2025-26 Budget Monitoring Report Mth6v1 - final
North Ayrshire Council · 13 November 2025
Back to Integration Joint Board — 13 November 2025 and its agenda
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Integration Joint Board 13th November 2025 Subject: 2025-26 – Month 6 Financial Performance Purpose: To provide an overview of the IJB’s financial performance as at Month 6 (September). Recommendation: It is recommended that the IJB: (a) notes the overall integrated financial performance report for the financial year 2025-26 and the current overall projected year- end overspend of £4.957m reducing to £1.604m after planned recovery actions; (b) notes the progress with delivery of agreed savings; (c) approves the actions which are being taken to progress financial recovery and that an updated recovery plan will be presented to the next IJB; and (d) notes the remaining financial risks for 2025-26. 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 MDT Child & Adolescent Mental Health Services BRAG Blue, Red, Amber, Green UNPACS UNPACS, (UNPlanned Activities) – Extra Contractual Referrals NRAC NHS Resource Allocation Committee PAC Performance and Audit Committee MHOF Mental Health Outcome Framework MDT Multi-Disciplinary Team 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
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relevant budget holders and services. It should be noted that, although this report refers to the position at the end of September 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 £4.957m (1.5%) reduced to £1.604m through already identified financial recovery actions. There is an increasing risk to achieving financial balance during 2025-26, the projected outturn position is summarised below with the residual risk following already identified financial improvement actions: TOTAL Health/ NHS AA Social Care/NAC Projected Overspend @ mth6 4.957 1.245 3.712 Financial Recovery Plan Projections (3.353) (1.244) (2.109) Residual Risk 1.604 0.001 1.603 The Integration Scheme describes the required approach where there is a projected overspend on the IJB integrated budget, which includes the requirement to agree a recovery plan to balance the overspending budget. Only if the recovery plan is unsuccessful will the Health Board and Council consider making available interim funds. The projection assumes all mitigations and controls established in 2024-25 continue throughout 2025-26 as it is recognised that the same uncertainty and risks remain into 2025-26 and there needs to be tight grip and control over expenditure overall. 1.3 The movement in the projected outturn position for the 2025-26 financial year is illustrated in the graph below:
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This illustrates the movement in the gross and net projected overspend and the residual overspend or risk split between NHS and LA funding partners. 1.4 From the core projections, overall, the main areas of pressure are: care at home, residential placements for children, physical disability care packages, supplementary staff in wards, staff costs in Montrose House and Unplanned Activities (UnPACs) within the lead partnership for mental health. The main areas of movement from Period 4 to Period 6 are: • Updated assessment of the vacancy savings projection with lower level than anticipated for social care, primarily due to a number of posts which have been removed as recurring savings. • Increase in Learning Disability care packages due to a small number of high cost packages. • Increase in supplementary staffing in Woodland View due to a short term IPC incident and associated staff cover costs. • Under-recovery of anticipated income following new charging policy. 1.5 The projected IJB outturn position has been adjusted to reflect the impact of Lead Partnership services. The overspend in relation to North Lead Partnership services for Mental Health is not fully attributed to the North HSCP as a share has been allocated to East and South HSCPs, similarly the impact of the outturn on East and South led services has been shared with North, both on an NRAC basis in line with the agreed risk sharing mechanism. There is a requirement for the 3 IJBs to be aware of the position for Lead Partnership services and plans to deliver services from within allocated budget, on that basis further information will be brought forward with further detail on Lead Partnership services. 1.6 Since the setting of the budget in March 2025 the 2025/26 financial position has been adversely impacted by the below factors out-with the control of the IJB. • National Care Home Contract (NCHC) – the recent increase to the NCHC rate to reflect the impact of the nursing pay award resulted in an additional unfunded cost of £0.175m. • NHS Board allocation for the Employers National Insurance increase confirmed at 60% of funding – full year impact £0.664m • The current allocation for the Agenda for Change costs in relation to the reduced working week are currently being queried with the NHS finance team to ensure we receive our ‘fair share’ of the funding. The current funding allocated is £0.659m, the cost of covering all reduced hours is £1.497m, currently calculating actual cover costs and will request NHS AA review funding allocation. This request will be informed by information collated from services on the actual impact and cost.
