Item 11 - IJB Reserves Strategy 2022-23
North Lanarkshire Council · 16 November 2022
Back to IJB Performance, Finance and Audit Committee — 16 November 2022 and its agenda
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1 REPORT Item No: 11 SUBJECT: IJB Reserves Strategy 2022/2023 TO: Performance, Finance and Audit Committee Lead Officer for Report: Ross McGuffie, Chief Officer North HSCP Author(s) of Report Amanda Kilburn, Chief Finance Officer North HSCP DATE: 16th November 2022 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integration Joint Board (IJB) For approval For endorsement For noting 1.2 This report provides an update on the review of the North Lanarkshire Integration Joint Board (IJB) reserves and seeks endorsement to establish new reserves in line with the planned commitments and Scottish Government guidance. 2. ROUTE TO THE INTEGRATION JOINT BOARD 2.1 This paper has been: Prepared By; Chief Finance Officer Reviewed By; Chief Officer 3. RECOMMENDATIONS 3.1 The PFA Committee is asked to agree the following recommendations: (1) Note the 2021/2022 closing balance on the IJB reserves at 31 March 2022; (2) Endorse the allocation of the Scottish Government funding to the ring-fenced reserves as outlined at section 8.1; (3) Endorse the allocation of funding to the risk based, earmarked and contingency reserves as detailed at sections 8.2, 8.3 and 8.4; (4) Endorse the re-allocation of reserves as detailed at section 9.1; (5) Note the update from Scottish Government with regards to reclaiming surplus Covid-19 reserves at section 6.4; and (6) Note the review of reserves is ongoing in consultations with operational colleagues to confirm the amount and timing of planned commitments and to align the reserves accordingly. 4. VARIATIONS TO DIRECTIONS 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 Consistent with a number of other Health and Social Care Partnerships, an underspend was reported by the IJB at 31 March 2022. This 2021/2022 underspend included funding received to meet the ongoing cost and recovery to the Covid-19 pandemic and also funding made available by the Scottish Government to progress policy commitments and national priorities. Yes No N/A
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2 5.2 The underspend reported at 31 March 2022 was £74.67m (NHSL - £58.697m; NLC - £15.973m). The factors contributing to the underspend were included in the financial monitoring report to the IJB on 22 June 2022. The proposed 2022/2023 IJB Reserves Strategy has been developed in consultation with the Director of Finance of NHS Lanarkshire (NHS) and the Head of Financial Solutions of North Lanarkshire Council (NLC). 6. CONCLUSIONS 6.1 The IJB Reserves Strategy 2022/2023 provides an opportunity to strengthen long- term financial sustainability by considering the allocation of the 2021/2022 underspend to the strategic priorities of the IJB and both partners. Although reserves funding is non-recurring, some of the reserves proposals extend the duration of the funding for more than one year. This provides greater stability for essential health and social care services and the transformational change programmes to deliver required outcomes post pandemic. It will also enable more time for a recurring funding solution to be identified and agreed, where necessary. The IJB Reserves Strategy 2022/2023 will enable the IJB and both partners to balance current commitments whilst planning and addressing financial risks. An extract from the IJB Reserve Policy detailing the specific use and purpose of creating reserves is at appendix 4. 6.2 The funding transferred to the IJB reserves is required to progress the agreed commitments in 2022/2023 which include ADP initiatives, Mental Health Action 15 Services, Children and Adolescent Mental Health Services, Carers Act support and the ongoing costs and recovery from Covid-19 pandemic. The IJB Reserves Strategy 2022/2023 is therefore in line with North Lanarkshire IJB Strategic Commissioning Plan 2020-2023 and Scottish Government directions for the use of the ring-fenced funding. 