Revenue Budget 2023-24 - Financial Performance to 30 November 2023
North Ayrshire Council · 23 January 2024
Back to Cabinet — 23 January 2024 and its agenda
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NORTH AYRSHIRE COUNCIL 24 January 2024 Cabinet Title: Revenue Budget 2023/24 : Financial Performance to 30 November 2023 Purpose: To advise Cabinet of the financial performance for the Council at 30 November 2023. Recommendation: That Cabinet agrees to: (a) note the information and financial projections outlined in the report; (b) note the latest financial projection for the Health and Social Care Partnership highlighted at 2.6; and (c) approve the virements detailed in Appendix 7. 1. Executive Summary 1.1 The General Services Revenue Estimates for 2023/24 were approved by Council on 1 March 2023. The Housing Revenue Account (HRA) Revenue Budget for 2023/24 was approved by Council on 15 February 2023. 1.2 As part of the monitoring procedures to keep the Cabinet informed of the financial performance of the Council, financial performance reports are presented on a regular basis. This is the third report for 2023/24 and covers the period to the end of November 2023 (Period 8). Projections have been made to the year-end. 1.3 At Period 8 the General Fund is forecasting a net in-year overspend of £0.264m, (0.1%), after transferring resources to/from earmarked reserves. 1.4 The Housing Revenue Account is forecasting a net in-year underspend of (£5.442m), (9.4%). 1.5 At the end of October 2023, the Health and Social Care Partnership is projecting a year-end overspend of £3.858m, (1.2%), for 2023/24, in line with the previously reported position. The Council services element is reporting a projected overspend of £2.500m, which is an improvement of (£1.007m) from the previously reported overspend, and the Health services element is reporting a projected overspend of £1.358m, which is an increase of £1.006m over the same period.
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1.6 Ongoing risks to the reported position have been identified arising from inflationary pressures across services, linked to the higher than anticipated Consumer Price Index. 2. Background General Fund 2.1 The Council set a breakeven budget for 2023/24. In addition to the budget approved on 1 March 2023, earmarked funds of £26.697m were carried forward from 2022/23 for service expenditure in 2023/24 and are reflected in the figures within the 2023/24 financial performance reports as they are drawn down. 2.2 Current financial projections indicate that a net in-year overspend of £0.264m, (0.1%), net of transfers to/from reserves, is anticipated for the year to 31 March 2024. 2.3 Details of the current financial projections are summarised in the following table: 2.4 The reported Planned Income includes a number of adjustments to Scottish Government funding from that included in the approved budget, as detailed in the following table: Appendix No Annual Budget Projection to 31 March 2024 Projected Variance for year (Fav)/Adv Projected Variance @ Period 5 (Fav)/Adv Movement Note Service Expenditure £000's £000's £000's £000's £000's Chief Executives 1 20,340 19,656 (684) (268) (416) (i) Communities 2 184,711 185,531 820 390 430 (ii) Place 3 55,507 56,657 1,150 1,008 142 (iii) Other Corporate Services 4 21,699 20,646 (1,053) (706) (347) (iv) Sub Total 282,257 282,490 233 424 (191) Health and Social Care Partnership 8 122,233 122,233 - - - 2.6 Balance for Services 404,490 404,723 233 424 (191) Financing Charges 5 11,994 11,994 - - - Contribution to Loans Fund Reserve 5 5,627 5,627 - - - Total Planned Expenditure 422,111 422,344 233 424 (191) Planned Income Aggregate External Finance 5 (348,780) (348,780) - - - Council Tax 5 (65,397) (65,366) 31 - 31 Use of Earmarked Funds 5 (7,934) (7,934) - - - Total Planned Income (422,111) (422,080) 31 - 31 Net Expenditure/ (Income) - 264 264 424 (160)
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2.5 Commentary on Significant Movements from the Approved Budget The Council's overall financial forecast against the revised budget is a net overspend position. This includes a number of movements at a service level. Detailed explanations of the significant variances in service expenditure compared to the approved budgets are provided in appendices 1 to 5 to this report. A brief explanation of the significant movements for each service since Period 5 is outlined as follows: (i) Chief Executive’s – underspend of (£0.684m), an increase of (£0.416m) from the previously reported underspend The movement since Period 5 is primarily related to: • Increased income across services, (£0.273m); • Vacancy management within Democratic services, (£0.083m); and • Lower than forecast contract renewal costs within ICT, (£0.053m). (ii) Communities – overspend of £0.820m, an increase of £0.430m from the previously reported overspend The movement since Period 3 reflects updated cost pressures across services, including: • Additional employee costs associated with maintaining teacher numbers in line with Scottish Government policy and absence cover arrangements, £0.674m; and • Additional external residential day placements, £0.255m. These have been partly offset by: • Reduced employee costs, including savings from recent industrial action, staff turnover within Early Learning and Childcare and a targeted reduction in overtime and casual staff costs, (£0.243m); and • Reduced expenditure on food supplies linked to reduced commercial catering and school meal uptake levels, (£0.223m). Non Domestic Rates Specific Grants TOTAL AEF Planned Income £000's £000's £000's Revised Budget 31 August 2023 (286,578) (40,982) (19,930) (347,490) Movements: Ukrainian Resettlement (794) (794) Fostering & Kinship Care (486) (486) PEF Adjustment (10) (10) Revised Planned Income (287,858) (40,982) (19,940) (348,780) General Revenue Grant £000's
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Virements in relation to the recognition of additional Community Mental Health income and the realignment of Facilities Management budgets have been included within Appendix 7. (iii) Place – overspend of £1.150m, an increase of £0.142m from the previously reported overspend The movement since Period 5 reflects updated income and cost forecasts across services, including: • Additional property costs associated with RAAC surveys, £0.178m; • Additional vehicle repair and maintenance costs linked to inflationary pressures and the maximisation of asset lives, £0.090m; • Statutory Compliance costs for portable appliance testing, £0.082m; and • Increased costs for arrears write-offs within Other Housing, £0.061m. These have been partly offset by: • Vacancy management across services, (£0.112m); • Additional income from planning fees and internal recharges, (£0.109m); and • Lower than previously projected utility costs linked to reduced energy consumption, (£0.078m). Virements in relation to the recognition of additional income within Roads and Employability have been included within Appendix 7. (iv) Other Corporate Items – underspend of (£1.053m), an increase of (£0.347m) from the previously reported underspend The movement since Period 5 is primarily related to lower than anticipated drawdowns from centrally held inflationary cost provisions to support pressures within services, (£0.301m). Health and Social Care Partnership 2.6 A copy of the HSCP financial performance report as at the end of November 2023 is attached at Appendix 8. The report highlights the key challenges and variances for the Partnership. The key points for Cabinet to note are summarised as: • The projected outturn is a year-end overspend of £3.858m for 2023/24. • The projected overspend on the Council Services element is £2.500m, a reduction of (£1.007m), with a projected overspend on the Health Services element of £1.358m, an increase of £1.006m; • The projected overspend for 2023/24 will be funded by IJB reserve balances - £2m has been earmarked to support the 23/24 financial position and any overspend above this level will be met from the unearmarked balance. This will contain the financial risk within the IJB but is likely to reduce the unearmarked balance below the recommended level of 2%;
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• The most significant areas of overspend include residential placements for children, supplementary staff in wards and unplanned activities within the lead partnership for mental health. A substantial programme of work is being progressed by the HSCP in partnership with colleagues in Education and Housing, to develop a plan to reduce the number of Children’s Residential Placements. Further detail is included in the report at Appendix 8. The main areas of risk identified in the report include: • Current high levels of inflation which impact on costs incurred directly by the Partnership and on our partner providers; • High risk areas of low volume / high-cost services areas e.g. Children’s residential placements, Learning Disability care packages and complex care packages; • Progress with the work to develop set aside arrangements and the risk sharing arrangements agreed as part of this; • Ongoing implementation costs of the Scottish Government policy directives; • Lead / hosted service arrangements, including managing pressures and reporting this across the 3 IJBs; • The impact on Lead Partnership and acute services from decisions taken by other Ayrshire areas; • The use of supplementary staffing for enhanced observations across a number of service areas; • The use of high-cost agency staff to support frontline service delivery in areas where there are recruitment challenges; • Continuing risks associated with provider sustainability; • The Local Government pay award for 2023-24 has recently been settled and will be paid from December; the increase is in excess of the budgeted 3% and will have an adverse impact on the projected financial position unless sufficient additional funding is forthcoming; and. • The NHS Ayrshire and Arran Health Board financial deficit and the risks around further escalation in the national framework for financial escalation. North Ayrshire IJB have already discussed our position in relation to the request for payment for delayed discharges. These risks will be monitored during 2023-24 and any impact reported through the financial monitoring report. Risks 2.7 Significant risks to the reported position have been identified arising from inflationary pressures in relation to essential commodities, including food, and contractor costs. In June 2023, Cabinet agreed to earmark £0.870m from the 2022/23 underspend to address unbudgeted inflationary pressures arising from the ongoing cost of living crisis. Any further increases beyond current budget provision may impact on future service provision.
