Item 7 - Financial Monitoring
North Lanarkshire Council · 14 February 2023
Back to IJB Performance, Finance and Audit Committee — 14 February 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 REPORT Item No: 7 1. PURPOSE OF REPORT 1.1 This paper is coming to the Performance, Finance and Audit (PFA) Committee: 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 from 1 April 2022 to 9 December 2022. 2. ROUTE TO THE PERFORMANCE, FINANCE AND AUDIT COMMITTEE 2.1 This paper has been: Prepared By: Chief Financial Officer Reviewed By: Chief Officer 3. RECOMMENDATIONS 3.1 The PFA Committee is asked to agree the following recommendations: (1) Note the contents of the report; (2) Note the financial position is a year-to-date underspend of £10.467m and: (3) Note the updated position regarding the return of unallocated Covid-19 ring- fenced reserves in sections 8.5 and 8.6. 4. VARIATIONS TO DIRECTIONS 5. BACKGROUND 5.1 This report is based on the financial monitoring reports received from the Director of Finance of NHS Lanarkshire (NHSL) and the Head of Financial Solutions of North Lanarkshire Council (NLC). The position detailed in these reports is therefore based on the information contained in each partner’s respective financial systems and includes accruals and adjustments in-line with their financial policies. 6. CONCLUSIONS 6.1 As detailed in the following table, the IJB year to date position is an underspend of £10.467m and the projected outturn for 2022/23 is an underspend of £14.325m, assuming the current trajectory of spend continues throughout this financial year. Service Year to Date Position £m Projected Year End Outturn £m Health Care Services 4.601 5.902 Social Care Services 5.866 8.423 Total North Lanarkshire HSCP 10.467 14.325 SUBJECT: Financial Monitoring Report 2022/2023 TO: Performance, Finance and Audit Committee Lead Officer for Report: Ross McGuffie, Chief Officer Author(s) of Report Amanda Kilburn, Chief Financial Officer DATE: 14th February 2023 Yes No N/A
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2 6.2 Subject to IJB approval, this estimated underspend will be allocated to manage, on a non-recurring basis, ring-fenced commitments, additional future business plans and any funding gap which may be highlighted in the North Lanarkshire IJB Medium Term Financial Plan 2023-2026. 6.3 The following provides a high-level summary of the key pressures and the main reasons why the IJB is currently projecting an underspend against its budget this year: Employee Costs net underspend of £10.291m: as previously highlighted there are ongoing challenges in terms of recruitment and retention issues across all service areas. For a wide range of posts recruitment has been unsuccessful due to the availability of the skills mix required or the competition being offered by other private and public sectors. These are issues that are being faced by IJBs across Scotland. Home Support net overspend of £0.377m: within Home Support Services, employee costs have increased as the service continues to support delayed discharges and demand however, this additional cost is being part funded from an earmarked reserve and the current number of vacant posts throughout other parts of the partnership. Payments to Other Bodies net underspend of £2.636m: the underspend is primarily due to the staff shortages and vacancies within the Care at Home sector who provide services to individuals via the self-directed support commissioning framework. There is also an underspend in package costs due to slippage in Self-Directed Support (SDS) start dates. It is anticipated these are in-year underspends only and the full budget will be required in future years. Independent Care Homes net overspend of £0.425m: there are currently 1,487 care packages within this service however when the budget was set for this financial year, it was based on 1,361 care packages. This has resulted in the service experiencing a pressure on the current allocated budget. Admin Costs net underspend of £1.862m: within the carers funding there is currently an unallocated budget of £1.8m. The anticipated underspend is reflective of the part-year implementation of contracts and additional funding from the Scottish Government for carers pressures in 2022/2023. As these pressures become evident within social care budgets, the funding will be moved to the relevant care package. Prescribing breakeven: Though prescribing is currently projecting a breakeven position, activity is 4% higher compared to the same period last year, however the cost per item is lower due to a reduction in the tariff price. Due to the uncertainty around costs and prescribing activity, the volatility experienced within prescribing is likely to continue for the foreseeable future. 6.4 Throughout the financial year, adjustments are made to the original budget due to additional funding allocations and budget transfers. Appendix 4 provides a reconciliation of the main budget adjustments applied this financial year.