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• Pay settlements for both NHS and Local Government staff have been agreed for 2025/26. The NHS element has been funded, and the current assumption is that the shortfall between budget planning assumptions and actual settlements will be fully funded for Local Government staff. 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 6 At month 6 against the full-year budget of £340.767m there is a projected year-end overspend of £4.957m (1.5%). 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 £3.924m in social care services and a projected overspend of £1.245m 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. Appendix F provides information on the costs of bank and agency staff. 2.3 Health and Community Care Services Against the full-year budget of £100.020m there is a projected overspend of £4.167m (4.2%) which is a favourable movement of £0.1638m and the main variances are: a) Care home placements – net projected overspend of £0.565m (£0.010m favourable). This includes an overspend on placements of £1.115m (£0.160m favourable) which includes a provision for an average of 7 interim beds and reflects the recent increase to the NCHC to reflect the impact of the nursing pay award resulted in an additional unfunded cost of £0.175m. The budgeted number of permanent placements was 765 and at month 6 there were 807 placements resulting in a projected overspend of £1.140m. The plan to manage down the number of permanent placements to reach the target is challenging due to the need to respond to referrals from hospital and to continue to support those in critical and substantial need in the community. The overspend is partially offset by income recovered from charging orders and gross funded placements which is projected to be £0.550m over recovered
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(£0.150m adverse). This income is challenging to predict as it depends on the length of the legal process and time taken to sell the property that the charging order is registered to and access to the funds or estate of service users. b) Care at home is projected to be £1.689m overspent (£0.017m adverse). The position reflects the cost of meeting the significant demand and level of provision for care at home support. c) Physical Disability Services – projected overspend of £0.486m (£0.057m adverse) split as follows: £0.958m over in residential placements, £0.296m under in direct payments and £0.176m under in community care packages. d) Integrated Island Services is projected to overspend by £0.507m (£0.196m adverse). The most significant variance is a projected overspend at Montrose House of £0.283m which relates to the net overspend on agency staff (i.e. net of underspend on employee costs) and overspends across property, continence and medical supplies, admin and transport. One of the main adverse movements relates to an income under recovery at Montrose House and a write off of aged debt. The Arran Patient Transfer contract is projected to overspend by £0.040m. e) Specialist Rehab wards – projected overspend of £0.175m (£0.015m favourable) (Redburn ward £0.203m overspend and Douglas Grant £0.028m underspend). The overspend is due to cover costs for vacancies as well as supplementary staffing for patients who require one to one support. f) Wards 1 and 2 – Projected overspend of £0.774m (£0.009m favourable). The overspend is due to increased use of supplementary staffing. All rehabilitation wards are operating at 100% occupancy supporting a high level of patient needs/complexity, which places pressure on staffing levels and the use of bank and agency staff to support additional patient observations. The senior manager has developed an action plan which will reduce this overspend and the reduction is reflected in the recovery plan. 2.4 Mental Health Services Against the full-year budget of £118.496m there is a projected overspend of £1.218m (1%) which is an adverse movement of £0.613m prior to the re-allocation of the Lead Partnership variance to East and South HSCP. The main variances are: • Learning Disabilities are projected to overspend by £1.036m (£0.416m adverse). The adverse movement is mainly due to one new high-cost care LD package £0.126m, a projected under recovery of income £0.153m and an adverse movement in children with a disability packages of £0.076m. • Community Mental Health services are projected to underspend by £0.060m (£0.094m adverse movement). The adverse movement is mainly due to an
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adverse movement of £0.041m in residential packages. The main reason for underspend in community packages is the availability and capacity of adult community providers to deliver new packages of care. • There is a projected underspend of £0.353m in relation to the cost of Hospital Based Complex Continuing Care (HBCCC), this reflects the impact of change in provision for these services. There were plans to reinvest this in the service, but these plans are on hold as holding the funding was agreed as part of the recovery plan at month 3. • The Lead Partnership for Mental Health is projected to be £0.687m overspent (£0.201m adverse) and the main variances are as follows: • Adult Inpatients – projected overspend by £0.954m (£0.315m adverse) due to very high levels of continuous intervention which require additional supplementary staff and enhanced observations (1:1 and 2:1) and use of bank staff. The month 5 and 6 costs were materially higher than the month 1 – 4 average, this was due to high levels of staff cover required to respond to an IPC incident at Woodland View. The projection assumes that £0.338m of costs are recharged to another HSCP on a cost basis for an outwith authority placements which has incurred additional costs in relation to usage of supplementary staffing due to sustained enhanced observations. • The UNPACS (Unplanned Activities) budget – projected overspend of £1.054m (£0.299m favourable) based on current placements. Since month 4 there has been the transfer of two packages. UnPACS 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 change 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. Part of the additional control measures agreed in month 3 was to expand the high- cost care package review group to include all UNPACS placement requests, the projected position includes provision for any new placements approved.
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• Learning Disability Services – projected to overspend by £0.349m (£0.293m adverse). This adverse movement relates to the delay in achieving the saving from Ward 7A. Whilst the ward closed there are still legacy costs as the staff are still being redeployed. • Elderly Inpatients – projected overspend of £0.117m (£0.016m favourable) due to the use of supplementary staffing. The elderly mental health wards continue to operate at full occupancy and at times with waiting lists, with several patients who are on enhanced observations and bank costs remain high. • Eating Disorders – projected to overspend by £0.135m (£0.008m adverse movement) due to the staffing level being higher than the funding allocation. This is being considered alongside the overall resource allocation. • Enhanced Mental Health Outcome Framework (EMHOF) – projected underspend of £0.624m (no movement). There was £0.624m of reserves held for EMHOF and the recovery plan approved the draw down of these reserves which is the reason for the favourable movement. • Psychiatry – is projected to overspend by £0.321m (£0.029m adverse) mainly due to junior doctor costs. A mitigation plan is being developed and the rota for junior doctors is being reviewed. • MH Pharmacy – is projected to overspend by £0.156m (£0.120m adverse). The overspend is less than projected due to a prior year rebate. Prior to this rebate there was an overspend due to increased demand and cost of medicines, and particularly the cost of Buvidal. This position is after investing £0.510m on a Pan Ayrshire basis (£0.170m per HSCP). • Action 15 – is projected to underspend of £0.279m (£0.050m favourable). There was £0.487m of reserves held for Action 15 and the recovery plan approved the draw down of these reserves which is the reason for the underspend. The projected underspend is after considering the legacy costs from the 2024/25 review of funding. Innovation Fund – projected underspend of £0.021m (£0.004m adverse movement) assuming that the posts to be redeployed as part of the EMHOF review are actioned. • 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 £0.972m
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(favourable movement of £0.444m) in 2025-26. Further information is included in the table below: Vacancy Savings Target (£1.160m) Projected to March 2026 £2.132m Over/(Under) Achievement £0.972m 2.5 Children and Justice Services Against the full-year budget of £42.224m there is a projected overspend of £1.636m (3.9%) which is an adverse movement of £0.030m and the main variances are: a) Care Experienced Children and Young People is projected to overspend by £1.996m (£0.081m adverse). Some of these costs are offset by the contribution from the Home Office for Unaccompanied Asylum-Seeking Children which is detailed below. The main areas within this are noted below: • The children’s residential placements are projected to overspend by £2.714m (£0.024m adverse) based 33 placements in month 6. This demonstrates an increase of 4 places since the start of the financial year. There are several factors leading to this challenging position: o We have 32 places available in our internal children’s houses, due to demand these have been operating at 100% occupancy or over for some time, leading to increased use of external placements where residential care is required. o There remains an acute shortage of foster carers leading to residential care being necessary in emergency placement situations. o 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. o A number of young people in residential care have requested Continuing Care, whereby a young person can remain in their placement until age 21. o 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. o Contractual inflation has still to be agreed for most placements and it is likely that this will increase the projected costs of residential places which is outwith the control of the service. o Children’s Services are continuing to work with other services including Education and Housing to address the challenges through the work of the ‘Brighter Pathways’ Programme Board and associated workstreams.