6.3 It is essential for the long-term financial stability and the sustainability of the IJB that sufficient funds are held in reserve to manage unanticipated pressures from year to year. The requirement for financial reserves is acknowledged in statute and is part of a range of measures in place to ensure that section 106 public bodies do not over- commit themselves financially. 6.4 The PFA Committee is asked to note that the Scottish Government provided an update to the continued holding and use of surplus Covid-19 reserves. Due to several significant changes to Public Health policies in relation to the pandemic over the summer, resulting in the profile of spend reducing significantly compared to when funding was provided to IJBs, the Scottish Government will reclaim surplus Covid-19 reserves to be redistributed across the sector to meet current Covid-19 priorities. The detail, process and timetable will follow through further communications. 7. OVERVIEW OF RESERVES CLOSING BALANCE AT 31 MARCH 2022 7.1 A total of £8.335m has been drawn down from reserves during 2021/2022 (NHSL - £7.564m; NLC - £0.771m). Excluding the 2021/2022 underspend, the reserve balances as at 31 March 2022 were as follows: Summary £m % Ring-Fenced Reserves 14.032 31% Earmarked Reserves 12.166 27% Risk-Based Reserves 14.902 33% Contingency Reserves 3.683 8% Total 44.783 100%
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3 7.2 The underspend at 31 March 2022 totalled £74.67m (NHSL - £58.697m, NLC - £15.973m). The total reserves balance at 1 April 2022 was therefore £119.452m. 7.3 In line with External Audit guidance, the underspend reported in the financial monitoring report at 31 March 2022 is reconciled to the movement in the reserves and shown in the 2021/2022 North Lanarkshire IJB Annual Accounts: 8. IJB RESERVES STRATEGY 2022/2023 8.1 Ring-fenced Reserves 8.1.1 Funding has been received from the Scottish Government for specific purposes. The PFA Committee is therefore asked to retrospectively endorse the transfer of the NHSL funding totalling £52.557 to the ring-fenced reserves summarised in the table below. 8.1.2 A detailed list of the ring-fenced reserves is at appendix 1. Movement in Reserves during 2021/2022 Total Reserves General Fund Balance £m Opening Balance at 1 April 2021 53.118 NHSL Drawdown from Reserves (7.564) NLC Drawdown from Reserves (0.771) NHSL Underspend 58.697 NLC Underspend 15.973 Closing Balance at 31 March 2022 119.452 Ring-Fenced Reserve £m Covid-19 Funding 31.621 Alcohol and Drug Partnership Funding 2.134 Children and Adolescent Mental Health Services 4.383 Mental Health and Learning Disability Services - Action 15 3.016 Mental Health and Learning Disability Services - Distress Brief Intervention 1.444 Mental Health and Learning Disability Services - Recovery and Renewal 1.840 Psychology Services - Recovery and Renewal 0.614 Multi-Disciplinary Teams 1.160 Area Wide Services - Pharmacy, NES, PCIP, Pre School Vision Screening, Displaced Persons 1.681 Health Care Support Funding 0.634 Hospital at Home Services 0.414 Care Home Allocations 0.318 Diagnostic Support Service - Dementia Funding 0.429 Scottish Government Priorities 2.869 Total Ring-Fenced Reserve 52.557
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4 8.2 Risk-based Reserves Proposals 8.2.1 Work is currently underway to complete the Medium-Term Financial Plan 2023-2026 and the Strategic Commissioning Plan 2023-2026. Uncertainty continues around the future demands and pressures for the partnership due to fluctuating cost of living pressures and continued increasing demand on all services. The probability of using reserves in 2023-26 to help achieve financial balance remains high. The PFA Committee is therefore asked to retrospectively endorse the transfer of £5.945m to the risk-based reserves summarised in the table below. 8.2.2 A detailed list of the risk-based reserves is at appendix 3. 8.3 Earmarked Reserves Proposals 8.3.1 Part of the underspend reported in 2021/2022 was in respect of core services. This was mainly due to underspends in direct employee costs reflecting recruitment delays and ongoing difficulties recruiting to specialist posts. 8.3.2 Following consultation with the NHSL and NLC partners, the PFA Committee is asked to retrospectively endorse the following earmarked reserves summarised in the tables below. 