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3 7. RESERVES 7.1 It is important for the long-term financial stability and the sustainability of the IJB that sufficient funds are held in reserve to manage unanticipated pressures from year to year. The requirement for financial reserves is acknowledged in statue and is part of a range of measures in place to ensure that s106 public bodies do not over-commit themselves financially. 7.2 The current IJB reserves position for 2022/23 is a revised balance of £93.954m and is summarised in the table below. A detailed analysis of these reserves is at Appendix 5: LEAD SUMMARY Opening Balance at 1 April 2022 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance at 31 March 2023 £m £m £m £m NHSL Ring-Fenced Reserves 44.999 (0.065) (9.617) 35.317 NHSL & NLC Earmarked Reserves 30.573 4.787 (6.235) 29.125 NHSL & NLC Risk-Based Reserves 18.894 0.405 (0.796) 18.503 NHSL Contingency Reserves 4.167 6.842 - 11.009 NHSL & NLC Closed Reserves 20.819 (11.969) (8.850) - Total 119.452 0.000 (25.498) 93.954 7.3 The IJB Reserves Strategy 2022/2023 will be presented to the IJB in March 2023. This updated strategy will include the revised structure of the reserves which will continue to enable the IJB to meet its agreed strategic objectives, and Scottish Government policy requirements. 8. COVID-19 8.1 Each month Covid-19 costs are being reported to the Scottish Government through the Lanarkshire Finance Performance Return (FPR). The costs incurred to date of £5.375m are included within the financial position reported and will be met by an existing IJB Covid-19 Reserve. 8.2 Whilst the scale of Covid-19 costs has reduced significantly in 2022/23 and are projected to reduce further in 2023/24, Scottish Government recognises that there are specific legacy costs that will require additional funding support in the new financial year. This includes funding for: Vaccinations staffing and delivery; Test and protect activities; Additional PPE requirements; and Some specific public health measures.
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4 8.3 Beyond the above, IJBs have been advised to expect to meet remaining costs from baseline funding. 8.4 The following table summarises the main areas of expenditure incurred to date and the projected cost to year end: 8.5 Scottish Government have confirmed the balance of £24.051m is to be returned from North Lanarkshire in respect of IJB Covid-19 reserves. This will be carried out by Scottish Government reducing the allocation given to NHSL pending a local arrangement between IJB and NHSL to off-set this reduction. 8.6 The table below shows the current position before and after this transfer: 9. CURRENT VACANCY POSITION 9.1 As highlighted throughout this report, employee costs are projecting a significant underspend within all services. Recruitment continues to be progressed for vacant posts in all areas. 9.2 The table below shows the current full time equivalent (FTE) vacancy numbers within each service against the budgeted establishment: Costs Incurred to Date Projected Full Year Costs Costs Incurred to Date Projected Full Year Costs £m £m £m £m £m Provider Sustainability Payments 1.638 2.106 - - 2.106 Additional Staff Costs - - 0.120 0.140 0.140 Primary Care Remobilisation Costs - - 1.408 2.177 2.177 Mental Health Assessment Hub - Hospital at Home & Unscheduled Care - - 2.209 3.147 3.147 TOTAL 1.638 2.106 3.737 5.464 7.570 Description of Cost TOTAL Covid-19 Total Estimated Cost 2022/23 Social Care Health Opening Balance As At 1 April 2022 Pending Drawdown from Reserves Return of Covid-19 Reserves to Scottish Government Revised Balance As At 31 March 2023 £m £m £m £m Covid-19 Funding 29.677 (5.626) (24.051) 0.000 Covid-19 Funding - Unscheduled Care 1.944 (1.944) 0.000 TOTAL 31.621 (7.570) (24.051) 0.000 Ring-Fenced Covid-19 Reserve