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Housing Revenue Account 2.8 The Housing Revenue Account budgeted for a breakeven position in 2023/24 and an in-year underspend of (£5.442m), (9.4%), is currently anticipated for the year to 31 March 2024. The projected position is summarised in the following table with further details provided in Appendix 6. 2.9 Commentary on Significant Movements from the Approved Budget A brief explanation of the significant movements from the previous forecasts is outlined as follows: (i) Property Costs – overspend of £1.592m, an increase from the previously reported overspend of £0.554m The movement is primarily related to increased expenditure on Planned & Cyclical Maintenance, £0.583m, and Other Property Costs, £0.312m, partly offset by reductions in Void Repairs, (£0.325m), and Responsive Repairs, (£0.061m). (ii) Third Party Payments – underspend of (£0.180m), an increase from the previously reported breakeven position The movement is related to an anticipated reduction in the contribution to the ASB team, (£0.180m). (iii) Income – underrecovery of £0.547m, a reduction from the previously reported underrecovery of (£0.423m) The movement is primarily related to increased income from other rents, (£0.065m), recharges, (£0.237m), and other income lines, (£0.122m). Annual Budget Projection to 31 March 2024 Projected Variance for year (Fav)/Adv Previous Variance @ Period 5 (Fav)/Adv Movement Note £000's £000's £000's £000's £000's Employee Costs 5,504 5,209 (295) (295) - Property Costs 22,718 24,310 1,592 1,038 554 (i) Supplies and Services 671 685 14 (16) 30 Transport and Plant Costs 28 28 - - - Administration Costs 1,892 1,899 7 16 (9) Third Party Payments 3,519 3,339 (180) - (180) (ii) Transfer Payments 172 172 - - - Other Expenditure 380 380 - - - Capital Financing 23,309 16,182 (7,127) (7,127) - Gross Expenditure 58,193 52,204 (5,989) (6,384) 395 Income (58,193) (57,646) 547 970 (423) (iii) Net Expenditure - (5,442) (5,442) (5,414) (28)
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3. Proposals 3.1 It is proposed that Cabinet agrees to: (a) note the information and financial projections outlined in the report; (b) note the latest financial projection for the Health and Social Care Partnership highlighted at 2.6; and (d) approve the virements detailed in Appendix 7. 4. Implications/Socio-economic Duty Financial 4.1 General Services The net projection for the year as at 30 November 2023 is a net overspend of £0.264m. Housing Revenue Account The net projection for the year as at 30 November 2023 is a net underspend of (£5.442m). Human Resources 4.2 None. Legal 4.3 None. Equality/Socio-economic 4.4 None. Environmental and Sustainability 4.5 None. Key Priorities 4.6 This report directly supports the Council Plan 2023 to 2028 by maximising financial flexibility to support the delivery of our priorities. Community Wealth Building 4.7 None.
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5. Consultation 5.1 Progress as outlined in this report has been approved by Executive Directors. Mark Boyd Head of Service (Finance) For further information please contact David Forbes, Senior Manager (Strategic Business Partner), on 01294 324551. Background Papers Revenue Budget 2023/24 : Financial Performance to 31 August 2023 – Cabinet 7 November 2023
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Appendix 1 CHIEF EXECUTIVES BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Objective Summary Annual Budget Projected Outturn Annual Variance Adverse or (Favourable) % Variance Note No £000 £000 £000 Chief Executive Chief Executive 145 149 4 3% Total for Chief Executive 145 149 4 3% Financial Services Change Programme 186 186 - 0% Audit, Fraud, Safety & Insurance 973 977 4 0% Corporate Procurement 974 940 (34) (3%) Financial Services 1,450 1,450 - 0% Revenues (500) (647) (147) 29% 1 Transformation 744 744 - 0% Total for Financial Services 3,827 3,650 (177) (5%) People & ICT Employee Services 900 900 - 0% HR & Organisational Development 1,072 1,084 12 1% ICT 5,313 5,065 (248) (5%) 2 Business Support 1,258 1,258 - 0% Customer Services 4,008 4,008 - 0% Total for People & ICT 12,551 12,315 (236) (2%) Democratic Services Legal & Licensing 496 370 (126) (25%) 3 Policy, Performance & Elections 468 318 (150) (32%) 4 Communications 469 473 4 1% Civil Contingencies 60 60 - 0% Committee Services 541 534 (7) (1%) Member Services 1,320 1,321 1 0% Ayrshire Support Service 410 421 11 3% Information Governance 53 45 (8) (15%) Total for Democratic Services 3,817 3,542 (275) (7%) Totals 20,340 19,656 (684) (3%)
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Appendix 1 Subjective Summary Annual Budget Projected Outturn Annual Variance Adverse or (Favourable) % Variance £000 £000 £000 Employee Costs 17,129 16,931 (198) (1%) Property Costs 68 85 17 25% Supplies and Services 3,365 3,124 (241) (7%) Transport and Plant Costs 23 22 (1) (4%) Administration Costs 1,357 1,350 (7) (1%) Other Agencies & Bodies 2,332 2,324 (8) (0%) Transfer Payments 852 852 - 0% Other Expenditure - - - - Capital Financing - - - - Gross Expenditure 25,126 24,688 (438) (2%) Income (4,786) (5,032) (246) 5% Net Expenditure 20,340 19,656 (684) (3%)
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Appendix 1a CHIEF EXECUTIVES BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Budget £000 Projected Variance £000 Variance as % of budget Section Note 1 Finance - Revenues Movement - There has been a £0.147m favourable movement from P5 due to a projected over recovery of income. (1,289) (147) 11% Income - There is a projected over recovery in Council Tax Statutory Additions of £0.077m and agreed revised Scottish Water income resulting in a £0.070m over recovery. (147) Note 2 People & ICT - ICT Movement - There has been a favourable movement of £0.053m from P5 due to lower than forecasted contract renewal costs. 2,248 (248) -11% Supplies & Services - £0.203m underspend in Software Licenses and support due to contracts ending and renewing at a lower cost. However it is anticipated that the cost of Office 365 licensing will increase by 20% in 2024/25 requiring this years underspend to be earmarked to cover some of this increase. £0.045m underspend in WAN due to the upgrade project although reinvestment of this budget is required to improve network bandwidths at a number of council sites. (248) Note 3 Democratic Services - Legal & Licensing Movement - There is a favourable movement of £0.116m primarily due to projected increase in Licence income mainly due to Short Term Lets of £0.124m. 1,156 (30) -3% Employee Costs - There is a projected underspend of £0.030m due to vacancy management. - 17 Property Costs - There is a projected overspend of £0.017m in Business Continuity Property Costs for NAC's contribution to the temporary mortuary at Prestwick Airport. (735) (113) Income - There is a projected over-recovery of £0.130m in Licensing income mainly due to new licence income for Short Term Lets, which is partally offset with an under recovery of £0.017m in Recovery of Legal Costs. (126) Democratic Services - Policy, Performance & Elections Movement - There is a favourable movement of £0.083m due to vacancy management 447 (153) -34% Employee Costs - There is a projected underspend of £0.153m due to vacancy management. 3 Other Minor Variances (150) Note 4
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Appendix 2 COMMUNITIES BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Objective Summary Annual Budget Projected Outturn Annual Variance Adverse or (Favourable) % Variance Note No £000 £000 £000 Early Years Education 20,780 20,253 (527) (3%) 1 Primary Education 49,373 48,979 (394) (1%) 2 Secondary Education 62,674 62,530 (144) (0%) 3 Additional Support Needs 13,752 14,573 821 6% 4 Education - Other 2,286 4,116 1,830 80% 5 Pupil Equity Fund 4,614 4,614 - 0% Facilities Management 17,796 17,030 (766) (4%) 6 Connected Communities 13,436 13,436 - 0% 7 Net Total 184,711 185,531 820 0% Subjective Summary Annual Budget Final Year End Outturn Annual Variance Adverse or (Favourable) % variance £000 £000 £000 Employee Costs - Teachers 96,400 98,430 2,030 2% Employee Costs - Non Teachers 57,469 55,773 (1,696) (3%) Property Costs 1,772 1,912 140 8% Supplies and Services 24,939 24,395 (544) (2%) Transport and Plant Costs 152 165 13 9% Administration Costs 590 597 7 1% Other Agencies & Bodies 14,198 15,014 816 6% Transfer Payments 580 580 - 0% Other Expenditure - - - Capital Financing 71 63 (8) (11%) Gross Expenditure 196,171 196,929 758 0% Income (11,460) (11,398) 62 (1%) Net Expenditure 184,711 185,531 820 0%
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Appendix 2a COMMUNITIES BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Budget £000 Projected Variance £000 Variance as % of budget Section Note 1 Early Years Education Movement : There has been a favourable movement of £0.051m compared to P5. This is primarily due to turnover and changes in updated Funded Provider phasing projections. 15,859 (245) -2% Employee Costs: Projected underspend of £0.506m in Early Years establishments due to turnover which is offset against a projected overall Early Years budget shortfall of £0.260m. 4,672 (250) -4% Third Party Payments: There are forecasted underspends of £0.372m in payments to funded providers and updated funded providers phasing and £0.028m in payments to other bodies for current registered children. There is a further intake of children in January which will confirm final numbers for this financial year. Payments to other Local Authorities is projected to be an overspend of £0.150m as more children are expected to take up Early Years places outwith North Ayrshire than children coming into NAC Early Years establishments.249 (32) -13% Other minor movements A reduction to the budget of £1.198m in 23/24 has necessitated a drawdown from Education earmarked funds pending permanent savings to be implemented for 24/25. Service redesign proposals are being developed. (527) Note 2 Primary Education Movement : There has been a favourable movement of £0.064m compared to P5 due to reduced employee costs 47,008 (446) -1% Employee Costs : projected underspend in non teaching costs across all Primary Schools. 2,179 61 3% Supplies & Services: projected overspend in the PPP unitary charge mainly due to NDR and utility increases (9) Other minor movements (394) Note 3 Secondary Education Movement : There has been a favourable movement of £0.067m compared to P5 due to reduced employee costs. 47,927 (262) -1% Employee Costs : projected underspend in non teaching costs across all Secondary Schools 14,590 115 1% Supplies & Services: projected overspend in the PPP unitary charge mainly due to NDR and utility increases. All PPP costs and income will be monitored over the coming months and the final outturn will be dependent on potential further penalty deductions to offset the overspend. 3 Other minor movements (144) Note 4 ASN Movement: There has been an unfavourable movement of £0.239m compared to P5. This is mainly due to an increase in placement costs. 12,019 (297) -2% Employee costs: Projected underspend of £0.257m in non teaching staff costs across all ASN school and bases provision and £0.040m forecasted underspend in teaching costs. The increased cost pressure for Classroom Assistants of £0.874m is managed this year by drawing down a temporary amount from earmarked funds. This position will be addressed as part of the ongoing discussion with the Scottish Government and as part of the 24/25 budget process. 355 (85) -24% There is a forecasted underspend of £0.085m on payments to Other Local Authorities due to a reduction in the number of NAC children accessing placements in their establishments. 1,003 113 11% There is a projected overspend of £0.113m on external day placements as a result of additional children requiring this level of support and an increase in rates from these establishments. 499 1,096 220% There is a projected overspend of £1.096m on external specialist residential placements. Currently there are 14 children in accommodation. Increased pressures on internal care settings as well as changing needs of children and young people have resulted in an increase in the need for external residential settings. Joint working is ongoing with HSCP to ensure that all options are fully explored to ensure that all options are considered to retain young people within their local community where possible. Where this is not possible, a forum has been set up to further discuss those young people who will require care and education provision to support them appropriately. Any future additional children who enter Residential Accommodation will increase the future projected overspend. - (6) Other minor movements. 821