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• Looked After and Accommodated Children (fostering, adoption, kinship etc) is projected to be £0.937m (£0.032m favourable) underspent. • Residential respite – placements are overspent by £0.071m (£0.002m fav movement). These short-term placements are used to prevent an admission to full time care or to avoid placement breakdown. • Employee costs – are projected to overspend by £0.170m (£0.099m adverse movement), largely due to staffing levels in the children’s houses and regrading of posts. • Care Leavers – projected underspend of £0.058m (£0.013m adverse movement) in rent costs. • Section 29 Payments (Throughcare Team) are projected to overspend by £0.049m (£0.015m favourable movement). b) Head of Service – is projected to underspend by £0.562m (£0.006m adverse). This consists of a projected overspend of £0.158m in relation to the previous staff reconfiguration saving in the children’s houses which was not achieved in 23-24 or 24-25 and this is offset by the grant funding in relation to Unaccompanied Asylum-Seeking Children (UASC), which is projected to amount to £0.777m and which contributes to costs incurred across a number of C&F service areas. c) C&F Health Team – is projected to overspend by £0.082m (£0.062m favourable) mainly in relation to the Band 6 to 7 regrade for Health Visitors and the progression of posts up the Band 7 scale. Part of this recurring cost was incorporated into budget pressures for 2025/26. The favourable movement is due to ongoing work by the senior manager to reduce the overspend. 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 contributed to payroll turnover. 2.7 CHIEF SOCIAL WORK OFFICER This is projected to underspend by £0.185m (£0.019m adverse). One contract has ceased at the end of June and there are savings against other areas. There is also an over-recovery of income in Learning and Development for social work student placements.
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2.8 MANAGEMENT AND SUPPORT Management and Support Services are projected to underspend by £1.685m (£0.659m favourable) and the main areas of variance are: • There is projected slippage on the LD and MH transition funding of £0.473m (£0.210m favourable) due to delays in children transitioning into adult services. This involves complex planning by services with service users and families and can change over time based on assessed need when moving into adult services. • The 2024-25 budget included a budgeted deficit on the social care side of £0.437m which is offset by a budgeted surplus of £0.437m on the health side of the budget. • There is also a balance of overachieved savings of £0.137m (£0.076m favourable) as a result of the 25/26 budget decision. • NHS shortfall in savings of £0.406m which is not coded to specific areas and held centrally until recurring savings can be identified. • The funding for the Reduced Working Week (non-Lead Partnership element) is coded to Management and Support pending final confirming of the allocation. It is projected to underspend by £0.293m as the overspends in relation to these costs are shown on other lines outwith Management and Support. • An over-recovery of payroll turnover of £0.600m (£0.500m adverse) for social care services and an over-recovery of £0.308m (£0.006m favourable) for health services as outlined in the table below. The turnover targets and achievement for the financial year for Health and Social Care services outwith the Lead Partnership is noted below: Social Care Health Vacancy Savings Target (£3.400m) (£1.567m) Projected to be achieved by March 2026 £4.000m £1.877m Over/(Under) Achievement £0.600m £0.308m 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. As part of the recovery plan, the vacancy scrutiny group has been enhanced with the Heads of Service and professional leads attending. Each post is scrutinised and filled only where deemed necessary with a recruitment freeze now implemented for all non-essential posts. For 2025/26 there will be a further recruitment delay with vacancy scrutiny approved vacancies being held for four weeks before they are advertised to create more payroll
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turnover. This will be for all vacancies except clinical or registered services vacancies or those which will incur cover costs. The turnover target for the North Lead Partnership for Mental Health services is detailed separately within the Lead Partnership information at section 2.4. 2.9 Savings Progress The approved 2025-26 budget included £4.019m of savings. BRAG Status Position at Budget Approval £m Position at Month 6 £m Red - - Amber 2.984 2.027 Green 1.035 0.200 Blue - 1.792 TOTAL 4.019 4.019 Appendix B provides an overview of those service changes which do have financial savings attached to them and the 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 (£000) 1 North MDT funding to Arran Medical Group (Virement 11) (0.043) 2 Budget transferred to Capital for INV-3395435821 (0.006) 2.11 Pan Ayrshire Lead Partnership services and Large Hospital Set Aside Lead Partnerships: - The IJB 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.