8.3.3 A detailed list of the earmarked reserves is at appendix 2. Risk-Based Reserve £m Financial & Strategic Planning 2023/2026 5.416 Social Care Demand 0.529 Total Risk Based Reserve 5.945 Earmarked Reserve - NHSL £m Operational Demands 1.930 Childrens Services 1.570 Minor Repair And Replacement Programme of Works 1.000 Area Wide Services 0.512 Podiatry Services 0.459 Children and Adolescent Mental Health Services 0.346 Dietetics Services 0.224 Total Earmarked Reserve 6.041 Earmarked Reserve - NCL £m Shifting the Balance of Care - Winter Business Case 4.839 Digital and IT Strategy 2.394 Financial Strategy - Changes to LA Services 1.411 Carers Act Support 0.852 Operational Demands 0.279 Adapations Demand 0.253 Total Earmarked Reserve 10.028
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5 8.4 Contingency Reserves Proposal 8.4.1 The balance of contingency reserves at 31 March 2022 was £3.683m. The PFA Committee is asked to retrospectively endorse the transfer of NHSL funding totalling £0.099m to the contingency reserve summarised in the table below. 8.4.2 A detailed list of the contingency reserves is at appendix 3. 8.4.3 Taking into consideration the contingency reserves and the risk-based reserves, the funding available to mitigate both risks and unplanned events totals £22.986m. This represents 3.2% of the financial envelope available. This is in line with the North Lanarkshire IJB Medium to Long Term Financial Plan 2020/2021 to 2029/2030, which recommended that the risk-based and general contingency reserves are established at 3% for 2022/2023 rising to 5% from 2023 onwards. Year 2020/2021 2021/2022 2022/2023 2023 to 2030 Contingency Reserve % 1% 2% 3% 5% 8.4.5 The PFA Committee is asked to endorse the principle that the total reserve of £22.986m is sufficient to mitigate risks and unplanned events during 2022/2023. 9. ON-GOING COMMITMENTS 9.1 A further analysis and review was carried out with both partners in respect of all reserves to ensure the reserves carried forward into 2022/2023 (excluding new reserves already highlighted in section 8) were still required and sufficient to cover on-going pressures or re-allocated to help with future demand pressures. Details of these proposed changes can be found below: Contingency Reserve £m Contingency Balance Held By NHSL 0.099 Total Contingency Reserve 0.099 Opening Balance As At 1 April 2022 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NLC Advocacy Services 0.123 0.061 0.184 NLC Assistive Technology Contract x 12 months (ATC) - 0.090 0.090 NLC Digital and IT Strategy Technology Improvements - Home Support Scheduling System 1.000 2.776 3.776 NLC Home Support Development 0.217 (0.217) - NLC Planned Date of Discharge - Discharge To Assess 0.200 0.241 0.441 NLC Planned Date of Discharge - Locality Social Work Manager Post 0.055 0.096 0.151 NLC Social Care Contracting Staff within Quality Assurance Services 0.047 0.028 0.075 1.642 3.075 0.000 4.717 Opening Balance As At 1 April 2022 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NLC IJB Financial Plan Contingency - Allocated to NLC 3.000 (3.000) - NLC Social Care Demand 6.117 (0.075) 6.042 9.117 (3.075) 0.000 6.042 TOTAL EARMARKED RESERVES LEAD RISK-BASED RESERVES TOTAL RISK-BASED RESERVES 2022/23 LEAD EARMARKED RESERVES
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6 9.2 The analysis also found that the earmarked reserve held against digital and IT strategy for the Home Support Scheduling System is insufficient to cover the potential cost commitment needed by the partnership. The 4-year investment is estimated at £3.776m with currently only £1m identified and earmarked in reserves. A business case to progress with this project is underway and will seek approval from the partnership and Enterprise Architecture Governance Group (EAGG). 9.3 Pending approval of the business case, a proposed transfer of an additional £2.776m has been earmarked to cover the 4-year investment. This project, once formally approved, is likely to begin 2023/2024 however, if the recommendation is to defer or reject the business case, the proposed earmark reserve will re-route to a contingency based reserve. 