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5 9.3 To help cover the current vacant posts, agency staff, bankaide, overtime and excess part time hours are used, the cost of which is included within the financial position reported. A detailed analysis of these costs is at Appendix 6. 10. DELEGATED SERVICES 10.1 The following table shows the costs of other North Lanarkshire Council services delegated to the IJB. The IJB remain accountable for these services, however, they continue to be delivered by North Lanarkshire Council. North Lanarkshire HSCP monitors the delivery of these services on behalf of the IJB. 10.2 The projected outturn position to 31 March 2023 is a breakeven position for both services. Service Annual Budget £m Projection to Year End £m Variance £m Housing 1.870 1.870 - Breakeven Transport 0.551 0.551 - Breakeven Total 2.421 2.421 - Breakeven 11. IMPLICATIONS 11.1 NATIONAL OUTCOMES The effective management of financial resources contributes to the achievement of the national outcomes. SERVICE ESTABLISHMENT (FTE) ACTUAL (FTE) VACANCIES (FTE) VACANCIES (%) North West Locality 384.98 344.63 40.35 10.5% North East Locality 323.53 300.25 23.28 7.2% Adult Services 273.56 249.25 24.31 8.9% Children Services 551.69 470.08 81.61 14.8% Mental Health 1,160.08 1,090.82 69.26 6.0% Social Care Services 834.20 666.10 168.10 20.2% Home Support 1,000.07 995.99 4.08 0.4% Other 123.57 215.16 -91.59 -74.1% TOTAL 4,651.68 4,332.28 319.40 6.9% SERVICE Overtime Year to Date Cost £ Excess Part Time Year to Date Cost £ Bankaide Year to Date Cost £ Agency Year to Date Cost £ North West Locality 109,382 29,493 386,000 28,505 North East Locality 59,213 34,183 257,000 - Adult Services 42,115 57,623 144,000 44,585 Children Services 119,456 70,769 297,000 11,948 Mental Health & Learning Disabilities 368,491 67,014 1,655,000 2,001,234 Social Care Services 713,752 - - 20,540 Home Support 2,897,656 - - - Other 22,645 12,987 33,000 - TOTAL 4,332,710 272,069 2,772,000 2,106,812
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6 11.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. The IJB Medium Term Financial Plan 2023 -2026 is currently being completed. 11.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 11.4 RISK ASSESSMENT/RISK MANAGEMENT The strategic financial risks detailed in the IJB Risk Register have also been updated and are included in a separate report to the IJB. 11.5 PEOPLE None 11.6 STAKEHOLDER ENGAGEMENT 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 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 North Lanarkshire Health and Social Care Partnership Budget Appendix 1 Hosted Services Led by North Lanarkshire Appendix 2 Hosted Services Led by South Lanarkshire Appendix 3 North Lanarkshire IJB Budget Reconciliation 2022/2023 Appendix 4 North Lanarkshire IJB Reserves Appendix 5 Analysis of Additional Employee Costs Appendix 6 ........................................... 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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7 North Lanarkshire Health and Social Care Partnership Budget Appendix 1 Expenditure Annual Year To Date Variance Budget Budget Actual Total 2022/2023 November 2022 November 2022 November 2022 £m £m £m £m Health Care Services Locality and Other Services 51.639 32.624 30.731 1.893 Addiction Services 5.272 2.075 1.548 0.527 Medical and Nursing Directorate 4.940 3.038 3.078 (0.040) Prescribing 69.582 46.388 46.388 0.000 Out of Area Services 4.571 3.047 3.216 (0.168) Area Wide Services 10.579 6.317 6.245 0.072 Hosted Services 163.003 103.430 101.116 2.314 Family Health Services 109.438 75.307 75.307 0.000 Set-Aside Budget 66.858 44.572 44.572 0.000 Covid-19 2.462 2.446 2.441 0.004 Total Expenditure - NHSL 488.344 319.245 314.643 4.601 Social Care Services Social Care Services Gross Expenditure 241.738 157.670 151.980 5.690 Social Care Services Gross Income (Including Covid-19 Income) (2.877) 3.926 3.750 0.175 Social Care Services Net Expenditure 238.861 161.596 155.730 5.866 Housing Revenue Account Expenditure 1.870 1.325 1.325 0.000 Transport Services Expenditure 0.551 0.169 0.169 0.000 Social Care, Housing and Transport Services Net Expenditure 241.282 163.090 157.225 5.866 Total Expenditure - NHSL and NLC 729.626 482.335 471.868 10.467 Funded By: Annual Budget 2022/2023 £m NHS Lanarkshire Funding (467.705) Social Care Funding (22.964) Resource Transfer (23.421) Commissioned Services (6.718) Scottish Government Funding - Covid-19 and Remobilisation (2.670) Transfer from Reserves (Approved) (17.969) Total Funding - NHSL (541.446) NLC Funding - Social Care Services (185.759) NLC Funding - Housing Services (1.870) NLC Funding - Transport Services (0.551) Transfer from Reserves (Approved) 0.000 Total Funding - NLC (188.180) Total Funding - NHSL and NLC (729.626) 2022/2023 Year To Date