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Appendix 2a Budget £000 Projected Variance £000 Variance as % of budget Section Note 5 Education Other Movement :There has been an unfavourable movement of £0.674m compared to P5. This is mainly due to a projected increase in teacher costs. 1,191 2,004 168% Employee costs: Additional costs associated with Teachers as a result of Scottish Government's requirement to maintain the same numbers as in the previous year and additionally increased absence rates. (1,798) (198) 11% Income: PPP insurance rebate £0.087m, PPP deductions of £0.089m in excess of budget, £0.022m salaries received from capital 24 Other minor movements. 1,830 Note 6 Facilities Management Movement: There has been a favourable movement of £0.301m compared to P5 mainly due to vacancy management and food savings within supplies and services. 13,285 (279) -2% Employee Costs: There is an underspend of £0.279m primarily due to recruitment challenges and a targeted reduction of overtime and casual costs. 6,403 (817) -13% Supplies and services: There is a saving of £0.063m in food due to reduced commercial catering and a further food savings of £0.301m due to reduced school meal uptake. In addition, there is an underspend within Early Years of £0.463m which has arisen due to a lower attendance rate than originally anticipated. 967 60 6% Property Costs: There is an overspend of £0.060m due to an increase in material and supplies costs. Savings anticipated due to a consultation and trial exercise with alternative products however, amount is unknown at present. 270 Income: There is an under-recovery in commercial catering income of £0.326m due to a reduction in commercial events and cost/income challenges within commercial venues, and an under-recovery of school meal income of £0.041m. This is partially offset by an over-recovery of cleaning and janitorial income of £0.098m. (766) Note 7 Connected Communities Movement: There has been no change since period 5. 8,106 (141) -2% Employee Costs: Underspends in Community Facilities, Libraries, Country Parks, Community Development and Arran Outdoor due to vacancy management. 498 80 16% Property Costs: £0.043m overspend in Libraries, £0.025m overspend in Country Parks on various property works and removal of trees affected by ash dieback and £0.011m overspend in Community Facilities on cleaning materials. 1,190 89 7% Supplies and Services: £0.033m overspend in Arts events costs, which is offset by an over-recovery of income, and small overspends in a number of budget lines across the service. (2,193) (34) 2% Income: £0.036m under recovery in Community Facilities as income has not returned to pre-covid levels and projected over-recovery of £0.037m in Arran Outdoor Education Centre and £0.026m in Arts. 6 Other minor movements. - General Due to the industrial action taken by various staff there is a underspend of approximately £200k across all sectors. This underspend is included in all non teaching employee budget lines across the entire Communities budget monitoring report. A further £20k of underspend was made against grant funded services SEF and PEF.
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Appendix 3 PLACE BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Objective Summary Annual Budget Projected Outturn Annual Variance Adverse or (Favourable) % Variance Note No £000 £000 £000 Directorate and Support 194 194 - 0% Housing and Public Protection Building Services (2,542) (2,542) - 0% 1 Property Governance (7) (7) - 0% Planning Services 322 209 (113) (35%) 2 Protective Services 1,736 1,641 (95) (5%) 3 Other Housing 2,723 2,682 (41) (2%) 4 Total for Housing and Public Protection 2,232 1,983 (249) (11%) Neighbourhood Services Roads 8,443 8,443 - 0% Streetscene 5,245 5,245 - 0% Waste Resources 9,626 10,247 621 6% 5 Municipalisation Advertising (123) (83) 40 (33%) Total for Neighbourhood Services 23,191 23,852 661 3% Economic Development, Growth and Investment Economic Policy 229 192 (37) (16%) Employability & Skills 2,298 2,299 1 0% Regeneration 1,270 1,270 - 0% Business 1,011 1,006 (5) (0%) Growth & Investment 251 251 - 0% Total for Economic Development, Growth and Investment 5,059 5,018 (41) (1%) Sustainability, Transport and Corporate Property Property Management & Investment 1,565 1,586 21 1% 6 Housing Assets & Investment (1) (1) - 0% Property Maintenance 3,494 3,790 296 8% 7 Property Running Costs 4,675 4,790 115 2% 8 Energy and Sustainability 5,172 5,197 25 0% 9 Internal Transport 9,926 10,248 322 3% 10 Total for Sustainability, Transport and Corporate Property 24,831 25,610 779 3% Net Total 55,507 56,657 1,150 2%
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Appendix 3 Subjective Summary Annual Budget Projected Year End Outturn Annual Variance Adverse or (Favourable) % variance £000 £000 £000 Employee Costs 48,339 48,642 303 1% Property Costs 21,421 21,865 444 2% Supplies and Services 10,261 10,418 157 2% Transport and Plant Costs 9,637 10,277 640 7% Administration Costs 808 813 5 1% Other Agencies & Bodies 21,456 21,423 (33) (0%) Transfer Payments - - - 0% Other Expenditure 182 226 44 24% Capital Financing - - - Gross Expenditure 112,104 113,664 1,560 1% Income (56,597) (57,007) (410) 1% Net Expenditure 55,507 56,657 1,150 2%
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Appendix 3a PLACE BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Budget £000 Projected Variance £000 Variance as % of budget Section Note 1 Building Services Movement: There has been no movement since P5 however the service are currently managing significant financial challenges to achieve a break-even position. 5,345 34 1% Supplies & Services: An overspend of £0.034m in supplies and services. This is due to an overspend of £0.015m in employee clothing and £0.012m in tools and implements. 579 177 31% Transport costs: An overspend of £0.177m in transport costs. This is due to an overspend of £0.065m in scaffolding, £0.064m in skip hire costs and £0.048m in other transport costs. 2,833 231 8% Third Party Payments: An overspend of £0.231m in third party payments is largely in relation to an increase in the volume of void and damp work. (21,515) (491) 2% Income: There is a projected over recovery in income of £0.491m largely in relation to the volume and scope of void works and other increased costs. 49 Other minor movements - Note 2 Planning Services Movement: There has been a favourable movement of £0.092m since P5 mainly due to increased planning fee income. 775 (25) (3%) Employee Costs: projected underspend of £0.025m due to vacancy management. (609) (88) 14% Income: Forecasted over recovery of £0.088m due to additional planning fee application Income. (113) Note 3 Protective Services Movement: There has been a favourable movement of £0.095m since P5 which is primarily due to a larger recharge to HRA and vacancy management within the Out of Hours team. 2,494 (57) (2%) Employee Costs: projected underspend of £0.057m due to vacancy management. 102 25 25% Supplies & Services: An overspend of £0.025m due to essential software upgrade requirements within Building Standards. (1,314) (69) 5% Income: There is a projected over recovery in income of £0.069m most of which is in relation to the HRA recharge for CCTV. 6 Other minor movements (95) Note 4 Other Housing Movement: There has been an unfavourable movement of £0.097m since P5 which is primarily due to a £0.052m reduction in forecasted rents for Temporary Furnished Accommodation and a projected overspend of £0.061m in arrears write offs. This is partially offset by an increase in forecasted employee costs underspend of £0.037m. 3,839 (126) (3%) Employee Costs: projected underspend of £0.126m due to vacancy management. This underspend includes vacant posts being held due to the Housing Service review, new employees taking up posts at the bottom of the pay scale and a number of staff not part of the Local Government Pension Scheme. 104 61 59% Other Expenditure: there is a projected overspend of £0.061m in arrears write offs. (5,862) (14) 0% Income: projected over recovery of £0.029m due to demand for Temporary Furnished Accommodation, partially offset by a forecasted reduction in HRA contribution of £0.011m. 38 Other minor movements (41)
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Appendix 3a Budget £000 Projected Variance £000 Variance as % of budget Section Note 5 Waste Services Movement : There has been no significant movement since P5 5,132 730 14% Employee Costs: The overspend includes temporary additional resources required to deal with new builds and to cover a significant, and challenging, sickness absence rate. The statutory nature of the service requires additional resources to cover unforeseen absences. A robust absence monitoring process is in place and an overall review of the Waste service in light of legislative changes and current service demands is ongoing. This will also take account of waste compositional analysis. 572 108 19% Supplies & Services: Forecast overspend on Compactors £0.047m, Tools and Implements £0.036m and Trade effluent £0.023m. 160 223 139% Transport Costs: Additional vehicles are temporarily in place to deal with pressures from new builds and seasonal demands in Garden Waste, however a reduction of 3 vehicles has been implemented since 1st October 2023. 6,425 (48) (1%) Third Party Payments: An underspend of £0.048m is largely in relation to the Clyde Valley contract. (3,110) (357) 11% Income: Additional income from the renewal of kerbside recyclate contracts of £0.324m. (35) Other minor movements 621 Note 6 Property Management and Investment Movement : There has been no movement since P5. 2,582 (29) (1%) Employee Costs: A projected underspend of £0.029m due to vacancy management. 139 (69) (50%) Supplies & Services: Projected underspend due to reduction in internal recharges. (1,263) 119 (9%) Income: There is a projected under-recovery in fee income of £0.119m. 21 Note 7 Property Maintenance Costs Movement : There has been adverse movement of £0.271m since P5 due to higher costs and unavoidable expenditure on RAAC surveys. 6,855 296 4% Property costs: There is a projected £0.178m overspend due to ongoing expenditure with RAAC surveys. In addition, there is an £0.082m overspend in Statutory Compliance due to increased costs in relation to portable appliance testing and £0.026m overspend in Largs Campus Unitary Charges due to contract uplift greater than budgeted. 296 Note 8 Property Running Costs Movement : There has been no significant movement since P5 6,349 112 2% Property Costs: There is a projected £0.112m overspend due to associated costs for community hubs within SHUs. Discussions are ongoing between HSPC housing and communities to resolve the matter. 3 Other minor movements 115 Note 9 Energy and Sustainability Movement : There has been a favourable movement of £0.078m since P5 due to decreased projected utility costs as a result of reduced consumption. 8,262 25 0% Property Costs: Due to the current energy crisis and after drawing down the maximum available £3.048m from contingencies and earmarked funds there is a projected overspend in property costs of £0.025m due to increased utility cost charges. A number of workstreams are ongoing to reduce consumption to reduce the above tariff related increases and as part of our overall sustainability strategy. 25 Note 10 Internal Transport Movement - There has been a net adverse movement of £0.015m since P5. This is due to an increase in projected overspend in Repairs and Maintenance of £0.090m, which has been primarily offset by favourable movements in projected Employee costs 1,796 (46) (3%) Employee Costs: Projected underspend of £0.046m due to vacancy management. 4,441 160 4% Transport Provision Costs: Projected overspend of £0.160m due to an increase in contractors operating and running costs which has resulted in higher contract pricing. 476 73 15% External Hires: Projected overspend of £0.073m which is mainly due to additional hire of vehicles, due to pending delivery of replacement vehicles. 1,117 160 14% Repairs & Maintenance: Projected overspend of £0.160m in repairs and maintenance which is due to price increases and maximising the life of assets due to replacement vehicles lead times. (25) Other minor movements 322
