Appendix 1 and 2 M8 IJB Budget Monitoring
Argyll and Bute Council · 29 January 2025
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 29 January 2025 and its agenda
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# ARGYLL AND BUTE HEALTH AND SOCIAL CARE PARTNERSHIP APPENDIX 1 REVENUE BUDGET MONITORING SUMMARY - YEAR TO DATE POSITION AS AT 30 NOVEMBER 2024 Reporting Criteria: +/- £50k or +/- 10% For information: The Council don't do monthly based accrual accounting, whereas Health do. On the Council side, there may be a mismatch between year to date actual and budgets, due to timing differences as to when invoices are paid. Health do monthly based accrual accounting, therefore, you should see a correlation in the year to date position and the year end outturn position. Service Actual £000 Budget £000 Variance £000 % Variance Explanation COUNCIL SERVICES: Chief Officer 706 508 (198) (39.0%) Adverse variance due to the under recovery of vacancy savings and termination payment for a senior officer leaving their substantive post. Service Development 265 267 2 0.7% Outwith reporting criteria. Looked After Children 4,707 4,237 (470) (11.1%) Overspend due to a retainer payment being required for 4 weeks for 2 children transitioning from secure to residential along with a rates increase agreed by Scotland Excel and a change in the split of the funding for a package. Child Protection 1,926 2,062 136 6.6% The YTD variance is based on known demands for the service coupled with deferred income received from previous years. Children with a Disability 595 718 123 17.1% The underspend is due to two third sector grants ending. Criminal Justice 86 139 53 38.1% The YTD variance is due to additional grant funding. Children and Families Central Management 1,963 1,972 9 0.5% Outwith reporting criteria. Older People - Homecare 12,637 11,627 (1,010) (8.7%) Overspend reflects an increase in payments to third party providers and the use of agency staff. Older People - Internal Residential 4,434 4,223 (211) (5.0%) Variance is due the use of agency staff to cover sickness, holidays and vacancies. Older People - External Residential 6,484 6,580 96 1.5% The YTD variance is due to timing difference with third party payments. Older People - Other 5,543 5,629 86 1.5% Variance is due to timing of re-charges to NHS and timing of payments to third parties. Physical Disability 2,413 2,540 127 5.0% The YTD variance is due to re-assessed care packages. Learning Disability 11,638 11,951 313 2.6% Underspend due to reduced service demand for this service area. Mental Health 2,559 2,322 (237) (10.2%) Overspend due to movements in assessed packages. Adult Services Central Management Costs 411 464 53 11.4% The YTD variance due to underspends on centrally held funds. COUNCIL SERVICES TOTAL 56,367 55,239 (1,128) (2.0%) HEALTH SERVICES: Explanation Health & Community Care Services 31,161 31,639 477 1.5% Underspend is due to vacancies across a number of services Acute & Complex Care Services 28,885 27,448 (1,437) (5.2%) Overspending is due to continued agency and locum usage to cover medical & nursing vacancies in LIH & Mental Health, high cost out of area private sector mental health placements Children & Families Services 7,245 7,198 (47) (0.7%) Outwith reporting criteria. Commissioned Services - NHS GG&C 51,990 51,309 (681) (1.3%) Overspending on cost per case activity within GGC relating to drug treatment prescribing Commissioned Services - Other 3,032 2,926 (106) (3.6%) High cost other Scottish Board services charge for emergency care on a cost per case basis Primary Care Services inc Dental 20,551 20,472 (80) (0.4%) Misc overspending due to 2C practises Other Primary Care Services 7,060 7,060 0 0.0% Outwith reporting criteria. Prescribing 16,506 16,373 (133) (0.8%) Continuing supply shortages and pricing increases Public Health 1,524 1,575 51 3.2% The YTD variance is due to vacancies Lead Nurse 1,259 1,331 72 5.4% The YTD variance is due to vacancies/ secondments Management Service 504 702 198 28.2% The YTD variance is due a technical accounting adjustment relating to clinical negligence provisions Planning & Performance 1,667 1,659 (8) (0.5%) Outwith reporting criteria. Budget Reserves 0 1,250 1,250 100.0% Slippage on reserves due to delays in implementation, generally due to recruitment Income (1,517) (1,389) 128 (9.2%) Seasonal increase in activity and long stay Mental Health patient Estates 7,476 7,352 (123) (1.7%) Inflationary pressures and increased demand for maintenance due to limited availability of capital funding, unachieved savings HEALTH SERVICES TOTAL 177,343 176,904 (439) (0.2%) GRAND TOTAL 233,710 232,143 (1,567) (0.7%)