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8 Hosted Services Appendix 2 November 2022 November 2022 November 2022 November 2022 November 2022 November 2022 November 2022 November 2022 November 2022 Budget Actual Variance Budget Actual Variance Budget Actual Variance 2022/2023 2022/2023 2022/2023 2022/2023 2022/2023 2022/2023 2022/2023 2022/2023 2022/2023 £m £m £m £m £m £m £m £m £m £m £m £m Sexual Health Services 2.984 1.993 1.880 0.113 1.522 1.017 0.904 0.113 1.462 0.977 0.977 0.000 Continence Services 2.361 1.574 1.585 (0.012) 1.204 0.803 0.814 (0.012) 1.157 0.771 0.771 0.000 Immunisation Services 1.898 1.071 1.782 (0.711) 0.968 0.546 1.257 (0.711) 0.930 0.525 0.525 0.000 Speech and Language Therapy Services 6.114 4.081 3.501 0.580 3.118 2.081 1.502 0.580 2.996 2.000 2.000 0.000 Children and Adolescents Mental Health Services 16.419 7.393 6.657 0.736 8.374 3.770 3.035 0.736 8.045 3.623 3.623 0.000 Childrens Services 12.437 8.023 7.787 0.236 6.343 4.092 3.855 0.236 6.094 3.931 3.931 0.000 Integrated Equipment and Adaptations Store 0.567 0.378 0.367 0.012 0.289 0.193 0.181 0.012 0.278 0.185 0.185 0.000 Dietetics Services 3.854 2.560 2.370 0.190 1.966 1.306 1.116 0.190 1.889 1.254 1.254 0.000 Podiatry Services 4.357 2.902 2.810 0.092 2.222 1.480 1.388 0.092 2.135 1.422 1.422 0.000 Prisoner Healthcare Services 1.707 1.138 1.105 0.033 0.870 0.581 0.547 0.033 0.836 0.558 0.558 0.000 Blood Borne Viruses Services 1.529 1.019 0.962 0.057 0.780 0.520 0.463 0.057 0.749 0.499 0.499 0.000 Hospital at Home 2.502 1.499 1.350 0.149 1.276 0.764 0.615 0.149 1.226 0.734 0.734 0.000 Mental Health and Learning Disability Services 73.916 49.728 48.889 0.839 37.697 25.361 24.522 0.839 36.219 24.367 24.367 0.000 TOTAL 130.644 83.359 81.045 2.314 66.628 42.513 40.199 2.314 64.015 40.846 40.846 0.000 Led by the North Partnership South Lanarkshire IJB - 49% Share Year to Date Annual Budget 2022/2023 Annual Budget 2022/2023 Year to Date North Lanarkshire IJB - 51% ShareYear to DateAnnual Budget 2022/2023 Hosted Services Appendix 3 November 2022 November 2022 November 2022 November 2022 November 2022 November 2022 November 2022 November 2022 November 2022 Budget Actual Variance Budget Actual Variance Budget Actual Variance 2022/2023 2022/2023 2022/2023 2022/2023 2022/2023 2022/2023 2022/2023 2022/2023 2022/2023 £m £m £m £m £m £m £m £m £m £m £m £m Community Dental Services 7.488 4.874 4.473 0.401 3.819 2.486 2.486 0.000 3.669 2.388 1.987 0.401 Brain Injury Unit 2.365 1.081 1.212 (0.131) 1.206 0.551 0.551 0.000 1.159 0.530 0.660 (0.131) Out of Hours Services 8.919 5.874 5.856 0.017 4.548 2.996 2.996 0.000 4.370 2.878 2.861 0.017 Palliative Care Services 7.218 4.845 4.732 0.114 3.681 2.471 2.471 0.000 3.537 2.374 2.260 0.114 Physiotherapy Services 10.204 6.816 6.469 0.347 5.204 3.476 3.476 0.000 5.000 3.340 2.993 0.347 Primary Care Services 0.801 0.527 0.490 0.037 0.409 0.269 0.269 0.000 0.393 0.258 0.221 0.037 Occupational Therapy Services 7.975 5.346 4.921 0.425 4.067 2.727 2.727 0.000 3.908 2.620 2.195 0.425 Diabetic Services 4.945 3.690 3.634 0.056 2.522 1.882 1.882 0.000 2.423 1.808 1.752 0.056 Telehealth 0.660 0.340 0.209 0.132 0.336 0.174 0.174 0.000 0.323 0.167 0.035 0.132 Sub Total 50.576 33.394 31.995 1.398 25.794 17.031 17.031 0.000 24.782 16.363 14.965 1.398 Ring Fenced Funding Primary Care Improvement Fund 12.874 5.961 5.961 0.000 6.566 3.040 3.040 0.000 6.308 2.921 2.921 0.000 Primary Care Transformation Fund 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Sub Total 12.874 5.961 5.961 0.000 6.566 3.040 3.040 0.000 6.308 2.921 2.921 0.000 TOTAL 63.449 39.354 37.956 1.398 32.359 20.071 20.071 0.000 31.090 19.284 17.885 1.398 Annual Budget 2022/2023 Year to Date South Lanarkshire IJB - 49% Share Led by the South Partnership Annual Budget 2022/2023 Year to Date Annual Budget 2022/2023 Year to Date North Lanarkshire IJB - 51% Share
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9 North Lanarkshire IJB Appendix 4 Movement on Reserves Audit Trail NHSL & NCL 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 44.999 (0.065) (9.617) 35.317 NHSL & NLC Earmarked Reserves 30.573 4.787 (6.235) 29.125 NHSL & NLC Risk-Based Reserves 18.894 0.405 (0.796) 18.503 NHSL Contingency Reserves 4.167 6.842 11.009 NHSL & NLC Closed Reserves 20.819 (11.969) (8.850) 0.000 119.452 0.000 (25.498) 93.954 LEAD SUMMARY Total 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 NLC Financial & Strategic Planning 2023/2026 5.416 1.017 6.433 NLC Long Covid Contingency 3.000 (0.727) 2.273 NHSL Prescribing Fund 4.361 4.361 NLC Social