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The outturn in relation to North Lead Partnership services is not fully attributed to the North IJB as a share is allocated to East and South Partnerships; similarly, the impact of the outturn on East and South led services is shared with North. At Month 6 the MH lead partnership is projected to overspend by £0.687m (£0.225m NRAC share for East and £0.196m for South). South HSCP (month 6 info) – projected overspend of £0.282m (£0.148m adverse) of which £0.104m (£0.054m adverse) will be allocated to North. The variance is mainly due to an overspend of £0.131m in the community store. This includes the costs of replacing mattresses, repairs and maintenance contract and equipment costs. The adverse movement is due to the purchase of additional mattresses when the wash bay was temporarily closed, and this impacted on the recycling of mattresses. There is also a projected overspend of £0.087m in the Family Nurse Partnership as the SG funding was based on the mid-point of the salary scale and all post are now at the top point of the scale. This will be a pressure in 2026/27. East HSCP (month 6 info) - projected overspend of £0.104m (£0.326m favourable) of which £0.038m will be allocated to North - £0.121m favourable movement). The main variances are: Allied Health Professions (Lead Partnership) There is a projected underspend of £0.420m on AHPs services which mainly relates to staffing savings. An increase in overall supplies expenditure has seen a small adverse movement from month 4 projected underspend £0.445m. Primary Care and Out of Hours Services (Lead Partnership) The Primary Care and Out of Hours Services £139.701m budget is projected to overspend by £0.416m, which is a small favourable movement of £0.206m from month 4. There are projected additional costs within Primary Care Contracting and Support £0.402m (£0.493m overspend month 4), due to a number of variances, including new Office 365 licence costs, as well as additional spend related to the GP’s Sub- Committee and staffing costs. Primary Medical Services are projected to overspend by £0.643m (£0.686m at month 4), largely due to increased pension and sickness cover costs. Primary Medical Services payments also show an overspend and IT continues to overspend. These projected additional costs are being partially offset by a projected underspend £0.309m (£0.170m at month 4) against Ayrshire Urgent Care Services based on average of month 1 to 6 expenditure and cross charges based on 2024/25 trends (and is after building-in an allowance for public holiday cover in the remainder of the financial year). Funding has been allocated to partially offset Urgent Care Pathway costs £0.823m (projected to outturn £0.248m over allocated funding). Funding has also been allocated to Covid-19 Therapeutics of £0.274m, with costs projected at £0.229m. There is a projected underspend of £0.555m (£0.304m at month 4) in Dental services that reflects that staffing numbers are running at less than establishment, alongside
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reduced equipment costs. The financial recovery plan includes anticipated reduced spend on Dental equipment £0.035m. Prison and Police Healthcare (Lead Partnership) The projected overspend of £0.013m at month 6 (£0.106m overspend month 4) is largely due to reduced staffing costs. Due to extended periods of vacancy, there has been a favourable movement of £0.119m, however this is partially offset by additional prescribing costs. Prison prescribing was highlighted as a budget pressure as part of the 2025/26 budget. Both East Ayrshire and South Ayrshire IJBs have approved additional funding to offset this pressure however North Ayrshire IJB did not provide for this in their approved budget. The additional funding has not been allocated against the prescribing budget at this stage, with further pan-Ayrshire discussions to be undertaken to determine how to account for this in the current financial year and going forward. It is possible that the Prison and Police Healthcare projected overspend highlighted in this report can be reduced as a consequence of this work. Other Services (Lead Partnership) The £0.095m projected overspend (£0.146m overspend month 4) is due to increased Area Wide Evening Services and Palliative Care Services costs. This is mainly due to additional staffing costs including high use of bank staff to meet service demands which are expected to reduce when vacancies are filled. As part of the recovery plan, recovery actions will be undertaken to reduce costs by an estimated £0.069m in the remainder of the financial year within Area Wide Evening Services: • Caseload and rota review to ensure prioritisation of essential criteria for overnight interventions. • Reviewing skills mix and reducing teams from eight to seven. • Reducing bank usage by ensuring optimum recruitment to vacancies and maximising attendance at work Palliative Care Services budgets continue to be closely monitored and reviewed; however increased costs largely reflect demand for provision of services. This pressure will require to be considered on a pan-Ayrshire basis, as part of the 2026/27 budget-setting process. Alongside financial recovery plan actions, it is anticipated that the prison prescribing pressure can be considered through forthcoming pan- Ayrshire discussions. East Ayrshire Financial Recovery Plan (approved on 29th October 2025) A financial recovery plan will be presented to the IJB on 29 October 2025 for consideration and approval (and presented to North and South Ayrshire IJBs for approval). The initial hosted services financial recovery plan assumes that costs can be contained at month 6 projected outturn position levels overall, with specific savings highlighted in the table below to achieve overall financial balance in 2025/26.
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Service Division Proposed Saving 2025/26 £m Primary Care – Dental equipment balance (revenue) 0.035 Area Wide Evening Services – Staff Cost Reductions 0.069 TOTAL 0.104 Set Aside: - Work has been undertaken with partnerships to progress and develop 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. Further work has been undertaken through the Ayrshire Finance Leads group to establish baseline resources for each partnership and how these compare to the NRAC “fair share” of resources. Ayrshire Finance Leads have now agreed a baseline methodology for set aside budgets which involves using the four full years prior to the pandemic, 2016/17 – 2019/20 inclusive. The HSCPs require to agree their final share of the baseline with each other, however the aggregate will remain unchanged. The table below shows the cost of the historic baseline at 2024/25 prices. The 2025/26 actual usage information is not known until later in the year. IJB Baseline at 2024/25 prices (£) East 31.870 North 39.966 South 34.488 Total 106.324 The annual budget for Acute Services is £488.0million. The directorate is overspent by £17.2 million after 6 months including legacy CRES. This was caused by overspends on medical and nursing staff, together non pay overspends on equipment and supplies. These are required due to the level of operational pressure experienced. Unfunded wards contributed an overspend of £3.6m after 6 months. Within the overall £17.2 million overspend Medicine are over by £6.8 million, Emergency Care by £5.4 million, Surgery by £1.9 million, Labs and Diagnostics by £1.8 million and Women and Children by £1.2 million. Legacy CRES and underspends on other budgets make up the difference.
