wards Window 0.650 0.650 0.000 2, 4 NHSL Minor Capital Works 1.027 1.027 0.000 3 NHSL Neonatal & Paediatrics Dieteics 0.450 (0.157) 0.293 (0.157) 1, 2, 5 NHSL Organisational Development Fund 0.260 0.260 0.000 3 NHSL Paediatric Diabetes Insulin Pumps and 0.569 (0.031) 0.538 (0.031) 1, 2, 3 NLC Planned Date of Discharge - Discharge 0.109 (0.057) 0.052 (0.057) 1, 5 NHSL Podiatry Services - Foot Screening 0.350 (0.008) 0.342 (0.008) 1, 2 NHSL Prisioner Healthcare - Transitional 0.020 (0.019) 0.001 (0.019) 3 NHSL Regrading of Posts Including Backpay 0.250 0.250 0.000 3 NHSL Scottish Clinical Leadership Fellowship 0.060 0.000 0.060 0.000 3 NHSL Sexual Health Services - Forensic 0.152 (0.152) 0.000 (0.152) 1, 2 NHSL Sexual Health Services - Long-Acting 0.404 (0.107) 0.297 (0.107) 1, 2 NLC Social Care Contracting Staff within 0.087 0.000 0.087 0.000 NLC/NHSL Staff Training Academy 2.042 (1.003) 1.039 (1.003) 3 NHSL Vulnerable and Complex Cases - Test 0.816 (0.315) 0.501 (0.315) 5 20.975 0.000 (5.131) 15.843 (5.131) Ambition Statement & Performance APPENDIX 5 Ambition Statement & Performance To Be Drawn Down 2024/25 To Be Drawn Down 2025/26 Ongoing Ongoing TOTAL RING-FENCED RESERVES LEAD EARMARKED RESERVES TOTAL EARMARKED RESERVES To Be Drawn Down 2024/25 To Be Drawn Down 2025/26 LEAD RING-FENCED RESERVES
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Opening Balance As At 1 April 2024 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2025 Movement in Reserves 2024/25 £m £m £m £m £m NHSL Prescribing Fund 4.361 4.361 0.000 2, 4 NLC Social Care Demand 12.684 (2.731) 9.953 (2.731) 2, 4 17.045 0.000 (2.731) 14.314 (2.731) Opening Balance As At 1 April 2024 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2025 Movement in Reserves 2024/25 £m £m £m £m £m NHSL Contingency Balance Held By NHSL 13.390 (0.286) 13.104 (0.286) 13.390 0.000 (0.286) 13.104 (0.286) 75.524 9.060 (19.748) 64.836 (10.687) KEY 1 2 3 4 5 Develop and support a workforce for the future. Improve mental health and wellbeing. Supporting people through a whole family approach. Ambition Statement & Performance Increased focus on prevention, early intervention and tackling inequalities by working with communities and people. Ambition Statement & Performance Do the right thing first time. TOTAL CONTINGENCY FUND RESERVES To Be Drawn Down 2024/25 To Be Drawn Down 2025/26 Ongoing Ambition Statement & Performance TOTAL RESERVES LEAD RISK-BASED RESERVES TOTAL RISK-BASED RESERVES To Be Drawn Down 2024/25 To Be Drawn Down 2025/26 Ongoing LEAD CONTINGENCY FUND RESERVES
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APPENDIX 6 2024/25 2025/26 Achieved to Date Achieved to Date £m £m £m £m £m 1 Ongoing Prescribing Savings 2.280 1.746 1.746 0.534 2 Financial Management - North Consequential Funding 3.446 3.446 3.446 0.000 3 Service Redesign: Mental Health Hospital Based Complex Care Contracted Beds 2.600 0.905 0.905 1.695 4 Review of Discretionary Spend 2.188 0 0.000 2.188 5 Review of Supplementary Staffing 0.982 0.787 0.787 0.195 6 Workforce Management and Service Redesign 4.699 2.786 2.786 1.913 7 Financial Management - Support Costs and Vacancy Review 1.486 1.614 1.614 (0.128) 17.681 11.284 0.000 11.284 6.397 2024/25 2025/26 Achieved to Date Achieved to Date £m £m £m £m £m 8 Financial Management - Overspends 4.827 0.426 0.426 4.401 9 Service Redesign: Review of Provision of Registered Social Landlords 0.600 0.296 0.488 0.784 (0.184) 10 Review of Supplementary Staffing 0.750 0.75 0.750 0.000 11 Service Redesign and Contract Review 0.400 0.517 0.326 0.843 (0.443) 12 Review of Operating Model Supporting Back to Basics 3.825 0.3 0.300 3.525 13 Financial Management - Vacancy Review 1.000 1.05 1.050 (0.050) 11.402 3.339 0.814 4.153 7.249 29.083 14.623 0.814 15.437 13.646 Reference 1 2 3 4 5 6 7 8 Reference 8 9 10 11 12 13 Health Care Services Savings Delivery Plan Review all areas of discretionary spend including postage, stationery and printing, staff travel and subsistence, domestic supplies, subscriptions and licenses and hospitality. Review of all overtime and agency costs including premium rate staffing review, professional and skill mix review and sickness absence review. The prescribing efficiency programme will continue. This will include additional efficiencies around medicines of low clinical value, drug patent expiry list, product switches, complex rebates and prescribing waste. Reducing current overspends to align with allocated budgets. For 2024/25, this is being off set by non-recurring consequential funding from Scottish Government. Additional non-recurring funding received in year from Scottish Government. This will be used in 2024/25. Outstanding Target to Date 2 Year Savings Delivery Plan (Target = £17.681m) Plan Total Achieved 2 Year Savings Delivery Plan (Target = £11.402m) Plan The current model of HBCCC is being reviewed with a view of moving patients into a more suitable and homely environment, such as a mainstream care home which would be a less intensive setting whilst also improving the quality of life of the individual. Total Adult Social Care Services TOTAL Total Achieved Review of all unfunded posts (£4.324m). Redesign of Continence Service delivery schedule and products (£0.375m). Review of all vacant posts and realignment of support costs to all funding streams to show true cost of each service. Health Care Services RAG Rating Adult Social Care Services RAG Rating North Lanarkshire IJB 2024/25 & 2025/26 - 2 Year Savings Delivery Plan Total Health Care Services Reference Reference Outstanding Target to Date Adult Social Care Services Savings Delivery Plan Review of non traditional respite, advocacy and community services. Review of whole system approach to ensure that when people contact our services the response is quick and effective, with a focus on helping people to help themselves first. Review of all vacant posts. Reducing current overspends to align with allocated budgets. (IEAS, Independent Care Homes, SDS, Private Sector Housing Grants) Review of all Registered Social Landlords services in North Lanarkshire keeping with the approach taken by other local authorities by opting to reconfigure some existing sheltered/very sheltered housing to retirement models. Review of all overtime and agency costs including premium rate staffing review, professional and skill mix review and sickness absence review.