Care Demand 6.117 (0.612) (0.069) 5.436 18.894 0.405 (0.796) 18.503 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 6.842 11.009 4.167 6.842 0.000 11.009 RISK-BASED RESERVES TOTAL RISK-BASED RESERVES LEAD CONTINGENCY FUND RESERVES TOTAL CONTINGENCY FUND RESERVES LEAD 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 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 Blood-Borne Viruses Services 0.146 0.146 NHSL Children and Adolescent Mental Health Services 5.283 (3.865) 1.418 NHSL Community Living Change Fund 1.298 1.298 NHSL Covid-19 Funding 29.742 (0.065) (2.670) 27.007 NHSL Covid-19 Funding - Unscheduled Care 1.944 1.944 NHSL Mental Health and Learning Disability Services - Veteran's First Point 0.026 (0.003) 0.023 NHSL Mental Health Improvement Fund - Psychology 0.084 (0.031) 0.053 NHSL Mental Health Infant - NES Funding 0.013 (0.004) 0.009 NHSL Mental Health Innovation Funding 0.120 0.120 NHSL Mental Health Recovery Renewal - Facilities Projects 1.840 (0.948) 0.892 NHSL Mental Health Support for Those Hospitalised with Covid-19 0.172 (0.134) 0.038 NHSL Mental Health Wellbeing in Primary Care Services 0.148 0.148 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 44.999 (0.065) (9.617) 35.317 LEAD RING-FENCED RESERVES TOTAL RING-FENCED RESERVES
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10 Appendix 4 (cont.) 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 Adult Social Care Winter Preparedness Fund 1.941 1.941 NLC Adaptations Fund 0.289 (0.200) 0.089 NLC Adult Protection (share with C&F and NHSL) 0.050 (0.017) 0.033 NLC Advocacy Services 0.123 0.061 (0.045) 0.139 NHSL Area Wide Services - Health Promotion - North Lanarkshire Leisure agreement 0.123 0.123 NHSL Area Wide Services - Pre School Vision Screening 0.075 0.075 NHSL Area Wide Services - Primary Care Corporate (iHUB Project - NES funding) 0.034 (0.021) 0.013 NHSL Area Wide Services - Refugees and Displaced Persons 0.400 (0.125) 0.275 NLC Assistive Technology Contract x 12 months (ATC) 0.000 0.090 (0.062) 0.028 NHSL Business Case - Health Care Support Workers, Multi-Disciplinary Teams 1.794 (1.481) 0.313 NLC Business Case - Non-Recurring NLC Costs 5.380 0.537 (1.941) 3.976 NHSL Care Homes Allocation 0.318 0.318 NLC Carers Act 2018 - Support 0.852 0.852 NHSL Champions Board Funding 0.045 0.153 0.198 NHSL Dietetics Services - Double Running Costs 0.110 (0.098) 0.012 NLC Digital and IT Strategy Technology Improvements - Community Alarms 0.694 (0.064) 0.630 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 (0.173) 0.527 NHSL Discharge Support Workers Band 4 x 2 WTE 0.107 0.107 NHSL Distinction Awards 0.036 0.036 NLC Financial Strategy - Changes to LA Services Muirpark 2.973 (1.242) 1.731 NHSL Forensic Band 3 x 5 WTE 0.147 0.147 NHSL GPIT Reprovisioning Gap 0.181 0.181 NHSL Health Inequalities - Screening 0.098 (0.004) 0.094 NHSL Health Visiting Students/Trainees 0.840 0.840 NHSL High Resource User Posts 0.025 0.027 (0.025) 0.027 NHSL Hospital at Home Services - Support Development 0.414 (0.288) 0.126 NHSL Integrated Authority Support 6.076 6.076 NHSL Kylepark Works 1.000 1.000 NHSL Long Acting Buprenorphine 0.255 0.255 NLC Mental Health Social Workers 2 x NL10 x 24 months 0.107 (0.074) 0.033 NHSL Minor Capital Works 1.387 (0.100) 1.287 NHSL Organisational Development Fund 0.000 0.260 0.260 NHSL Paediatric Diabetes Insulin Pumps and Additional Staff 0.908 0.908 NLC Planned Date of Discharge - Discharge To Assess 0.200 0.241 (0.074) 0.367 NLC Planned Date of Discharge - Locality Social Work Manager Post 0.055 0.096 (0.051) 0.100 NHSL Podiatry Services - Foot Screening 0.459 (0.019) 0.440 NHSL Prisioner Healthcare - Transitional Project Band 8A 0.070 0.070 NHSL Regrading of Posts Including Backpay 0.125 0.125 0.250 NHSL Scottish Clinical Leadership Fellowship 0.045 0.045 NHSL Sexual Health Services - Forensic Medical 0.222 0.222 NHSL Sexual Health Services - Long-Acting Reversible Contraception (LARC) 0.109 0.393 (0.011) 0.491 NLC Social Care Contracting Staff within Quality Assurance Services 0.047 0.028 (0.052) 0.023 NHSL Supervisor Training 0.077 0.077 NLC Unmet Saving 21/22 - IDS/LSS (merging building Coatbridge & Cumbernauld) 0.086 (0.068) 0.018 NLC Violence Against Women (Joint Initiative with SLC and C&F) 0.030 0.030 30.573 4.787 (6.235) 29.125 LEAD EARMARKED RESERVES TOTAL EARMARKED RESERVES
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11 Appendix 4 (Cont.)