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There is a material underlying deficit caused by: • Length of Stay (LoS) and emergency admission rates in NHS Ayrshire and Arran acute hospitals are above the Scottish average. • 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. In respect of Lead Partnership Services, the 3 Chief Officers and CFOs have met to consider improvements in the reporting and visibility of financial and operational performance for those services which we lead or are led by another HSCP. Actions have been agreed to develop more regular shared information to be shared across all 3 IJBs with an intention to incorporate this further detail into future financial monitoring reports during 2025/26. 2.12 FINANCIAL RISKS There are a number of financial risk areas that impact or may impact on the financial position. • Current overspend areas, especially in low volume / high-cost services e.g. Children’s residential placements, UNPACs, and supplementary staffing across community, mental health and learning disability wards. • Growing demand for services. • Staff recruitment and retention challenges across a number of service areas. • The expectation that performance will continue to be maintained or improved despite the significant resource challenges. • Ongoing delivery costs of Scottish Government policy directives, particularly where these are not fully funded or inflation proofed. • Pay settlements for both NHS and Local Government staff have been agreed for 2025/26. The NHS element has been funded, and the current assumption is that the shortfall between budget planning assumptions and actual settlements will be fully funded for Local Government staff. • Unearmarked reserves are depleted, there is no scope to absorb in-year variances, with any overspends requiring additional funding from partners. • The ongoing review of the Integration Schemes, where there is a focus on financial arrangements and risk share. • The wider system financial challenges and impact across the whole system, for example the financial position of NHS AA and the decisions taken to reduce the Board’s deficit may have impacts on other parts of the health and care system.
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• Removal of brokerage for NHS Boards, NHS AA have been asked by Scottish Government to deliver further financial improvement beyond their Board approved financial plan. • The overall sustainability of commissioned care providers, with eNICs compounding historic challenges re financial sustainability, there is a heightened risk of provider failure leading to handing back of care and contracts. • The ongoing ability to source packages of care for service users. • Progress with the work to develop set aside arrangements and the risk sharing arrangements agreed as part of this. • The recurring underlying levels of overspend which may impact on the Partnership’s ability to continue to sustain service levels in the future. • The use of supplementary staffing for enhanced observations across a number of service areas and the use of high-cost agency staff to support frontline service delivery in areas where there are recruitment challenges. • Agenda for Change Pay Reform programme – including Nursing Band 5-6 re- grade, protected learning time and reduction to the working week. • Scot Excel inflationary increases for children’s services have been significantly higher than assumed. • There is a risk in relation to recovering recharge income in relation to the LD Assessment and Treatment patients from outwith Ayrshire. • Risk related to NHS Reform investment being allocated by Scottish Government on a payment by results basis and in arrears. • Local Government Settlement and Distribution Group (SDG) – The SDG periodically review existing distributions to ensure that they remain fit for purpose. The impact of this in future years is not yet known but it is a significant quantum of the overall funding. These risks will continue to be monitored during 2025/26. 2.13 RESERVES The IJB opening reserves position, subject to completion of the 24/25 audit, is summarised in the table below. General Fund Reserve Earmarked Reserves Total Unearmarked External Funding HSCP £m £m £m £m Balance – 1 April 2025 - 2.381 0.780 3.161 Anticipated Drawdown - (2.381) (0.780) (3.161) Balance – 31 March 2026 - - - - The £0.780m HSCP earmarked reserve relates to the Service Redesign and Change Fund which is fully committed in 2025/26. Further detail on the reserves is given in Appendix D.
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2.14 Financial Recovery Plan The IJB set a balanced budget for 2025/26 on 20th March 2025. This did not include any draw on reserves but did include the approval of £4.019m of savings to achieve financial balance. Services will continue to work towards implementing the recovery plan to deliver cost reduction targets while carefully managing the level of risk. This will include the preparation of equality impact assessments. The management actions and governance framework outlined below which were agreed in 2024/25 will continue throughout 2025/26: MANAGEMENT ACTIONS/CONTROLS AGREED IN 2024/25 • Review of expenditure authorisation levels across the Partnership and escalation of specific decisions to senior officers. In particular, a new governance group has been introduced, involving the Director and Heads of Service, to oversee the agreement of higher value packages of care (above £40,000 per annum). • Staff communication in relation to discretionary/non-essential