Appendix 3a and b - Savings updated M6
Argyll and Bute Council · 23 November 2022
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 23 November 2022 and its agenda
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Appendix 3a - 2022/23 Fully Complete Savings Target Ref. Savings Description £' 000 Social Work 2021-7b Review of provisioning of day services and remodel considering options of greater third sector involvement aiming for 10% reduction in cost, several targets under this project have been amalgamated. 145 2021-32 Review housing support services and remove where not required for LD and PD clients - several targets under this project have been amalgamated. 86 2122-01 C &F Align business model for staffing for the 3 children's homes 6 2122-03 C&F - Do not replace independent chair of panel 2 2223-22 Older Adults - Remove current year underspend and anticipated unfunded growth from budget. 390 2223-23 Older Adults - Funding to cover care home contract uplift. 193 2223-11 MH - Reduction in value of 3rd Party Contract 10 2223-12 C&F Shift the balance of care across fostering, kinship and out of area residential placements. 100 2223-13 C&F - Redesign and review of Justice services to become fully funded by specific grant. 60 2223-15 C&F - Printer and Paper cost reduction 4 2223-16 Day Services - Internal Staffing 20 2223-20 LD&PD Transport costs - Day Services. 12 2223-21 Corp - Hold programme manager post vacant. 76 2223-10 Corp - Additional non-recurring vacancy savings to be removed from budget in year as they arise. 250 Health 1920-38b Lorne & Islands Hospital staffing 21 2122-10 Redirect Oban Integrated Care Funding to pay for day responder service as in other areas 14 1819-44 Advanced Nurse Practitioners - Oban 14 2122-36 Campbeltown hospital patients travel £30k 30 2223-3 MH - Review of specific high cost care packages. 115 2223-4 Ensure that funding for pay rate uplifts are passed through to Health Budgets 50 2223-24 Primary Care -Ensure national funding is fully utilised to cover eligible costs - Denistry. 22 2223-26 Public Health - Review of Living Well grants 18 2223-6 Estates - Reduce Energy Usage 60 2122-37 Campbeltown hospital catering 2 2223-2 Corp - Additional non-recurring vacancy savings to be removed from budget in year as they arise. 750 2223-25 Public Health -Reduce specific engagement budget which is now subsumed into mainstream PH activities 9 Declared on non-recurring basis at present: 1920-35 Bed reduction savings : Cowal Community Hospital 150 2021-29 Dunoon Gum clinic - underspend 20 2,629
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Appendix 3b - LIVE SAVINGS PROGRAMME Target Declared M6 Remaining RISK NOTES Ref. Savings Description £' 000 £' 000 £' 000 Social Work 2122-11 Remove funding for all lunch clubs 29 22 7 Saving declared last year non-recurring, expect to declare in 2022/23 1819-19b Review and Redesign of Learning Disability Services - Sleepovers and Technology Argyll Wide 50 31 19 Member of staff now appointed to progress 2122-15b End grants paid to link clubs, some of which are no longer providing services 2 2 2223-18 Increased utilisation of new housing capacity for service users. 31 31 Dunbeg project complete, full savings target expected in 2023/24 - no further action required. 1819-33 Catering, Cleaning and other Ancillary Services 71 71 Catering related project - proposal to work with Argyll & Bute Council under development 2223-17 Reduce the number of individual sleepovers and utilise TEC 78 18 60 Project underway - Expecting half of target to be declared in Q3 and full target in 2023/24, no further action required. TBC MH/LD/PD 225 225 Specific projects still to be developed 2223-19 Implement reviews of care packages to ensure these are equitable across the area and transition to older adult care packages were appropriate 80 80 Project delayed as staffing resource has been deployed to assist with severe service pressure and unmet need in Oban area 2122-02 Carry out hostel review to achieve best value in admin and catering 23 23 Changes to contracts to be phased in to reduce term time contracted weeks - expect saving to be delivered by August 2023 per SLT decision to phase contract changes. Health 2021-1 Mental Health redesign of dementia services 200 100 100 Declared on a non-recurring basis last year, structure to be confirmed and expect to declare in 22/23. 