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Appendix 3a and b - Savings updated

Argyll and Bute Council · 21 September 2022
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 21 September 2022 and its agenda

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Page 1

Appendix 3a - 2022/23 Fully Complete Savings
Target
Ref. Savings Description £' 000
Social Work
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
2223-20 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
2122-10 Redirect Oban Integrated Care Funding  to pay for day responder service as in other areas 14
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
2,313
Total Savings Programme 6,002
% Fully Complete 39%

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Appendix 3b - LIVE SAVINGS PROGRAMME
Target Declared M4 Remaining RISK NOTES
Ref. Savings Description £' 000 £' 000 £' 000
Social Work
2122-11 Remove funding for all lunch clubs 29 29 Saving declared last year non-recurring, expect to declare in 2022/23
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. 145 145 Restructuring complete - no further action required
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 4 82 Expect to declare in 2022/23
1819-19b Review and Redesign of Learning Disability Services - Sleepovers and Technology Argyll Wide 50 50 Member of staff now appointed to progress
2223-16 Day Services - Internal Staffing 20 20 Restructuring complete - no further action required
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 unlikely to be realised due to changes in care & support needs
1819-33 Catering, Cleaning and other Ancillary Services 71 71 Catering related project - proposal to work with Argyll & Bute Council under development
TBC MH/LD/PD 225 225 Specific projects still to be developed
2223-17 Reduce the number of individual sleepovers and utilise TEC 78 78 Project underway - Expecting half of target to be declared in Q3
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
2122-36 Campbeltown hospital patients travel £30k 30 30 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
1819-44 Advanced Nurse Practitioners - Oban 14 14 Complete
1920-38b Lorne & Islands Hospital staffing 21 21 Complete
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
2122-32 1% general efficiency requirement across all hospital budgets 186 116 70 Carried forward saving - work on-going
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 70 519 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 56 414 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
March 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.
3,689 463 3,226
799 221 578 Saving perceived as low risk
2,399 242 2,157 Saving anticipated to be challenging to deliver in full within year
491 0 491 Saving now considered unlikely to be deliverable in 2022/23