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12 Opening Balance As At 1 April 2022 Transfers To / From Reserves Pending Drawdown from Reserves Revised Balance As At 31 March 2023 £m £m £m £m NHSL Administration Support Services 0.240 (0.239) (0.001) 0.000 NHSL Area Wide Services - Admin 0.080 (0.080) 0.000 NHSL Area Wide Services - Audiology Equipment 0.011 (0.011) 0.000 NHSL Area Wide Services - Locality Funding 0.432 (0.432) 0.000 NHSL Area Wide Services - Mental Health Pharmacy, PCIP and NES SLA with GPs 1.048 (1.048) 0.000 NHSL Area Wide Services - NES Training 0.132 (0.132) 0.000 NHSL Area Wide Services - Update Consolidated Health Information (CHI) 0.015 (0.015) 0.000 NHSL Assistant Support Worker - Promise 0.026 (0.026) 0.000 NLC Carers Act 2018 - Waving of Charges 0.580 (0.580) 0.000 NHSL Children and Adolescent Mental Health Services - Choice and Partnership Approach (CAPA) Team 0.717 (0.717) 0.000 NHSL Children and Adolescent Mental Health Services - Service Improvement Post (Band 7 - 18 months) 0.088 (0.088) 0.000 NHSL Children and Adolescent Mental Health Services - Udston Top Up Funding 0.346 (0.346) 0.000 NHSL Children and Adolescent Mental Health Services - Waiting List Co-ordinator (Band 5) 0.038 (0.038) 0.000 NHSL Childrens Services - Childrens Inspection Senior Nurse (3 months) 0.017 (0.017) 0.000 NHSL Childrens Services - Manager Post (1WTE) 0.040 (0.040) 0.000 NHSL Childrens Services - Paediatric Band 7, Band 6 x 4.12 WTE, Band 2 x 9.59 WTE 0.645 (0.645) 0.000 NHSL CLAN Cancer Support Funding 0.095 (0.095) 0.000 NHSL Clinical Fellow Funding 0.080 (0.080) 0.000 NHSL Clinical Guidelines Post 0.023 (0.023) 0.000 NHSL Clinical Pharmacist - Additions 0.035 (0.035) 0.000 NHSL Community Assessment and Rehabilitation Service - Rehabilitation Pilot 0.023 (0.023) (0.000) NHSL Community WIFI 0.342 (0.342) 0.000 NHSL Development of Health Promoting Culture 0.141 (0.141) 0.000 NHSL Diagnostic Support Service - Dementia Post 0.429 (0.429) 0.000 NHSL Dietetics Services 0.046 (0.046) 0.000 NHSL Dietetics Services - Band 6 0.114 (0.114) 0.000 NHSL Dietetics Services - Diabetes Type 2 and Adult Weight Management 0.024 (0.024) 0.000 NHSL Dietetics Services - Oral Nutrition 0.038 -0.038 0.000 NHSL Dietetics Services - Weight Management 0.049 (0.049) 0.000 NHSL Eating Disorders Funding 0.111 0.065 (0.176) 0.000 NHSL Health Inequalities - Health Promotion Posts 0.006 (0.006) 0.000 NHSL Health Inequalities Funding 0.024 (0.024) 0.000 NLC Home Support Development 0.217 (0.217) 0.000 NHSL Hospital at Home Services - Shortfall 0.110 (0.110) 0.000 NLC IJB Financial Plan Contingency - Allocated to NLC 3.000 (3.000) 0.000 NLC Impact of Covid-19 Pandemic Review 0.100 (0.100) 0.000 NHSL Integrated Support Worker 0.153 (0.153) 0.000 NHSL IT Federated Trust Environment Strategy 0.214 (0.214) 0.000 NHSL Joint Equipment Store 0.554 (0.554) 0.000 NHSL Kings Fund Organisational Development 0.014 (0.014) 0.000 NHSL LD Band 3 x 4 WTE 0.118 (0.118) 0.000 NHSL Long Term Conditions (LTC) Lead Clinician 0.010 (0.010) 0.000 NHSL Maternity and Neonatal Psychological Interventions 0.044 (0.044) 0.000 NHSL Medical Director - Associate Medical Director (MR) 0.074 (0.074) 0.000 NHSL Medical Director - Child Death Review Funding 0.021 (0.021) 0.000 NHSL Mental Health and Learning Disability Services - Action 15 3.019 (3.019) 0.000 NHSL Mental Health and Learning Disability Services - Distress Brief Intervention 1.552 (1.552) 0.000 NHSL Mental Health and Learning Disability Services - Mental Health Improvement Fund 0.254 (0.254) 0.000 NHSL Mental Health PDN 0.2wte for 20/21 spend previously approved 