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Appendix 4 OTHER CORPORATE ITEMS BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Objective Summary Annual Budget Projected Outturn Annual Variance Adverse or (Favourable) % Variance Note No £000 £000 £000 Strathclyde Passenger Transport 2,257 2,234 (23) (1%) SPT Concessionary Fares 286 291 5 2% Ayrshire Joint Valuation Board 965 932 (33) (3%) 3,508 3,457 (51) (1%) 1 Other Corporate Costs Pension Costs 1,895 1,895 - 0% Central Telephones 350 350 - 0% Other Corporate Items (incl Transformation Costs, Bad Debt Provision, External Audit fees and other centrally held funding.) 13,359 12,447 (912) (7%) 2 Housing Benefits 2,587 2,497 (90) -3% 3 21,699 20,646 (1,053) (5%)
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Appendix 4a OTHER CORPORATE ITEMS BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Budget £000 Projected Variance £000 Variance as % of budget Section Note 1 Joint Boards There has been no signficant movement since Period 5 3,508 (51) -1% Projected underspend of £0.051m due confirmation of annual requisitions and applicable refunds. (51) Note 2 Other Corporate Items There has been a favourable movement of £0.340m since Period 5 primarily due to a revised drawdown of centrally held inflation provision to support pressures within services. 13,359 (912) -7% The projected underspend is primarily related to centrally held inflationary cost provisions, which are being applied to offset pressures reported across other services, and additional income from employee benefit schemes. The impact of inflation will continue to be monitored throughout the year. (912) Note 3 Housing Benefit There has been no signficant movement since Period 5 2,587 (90) -3% Projected underspend of £0.090m due to the provision of Housing Benefits and overpayment recovery. (90)
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Appendix 5 MISCELLANEOUS ITEMS BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Objective Summary Annual Budget Projected Outturn Annual Variance Adverse or (Favourable) % variance Note No £000 £000 £000 Financing Charges 12,810 12,810 - - Contribution to Loans Fund Reserve 4,811 4,811 - - Scottish Government Funding (348,780) (348,780) - - Council Tax (65,397) (65,366) 31 (0%) 1 Use of Earmarked Funds (7,934) (7,934) - - Net Total (404,490) (404,459) 31 (0%) There has been a significant increase in the value of CTR claims received to date, £0.491m. This has been offset by reduced bad debt provision and the utilisaton of centrally held cost of living provisions. Note 1 Council Tax
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Appendix 6 HOUSING REVENUE ACCOUNT BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Annual Budget Projected Outturn Annual Variance Adverse or (Favourable) % Variance Note No £ £ £ Employee Costs 5,504 5,209 (295) (5%) 1 Property Costs Responsive Repairs 7,189 7,111 (78) (1%) Void Repairs 3,577 4,260 683 19% Planned and Cyclical Maintenance 4,885 5,454 569 12% Aids and Adaptions 1,617 1,663 46 3% Other property costs 5,450 5,822 372 7% Total for Property Costs 22,718 24,310 1,592 7% 2 Supplies & Services 671 685 14 2% Transport Costs 28 28 - 0% Administration Costs 1,892 1,899 7 0% Third Party Payments 3,519 3,339 (180) (5%) 3 Transfer Payments 172 172 - 0% Other Expenditure 380 380 - 0% Capital Financing Costs 23,309 16,182 (7,127) (31%) 4 Gross Expenditure 58,193 52,204 (5,989) (10%) Income Council House Rents (56,803) (55,845) 958 (2%) Other Rents (332) (397) (65) 20% Recharges (828) (1,065) (237) 29% Other Income (230) (339) (109) 47% Total Income (58,193) (57,646) 547 (1%) 5 Net Expenditure - (5,442) (5,442)
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Appendix 6a HRA BUDGETARY CONTROL 2023/24 REPORT FOR THE 8 MONTHS TO 30 November 2023 Budget £000 Variance £000 Variance as % of budget Note 1 5,504 (295) -5% (295) Note 2 22,718 1,592 7% 1,592 Note 3 3,519 (180) -5% (180) Note 3 23,309 (7,127) -31% (7,127) Note 4 (58,193) 547 -1% 547 B/fwd from 2021/22 Transfer to / from Reserves Use of Earmarked sums Earmarking of in year surplus Funding of Capital Projects Projected Balance at 31/03/23 £m £m £m £m £m £m 4.709 - - 5.442 (2.648) 7.503 1.500 - - - - 1.500 5.000 - - - (1.417) 3.583 0.198 - - - - 0.198 0.123 - - - - 0.123 0.781 - - - - 0.781 0.416 - - - - 0.416 0.052 - - - - 0.052 0.636 - - - - 0.636 0.270 - - - - 0.270 13.685 - - 5.442 (4.065) 15.062 HRA reserves and balances Capital Financing Costs There is a projected underspend in capital financing costs of £7.127m due to lower than anticipated loan charges. This is due to the profiling within the HRA Capital budget and the continued under borrowed position as the council utilises internal funds in line with the Treasury Management and Investment Strategy. The underspend will be reflected in the Business Plan which is currently being reviewed. Movement: There has been no movement since Period 5. Property Costs Movement - there has been an adverse movement of £0.555m since Period 5. This is due to an adverse movement of £0.583m in Planned and Cyclical Maintenance, £0.046m in Aids & Adaptations and £0.312m in other property costs. This has been partially offset by a favourable movement of £0.061m in Responsive Repairs and £0.325m in Void Repairs. A projected overspend of £1.593m in Property Costs. This is due to a projected overspend of £0.569m in Planned and Cyclical Maintenance, £0.046m in Aids and Adaptations, £0.682m in Void Repairs as a result of an increase in the volume and scope of the works and £0.373m in other property costs. This is partially offset by a projected underspend of £0.077m in Responsive Repairs. Income Movement - There has been a favourable movement of £0.424m since Period 5. This is due to an increase in other rents of £0.065m, £0.237m in recharges and £0.122m in other income. There is a projected under recovery of income of £0.546m. Rental Income is projected to be under recovered by £0.958m which is currently being investigated however, it is understood to be mainly as a result of protracted and long term voids. This is partially offset by an over recovery of £0.065m other rents; £0.237m in recharges, some of which relates to increased costs; and £0.110m in other income. Third Party Payments Movement - there has been a favourable movement of £0.180m in the ASB contribution since Period 5. A projected underspend of £0.180m in third party payments due to an anticipated reduction in the ASB contribution. Section Employee costs An underspend in employee costs of £0.295m. This is due to vacancy management. Movement - there has been no movement since Period 5. Council House Building Fund Welfare Reform Contingency Balance Infrastructure Improvements Major Refurbishment Works Tenant led balance Electrical Testing Sustainability Fund Software Licences Voids - non programmed works
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Appendix 7 1) Budget Virements Place Roads - Third Party Payments T 1.078 Roads - Income T -1.078 Employability - Third Party Payments T 0.117 Employability - Employee Costs T 0.042 Employability - Grant Income T -0.159 0.000 Facilities Management - Income P 0.156 Facilities Management - Supplies & Services P -0.045 Facilities Management - Employee Costs P -0.111 Community Mental Health - Employee Costs T 0.166 Community Mental Health - Supplies & Services T 0.004 Community Mental Health - Administration Costs T 0.003 Community Mental Health - Third Party Payments T 0.086 Community Mental Health - Grant Income T -0.259 0.000 0.000 Communities Budget Management - 30 November 2023 Virement/Budget Adjustment Requests 2023/24 Perm (P) / Temp(T) Virement £m Directorate Total £m
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Appendix 8 Integration Joint Board 14th December 2023 Subject : 2023-24 – Month 7 Financial Performance Purpose : To provide an overview of the IJB’s financial performance as at month 7 (October). Recommendation : It is recommended that the IJB: (a) notes the overall integrated financial performance report for the financial year 2023-24 and the current overall projected year- end overspend of £3.858m; (b) notes the progress with delivery of agreed savings; (c) notes the actions which are being taken to progress financial recovery; (d) notes the remaining financial risks for 2023-24; and (e) approves the budget reductions which are detailed at paragraph 2.10. Direction Required to Council, Health Board or Both Direction to :- 1. No Direction Required X 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership MH Mental Health CAMHS Child & Adolescent Mental Health Services BRAG Blue, Red, Amber, Green UNPACS UNPACS, (UNPlanned Activities) – Extra Contractual Referrals NRAC NHS Resource Allocation Committee GAE Grant Aided Expenditure PAC Performance and Audit Committee MARAC Multi Agency Risk Assessment Conference 1. EXECUTIVE SUMMARY 1.1 The report provides an overview of the financial position for the Partnership and outlines the projected year-end outturn position informed by the projected expenditure and income commitments; these have been prepared in conjunction with relevant budget holders and services. It should be noted that, although this report
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Appendix 8 refers to the position at the end of October, further work is undertaken following the month end to finalise projections, therefore the projected outturn position is as current and up to date as can practicably be reported. 1.2 The projected outturn is a year-end overspend of £3.858m (1.2%) for 2023-24 which is a favourable movement of £0.128m from month 6. This includes the financial impact of the NHS pay award, the impact of the Council pay award is still being finalised. 1.3 From the core projections, overall, the main areas of pressure are residential placements for children, supplementary staff in wards and Unplanned Activities (UnPACs) within the lead partnership for mental health. 2. CURRENT POSITION 2.1 The report includes an overview of the financial position including commitments against the available resource, explanations for the main budget variances and an update on progress in terms of savings delivery. 2.2 FINANCIAL PERFORMANCE – AT MONTH 7 At month 7 against the full-year budget of £311.735m there is a projected year-end overspend of £3.858m (1.2%). The Integration Scheme outlines that there is an expectation that the IJB takes account of the totality of resources available to balance the budget in year. Following this approach, an integrated view of the financial position should be taken, however it is useful to note that this overall position consists of a projected overspend of £2.500m (£0.079m favourable) in social care services and a projected overspend of £1.358m (£0.049m favourable) in health services. Appendix A provides the financial overview of the Partnership position. The sections that follow outline the significant variances in service expenditure compared to the approved budgets. The projections for some areas will be subject to fluctuations as they depend on recruitment plans for new funding and also the capacity of providers to take on work. 2.3 Health and Community Care Services Against the full-year budget of £89.893m there is a projected overspend of £0.382m (0.4%) and the main variances are: a) Care home placements including respite placements (net position after service user contributions and charging order income) are projected to underspend by £0.488m (£0.017m favourable movement).