spend. • Review of temporary posts and robust vacancy management/approval. The vacancy scrutiny group now has representation from all of the Heads of Service and a recruitment freeze will be implemented for all but essential frontline posts. • Restrictions on all but essential overtime working. • Ongoing review of future year savings or transformation programmes to identify scope for acceleration. • Maximise opportunities from the recently reopened Independent Living Fund (ILF) Scotland. GOVERNANCE MEASURES AGREED IN 2024/25 • Establishment a ‘Finance Working Group’, chaired by the IJB Chair or Vice Chair. The Director and Heads of Service are members of the group. It meets monthly to facilitate increased oversight and scrutiny of the financial position and transformation programme as well as detailed budget planning for future financial years. • Strengthened support from Finance Team to front line services and increased engagement with Heads of Service and Senior Management Teams, including line by line reviews of all budget areas. MANAGEMENT ACTIONS/CONTROLS AGREED IN 2025/26 (AUGUST 2025 and SEPTEMBER 2025) • Recruitment delay – there will be a recruitment drag with vacancy scrutiny approved vacancies being held for four weeks before they are advertised to
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create more payroll turnover. This will be for all vacancies except clinical or registered services vacancies or those which will incur cover costs. • High-cost care package group – the remit of this group will be expanded to include care packages for children with a disability and all UNPACs placement requests. • Oversight group for looked after and accommodated children in residential care – this group meets fortnightly to actively review all placements. • The senior managers for the main areas of overspend have been tasked with preparing an SBAR reports to be considered at the PSMT. This will cover current action being taken to reduce the overspend and future planned action. This will inform the update to the month 6 recovery plan. These actions will be tracked each reporting period and if progress is not being made an update will be made to the finance working group and IJB. • The Director and Chief Finance Officer have started a rolling programme of one-to-one meetings with individual budget holders across the HSCP to consider opportunities for cost reduction, service change and any spend to save propositions – to support the development of the 2026/27 budget but also to identify further cost reductions for the current financial year. RECOVERY ACTIONS – MONTH 6 UPDATE • The updated recovery action is outlined in Appendix E. This includes the proposals agreed at month 3 and 4 and updated progress at month 6 and any changes to target reductions. The actions are a mix of cost reduction targets across various services and a drawdown of reserves. At month 3 the residual risk position was: TOTAL Health/ NHS AA Social Care/NAC Projected Overspend @ mth3 5.187 2.271 2.916 Financial Recovery Plan Projections (4.012) (1.752) (2.260) Residual Risk 1.175 0.519 0.656 • At month 4 this deteriorated to: TOTAL Health/ NHS AA Social Care/NAC Projected Overspend @ mth4 5.259 2.051 3.208 Financial Recovery Plan Projections (3.526) (1.275) (2.251) Residual Risk 1.733 0.776 0.957 • At month 6 this has deteriorated to: TOTAL Health/ NHS AA Social Care/NAC Projected Overspend @ mth6 4.957 1.245 3.712 Financial Recovery Plan Projections (3.353) (1.244) (2.109) Residual Risk 1.604 0.001 1.603
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• This plan will be reviewed each month and further recovery actions will be presented to the IJB for approval. Services are working on further recovery actions to come to IJB in December – these will impact further on waits and service performance. PROPOSALS 3.1 Anticipated Outcomes Continuing to closely monitor the financial position will allow the IJB to take corrective action where required to deliver services in 2025-26 from within the available resource, thereby limiting the financial risk to the funding partners. The transformational change programme will have the greatest impact on the financial sustainability of the partnership, the IJB require to have a clear understanding of progress with the delivery of the transformation plan. 3.3 Measuring Impact Ongoing updates to the financial position will be reported to the IJB throughout 2025- 26. 4. IMPLICATIONS 4.1 Financial The outturn is an overall year-end overspend of £4.957m (1.5%) prior to recovery action. The report outlines the main variances for individual services. The IJB unearmarked reserve balance is zero. This current position poses a financial risk to North Ayrshire Council and NHS Ayrshire and Arran. 4.2 Human Resources The report highlights vacancy or turnover savings achieved during the year. 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. Tight vacancy scrutiny management arrangements are in place for the HSCP. 4.3 Legal None. 4.4 Equality/Socio-Economic None. 4.5 Risk Para 2.12 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.
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The ‘financial viability of the HSCP’ risk on our strategic risk register. 4.6 Community Wealth Building None. 4.7 Key Priorities The ability to deliver on our strategic priorities may be compromised due to the greater financial risk faced in 2025-26 and the increased focus required on financial rather than service improvement. This will be kept under close scrutiny throughout 2025-26. If we are unable to successfully develop a financial recovery plan to achieve financial balance, consideration may be given to revising the strategic commissioning plan. 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 – Eleanor Currie, Chief Finance Officer [eleanorcurrie@north-ayrshire.gov.uk]