9.4 Full details of the funding held in earmarked reserves for the current and proposed digital and IT strategy projects are shown in the table below: 9.5 An on-going update on the use and remaining balances of reserves will be included in future finance monitoring reports and presented to both the PFA Committee and the IJB. A further review will be carried out in conjunction with the new Medium Term Financial Plan 2023 -2026. 9.6 Below is the total summary of current reserves. 10. RISK 10.1 The extent to which Scottish Government will continue to request the return of uncommitted ring-fenced reserves is unknown. To date, the Scottish Government are currently implementing a plan to recover uncommitted Covid-19 reserves and have also advised IJBs that some 2022/2023 funding will only be made available once all respective reserves have been depleted. The establishment of earmarked and contingency reserves is therefore a key element of the overall governance arrangements to mitigate financial risk. Opening Balance As At 1 April 2022 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m Digital and IT Strategy Technology Improvements - Community Alarms 0.694 0.694 Digital and IT Strategy Technology Improvements - Home Support Scheduling System 1.000 2.776 3.776 Digital and IT Strategy Technology Improvements - Other 0.566 0.566 Digital and IT Strategy Technology Improvements - SWIS 0.700 0.700 TOTAL 2.960 2.776 0.000 5.736 EARMARKED RESERVES Opening Balance As At 1 April 2022 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NHSL Ring-Fenced Reserves 66.590 0.000 (15.774) 50.816 NHSL & NLC Earmarked Reserves 26.802 3.075 (0.812) 29.065 NHSL & NLC Risk-Based Reserves 21.894 (3.075) 0.000 18.819 NHSL Contingency Reserves 4.167 0.000 0.000 4.167 119.452 (0.000) (16.586) 102.866Total SUMMARYLEAD
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7 10.2 As reserves funding is non-recurring, any agreement to fund recurring costs with reserves will need to be risk managed. To help mitigate this risk, the Chief Finance Officer will agree the exit strategy with partners before the funding is exhausted or identify a potential recurring funding solution. 11. IMPLICATIONS 11.1 NATIONAL OUTCOMES The effective management of financial resources contributes to the achievement of the national outcomes. 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 financial risks are detailed at section 9. 11.5 PEOPLE None 11.6 STAKEHOLDER ENGAGEMENT The Director of Finance of NHSL and the Head of Financial Solutions of NLC have both been consulted on the proposed IJB Reserves Strategy 2021/2022 for the North Lanarkshire IJB. 11.7 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed: Yes No N/A 11.8 CARBON MANAGEMENT IMPLICATIONS Yes No N/A 12. BACKGROUND PAPERS None. 13. APPENDICES Ring-Fenced Reserves Appendix 1 Earmarked Reserves Appendix 2 Risk-Based & Contingency Reserves Appendix 3 IJB Reserves Policy – Extract Appendix 4 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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8 Appendix 1 Opening Balance As At 1 April 2022 Transfers To / From Reserves Drawdown of Reserves Revised Balance As At 31 March 2023 £m £m £m £m NHSL Alcohol and Drug Partnership Funding 3.154 (1.962) 1.192 NHSL Alcohol and Drug Partnership - Local Implementation Plan 0.167 0.167 NHSL Adult Neurodevelopmental Pathway Pilot - Recovery & Renewal Fund 0.050 0.050 NHSL Adult Social Care Winter Preparedness Fund 1.941 1.941 NHSL Area Wide Services - Audiology Equipment 0.011 0.011 NHSL Area Wide Services - Mental Health Pharmacy, PCIP and NES SLA with GPs 1.048 (1.048) - NHSL Area Wide Services - NES Training 0.132 (0.132) - NHSL Area Wide Services - Pre School Vision Screening 0.075 0.075 NHSL Area Wide Services - Refugees and Displaced Persons 0.400 (0.076) 0.324 NHSL Area Wide Services - Update CHI 0.015 0.015 NHSL Blood-Borne Viruses Services 0.146 0.146 NHSL Care Homes Allocation 0.318 0.318 NHSL Children and Adolescent Mental Health Services 5.283 (3.865) 1.418 NHSL Community WIFI 0.342 0.342 NHSL Covid-19 Funding 29.677 (1.711) 27.966 NHSL Covid-19 Funding - Unscheduled Care 1.944 1.944 NHSL Development of Health Promoting Culture 0.141 0.141 NHSL