Appendix 1 and 2 M7 IJB Budget Monitoring
Argyll and Bute Council · 29 November 2023
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 29 November 2023 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 OCTOBER 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 (87) 208 295 141.8% Variance due to over‐recovery of vacancy savings (£190k) and underspends on centrally held funding. Service Development 242 244 2 0.8% Outwith reporting criteria. Looked After Children 4,213 4,327 114 2.6% Underspend due to reduced demand for fostering, kinship and adoption placements and over‐recovery of income for provision of nursery meals. This is combined with payroll underspends due to vacancies and absence. Child Protection 1,696 1,817 121 6.7% Saving from vacancies combined with demand for services across contact & welfare. Children with a Disability 555 492 (63) (12.8%) The YTD variance reflects demand for service. Criminal Justice 79 198 119 60.1% Variance is as a result of payroll underspends due to vacancies and underspends on payments to other bodies. Children and Families Central Management Costs 1,702 1,736 34 2.0% Outwith reporting criteria. Older People 23,914 22,851 (1,063) (4.7%) Overspend reflects demand within the care home placement budget and overspends on employee costs due to use of agency staff in residential units and homecare. Physical Disability 1,980 1,920 (60) (3.1%) Overspend reflects demand for service within the supported living budgets and overspending on purchases within the IES store. This is partially offset by underspends in the residential budget. Learning Disability 9,231 9,610 379 3.9% Saving reflects reducing demand for residential placements partially offset by demand for supported living. Mental Health 1,640 1,608 (32) (2.0%) Outwith reporting criteria. Adult Services Central Management Costs 457 605 148 24.5% Saving is mainly due to YTD underspends on centrally held funds. COUNCIL SERVICES TOTAL 45,622 45,616 (6) (0.0%) HEALTH SERVICES: Explanation Health & Community Care Services 26,151 26,026 (125) (0.5%) Overspending on agency nursing, medical & AHP, partly offset by vacancies Acute & Complex Care Services 23,429 22,952 (477) (2.1%) Agency nursing, medical & AHP costs in both LIH & Mental Health Services Children & Families Services 5,795 5,938 143 2.4% Saving due to service vacancies Commissioned Services ‐ NHS GG&C 44,684 44,663 (21) (0.0%) The YTD variance is outwith reporting criteria. There are delays in getting some cost per case data from GGC including oncology drug costs. The 23/24 inflationary uplift has yet to be nationally agreed, it is expected there will be no adverse impact. Commissioned Services ‐ Other 2,434 2,688 254 9.5% The YTD 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 16,358 16,439 81 0.5% Outwith reporting criteria. Other Primary Care Services 5,597 5,597 0 0.0% Outwith reporting criteria. Prescribing 14,529 12,788 (1,741) (13.6%) Increasing cost of drugs and amendments to drug tariff. National delays in prescribing data mean the majority of the costs are estimated based on prior months data and updates from the national FHS Execs Group. Public Health 1,302 1,328 26 2.0% Outwith reporting criteria. Lead Nurse 956 1,064 108 10.1% Saving relates to service vacancies Management Service 490 555 65 11.7% Saving relates to service vacancies Planning & Performance 1,640 1,586 (54) (3.4%) Overspend due to unachieved savings Budget Reserves 0 1,000 1,000 100.0% Anticipated slippage on reserves and spend associated with SG allocations. Income (1,196) (1,072) 124 (11.5%) Seasonal income, variance is reducing now tourist season is dwindling. Estates 6,470 6,358 (112) (1.8%) Overspend due to unachieved savings HEALTH SERVICES TOTAL 148,639 147,910 (729) (0.5%) GRAND TOTAL 194,261 193,526 (735) (0.4%)
