Appendix 1 and 2 M9 IJB Budget Monitoring
Argyll and Bute Council · 31 January 2024
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 31 January 2024 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 31 DECEMBER 2023 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 42 487 445 91.4% Saving due to vacancy savings combined with underspends on centrally held funding. Service Development 337 343 6 1.7% Outwith reporting criteria. Looked After Children 5,608 5,842 234 4.0% Saving is as a result of demand for fostering, kinship and adoption placements and over-recovery of income for nursery meals. This is combined with payroll underspends due to vacancies and long term absence. Child Protection 2,327 2,508 181 7.2% Saving as a result of vacancies combined with demand for services across contact & welfare. Children with a Disability 697 664 (33) (5.0%) Outwith reporting criteria. Criminal Justice 192 193 1 0.5% Outwith reporting criteria. Children and Families Central Management Costs 2,312 2,368 56 2.4% The YTD variance is as a result of the receipt of grant income in advance of budget profile. Older People 31,696 29,916 (1,780) (6.0%) Overspend reflects demand within the care home placement and homecare budgets and overspends on employee costs due to use of agency staff in residential units and homecare. Physical Disability 2,539 2,485 (54) (2.2%) Variance reflects demand for service within the supported living and overspends on purchases within the IES store. Learning Disability 12,208 12,641 433 3.4% Saving reflects demand for residential placements partially offset by demand for supported living. Mental Health 2,433 2,393 (40) (1.7%) Outwith reporting criteria. Adult Services Central Management Costs 592 1,057 465 44.0% Underspends on centrally held funds. COUNCIL SERVICES TOTAL 60,983 60,897 (86) (0.1%) HEALTH SERVICES: Explanation Health & Community Care Services 33,818 33,846 28 0.1% Saving due to reduced cost per case activity with other Health Boards Acute & Complex Care Services 30,386 29,790 (596) (2.0%) Overspend due to agency nursing, medical & AHP costs in both LIH & Mental Health Services Children & Families Services 7,536 7,668 132 1.7% Saving due to vacancies Commissioned Services - NHS GG&C 58,490 58,490 0 0.0% Assumed no adverse impact from SLA uplifts. Commissioned Services - Other 3,402 3,587 184 5.1% The variance is influenced by patients delayed on waiting lists with other NHS Scotland providers. Further detail has been requested from the provider Boards on expected surgery dates for these high cost, low volume procedures Primary Care Services inc Dental 21,127 21,340 213 1.0% Vacancies, mainly in Dental Services Other Primary Care Services 7,488 7,488 0 0.0% Outwith reporting criteria. Prescribing 18,444 16,771 (1,673) (10.0%) Increasing cost of drugs and amendments to drug tariff. Whilst data is being made available, there is still a backlog in prescribing data and a requirement to rely on estimates for more than 2 months costs. Public Health 1,599 1,624 25 1.5% Saving due to service vacancies. Lead Nurse 1,228 1,369 141 10.3% Saving due to service vacancies. Management Service 850 972 121 12.5% Saving due to service vacancies. Planning & Performance 2,003 1,916 (87) (4.6%) Unachieved savings Budget Reserves 0 1,425 1,425 0.0% Anticipated slippage on reserves and SG allocations. Income (1,527) (1,420) 107 (7.5%) Seasonal income, variance is reducing now tourist season is dwindling. Estates 8,641 8,391 (250) (3.0%) Unachieved savings HEALTH SERVICES TOTAL 193,488 193,258 (230) (0.1%) GRAND TOTAL 254,471 254,155 (316) (0.1%)