Diagnostic Support Service - Dementia Post 0.429 0.429 NHSL Dietetics Services - Diabetes Type 2 and Adult Weight Management 0.024 0.024 NHSL Distinction Awards 0.036 0.036 NHSL Eating Disorders Funding 0.176 (0.176) - NHSL Health Care Support Workers - Band 3 0.634 (0.413) 0.221 NHSL Health Inequalities Funding 0.024 0.024 NHSL Health Inequalities - Health Promotion Posts 0.006 0.006 NHSL Health Inequalities - Screening 0.098 0.098 NHSL Hospital at Home Services - Support Development 0.414 (0.288) 0.126 NHSL Integrated Authority Support 6.076 6.076 NHSL Joint Equipment Store 0.500 0.500 NHSL Long Acting Buprenorphine 0.255 0.255 NHSL Maternity and Neonatal Psychological Interventions 0.044 0.044 NHSL Medical Director - Child Death Review Funding 0.021 (0.021) - NHSL Mental Health and Learning Disability Services - Action 15 3.019 (3.019) - NHSL Mental Health and Learning Disability Services - Distress Brief Intervention 1.552 (1.444) 0.108 NHSL Mental Health and Learning Disability Services - Mental Health Improvement Fund 0.254 0.254 NHSL Mental Health and Learning Disability Services - Veteran's First Point 0.026 0.026 NHSL Mental Health Improvement Fund - Psychology 0.084 (0.068) 0.016 NHSL Mental Health Infant - NES Funding 0.013 0.013 NHSL Mental Health Innovation Funding 0.120 0.120 NHSL Mental Health Recovery Renewal - Facilities Projects 1.840 (0.149) 1.691 NHSL Mental Health Support for Those Hospitalised with Covid-19 0.172 (0.114) 0.058 NHSL Mental Health Wellbeing in Primary Care Services 0.148 0.148 NHSL Multi-Disciplinary Teams 1.160 (0.050) 1.110 NHSL Nursing Services - District Nurse 0.292 (0.292) - NHSL Nursing Services - Family Nurse Partnership 0.033 0.033 NHSL Nursing Services - School Nursing 0.162 (0.162) - NHSL Nursing Services - Queens Nursing Institute Grants 0.004 0.004 NHSL Psychology Services- Capacity Building 0.117 (0.117) - NHSL Psychology Services - Improving Access 0.095 0.095 NHSL Psychology Services - Recovery and Renewal Phase 1 & 2 0.614 (0.614) - NHSL Public Health Intelligence Data Analysts 0.061 0.061 NHSL Sexual Health Services - Health & Homeless Post 0.004 (0.004) - NHSL Sexual Health Services - Forensic Medical - Exam Suite 0.028 0.028 NHSL Sexual Health Services - Forensic Medical Examination Regional Funding 0.182 0.182 NHSL Shielding - Social Care Support Fund 0.038 0.038 NHSL Staff Wellbeing 0.254 0.254 NHSL Test and Protect Funding 0.520 0.520 NHSL Third Sector Initiatives To Improve Health 0.306 0.306 NHSL Vulnerable Population Post - Health Improvement Funding 0.068 0.068 66.589 0.000 (15.774) 50.815TOTAL RING-FENCED RESERVES RING-FENCED RESERVESLead 2022/23
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9 Appendix 2 Opening Balance As At 1 April 2022 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NLC Adaptations Fund 0.289 0.289 NHSL Administration Support Services 0.240 (0.001) 0.239 NLC Adult Protection (share with C&F and NHSL) 0.050 0.050 NLC Advocacy Services 0.123 0.061 0.184 NHSL Area Wide Services - Admin 0.080 (0.080) - NHSL Area Wide Services - Health Promotion - North Lanarkshire Leisure agreement 0.123 0.123 NHSL Area Wide Services - Locality Funding 0.432 0.432 NHSL Area Wide Services - Primary Care Corporate (iHUB Project - NES funding) 0.034 (0.021) 0.013 NHSL Assistant Support Worker - Promise 0.026 0.026 NLC Assistive Technology Contract x 12 months (ATC) - 0.090 0.090 NLC Business Case - Non-Recurring NLC Costs 5.380 5.380 NLC Carers Act 2018 - Support 0.852 0.852 NLC Carers Act 2018 - Waving of Charges 0.580 0.580 NHSL Champions Board Funding 0.045 0.045 NHSL Children and Adolescent Mental Health Services - Choice and Partnership Approach (CAPA) Team 0.717 0.717 NHSL Children and Adolescent Mental Health Services - Service Improvement Post (Band 7 - 18 months) 0.088 0.088 NHSL Children and Adolescent Mental Health Services - Udston Top Up Funding 0.346 0.346 NHSL Children and Adolescent Mental Health Services - Waiting List Co-ordinator (Band 5) 0.038 0.038 NHSL Childrens Services - Childrens Inspection Senior Nurse (3 months) 0.017 0.017 NHSL Childrens Services - Manager Post (1WTE) 0.040 0.040 NHSL Childrens Services - Paediatric Band 7, Band 6 x 4.12 WTE, Band 2 