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ARGYLL AND BUTE HEALTH AND SOCIAL CARE PARTNERSHIP APPENDIX 2 REVENUE BUDGET MONITORING FORECAST OUTTURN ‐ AS AT 31 OCTOBER Reporting Criteria: +/‐ £50k or +/‐ 10% Service Annual Budget £000 Forecast Outturn £000 Variance £000 % Variance Explanation COUNCIL SERVICES: Chief Officer 792 323 469 59.2% Underspend due to an over‐recovery on vacancy savings (£278k) combined with underspends on centrally held funds, printing & stationery and postages. Service Development 482 471 11 2.3% Outwith reporting criteria. Looked After Children 7,848 7,643 205 2.6% Underspend due to demand for fostering, kinship and adoption placements as well as on supporting young people leaving care. Also an over‐recovery on income from the Home Office for unaccompanied asylum seeking children. This is all partially offset by demand for external residential placements and payroll overspends in the children's houses. Child Protection 3,676 3,394 282 7.7% Underspend is as a result of demand for contact and welfare services as well as forecast underspends in the Area Teams on payroll costs, payments to other bodies, travel and subsistence. Children with a Disability 1,000 1,043 (43) (4.3%) Outwith reporting criteria. Criminal Justice 224 110 114 50.9% Forecast underspend is due to vacancies within the Criminal Justice team. Children and Families Central Management Costs 3,718 3,689 29 0.8% Outwith reporting criteria. Older People 44,405 46,255 (1,850) (4.2%) Forecast overspend reflects demand driven overspends within the care home placement budgets and homecare. High staff costs across HSCP residential units due to agency cover are also contributing. These are partially offset by staffing underspends across ACM teams and internal residential units. Physical Disability 3,539 3,661 (122) (3.4%) Overspend reflects higher than budgeted demand for Supported Living (£103k), Respite (£9k) and higher than budgeted equipment purchasing in the Integrated Equipment Service (£15k). These are offset slightly by a forecast underspends in the Residential Care and ACM Budgets. Learning Disability 19,411 18,811 600 3.1% Underspend reflects known demand for Residential Placements partially offset by overspends on Supported Living and Respite due to demand. Mental Health 3,599 3,667 (68) (1.9%) Forecast overspend reflects higher than budgeted demand for services in Supported Living (£91k) and Residential Placements (£104k). These are partially offset by an underspend on addictions service and assessment and care management due to vacancies. Adult Services Central Management Costs 2,395 2,019 376 15.7% The forecast underspend is mainly due to underspends on centrally held funds and vacancies. COUNCIL SERVICES TOTAL 91,089 91,086 3 0.0% HEALTH SERVICES: Explanation Health & Community Care Services 44,631 44,841 (210) (0.5%) The adverse forecast variance is due to the cost of agency staffing in nursing and GP out of hours services Acute & Complex Care Services 38,995 40,185 (1,190) (3.1%) The adverse forecast variance is due to the cost of agency staffing covering consultant and nursing vacancies and leave Children & Families Services 10,150 9,950 200 2.0% The favourable forecast variance is due to vacancies Commissioned Services ‐ NHS GG&C 76,565 76,565 0 0.0% The forecast variance is outwith reporting criteria. Commissioned Services ‐ Other 4,409 4,409 0 0.0% The forecast variance is outwith reporting criteria. Primary Care Services inc Dental 27,169 27,069 100 0.4% The forecast variance is due to reduced non‐pay spend. Other Primary Care Services 10,909 10,909 0 0.0% The forecast variance is outwith reporting criteria. Prescribing 21,970 24,470 (2,500) (11.4%) 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 2,189 2,189 0 0.0% The forecast variance is outwith reporting criteria. Lead Nurse 1,826 1,726 100 5.5% The favourable forecast variance is due to vacancies Management Service 1,593 1,543 50 3.1% The forecast variance is outwith reporting criteria. Planning & Performance 2,310 2,410 (100) (4.3%) The adverse forecast variance is due to unachieved savings targets. Budget Reserves 12,880 10,130 2,750 21.4% The favourable forecast variance is due to expected slippage on reserves and SG allocations. Income (1,838) (1,888) 50 (2.7%) Seasonal patient activity. Estates 11,219 11,319 (100) (0.9%) The adverse forecast variance is due to unachieved savings targets. HEALTH SERVICES TOTAL 264,977 265,827 (850) (0.3%) GRAND TOTAL 356,066 356,913 (847) (0.2%)