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Appendix 8 The budgeted number of permanent placements is 780 and at month 7 there are 786 placements. The projection assumes that the current number of placements will continue to the end of the year. Within the projection there is an assumption that recent placements which do not have a completed financial assessment (often due to the pressure to discharge from hospital) are costed with 50% of the cases at the current average cost of a placement and 50% at the gross or interim funded rate. It is likely that there will still be some cases being gross or interim funded at the year end. Their actual cost will not be known until the financial assessment is completed and this can impact on the final position. The level of income recovered from charging orders is included in the projection above and is assumed to be £0.204m over recovered (£0.070m favourable) based on the income received to date. This income is not easy to project as it depends on the length of the legal process and time taken to sell the property that the charging order is registered to. b) Interim care beds are projected to underspend by £0.250m (£0.250m favourable) based on the usage to date and projected usage until the year end. c) Care at home (in house and purchased) is projected to be £0.418m underspent (£0.064m adverse). The position includes an underspend in in-house services of £0.919m (£0.080m adverse) as there are vacant posts, but some of the current capacity is being met by existing staff working additional hours and casual staff. Bank staff are being offered contracts and additional staff are being recruited which will replace the need for existing staff to work additional hours. This is partly offset by an overspend in purchased services of £0.500m (£0.017m favourable) as the budget was reduced to reflect the additional costs of bringing some services in-house after the provider withdrew from the contract. d) Reablement services are projected to be £0.125m (£0.002m favourable) underspent due to vacancies. e) Care at Home Charging Income is projected to under recover by £0.060m (£0.011m favourable) due to an ongoing shift towards personal care which is non chargeable. f) Physical Disability Services - projected underspend of £0.250m (£0.033m favourable) in community care packages, £0.449m underspend (£0.056m favourable) in direct payments and £0.458m overspend (£0.018m favourable) for residential placements. There is also an under-recovery of income of £0.133m (no movement). g) Anam Cara is projected to overspend by £0.073m (£0.004m adverse) due to covering vacancies and sickness absence (£0.017m) and under-recovered income (£0.056m).
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Appendix 8 h) Integrated Island Services is projected to be £0.308m overspent (£0.041m adverse movement). There is an overspend at Montrose House of £0.241m (adverse movement of £0.046m) which relates to employee costs (the net cost of agency staff versus vacancies), supplies and cleaning costs and an under- recovery of charging income. There is also an overspend of £0.050m due to Band 6 nurses receiving back-dated recruitment and retention premium this financial year. Arran medical services are projecting to overspend by £0.032m and the remaining projected overspend is due to supplies costs increasing. The overspends are partially offset by a projected underspend in care at home costs of £0.086m (£0.049m adverse movement). There are staffing vacancies which are included within the payroll turnover savings figures below which offset the use of agency and bank staff. i) District Nursing is projected to overspend by £0.195m (£0.041m favourable movement) due to an overspend on bank nursing costs and supplies. The favourable movement is due to a reduction in the use of bank staff as posts have been recruited to. j) Rehab wards are projected to overspend by £0.202m which is an £0.018m favourable movement (Redburn ward £0.213m overspent and Douglas Grant £0.011m underspent). The overspend is due to cover costs for vacancies as well as supplementary staffing for patients who require one to one support. k) Wards 1 and 2 are projected to overspend by £0.925m (£0.075m adverse movement) due to increased use of supplementary staffing. l) Cumbrae Lodge Continuing Care beds are projected to underspend by £0.150m (no change) due to a reduced charge to reflect the reduction in beds used during the transition to the new service. 2.4 Mental Health Services Against the full-year budget of £103.504m there is a projected overspend of £1.618m (1.6%) prior to the reallocation of the Lead Partnership overspend to East and South HSCP. This also excludes any potential variance on the Mental Health Recovery and Renewal Funding where any underspend will be earmarked at the year-end for use in 2024-25. The main variances are: a) Learning Disabilities are projected to overspend by £0.670m (£0.010m adverse) and the main variances are: • Care Packages (including residential and direct payments) - projected underspend of £0.109m in community care packages (£0.136m adverse), projected overspend of £0.384m in direct payments (£0.036m adverse) and £0.446m for residential placements (£0.114m favourable).
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Appendix 8 • Trindlemoss non-employee costs are projected to underspend by £0.075m. b) Community Mental Health services are projected to underspend by £0.245m (£0.021m adverse movement) which is mainly due to an underspend of £0.474m in community packages (including direct payments) and an overspend in residential placements of £0.244m. c) The Lead Partnership for Mental Health is projecting to be £1.188m overspent (£0.220m favourable movement) and the main variances are as follows: • A projected overspend in Adult Inpatients of £0.520m (£0.033m favourable movement) due to overspends in supplementary staff for enhanced observations, staff cover due to sickness (inc. covid outbreak) and reduced bed sale income. • The UNPACS (Unplanned Activities) budget is projected to overspend by £1.410m (£0.003m adverse movement) based on current number of placements and enhanced costs remaining until the year end. The adverse movement is due to additional costs for enhanced observations. These placements are for individuals with very specific needs that require a higher level of security and/or care from a staff group with a particular skill set/competence. There are no local NHS secure facilities for women, people with a learning disability or people with neurodevelopmental disorder. This can necessitate an UNPACs placement with a specialist provider which can be out-of-area. The nature of mental health UNPACs spend is that it is almost exclusively on medium or long term complex secure residential placements which are very expensive so a small increase in placements can have a high budgetary impact. Due to the complexity and risk involved, transitions between units or levels of security can take many months. Applications to approve a placement are made to the Associate Medical Director for Mental Health who needs to be satisfied that the placement is appropriate and unavoidable prior to this being agreed. • A projected overspend in MH Pharmacy of £0.084m (£0.030m favourable) due to an increase in substitute prescribing costs. The favourable movement is due to revising the projection to reflect updated information from the new prescribing system. • Learning Disability Services are projected to overspend by £0.322m (no movement). There is a high usage of supplementary staffing due to backfill for sickness, increased and sustained enhanced observations and vacancies. The enhanced observations are reviewed on a daily basis. • Elderly Inpatients are projected to overspend by £0.173m (£0.008m favourable) due to the use of supplementary staffing. • The Innovation Fund is projected to underspend by £0.232m (£0.043m adverse) due to slippage within some of the projects and not all of the funding was allocated.