x 9.59 WTE 0.645 (0.645) - NHSL CLAN Funding 0.095 0.095 NHSL Clinical Fellow Funding 0.080 0.080 NHSL Clinical Guidelines Post 0.023 0.023 NHSL Clinical Pharmacist - Additions 0.035 0.035 NHSL Community Assessment and Rehabilitation Service - Rehabilitation Pilot 0.023 0.023 NHSL Dietetics Services 0.046 0.046 NHSL Dietetics Services - Band 6 0.114 0.114 NHSL Dietetics Services - Double Running Costs 0.110 0.110 NHSL Dietetics Services - Oral Nutrition 0.038 0.038 NHSL Dietetics Services - Weight Management 0.049 0.049 NLC Digital and IT Strategy Technology Improvements - Community Alarms 0.694 0.694 NLC Digital and IT Strategy Technology Improvements - Home Support Scheduling System 1.000 2.776 3.776 NLC Digital and IT Strategy Technology Improvements - Other 0.566 0.566 NLC Digital and IT Strategy Technology Improvements - SWIS 0.700 0.700 NHSL Discharge Support Workers Band 4 x 2 WTE 0.107 0.107 NLC Financial Strategy - Changes to LA Services Muirpark 2.973 2.973 NHSL Forensic Band 3 x 5 WTE 0.147 0.147 NHSL GPIT Reprovisioning Gap 0.181 0.181 NHSL Health Visiting Students/Trainees 0.840 0.840 NHSL High Resource User Posts 0.025 (0.025) - NLC Home Support Development 0.217 (0.217) - NHSL Hospital at Home Services - Shortfall 0.110 0.110 EARMARKED RESERVESLEAD 2022/23
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10 Opening Balance As At 1 April 2022 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NLC Impact of Covid-19 Pandemic Review 0.100 0.100 NHSL Integrated Support Worker 0.153 0.153 NHSL IT Federated Trust Environment Strategy 0.214 0.214 NHSL Joint Equipment Store 0.054 0.054 NHSL Kings Fund Organisational Development 0.014 0.014 NHSL Kylepark Works 1.000 1.000 NHSL LD Band 3 x 4 WTE 0.118 0.118 NHSL LTC Lead Clinician 0.010 0.010 NHSL Medical Director - Associate Medical Director (MR) 0.074 0.074 NHSL Mental Health PDN 0.2wte for 20/21 spend previously approved 0.011 0.011 NLC Mental Health Practice Assessor 0.006 0.006 NHSL Mental Health Practice Development (HF) 0.047 0.047 NLC Mental Health Social Workers 2 x NL10 x 24 months 0.107 0.107 NHSL Minor Capital Works 1.387 1.387 NHSL Motherwell Rehabilitation Team Leadership 0.058 0.058 NHSL NA Band 7 x 0.2 WTE 0.011 0.011 NHSL Neurodevelopmental Pathway OT 0.095 0.095 NHSL Nursing Appointments 0.119 0.119 NHSL Nursing Services 0.125 0.125 NHSL Nursing Services - Extend Health Improvement Unit posts to March 2020 0.075 0.075 NHSL Nursing Services - Quest Patient Safety Posts 0.003 0.003 NHSL Nursing Services - Solihull Training 0.018 0.018 NHSL Paediatric Diabetes Insulin Pumps and Additional Staff 0.908 0.908 NLC Payment to Voluntary Org - Glenboig 0.006 0.006 NLC Planned Date of Discharge - Discharge To Assess 0.200 0.241 0.441 NLC Planned Date of Discharge - Locality Social Work Manager Post 0.055 0.096 0.151 NHSL Podiatry Services - Foot Screening 0.459 0.459 NHSL Pre School Screening Exclusion Incident Audit 0.025 0.025 NHSL Prisioner Healthcare - Transitional Project Band 8A 0.070 0.070 NHSL Project Manager - Adverse Events 0.036 0.036 NHSL Promise Funding (2 years) 0.052 0.052 NHSL Public Projection Joint Resourcing 0.075 0.075 NHSL Regrading Band 4 x 5 WTE to Band 5 Backpay 0.125 0.125 NHSL Return to Nursing Students 0.107 0.107 NHSL Scottish Clinical Leadership Fellowship 0.045 0.045 NLC SDS Transformational Team 0.025 0.025 NHSL Sexual Health Services 0.109 (0.011) 0.098 NHSL Sexual Health Services - LARC (2 clinics for 2 years) 0.386 (0.004) 0.382 NHSL Sexual Health Services - STI 0.122 (0.025) 0.097 NLC Social Care Contracting Staff within Quality Assurance Services 0.047 0.028 0.075 NHSL Speech, Language and Therapy Services 0.807 0.807 NHSL Speech, Language and Therapy Services - Contract 0.250 0.250 NHSL Supervisor Training 0.077 0.077 NHSL Test of Change - High Intensity Service Users 0.027 0.027 NHSL Training Fund 0.246 0.246 NLC Unmet Saving 21/22 - IDS/LSS (merging building Coatbridge & Cumbernauld) 0.086 0.086 NLC Violence Against Women (Joint Initiative with SLC and C&F) 0.030 0.030 NLC Winter Plan 0.300 0.300 NHSL Winter Plan - Discharge To Assess 0.010 0.010 26.802 3.075 (0.812) 29.065TOTAL EARMARKED RESERVES LEAD EARMARKED RESERVES Appendix 2 (CONT.)