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Analysis of Additional Employee Costs 2024/25 Appendix 7 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Other £ TOTAL £ 1 50,169 38,615 22,052 56,191 305,642 4,702 477,371 2 41,325 32,875 23,320 46,102 264,497 7,042 415,161 3 51,328 40,468 21,249 52,407 367,143 3,350 535,945 4 58,802 28,506 17,872 45,313 315,928 4,243 470,664 5 61,261 31,359 29,225 52,339 399,493 4,356 578,033 6 49,005 24,134 22,906 47,399 332,879 3,695 480,018 7 60,542 27,518 26,314 48,610 346,546 4,197 513,726 8 81,265 47,032 47,065 94,164 482,507 5,357 757,389 9 54,221 33,349 33,189 69,882 311,645 3,864 506,150 10 61,292 37,435 26,554 66,299 309,943 2,679 504,201 11 55,522 38,627 28,189 67,943 383,477 3,695 577,453 12 71,448 54,317 24,117 87,926 446,202 3,428 687,438 TOTAL 696,180 434,234 322,052 734,575 4,265,902 50,607 6,503,550 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Social Care Services £ TOTAL £ 1 6,112 -1,743 -17 - 286,364 - 290,716 2 - - 606 -80 569,840 - 570,366 3 1,526 - 1,229 - 337,115 - 339,870 4 1,280 - 51,839 - 335,537 - 388,656 5 528 - -33,399 - 351,443 2,311 320,883 6 1,352 0 606 0 290,147 0 292,105 7 0 -428 -11,959 4,286 282,409 0 274,308 8 569 0 -1,096 167,781 291,259 5,732 464,245 9 1,132 2,171 -535 14,802 446,221 2,626 466,416 10 347 0 122 43,878 391,594 20,373 456,314 11 71 0 0 21,229 529,862 22,197 573,359 12 0 0 -121 16,128 341,553 5,298 362,859 13 52,687 52,687 TOTAL 12,917 0 7,275 268,024 4,453,344 111,224 4,852,784 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Social Care Services £ Home Support £ Other £ TOTAL £ 1 7,896 6,109 4,121 14,860 30,578 -5,031 -36,239 737 23,031 2 11,173 8,470 4,855 17,042 30,317 84,416 341,911 2,508 500,692 3 7,738 7,429 5,896 10,311 21,831 65,331 331,451 1,247 451,234 4 7,253 5,666 3,373 17,206 29,554 48,786 385,446 1,407 498,691 5 6,018 1,257 7,614 10,756 19,232 40,111 412,126 253 497,367 6 7,059 714 5,354 12,415 30,811 60,954 400,282 490 518,079 7 4,767 2,620 3,308 13,841 24,698 63,268 360,760 2,293 475,555 8 6,319 1,819 2,563 10,898 27,613 80,104 408,207 1,451 538,974 9 4,406 3,456 5,223 6,404 30,771 77,587 412,013 536 540,396 10 4,810 2,039 3,232 3,135 25,246 77,353 235,019 783 351,616 11 7,483 1,061 5,641 2,516 31,655 35,152 328,589 543 412,641 12 4,822 2,051 5,132 2,267 33,597 72,952 303,962 1,520 426,302 13 75,873 553,455 629,327 TOTAL 79,743 42,691 56,312 121,652 335,902 776,856 4,436,982 13,767 5,863,905 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Other £ TOTAL £ 1 4,408 2,005 7,033 9,061 9,873 1,559 33,939 2 2,745 3,160 4,339 3,462 5,718 1,250 20,674 3 1,508 1,689 4,890 850 6,956 776 16,669 4 2,606 991 5,042 3,474 5,352 1,315 18,780 5 1,732 2,785 5,716 1,863 6,623 966 19,685 6 2,353 632 7,455 1,266 7,388 554 19,648 7 3,283 307 8,342 4,200 6,327 1,087 23,546 8 3,199 1,606 5,031 2,974 6,134 1,246 20,190 9 2,411 1,403 6,968 4,406 7,091 316 22,594 10 1,590 1,635 6,561 3,101 3,969 1,633 18,489 11 2,839 341 4,517 4,556 6,343 1,082 19,678 12 2,516 794 7,443 6,178 4,776 1,844 23,550 TOTAL 31,190 17,348 73,336 45,390 76,550 13,628 257,441 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