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Appendix 8 • Addictions in patients are projected to overspend by £0.003m (£0.011m favourable) due to the use of supplementary staffing. • The Directorate cost centre is projected to overspend by £0.095m mainly due and overspend of £0.049m on supplies and £0.012m of legal fees. • The turnover target for vacancy savings for the Lead Partnership is held within the Lead Partnership as this is a Pan-Ayrshire target. There is a projected over-recovery of the vacancy savings target of £1.254m (£0.191m favourable) in 2023-24, further information is included in the table below: The current projection to the year-end is informed by the recruitment plans and the confidence in recruitment success and realistic timescales for filling individual vacancies. The areas contributing to this vacancy savings position are noted below: • Adult Community MH £0.033m • CAMHS £0.592m • Mental Health Admin £0.330m • Psychiatry £0.377m • Psychology £0.735m • Associate Nurse Director £0.060m Vacancy Savings Target (£0.873m) Projected to March 2024 £2.127m Over/(Under) Achievement £1.254m 2.5 Children and Justice Services Children’s Services Against the full-year budget of £39.560m there is a projected overspend of £5.269m (13.3%) (£0.253m adverse) and the main variances are: a) Care Experienced Children and Young People is projected to overspend by £4.928m (£0.188m adverse). The main areas within this are noted below: • Children’s residential placements are projected to overspend by £5.734m (£0.184m adverse). We started 2023/24 with 32 external placements and there are currently 35 placements (month 6 was 34 placements) which are assumed to continue until the end of the year. Within the £5.734m there is £0.145m relating to enhanced costs for two placements. One placement has also moved from being 50/50 funded with Education to 100% HSCP as the placement no longer has an education element. There are a number of factors leading to this challenging position:
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Appendix 8 • We have 32 places available in our internal children’s houses, due to demand these have been operating at 100%+ occupancy for some time, leading to increased use of external placements where residential care is required. • The requirement to support Unaccompanied Asylum-Seeking Children (UASC) under the National Transfer Scheme and to support trafficked young people who have been identified in North Ayrshire. • A number of young people in residential care have requested Continuing Care, whereby a young person can remain in their placement until age 21. • Where appropriate young people are placed to meet their educational needs, the cost of Residential School Placements in the most cases is shared 50/50 with Education services. Children’s Services are continuing to work with other services including Education and Housing to address the challenges. A change programme is being developed to respond to the pressures of residential care, further detail of the scope and plan around this work will be presented to a future IJB. • Looked After and Accommodated Children (fostering, adoption, kinship etc) is projected to be £0.486m underspent (£0.013m favourable); this is based on the current number of placements and reflects additional monies received to support the uplift in rates for fostering and kinship placements (16+year olds) and the costs associated with this. b) Children with disabilities – residential placements are projected to overspend by £0.305m (£0.097m favourable). This is based on 9 current placements and 1 further placement which is expected to commence during December. Direct payments are projected to underspend by £0.240m (£0.051m favourable). Community packages are projected to underspend by £0.119m (£0.015m favourable) based on 73 current number of packages and assumptions around further packages until the year end. c) Residential respite – placements are projected to overspend by £0.049m (no movement). These short-term placements are used to prevent an admission to full residential care. There is one short term placement, but this could vary throughout the year and have an impact on the projection. d) Head of Service – is projected to overspend by £0.306m (£0.006m adverse). The overspend is mainly due to the planned saving of £0.233m in relation to the staff reconfiguration in the children’s houses which is not expected to be fully achieved in 23-24. There are also projected costs of £0.092m for the JII (Joint Investigative Interview) project which is not funded.
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Appendix 8 e) Intervention Services – are projected to underspend by £0.020m (£0.068m adverse). The adverse movement is due to posts being filled sooner than planned and increased transport costs. f) Justice Services – is projected as being spent in full, however, there is a risk the service could go into an overspend if there is no additional grant funding to mitigate the potential impact of the 23/24 pay award. 2.6 ALLIED HEALTH PROFESSIONALS (AHP) The non-employee costs element of the AHP services are projected to be on-line. All underspends in employee costs have been taken as payroll turnover. 2.7 CHIEF SOCIAL WORK OFFICER There is a projected underspend of £0.465m (£0.081m favourable) mainly due to a projected underspend in the Carers Strategy funding. 2.8 MANAGEMENT AND SUPPORT Management and Support Services are projected to underspend by £1.703m (£0.053m adverse) and the main areas of underspend are: • An over-recovery of payroll turnover of £0.723m for social care services and an over-recovery of payroll turnover of £0.306m for health services as outlined in the table below. This is an adverse movement of £0.111m on the health services element. • There is projected slippage on the LD and MH transition funding of £0.694m (£0.141m favourable) due to delays in children transitioning into adult services. The turnover targets and projected achievement for the financial year for Health and Social Care services outwith the Lead Partnership is noted below: The position in the table above reflects the assumption in the current financial projections. For social care, a total of £1.937m (64.3% of annual target) has been achieved to date. Social Care Health Services Vacancy Savings Target (3.014m) (1.433m) Projected to March 2024 3.737m 1.739m Over/(Under) Achievement 0.723m 0.306m
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Appendix 8 The health vacancy projection to the year-end is based on the month 7 position and is informed by the recruitment plans and confidence in recruitment to posts for the remainder of the year. The areas contributing to the health and social care vacancy savings are spread across a wide range of services with vacancy savings being achieved in most areas. The main areas at month 7 are: • Children and Families £0.600m • Learning Disability £0.047m • Management and Support £0.196m • Community Care Service Delivery £0.187m • Rehab and Reablement £0.174m • Locality Services £0.205m • Integrated Island Services £0.220m • Community Mental Health £0.073m There have been no intentional plans to pause or delay recruitment and services have actively continued to recruit; in some service areas it has proven difficult to fill posts. The turnover target for the North Lead Partnership for Mental Health services is detailed within the Lead Partnership information at section 2.4. 2.9 Savings Progress a) The approved 2023-24 budget included £4.963m of savings. BRAG Status Position at Budget Approval £m Position at Month 7 £m Red - 0.273 Amber 2.245 0.322 Green 2.718 0.560 Blue - 3.808 TOTAL 4.963 4.963 b) The main area to note is that previous amber savings of £0.273m, relating to the reconfiguration of staffing within Children and Families, have been escalated to red. Progress to date suggests that the timescale for this saving will not be met and the full £0.273m will not be achieved in 2023-24 but this is accounted for in the projected outturn. Work is ongoing to refresh the Transformation Plan to focus on the financial challenges which the Partnership expects to face in 2024/25 and 2025/26. The plan is critical to the ongoing sustainability of service delivery. Once it has been endorsed
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Appendix 8 by the Transformation Board it will be included within future financial monitoring reports. The Transformation Board also has responsibility for overseeing the delivery of the plan and for ensuring that projects remain on track. Appendix B provides an overview of those service changes which do have financial savings attached to them and the current BRAG status around the deliverability of each saving. 2.10 Budget Changes The Integration Scheme states that “either party may increase it’s in year payment to the Integration Joint Board. Neither party may reduce the payment in-year to the Integration Joint Board nor Services managed on a Lead Partnership basis…. without the express consent of the Integration Joint Board.” Appendix C highlights the movement in the budget position following the initial approved budget. Reductions Requiring Approval: Ref Description Amount 1 North Contribution to the TEC team – this contribution has been made since 2020 but this makes the contribution permanent. 0.075 2 Trindlemoss GP input – increased cost of service 0.008 3 Support the ongoing availability of Buvidal – transfer to NADARS 0.002 4 Contribution from CAMHS to Acute for de- escalation rooms 0.025 5 Pharmacy tariff transfer to reflect historic NRAC share. 0.015 2.11 Pan Ayrshire Lead Partnership services and Large Hospital Set Aside Lead Partnerships: - The IJB outturn position is adjusted to reflect the impact of Lead Partnership services. The outturn for all Lead Partnership services is shared across the 3 Partnerships on an NRAC basis; this position is currently the default pending further work to develop a framework to report the financial position and risk sharing across the 3 Partnerships in relation to hosted or lead service arrangements, which has been delayed by the requirement to focus efforts on the Covid response. The final outturn in relation to North Lead Partnership services would not be fully attributed to the North IJB as a share would be allocated to East and South Partnerships; similarly, the impact of the outturn on East and South led services will