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11 Appendix 3 Opening Balance As At 1 April 2022 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NLC IJB Financial Plan Contingency - Allocated to NLC 3.000 (3.000) - NLC Financial & Strategic Planning 2023/2026 5.416 5.416 NLC Long Covid Contingency 3.000 3.000 NHSL Prescribing Fund 4.361 4.361 NLC Social Care Demand 6.117 (0.075) 6.042 21.894 (3.075) 0.000 18.819 Opening Balance As At 1 April 2022 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NHSL Contingency Balance Held By NHSL 4.167 4.167 4.167 0.000 0.000 4.167TOTAL CONTINGENCY FUND RESERVES LEAD RISK-BASED RESERVES TOTAL RISK-BASED RESERVES LEAD CONTINGENCY FUND RESERVES
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12 IJB RESERVES POLICY – EXTRACT APPENDIX 4 As the North Lanarkshire Integration Joint Board (IJB) has the same legal status as a local authority, i.e. a section 106 body under the Local Government (Scotland) 1973 Act, and is classified as a local government body for accounts purposes by the Office of National Statistics, it is able to hold a General Fund and this General Fund will be accounted for in the financial accounts and records of the IJB. The North Lanarkshire IJB Reserves Policy allocates funding to a ring-fenced, earmarked, risk-based or contingency reserve. Extracts of the IJB Reserves Policy is noted below for background information. For each reserve there should be a clear protocol setting out the reason/purpose of the reserves, how and when the reserve can be used, procedures for the reserves management and control and the review timescale to ensure continuing relevance and adequacy. IJB Reserves will be held for four specific purposes as follows: RING-FENCED RESERVES A ring-fenced reserve will be established when funding has been received for a specific purpose. If the funding has been received during the year but has not been spent by the year-end, the funding may be accounted for by the partner as a pre-payment in line with agreed accounting standards. If the funding cannot be accounted for as a pre-payment, the IJB will be asked to establish a ring-fenced reserve to ensure the funding received remains available for the specific purpose intended and to minimise the risk that the partner would be asked to repay funding which has not been spent in line with the conditions of receipt of the funding. EARMARKED RESERVES An earmarked reserve will be established when funding has been allocated by the IJB to the partner to commission services in line with agreed directions however the service has not been delivered by the year-end, but a commitment has already been made under the delegated authority by the Chief Officer, which cannot be accrued at specific times (e.g. at the year-end) due to not being in receipt of the service or goods. RISK-BASED RESERVES A risk-based reserve will be established to provide a contingency to address a specific financial risk. Following consultation with each partner, the IJB Chief Finance Officer will recommend to the IJB the need to establish such a reserve and the amount the reserve should be set at. The amount of such a reserve will be dependent on the professional judgement of the relevant officers and also the constraints of the overall financial envelope within which both the partners and the IJB are operating. CONTINGENCY RESERVES A contingency reserve will be established by the IJB to cushion the impact of unexpected events or emergencies. The contingency reserve would also provide a working cash balance to help cushion the impact of uneven cash flows. It is noted that the amount of the contingency reserve will be constrained by the financial envelope available to the IJB from the partners and the commissioning intentions agreed with the partners in the IJB Strategic Plan to meet need.
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