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PUBLIC INFORMATION 2025-26 Budget Monitoring Report–Objective Summary as at 30th September 2025 Appendix A Budget Outturn Projected Over/ (Under) Spend Variance Budget Outturn Projected Over/ (Under) Spend Variance Budget Outturn Projected Over/ (Under) Spend Variance £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 COMMUNITY CARE AND HEALTH 79,033 81,988 2,955 20,987 22,199 1,212 100,020 104,187 4,167 4,330 (163) : Locality Services 32,974 33,962 988 5,900 5,899 (1) 38,874 39,861 987 1,206 (219) : Community Care Service Delivery 41,771 43,382 1,611 0 41,771 43,382 1,611 1,745 (134) : Rehabilitation and Reablement 2,136 2,176 40 0 2,136 2,176 40 10 30 : Long Term Conditions 896 946 50 10,633 11,609 976 11,529 12,555 1,026 1,063 (37) : Community Link Workers 374 370 (4) 0 0 0 374 370 (4) (5) 1 : Integrated Island Services 882 1,152 270 4,454 4,691 237 5,336 5,843 507 311 196 MENTAL HEALTH SERVICES 41,075 41,960 885 77,421 77,754 333 118,496 119,714 1,218 605 613 : Learning Disabilities 31,938 32,974 1,036 738 738 0 32,676 33,712 1,036 620 416 : Community Mental Health 7,112 6,955 (157) 1,812 1,812 0 8,924 8,767 (157) (154) (3) : Addictions 2,025 2,031 6 1,901 1,900 (1) 3,926 3,931 5 7 (2) : HBCCC 0 0 0 353 0 (353) 353 0 (353) (353) 0 : Lead Partnership Mental Health NHS Area Wide 0 0 0 72,617 73,304 687 72,617 73,304 687 485 202 CHILDREN & JUSTICE SERVICES 36,349 37,921 1,572 5,875 5,939 64 42,224 43,860 1,636 1,606 30 : Irvine, Kilwinning and Three Towns 3,259 3,344 85 0 0 0 3,259 3,344 85 62 23 : Garnock Valley, North Coast and Arran 3,619 3,687 68 0 0 0 3,619 3,687 68 57 11 :Intervention Services 1,827 1,836 9 0 0 0 1,827 1,836 9 5 4 : Care Experienced Children & Young people 22,749 24,745 1,996 0 0 0 22,749 24,745 1,996 1,915 81 : Head of Service - Children & Families 1,363 801 (562) 0 0 0 1,363 801 (562) (567) 5 : Justice Services 3,101 3,101 0 0 0 0 3,101 3,101 0 0 0 : C&F Health Team 431 407 (24) 4,995 5,101 106 5,426 5,508 82 118 (36) : Lead Partnership NHS Children's Services 0 0 0 880 838 (42) 880 838 (42) 16 (58) CHIEF SOCIAL WORK OFFICER 1,983 1,798 (185) 0 0 0 1,983 1,798 (185) (204) 19 PRIMARY CARE 0 0 0 54,721 54,805 84 54,721 54,805 84 36 48 ALLIED HEALTH PROFESSIONALS 0 11,504 11,505 1 11,504 11,505 1 1 0 MANAGEMENT AND SUPPORT COSTS 8,172 6,657 (1,515) 3,647 3,477 (170) 11,819 10,134 (1,685) (1,026) (659) OUTTURN ON A MANAGED BASIS 166,612 170,324 3,712 174,155 175,679 1,524 340,767 346,003 5,236 5,348 (112) Return Hosted Over/Underspends to East 0 0 0 0 (225) (225) 0 (225) (225) (159) (66) Return Hosted Over/Underspends to South 0 0 0 0 (196) (196) 0 (196) (196) (139) (57) Receive Hosted Over/Underspends South 0 0 0 0 104 104 0 104 104 50 54 Receive Hosted Over/Underspends East 0 0 0 0 38 38 0 38 38 159 (121) OUTTURN ON AN IJB BASIS 166,612 170,324 3,712 174,155 175,400 1,245 340,767 345,724 4,957 5,259 (302) Over/ (Under) Spend Variance at Period 4 Movement in variance from Period 4 TOTAL Partnership Budget - Objective Summary Council Health 2025/26 Budget
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2025-26 Savings Tracker Appendix B Social Care: Ref Description Deliverability Status at budget setting Deliverability Month 6 2025/26 Saving Previously Agreed Savings (Full year impact) 1 Review of Day Care provision Green Blue 0.100 2 Service redesign (CAAST Team and Corporate Parenting team) Green Blue 0.034 Adjustments 3 Payroll Turnover Green Blue 0.099 Mental Health 4 LD Responder Service Amber Amber 0.150 Children, Families & Criminal Justice 5 Brighter Pathways Amber Amber 1.000 Community Care & Health 6 Review of Day Care provision Amber Blue 0.107 7 Care at Home Amber Blue 0.500 8 Care Package Review (all services) Amber Green 0.200 9 Deletion of vacant posts Green Blue 0.056 10 Increase to charging Green Amber 0.186 11 Admin Post Savings Green Blue 0.114 12 Financial Inclusion Green Blue 0.357 TOTAL SOCIAL CARE SAVINGS 2.903 Cross Service
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Health: Ref Description Deliverability Status at budget setting Deliverability Month 6 2025/26 Saving Adjustments 13 Increase recharge to East Ayrshire for beds at Woodland View Green Blue 0.010 14 Payroll Turnover Green Blue 0.079 Other Savings 15 Admin Savings Amber Blue 0.186 16 Trindlemoss House - move to social care model Amber Amber 0.250 17 EICT/Rehab Amber Blue 0.150 18 Community MH/Wellbeing Review Amber Amber 0.100 19 Ward 7A - Woodland View Amber Amber 0.341 TOTAL HEALTH SAVINGS 1.116 TOTAL NORTH HSCP SAVINGS 4.019
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2025-26 Budget Reconciliation Appendix C COUNCIL Period Permanent or Temporary £'m Initial Approved Budget 137.739 Adjustments to baseline 0.014 Revised Budget 137.753 Resource Transfer 25/26 1-3 25.504 Additional Funding - 24/25 Adult Social Care RLW 1-3 P 0.073 Additional Funding RLW 1-3 P 0.126 Additional Funding - Money Smart 1-3 P 0.094 ICT Transfers 1-3 P (0.005) Additional Funding - Whole Family Wellbeing Funds 1-3 T 0.179 CJSW - S27 1-3 P 3.280 Development of People working in Childrens SW 1-3 P (0.390) Roundings 3 (0.002) 166.612Social Care Budget Reported at Month 4 HEALTH Period Permanent or Temporary £'m Initial Budget exc set aside 161.934 Month 10-12 Adjustments and adjusting for the full year impact of part years amounts and temporary funding. 8.532 Revised Budget 170.466 Resource Transfer 24/25 24.640 Resource Transfer 25/26 (25.504) NORTH NATIONAL INS 25-26 AMBUS 1 0.997 PRESCRIBING 25-26 AMBUSH 1 2.754 PRESCRIBING CRES 25-26 AMBUSH 1 (0.715) Training Grade Adj - April 1 (0.058) Training Grade Rates Adj - April 1 0.030 MH: Anticipate PDS Dementia (North) 25/26 1 0.094 MH: Anticipate Delivery of Veteran Specific 25/26 1 0.105 Anticipated RWW from SG 1 0.659 Anticipate 20% Tranche 2 ADP 1 0.174