2122-35 Mid Argyll hospital removal of surplus budgets on hotel services £20k, comms £4.3k; GMS out of hours £2k; equipment £1.5k 4 4 Small balance to be declared 2122-33 centralise lab ordering £20k and theatre stock ordering £5 along with North Highland 20 20 Expect to declare in 22/23 2122-43 Oban Patient travel £25k; staff travel £10k 10 10 Expect to declare in 22/23 2122-60 Planning & Performance team - reduce budget for travel & printing £3k; Consultant Travel £10k 10 5 5 Expect to declare in 22/23 2122-38 Campbeltown hospital sundry underspends comms £6k; portering £1; pharmacy £6k; general management discretionary £5k, transport £2k; GMS out of hours £1.5k 13 13 Expect to declare in 22/23 2122-42 Islay: saving on local outreach clinics and accommodation through more remote clinics 15 15 Expect to declare in 22/23 2223-27 Children & families 130 112 18 Plan in place for balance of saving, low risk 2122-32 1% general efficiency requirement across all hospital budgets 186 170 16 Small balance to be declared 1819-32 Catering & cleaning review 20 20 Catering related project - proposal to work with Argyll & Bute Council under development 2021-2 Standardise procurement of food across all sites and expansion in conjunction with Council for early years 69 69 Catering related project - proposal to work with Argyll & Bute Council under development 2021-19 Redesign of hotel services to reflect reduction in inpatient numbers 99 99 Catering related project - proposal to work with Argyll & Bute Council under development 2021-23 Catering & domestic - spending below budgets 30 30 Catering related project - proposal to work with Argyll & Bute Council under development 2122-46 Helensburgh outreach clinics £8k; casualty payments £14k, 14 14 Negotiations underway - requires variation to GP contract 2122-30 Introduce more re-use of walking frames and improved procurement of musculo-skeletal supplies 20 20 Work underway to develop project 2021-4a Admin & clerical general productivity / efficiency enhancement via shift to digital working in 2020/21 and 2021/22 100 100 Project underway 2021-4b Right size admin budgets Mid Argyll and LIH 27 27 Project underway 2021-20 Centralised booking of medical records - reduction in admin costs 97 97 Project underway 2223-7 Transfer Switchboard Services to Highland Health Board from Glasgow. 54 54 Project underway but delay with transfer to NHS Highland 2223-1 Management and review of prescribing processes and products to ensure best value is being achieved. 589 169 420 Work on-going - saving challenging due to on-going supply chain disruption - £360k of savings identified to date. 1920-4 Review of Service Contracts 20 20 Specific savings to be identified as part of contract management processes 2223-5 Ensure that all staff are deployed to substantive roles within the HSCP staffing structure. 129 129 HR now providing support to progress. 2223-8 1% reduction in hospital budgets. 470 68 402 Approximately half of the target has been identified to date 2021-64 Review of Forensic Medical Examiner Costs - Bute & Cowal and Out of hours 50 50 Negotiations underway - dependent upon Dunoon contract 2223-9 Reduction in Forensic Service Contract costs. 20 20 Negotiations underway 2122-66 Savings from building rationalisation following increase in home working 72 72 Saving is subject to Cowal Community Hospital Capital Project - This has not yet been formally signed off and completion is now April 2023 at best 1920-22 Dunoon Medical Services (see also 2021-16) 100 100 As Above 2021-3 AHP - carry out workforce planning and establishment setting to find efficiencies in posts and realign services provided to match 86 86 Workforce Establishment Setting Underway - this is not now expected to result in a net saving 2021-16 Rationalisation of medical services for Dunoon (adds to 1920-22) 20 20 Subject to Dunoon GMS procurement and capital project 2122-04 Bring back urology services from NHS Greater Glasgow & Clyde and offer from Oban Hospital instead 110 110 Unable to progress as Medical Staffing in LIH is not stable at present. 3,373 695 2,678 669 440 229 Saving perceived as low risk 1,988 255 1,733 Saving anticipated to be challenging to deliver in full within year 716 0 716 Saving now considered unlikely to be deliverable in 2022/23