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# ARGYLL AND BUTE HEALTH AND SOCIAL CARE PARTNERSHIP APPENDIX 2 REVENUE BUDGET MONITORING FORECAST OUTTURN - AS AT 30 NOVEMBER 2024 Reporting Criteria: +/- £50k or +/- 10% Service Annual Budget £000 Outturn £000 Variance £000 % Variance Explanation COUNCIL SERVICES: Chief Officer (600) (302) (298) 49.7% The forecast overspend reflects an under recovery in vacancy savings and a termination payment due to a senior officer leaving their substantive post. Service Development 453 456 (3) (0.7%) Outwith reporting criteria. Looked After Children 6,691 7,419 (728) (10.9%) Forecast overspend reflects current known demand for the service. Currently have 18 children in residential placements with an average cost of £132k per annum and potentially more under consideration along with an overspend on staff costs due to a re-grading process (£240k). Child Protection 3,603 3,436 167 4.6% The forecast underspend is as a result of demand for contact and welfare services. Children with a Disability 1,052 849 203 19.3% The forecast underspend reflects a reduction in third sector grants payable to external organisations, one of which may re-start before the end of the financial year. Criminal Justice 174 77 97 55.7% Underspend reflects additional grant funding received along with vacant posts. Children and Families Central Management 3,733 3,698 35 0.9% Outwith reporting criteria. Older People - Homecare 19,550 20,406 (856) (4.4%) Overspend reflects the latest assessed needs packages for the homecare service and increasing reliance on agency staff. The forecast overspend on agency staff is curently £2.3m however this is partially offset by underspend in staffing budgets and third party payments. Older People - Internal Residential 7,483 7,387 96 1.3% Forecast underspend is due to a projected increase in other income from residential care partial offset by an overspend in agency staff costs. Older People - External Residential 11,425 12,381 (956) (8.4%) Overspend reflects the latest demand for service based care packages with highest demand being in Mid Argyll, Lorn, and H&L partially offset by a drop in demand in Bute. Older People - Other 9,383 9,331 52 0.6% Overspend is predominatly due to the costs associated with delayed discharge service. Physical Disability 3,852 3,664 188 4.9% Underspend is due to a combination of re-assessed needs packages and attritions. Learning Disability 20,289 19,784 505 2.5% Underspend reflects demand for service and known commitments with MAKI and OLI showing an underspend position partial offset by a small overspend in H&L. Mental Health 3,894 4,270 (376) (9.7%) Forecast overspend is based on assessed care needs and agreed packages. We currently have 13 clients in residential placements. Adult Services Central Management Costs 812 785 27 3.3% Outwith reporting criteria. COUNCIL SERVICES TOTAL 91,794 93,641 (1,847) (2.0%) HEALTH SERVICES: Explanation Health & Community Care Services 47,317 47,047 270 0.6% Saving due to vacancies across a number of services Acute & Complex Care Services 40,925 43,025 (2,100) (5.1%) Overspend on agency locum usage to cover medical & nursing vacancies in LIH & Mental Health, high cost out of area private sector mental health placements Children & Families Services 10,781 10,781 0 0.0% Outwith reporting criteria. Commissioned Services - NHS GG&C 76,963 77,458 (495) (0.6%) Cost per case activity within GGC relating to homecare drug prescribing & high cost procedures Commissioned Services - Other 4,321 4,470 (149) (3.4%) High cost other Scottish Board services charge for emergency care on a cost per case basis Primary Care Services inc Dental 29,930 30,579 (649) (2.2%) Agency locum costs associated with running 2c GP Practices in A&B Other Primary Care Services 10,741 10,741 0 0.0% Outwith reporting criteria. Prescribing 24,792 24,956 (164) (0.7%) Anticipated additional costs of prescribing, PSD reporting on the detail of costs runs two months in arrears. On going supply shortages and price increases are also impacting. Public Health 2,682 2,612 70 2.6% Saving due to vacancies Lead Nurse 1,988 1,913 75 3.8% Saving due to vacancies/secondments Management Service 1,614 1,368 246 15.2% The forecast variance is due a technical accounting adjustment relating to clinical negligence provisions & vacancies Planning & Performance 2,462 2,525 (63) (2.6%) Overspend due to unachieved Savings Budget Reserves 13,855 11,755 2,100 15.2% Slippage on reserves due to delays in implementation, generally due to recruitment Income (1,944) (2,101) 157 (8.1%) Forecast activity for patients from outwith A&B, long stay Mental Health patient discharged Estates 11,227 11,271 (44) (0.4%) Inflationary pressures and increased demand for maintenance due to limited availability of capital funding and unachieved savings HEALTH SERVICES TOTAL 277,654 278,400 (746) (0.3%) GRAND TOTAL 369,448 372,041 (2,593) (0.7%)