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ARGYLL AND BUTE HEALTH AND SOCIAL CARE PARTNERSHIP APPENDIX 2 REVENUE BUDGET MONITORING FORECAST OUTTURN - AS AT 31 DECEMBER 2023 Reporting Criteria: +/- £50k or +/- 10% Service Annual Budget £000 Forecast Outturn £000 Variance £000 % Variance Explanation COUNCIL SERVICES: Chief Officer 934 473 461 49.4% Underspend due to an over-recovery on vacancy savings (£248k) combined with underspends on centrally held funds. Service Development 480 472 8 1.7% Outwith reporting criteria. Looked After Children 7,844 7,518 326 4.2% Forecast underspend is as a result of demand for fostering, kinship and adoption placements and supporting young people leaving care. There is also an over-recovery on income from the Home Office for unaccompanied asylum seeking children. This is partially offset by demand for external residential placements and payroll overspends in the children's houses. Child Protection 3,675 3,394 281 7.6% Underspend is as a result of demand for contact and welfare services as well as forecast underspends in the Area Teams on payroll costs and payments to other bodies. Children with a Disability 999 1,042 (43) (4.3%) Outwith reporting criteria. Criminal Justice 224 172 52 23.2% The forecast underspend is due to vacancies within the Criminal Justice team. Children and Families Central Management Costs 3,709 3,682 27 0.7% Outwith reporting criteria. Older People 44,503 46,856 (2,353) (5.3%) Overspend reflects demand driven overspends within the care home placement budgets (£1.1m) and homecare (£1.6m). High staff costs across HSCP residential units due to agency cover. These overspends are partially offset by staffing underspends across ACM teams and underspends on payments to other services from the delayed discharge budgets. Physical Disability 3,527 3,605 (78) (2.2%) Overspend reflects higher than budgeted demand for Supported Living and higher than budgeted equipment purchasing in the Integrated Equipment Service. These are offset slightly by a forecast underspends in the Residential Care budgets. Learning Disability 19,368 18,786 582 3.0% Underspend reflects known demand for Residential Placements partially offset by overspends on Supported Living and Respite due to demand. Mental Health 3,594 3,635 (41) (1.1%) Outwith reporting criteria. Adult Services Central Management Costs 2,231 1,452 779 34.9% The forecast underspend is mainly due to underspends on centrally held funds and vacancies. COUNCIL SERVICES TOTAL 91,088 91,087 1 0.0% HEALTH SERVICES: Explanation Health & Community Care Services 45,143 45,301 (158) (0.4%) The adverse forecast variance is due to the cost of agency staffing in nursing and GP out of hours services Acute & Complex Care Services 39,519 40,526 (1,007) (2.5%) The adverse forecast variance is due to the cost of agency staffing covering consultant and nursing vacancies and leave Children & Families Services 10,229 10,079 150 1.5% The favourable forecast variance is due to vacancies Commissioned Services - NHS GG&C 79,320 79,256 64 0.1% Outwith reporting criteria. Commissioned Services - Other 4,584 4,400 184 4.0% Reduced activity due to delays in patients on Golden Jubilee waiting list Primary Care Services inc Dental 27,230 27,080 150 0.6% Underspend due to vacancies. Other Primary Care Services 10,609 10,609 0 0.0% Outwith reporting criteria. Prescribing 22,326 24,526 (2,200) (9.9%) The adverse forecast variance is due to the impact of increased drug pricing & changes to the drug tariff. Due to issues with the implementation of a new national system, robust prescribing data cannot be produced and the forecast is based on limited actual data Public Health 2,196 2,196 0 0.0% Outwith reporting criteria. Lead Nurse 1,844 1,654 190 10.3% The favourable forecast variance is due to vacancies Management Service 1,608 1,476 132 8.2% The favourable forecast variance is due to vacancies Planning & Performance 2,345 2,443 (98) (4.2%) The adverse forecast variance is due to unachieved savings targets. Budget Reserves 6,293 3,993 2,300 36.5% The favourable forecast variance is due to expected slippage on reserves and SG allocations. Income (1,894) (1,994) 100 (5.3%) Seasonal patient activity. Estates 11,268 11,518 (250) (2.2%) The adverse forecast variance is due to unachieved savings targets. HEALTH SERVICES TOTAL 262,620 263,063 (443) (0.2%) GRAND TOTAL 353,708 354,150 (442) (0.1%)