0.011 (0.011) 0.000 NLC Mental Health Practice Assessor 0.006 (0.006) 0.000 NHSL Mental Health Perinatal and Infant 0.532 (0.532) 0.000 NHSL Mental Health Practice Development (HF) 0.047 (0.047) 0.000 NHSL Motherwell Rehabilitation Team Leadership 0.058 (0.058) 0.000 NHSL Neurodevelopmental Pathway OT 0.095 (0.095) 0.000 NHSL Nursing Appointments 0.119 (0.119) 0.000 NHSL Nursing Services 0.125 (0.125) 0.000 NHSL Nursing Services - District Nurse 0.292 (0.292) 0.000 NHSL Nursing Services - Extend Health Improvement Unit posts to March 2020 0.075 (0.075) 0.000 NHSL Nursing Services - Family Nurse Partnership 0.033 (0.033) (0.000) NHSL Nursing Services - Nursing Assoicate Post Band 7 x 0.2 WTE 0.011 (0.011) 0.000 NHSL Nursing Services - Queens Nursing Institute Grants 0.004 (0.004) 0.000 NHSL Nursing Services - Quest Patient Safety Posts 0.003 (0.003) 0.000 NHSL Nursing Services - School Nursing 0.162 (0.162) 0.000 NHSL Nursing Services - Solihull Training 0.018 (0.018) 0.000 NLC Payment to Voluntary Org - Glenboig 0.006 (0.006) 0.000 NHSL Pre School Screening Exclusion Incident Audit 0.025 (0.025) 0.000 NHSL Project Manager - Adverse Events 0.036 (0.036) 0.000 NHSL Promise Funding (2 years) 0.052 (0.052) 0.000 NHSL Psychology Services- Capacity Building 0.117 (0.117) 0.000 NHSL Psychology Services - Improving Access 0.095 (0.095) 0.000 NHSL Psychology Services - Recovery and Renewal Phase 1 & 2 0.614 (0.614) 0.000 NHSL Public Health Intelligence Data Analysts 0.061 (0.061) 0.000 NHSL Public Projection Joint Resourcing 0.075 (0.075) 0.000 NHSL Return to Nursing Students 0.107 (0.107) 0.000 NLC SDS Transformational Team 0.025 (0.025) 0.000 NHSL Sexual Health Services - Health & Homeless Post 0.004 (0.004) 0.000 NHSL Sexual Health Services - Long-Acting Reversible Contraception (LARC) (2 clinics for 2 years) 0.386 (0.382) (0.004) 0.000 NHSL Sexual Health Services - Sexually Transmitted Infections 0.122 (0.011) (0.111) 0.000 NHSL Speech, Language and Therapy Services 0.807 (0.807) 0.000 NHSL Speech, Language and Therapy Services - Contract 0.250 (0.250) 0.000 NHSL Test of Change - High Intensity Service Users 0.027 (0.027) (0.000) NHSL Third Sector Initiatives To Improve Health 0.306 (0.306) 0.000 NHSL Training Fund 0.246 (0.246) 0.000 NHSL Vulnerable Population Post - Health Improvement Funding 0.068 (0.068) (0.000) NLC Winter Plan 0.300 (0.300) 0.000 NHSL Winter Plan - Discharge To Assess 0.010 (0.010) (0.000) 20.819 (11.969) (8.850) 0.000 LEAD CLOSED RESERVES TOTAL CLOSED RESERVES
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13 North Lanarkshire IJB Budget Reconciliation 2022/2023 Appendix 5 2022/23 NHSL Financial Allocation to North Lanarkshire HSCP £m 2022/23 NLC Financial Allocation to North Lanarkshire HSCP £m 2022/22 North Lanarkshire HSCP Financial Allocation 506.931 2022/22 North Lanarkshire HSCP Financial Allocation 132.575 Add: Set-Aside Budget 66.858 NLC Funding - Housing Services 1.870 Less: Budget Adjustments NLC Funding - Transport Services 0.551 Social Care Fund -22.964 Add: Budget Adjustments Resource Transfer -23.421 Social Care Fund 22.964 Commissioned Services -6.799 Resource Transfer 23.421 NHSL Financial Allocation at 31 May 2022 520.605 Commissioned Services 6.799 NLC Financial Allocation at 16 September 2022 188.180 Draw Down from Reserves 1.949 Increase to Employers NI 1.262 NES Trainee 1.021 Other Budget Adjustments 0.425 NHSL Financial Allocation at 30 June 2022 525.262 Draw Down from Reserves 0.460 Junior Medical Income -0.040 Other Budget Adjustments 0.023 NHSL Financial Allocation at 31 July 2022 525.705 Draw Down from Reserves 0.453 