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Appendix 8 require to be shared with North. At Month 7 the MH lead partnership is projected to overspend by £1.188m (£0.389m NRAC share for East and £0.340m for South). South HSCP (month 6 information) – projected overspend of £0.360m (£0.080m favourable) of which £0.133m will be allocated to North. The overspend is mainly due to an overspend of £0.247m in the community store to replace obsolete equipment, which will reduce maintenance costs in the medium term, £0.107m in the continence service and £0.010m in the Family Nurse Partnership. East HSCP (month 6 information) – projected underspend of £0.149m of which £0.055m will be allocated to North. The underspend is mainly due to: Primary Care and Out of Hours Services (Lead Partnership) There is a projected underspend of £0.198m on the Primary Care Lead Partnership budget and includes a projected underspend in Dental services totalling £0.270m, where staffing numbers are running at less than establishment. Recruitment over the remainder of the financial year has to potential to impact on the projected outturn position at month 6. In addition, there are projected reduced costs within Primary Care contracting and support £0.340m, largely due to staff turnover. These reduced costs are partially offset by additional costs in the GP element of Out of Hours services, as well as additional costs in the overnight nursing service, totalling £0.470m, as well as a small overspend on projected staff costs in Primary Medical Services £0.060m. Work is ongoing to address the Out of Hours increased costs as far as possible over the course of the 2023/24 financial year. This projected outturn position assumes funding will be allocated to fully offset Urgent Care Pathway projected costs £1.198m, as well as Covid-19 Therapeutics projected costs £0.257m Prison and Police Healthcare (Lead Partnership) The £0.065m projected overspend at month 6 is largely due to increased costs associated with the new national medical contract. Set Aside : - preparatory work is well underway with NHS Ayrshire and Arran and the other Ayrshire partnerships to progress and develop the set aside arrangements to fully implement the legislative requirement. This includes arrangements in relation to the use of Directions, Joint Commissioning Plans and overall progression towards fair share allocations of resources. The North budget for set aside resources for 2023-24 is currently £35.547m. This is based on the 2022-23 figure of £34.850m inflated by the 2023-24 uplift of 2%. Ayrshire Finance Leads have agreed a baseline methodology for set aside budgets which involves using the four full years prior to the pandemic, 2016/17 – 2019/20 inclusive. This will be included in a Q2 update for Ayrshire Finance Leads on 15/12/23. The annual budget for Acute Services is £421.7m. The directorate is overspent by £16.5m after 7 months. This is caused by increasing overspends on agency medical and nursing staff, together with drug expenditure. These have been required due to the level of operational pressure being experienced, in common with many other
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Appendix 8 areas in Scotland. Several unfunded wards and beds are open across both main hospital sites. There is a material underlying deficit caused by: • Unachieved efficiency savings • High expenditure on medical and nursing agency staff, high rates of absence and vacancies causing service pressure. • Delayed transfers of care and high acuity of patients. The IJBs and the Health Board work closely in partnership to maintain service and improve performance. 2.12 FINANCIAL RECOVERY PLAN The Integration Scheme requires the preparation of a recovery plan if an overspend position is being projected to plan to bring overall service delivery back into line with the available resource. Heads of Service have closely reviewed expenditure and have implemented actions which have seen the projected year-end position improve by a net £0.468m since Month 3. The main contributors to this are noted in the table below: TOTAL Payroll Turnover – Health (non-Lead) 45,000 Anam Cara staffing 104,000 Care Experienced Young People 770,000 Looked After Children 125,000 Transitions funding 286,000 Care Homes 58,000 Physical Disabilities (Community Packages, Direct Payments and Residential) 200,000 Interim Care Beds 250,000 Mental Health Care Packages 201,000 Mental Health Lead Partnership – North element 86,000 Children with a disability 97,000 Carers Funding 81,000 District Nursing 41,000 Rehab Wards 18,000 These areas of improvement have been partially offset by adverse movements in Care at Home, Integrated Island Services, Wards 1 and 2 at Woodland View, UNPACS and intervention services. Work is ongoing to further improve the projected position and an updated plan will be included in the Month 9 report which will be brought to the February IJB. This work is built on the following general principles:
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Appendix 8 • No adverse impact on delayed discharges or patient flow during Winter • Exercising professional judgement around the use of waiting lists where this may have an impact elsewhere in the system • Reviewing the need for more active management of non-frontline vacant posts • The non-recurring use of reserves • Working with East and South on lead partnership projections • The potential for a freeze on non-essential spend. As a contingency there is provision of £2m non-recurring funding set aside in the reserves (appendix D) to contribute towards the 2023-24 position. This would reduce the current projected overspend to £1.858m. The IJB also holds a General Fund reserve balance of £5.821m of unallocated funds, this would underwrite the risk of the remainder of the projected overspend if it cannot be managed downwards in the coming months. This would be a last resort as this funding is non-recurring and it does not resolve the areas underlying the projected overspend. 2.13 FINANCIAL RISKS There are a number of ongoing financial risk areas that may impact on the 2023-24 budget during the year, these include: • Current high levels of inflation which impact on costs incurred directly by the Partnership and on our partner providers • High risk areas of low volume / high-cost services areas e.g. Children’s residential placements, Learning Disability care packages and complex care packages; • Progress with the work to develop set aside arrangements and the risk sharing arrangements agreed as part of this. • Ongoing implementation costs of the Scottish Government policy directives • Lead / hosted service arrangements, including managing pressures and reporting this across the 3 IJBs. • The impact on Lead Partnership and acute services from decisions taken by other Ayrshire areas. • The use of supplementary staffing for enhanced observations across a number of service areas. • The use of high-cost agency staff to support frontline service delivery in areas where there are recruitment challenges. • Continuing risks associated with provider sustainability. • The Local Government pay award for 2023-24 has recently been settled and will be paid from December; the increase is in excess of the budgeted 3% and will have an adverse impact on the projected financial position unless sufficient additional funding is forthcoming. • The NHS Ayrshire and Arran Health Board financial deficit and the risks around further escalation in the national framework for financial escalation.
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Appendix 8 North Ayrshire IJB have already discussed our position in relation to the request for payment for delayed discharges. These risks will continue to be monitored during the remainder of 2023-24 and any impact reported through the financial monitoring report. 2.14 RESERVES The IJB reserves position is summarised in the table below. The ‘free’ general fund balance of £5.821m is held as a contingency balance; this equates to around 2.1% of the initial approved IJB budget for 2023-24 which is within, but towards the lower end, of the target range of 2%-4%. General Fund Reserve Earmarked Reserves Total Unearmarked External Funding HSCP £m £m £m £m Opening Balance - 1 April 2023 6.448 6.997 4.219 17.664 Audit Adjustment (0.627) (0.309) - (0.936) Corrected Opening Balance 5.821 6.688 4.219 16.728 2023-24 Draw Per the Budget Paper - (1.252) - (1.252) Current Reserve balances 5.821 5.436 4.219 15.476 The 2023-24 budget approved the use of £1.252m of previously earmarked reserves to support a balanced budget position for 2023-24. The HSCP earmarked reserves also includes a further amount of £2.0m which was agreed to support the financial position during 2023-24. The reserves above now reflect the adjustment of £0.936m which was identified in the external audit of the 2022/23 accounts and reported to the November IJB. This related to a difference between the total IJB reserves and the balances due to the IJB from partners’ audited accounts and has now been reconciled. 3. PROPOSALS 3.1 Anticipated Outcomes Continuing to closely monitor the financial position will allow the IJB to take corrective action where required to ensure the Partnership can deliver services in 2023-24 from within the available resource, thereby limiting the financial risk to the funding partners. 3.3 Measuring Impact Ongoing updates to the financial position will be reported to the IJB throughout 2023- 24.
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Appendix 8 4. IMPLICATIONS 4.1 Financial The financial implications are as outlined in the report. Against the full-year budget of £311.735m there is a projected overspend of £3.858m. The report outlines the main variances for individual services. 4.2 Human Resources The report highlights vacancy or turnover savings achieved to date. Services will review any staffing establishment plans and recruitment in line with normal practice when implementing service change and reviews as per agreement with the IJB, there is no intention to sustain the staffing capacity reduction on a recurring or planned basis. 4.3 Legal None. 4.4 Equality/Socio-Economic None. 4.5 Risk Para 2.13 highlights the financial risks. The report falls in line with the agreed risk appetite statement which is a low-risk appetite in respect to adherence to standing financial instructions, financial controls and financial statutory duties and a high-risk appetite in relation to finance and value for money. 4.6 Community Wealth Building None. 4.7 Key Priorities None. 5. CONSULTATION 5.1 This report has been produced in consultation with relevant budget holders and the Partnership Senior Management Team. 5.2 The IJB financial monitoring report is shared with the NHS Ayrshire and Arran Director of Finance and North Ayrshire Council’s Head of Finance after the report has been finalised for the IJB. Caroline Cameron, Director Author – Paul Doak, Head of Finance and Transformation Eleanor Currie, Principal Manager Finance [pdoak@north-ayrshire.gov.uk/eleanorcurrie@north-ayrshire.gov.uk]
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PUBLIC INFORMATION 2023-24 Budget Monitoring Report–Objective Summary as at 31st October 2023 Appendix A Budget Outturn Over/ (Under) Spend Variance Budget Outturn Over/ (Under) Spend Variance Budget Outturn Over/ (Under) Spend Variance £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 COMMUNITY CARE AND HEALTH 70,430 69,219 (1,211) 19,463 20,806 1,343 89,893 90,025 132 366 (234) : Locality Services 28,193 27,346 (847) 5,354 5,549 195 33,547 32,895 (652) (229) (423) : Community Care Service Delivery 36,607 35,995 (612) 0 0 0 36,607 35,995 (612) (693) 81 : Rehabilitation and Reablement 2,131 2,136 5 0 0 0 2,131 2,136 5 2 3 : Long Term Conditions 943 1,004 61 10,420 11,449 1,029 11,363 12,453 1,090 1,027 63 : Community Link Workers 181 174 (7) 0 0 0 181 174 (7) (8) 1 : Integrated Island Services 2,375 2,564 189 3,689 3,808 119 6,064 6,372 308 267 41 MENTAL HEALTH SERVICES 29,804 30,234 430 73,700 74,888 1,188 103,504 105,122 1,618 1,804 (186) : Learning Disabilities 22,959 23,629 670 478 478 0 23,437 24,107 670 660 10 : Community Mental Health 5,961 5,716 (245) 1,753 1,753 0 7,714 7,469 (245) (266) 21 : Addictions 884 889 5 1,837 1,837 0 2,721 2,726 5 2 3 : Lead Partnership Mental Health NHS Area Wide 0 0 0 69,632 70,820 1,188 69,632 70,820 1,188 1,408 (220) CHILDREN & JUSTICE SERVICES 34,714 39,831 5,117 4,846 4,998 152 39,560 44,829 5,269 5,016 253 : Irvine, Kilwinning and Three Towns 3,183 3,152 (31) 0 0 0 3,183 3,152 (31) 3 (34) : Garnock Valley, North Coast and Arran 3,062 2,997 (65) 0 0 0 3,062 2,997 (65) (73) 8 :Intervention Services 1,828 1,807 (21) 0 0 0 1,828 1,807 (21) (88) 67 : Care Experienced Children & Young people 22,941 27,869 4,928 0 0 0 22,941 27,869 4,928 4,740 188 : Head of Service - Children & Families 1,070 1,376 306 0 0 0 1,070 1,376 306 300 6 : Justice Services 2,413 2,412 (1) 0 0 0 2,413 2,412 (1) 0 (1) : Universal Early Years 217 218 1 4,199 4,351 152 4,416 4,569 153 134 19 : Lead Partnership NHS Children's Services 0 0 0 647 647 0 647 647 0 0 0 CHIEF SOCIAL WORK OFFICER 1,858 1,393 (465) 0 0 0 1,858 1,393 (465) (384) (81) PRIMARY CARE 0 0 0 52,998 52,932 (66) 52,998 52,932 (66) 0 (66) ALLIED HEALTH PROFESSIONALS 0 10,200 10,200 0 10,200 10,200 0 0 0 COVID NHS 0 0 0 0 (274) (274) 0 (274) (274) (274) 0 MANAGEMENT AND SUPPORT COSTS 8,908 7,539 (1,369) 3,476 3,142 (334) 12,384 10,681 (1,703) (1,756) 53 NATIONAL COMMISSIONED SERVICE 0 0 0 3 3 0 3 3 0 0 0 FINANCIAL INCLUSION 1,335 1,333 (2) 0 0 0 1,335 1,333 (2) (3) 1 OUTTURN ON A MANAGED BASIS 147,049 149,549 2,500 164,686 166,695 2,009 311,735 316,244 4,509 4,769 (260) Return Hosted Over/Underspends East 0 0 0 0 (389) (389) 0 (389) (389) (461) 72 Return Hosted Over/Underspends South 0 0 0 0 (340) (340) 0 (340) (340) (403) 63 Receive Hosted Over/Underspends South 0 0 0 0 133 133 0 133 133 133 0 Receive Hosted Over/Underspends East 0 0 0 0 (55) (55) 0 (55) (55) (52) (3) OUTTURN ON AN IJB BASIS 147,049 149,549 2,500 164,686 166,044 1,358 311,735 315,593 3,858 3,986 (128) Over/ (Under) Spend Variance at Period 6 Movement in projected variance from Period 6 TOTAL Partnership Budget - Objective Summary Council Health 2023/24 Budget
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PUBLIC INFORMATION 2023-24 Savings Tracker Appendix B Savings ref number Description Deliverability Status at budget setting Deliverability Status at month 7 2023/24 Saving Description of the Saving 1 Staffing reconfiguration - children & families Amber Red 273,000 Review staffing provision within children’s houses with the saving phased over 2023/24 and 2024/25 – 50/50 2 Deliver the Strategic Plan objectives for Older People's Residential Services - Reduction in Care Home Places Amber Blue 1,000,000 The budget for 23/24 would fund an average 780 places at the current split of nursing/residential (60/40). This reflects reduced demand and investment in CAH to support more people at home. 3 Care Home Respite Amber Green 560,000 All respite care to be provided in-house at Anam Cara and Montrose House and any use of other respite provision funded via Carers budget. 4 Montrose House Capacity Green Amber 210,000 Registration amended from 30 beds to 20 beds across 2 staffed wings. This is supported by introduction of intermediate care beds at Arran War Memorial Hospital. 5 Reconfigure respite provision at Anam Cara Amber Amber 112,000 The service is currently relocated to Taigh Mor (8 beds) on a temporary basis and this proposal would reduce capacity from 14 beds to 9 beds in one wing when it reverts to Anam Cara. 6 Trindlemoss pool running costs Green Blue 85,000 Trindlemoss Pool has never opened due to ongoing maintenance issues. The historic budgeted running costs are £0.085m but it is expected actual costs would be much higher. The pool will not open and alternative therapies will be provided e.g. bounce therapy.7 Trindlemoss Day Care Green Blue 168,932 Trindlemoss day opportunities staffing was restructured during 2021/22 and 2022/23. This saving has already been achieved and will remove the additional staffing budget. 8 Intermediate Placement Scheme - cessation of service Green Blue 30,000 The contract has ceased and will not be renewed. 9 Carers Act Funding - Substitution of Spend Green Blue 500,000 There is a plan in place to invest across carer service contract, preparation of carer plans, short breaks and other support to carers. This proposal will invest £0.500m in contributions to Red Rose House, Roslin House, Anam Cara, waiving of charges and day services. Children, Families & Criminal Justice Community Care & Health Mental Health Other Areas
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PUBLIC INFORMATION Savings ref number Description Deliverability Status at budget setting Deliverability Status at month 7 2023/24 Saving Description of the Saving 10 Payroll Turnover - increase to target (social care) Green Blue 1,000,000 The saving is based on less than 50% of the 2022/23 overachievement 11 Income Generation - 5% Increase to fees and charges Green Blue 46,600 Implement a 5% increase to fees and charges and a 5% increase to the maximum charge. The impact will be limited where service users are already paying the maximum charge. 12 Staffing Reconfiguration - Finance and Transformation Green Blue 35,091 Saving released through management and admin structure change TOTAL SOCIAL CARE SAVINGS 4,020,623 Health: Savings ref number Description Deliverability Status at budget setting Deliverability Status at month 7 Approved Saving 2023/24 £m Description of the Saving 13 Payroll Turnover - Health Lead Partnership Green Blue 392,245 The saving is based on less than 25% of the 2022/23 overachievement 14 Payroll Turnover - Health Non Lead Partnership Green Blue 250,000 The saving is based on less than 50% of the 2022/23 overachievement 15 Reprovisioning of Continuing Care beds Amber Blue 300,000 Currently provided through Cumbrae Lodge Care Home in Irvine but the provider does not want to continue to provide the service. Plans are being developed to relocate the service to Taigh Mor in Beith with an anticipated saving of £0.3m. TOTAL HEALTH SAVINGS 942,245 4,962,868 TOTAL NORTH HSCP SAVINGS Other Areas
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PUBLIC INFORMATION 2023-24 Budget Reconciliation Appendix C COUNCIL Period Permanent or Temporary £'m Initial Approved Budget 121.408 Less Living Wage Fund not yet allocated (2.826) Revised Budget 118.582 Resource Transfer 1-6 P 24.640 HSCP Fin Circ 3 1-3 T 0.013 Living Wage - final allocation 1-3 P 2.808 ICT Licences Various 1-3 P (0.012) Island Funds 1-3 T 0.015 Facilities Management Costs - Montrose House 1-3 P 0.387 West Road - Capital funded from Revenue 1-3 T (0.300) Care at Home – Draw from reserves 4 T 0.173 Transport (taxi) budget transferred to HSCP 6 P 0.247 Curator fees budget transferred from Legal Services 6 P 0.004 Fostering and Kinship – additional SG funding re increased rates. 6 P 0.486 Commercial Waste 7 P 0.005 Roundings 7 0.001 Social Care Budget Reported at Month 7 147.049 HEALTH Period Permanent or Temporary £'m Initial Baseline Budget 164.500 Month 10-12 Adjustments 2.473 MDT funding 0.828 Adjust for full year impact of part year amounts 0.052 Revised Baseline 167.853 Baseline Funding Increase 2.164 Adjust for recurring funding 7.629 Adjust for non-recurring 2.434 Resource Transfer (23.597) 2023/24 Opening Position 156.483 Net impact of Pan Ayrshire Pressures 1 P 0.028
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PUBLIC INFORMATION Top Slicing Posts 2022-23 2 (0.054) MDT Funds to Arran Medical Group 3 (0.033) Training Grade Adjustments 3 (0.035) Ward 3 Band 2 Domestic 3 (0.004) V2 B6 to AHM233 3 (0.061) Virement 12 Band 2 Domestic 4 (0.010) Virement 18 Band 3 budget transfer - J Baird 4 0.019 Lymphoedema Top Slice RX 4 (0.029) HD Ref 51 Band 2-4 4 0.054 District Nursing Anticipated 5 0.032 HD REF 110 Multi-Disciplinary Teams 5 0.120 Post (EB) transferred to Medical Records 5 (0.037) Integrated Infant Feeding (South) 5 0.057 Integrated Infant Feeding (SG) 5 0.050 2023-24 RX Budget 6 (0.908) Training Grade ADJ - August 6 0.270 PFG LOCAL IMPROVEMENT 6 0.457 ADP National Mission 6 0.207 ADP Residential Rehab 6 0.094 ADP AFC Pay Uplift 6 0.091 ADP Lived & Living Experience 6 0.009 ADP Drug Prevalence 6 0.059 ADP Whole Family Approach 6 0.066 ADP MAT 70% 6 0.175 HD126: MENTAL HEALTH AFTER COVID HOSPITALISATION SERVICE 23-24 6 0.039 REMOVE Anticipate MACH (Mental Health After Covid) 6 (0.102) HD185: MENTAL HEALTH OUTCOMES FRAMEWORK 6 2.178 HD227: DELIVERY OF VETERAN SPECIFIC MENTAL HEALTH SUPPORT 6 0.105 HD229: DIGITAL THERAPY POSTS 6 0.059 COMMUNITY PHLEBOTOMY - NORTH SHARE 6 (0.039) SOUTH ADP WARD 5 W/VIEW PAY UPLIFT 6 0.003 SOUTH ADP ORT PAY UPLIFT 6 0.005 SOUTH ADP PREV&SERVICES SUPPORT PAY UPLIFT 6 0.004 Apprenticeship Levy 6 0.225 Training Grade ADJ - September 6 (0.007) ADP PSST Support - South 6 0.008
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PUBLIC INFORMATION South Naloxone kits 6 0.002 South MAT Funding - Psychiatry 6 0.029 ADP Pay Uplift 6 0.003 Drug Tarif Anticipate 2023-24 6 0.525 North HSCP Medical Pay Award 23/24 6 0.532 LDS Shortfall - Alloway Place 7 (0.008) TEC (North) to CSS 7 (0.075) Budget adj for Buvidal use NADARS 7 (0.002) MH Strategy Action 15 Workforce 23-24 7 0.879 CAMHS IMP - IPCU 7 0.243 CAMHS IMP - INT HOME TREATMENT TEAMS 7 0.221 CAMHS IMP - OOH UNSCHEDULED CARE 7 0.148 CAMHS IMP - LD FORENSIC AND SECURE 7 0.089 HD305: SPECIALIST COM PERINATAL MH, INFANT MH & NEONATAL PSYCHOLOGY INTERVENTION 7 0.373 ANTICIPATE TRANCHE 2: SPECIALIST COM PERINATAL MH, INFANT MH & NEONATAL PSYCHOLOGY INTERVENTION 7 0.215 DE-ESCALATION ROOMS TO RESOURCE 7 (0.025) Hd254 Pharmacy tariff reduction to reflect historic NRAC share. 7 (0.015) Hd256 Increase to the pharmacy tariff to match the actuals on the national allocation letter. 7 0.018 Roundings 7 (0.001) Anticipated budgets included in the report but not in the ledger 7 3.000 Health Budget Reported at Month 7 164.686 TOTAL COMBINED BUDGET 311.735