Child Death Review Funding 22-23 0.024 Increase to Hosted Services Led by South 1.146 Other Budget Adjustments 0.220 NHSL Financial Allocation at 31 August 2022 527.548 Draw Down from Reserves 1.740 Junior Doctor Income 2.274 Adustment to Commissioned Services 0.082 Increase to Hosted Services Led by South 0.433 Other Budget Adjustments 0.002 NHSL Financial Allocation at 30 September 2022 532.079 Draw Down from Reserves 1.039 Scottish Government Funding Health Care Support Workers 1.743 Scottish Government Funding for Band 2-4 (North Allocation) 0.933 Increase to Hosted Services Led by South 0.634 Other Budget Adjustments 0.160 NHSL Financial Allocation at 30 October 2022 536.588 Draw Down from Reserves 1.275 Medical Pay Award 4.5% 0.979 Junior Medical 0.132 Increase to Hosted Services Led by South 2.450 Other Budget Adjustments 0.022 NHSL Financial Allocation at 30 November 2022 541.446 Budget Adjustments Posted in Month 8 Budget Adjustments Posted in Month 6 Budget Adjustments Posted in Month 3 Budget Adjustments Posted in Month 4 Budget Adjustments Posted in Month 5 Budget Adjustments Posted in Month 7
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14 Analysis of Additional Employee Costs Appendix 6 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Other £ TOTAL £ 1 44,000 32,000 17,500 35,500 209,500 2,000 340,500 2 44,000 32,000 17,500 35,500 209,500 2,000 340,500 3 53,000 34,000 22,000 30,000 205,000 3,000 347,000 4 54,000 30,000 17,000 38,000 216,000 5,000 360,000 5 49,000 33,000 17,000 41,000 212,000 4,000 356,000 6 43,000 31,000 12,000 34,000 196,000 4,000 320,000 7 53,000 32,000 17,000 43,000 221,000 6,000 372,000 8 46,000 33,000 24,000 40,000 186,000 7,000 336,000 TOTAL 386,000 257,000 144,000 297,000 1,655,000 33,000 2,772,000 North West Locality £ Adult Services £ Children Services £ Learning Disabilities £ Mental Health £ Social Care Services £ TOTAL £ 1 1,396 6,804 9,018 19,329 72,766 109,313 2 406 6,804 1,303 37,927 338,077 384,517 3 2,527 6,804 42,413 184,579 236,323 4 4,348 4,796 37,915 199,682 246,741 5 5,698 4,988 38,211 212,758 261,655 6 759 4,797 1,627 49,939 193,626 250,748 7 2,817 4,796 59,821 234,119 7,204 308,757 8 10,554 4,796 97,273 182,799 13,336 308,758 TOTAL 28,505 44,585 11,948 382,828 1,618,406 20,540 2,106,812 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Social Care Services £ Home Support £ Other £ TOTAL £ 1 13,187 8,071 10,569 12,294 49,952 8,427 109,798 4,808 217,106 2 12,032 8,789 3,582 9,091 42,880 73,558 285,090 1,096 436,118 3 21,425 6,426 4,508 7,572 29,605 76,713 277,793 2,558 426,600 4 12,482 4,153 2,223 16,873 30,022 74,719 290,873 2,923 434,268 5 17,069 10,685 3,218 9,750 53,447 87,187 321,181 1,541 504,078 6 10,687 7,575 4,373 14,542 48,147 76,800 326,698 2,629 491,451 7 13,149 4,503 6,412 21,905 55,807 84,165 362,809 4,290 553,040 8 9,351 9,011 7,230 27,429 58,631 113,755 503,326 2,800 731,533 9 118,428 420,088 538,516 TOTAL 109,382 59,213 42,115 119,456 368,491 713,752 2,897,656 22,645 4,332,710 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Other £ TOTAL £ 1 6,869 5,164 12,800 6,579 10,496 889 42,797 2 3,401 4,223 7,228 5,775 8,002 796 29,425 3 4,231 6,891 8,791 6,755 9,229 656 36,553 4 3,007 4,827 5,230 8,288 7,947 2,269 31,568 5 3,801 3,348 5,450 7,051 9,240 4,532 33,422 6 3,660 3,937 5,002 11,180 7,207 649 31,635 7 2,077 1,879 6,954 12,542 8,465 1,605 33,522 8 2,447 3,914 6,168 12,599 6,428 1,591 33,147 TOTAL 29,493 34,183 57,623 70,769 67,014 12,987 272,069 Period Period Period Period BANKAIDE COSTS YEAR TO DATE OVERTIME COSTS YEAR TO DATE AGENCY COSTS YEAR TO DATE EXCESS PART TIME COSTS YEAR TO DATE