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HEALTH Period Permanent or Temporary £'m Training Grade Adj - May 2 (0.013) Bwp 25-26 East Chest Heart Stroke 2 0.001 Bwp 25-26 East Nest Expansion 2 0.023 Bwp 25-26 East - Sds Advice Service 2 0.013 Bwp 25-26 East Sub Prescribing 2 0.170 25-26 South Budget Paper - North Substitute Prescribing 2 0.170 25-26 South Budget Paper - Pan Ayrshire Chest Heart And Stroke 2 0.001 25-26 North Budget Paper - Pan Ayrshire (vision Support Service 2 (0.005) 25-26 North Budget Paper - Pan Ayrshire (communitystore) 2 (0.155) HD52: EARLY INTERVENTION PSYCHOSIS 3 0.100 25-26 Pay Award Increase North 3 1.179 Training Grade Adjustment (Dean Funding) 4 0.011 Medical Pay Award - Senior Medical - Additional 1% 4 0.086 Medical Pay Award - Specialty Doctors - Additional 1% 4 0.006 Virement to Medical Directorate from Mental Health Admin 4 (0.028) Transfer MAT Standards Psychiatrist 0.2 WTE 4 0.029 Primary Care Prescribing Tariff Reduction 4 (0.556) BBV transfer from Public Health 4 0.269 Training Grade Adjustment (Dean Funding) - August 5 0.129 Budget transferred to Capital for INV-3395435821 5 (0.006) Transfer from South - ANP contribution 5 0.030 Primary Care Prescribing Budgets reworked 5 0.130 HD157 3% pay award ADP North 5 0.057 North MDT funding to Arran Medical Group (Virement 11) 5 (0.043) Training Grade Adjustment (Dean Funding) - September 6 0.018 ANTICIPATED BUDGETS INCL HERE (NOT IN LEDGER) 6 (1.104) Roundings 0.001 174.155 TOTAL COMBINED BUDGET 340.767 Health Budget Reported at Month 6
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25-26 IJB Reserves Position Appendix D Area of Reserves Balance at 31 March 2025 Earmarked Funds £ : Alcohol & Drug Partnership 353 : Mental Health Action 15 135 : Primary Care Improvement Fund 46 : Service Redesign / Challenge Fund 780 : Family Wellbeing Fund 934 : Breastfeeding Network 36 : MH Recovery and Renewal /Enhanced MH Outcome Framework 365 : Early Intervention in Psychosis 92 : LD funding 82 : Donation (Police Scotland) 1 : Primary Care Improvement Fund IP 303 : GP Premises Improvements - tranches 1 and 2 3 : Dental Practice Improvement 29 : Appropriate Adult 2 Total Earmarked 3,161
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Financial Recovery Action Plan Appendix E £m Projected Overspend at Month 6 4,957 SERVICE AREA Target at Month 6 Achieved at Month 6 Still to be achieved Target set (IJB Date) Comment a) Care home placements (568) (59) (509) August 2025 - month 3 report This will bring the overall budget for placements and charging order income online. b) Physical Disability Services (res, community and DPs) 0 0 0 August 2025 - month 3 report Some PD residential packages £508K (prev £575K) have moved to the older people Care Home placements budget. The older people placements will need to manage this transfer within the existing budget. c) Specialist Rehab wards (75) (39) (36) August 2025 - month 3 report Based on planned action developed by the senior manager. d) Wards 1 and 2 (275) (53) (222) August 2025 - month 3 report Based on planned action developed by the senior manager. e) Care at Home (300) 0 (300) August 2025 - month 3 report Reflects the potential reduction to costs as an impact of the SG investment in unscheduled care TOTAL (1,218) (151) (1,067) Mental Health Services Revised Target at Month 6 Achieved at Month 6 Still to be achieved Target set (IJB Date) Comment a) Learning Disabilities 0 0 0 August 2025 - month 3 report b) Community Mental Health services 0 0 0 August 2025 - month 3 report c) Lead Partnership for Mental Health : - Adult Inpatients (150) 0 (150) August 2025 - month 3 report Inpatient Review being undertaken - Elderly Inpatients (150) (66) (84) August 2025 - month 3 report Inpatient Review being undertaken - Psychiatry (150) 0 (150) August 2025 - month 3 report Junior doctor rota still to be revised. - Action 15 Reserves (486) (486) 0 August 2025 - month 3 report Draw down of the full pan Ayrshire reserve - agreed with the CFOs at East and South - Enhanced MH Outcome Framework Reserves (624) (624) 0 August 2025 - month 3 report Draw down of the full pan Ayrshire reserve - agreed with the CFOs at East and South NORTH AYRSHIRE ELEMENT 38.65% (603) (455) (148) August 2025 - month 3 report TOTAL (603) (455) (148) No cost reduction proposed but the service need to maintain the current position. All new placements need to be offset by discharges or reductions from care package reviews.
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SERVICE AREA Revised Target at Month 6 Achieved at Month 6 Still to be achieved Target set (IJB Date) Comment Children and Justice Services Target set (IJB Date) Comment a) Residential Placements (1,000) 0 (1,000) August 2025 - month 3 report Based on some placements moving to tenancies and other placements moving from external to in-house provision. TOTAL (1,000) 0 (1,000) Revised Target at Month 6 Achieved at Month 6 Still to be achieved Target set (IJB Date) Comment ALLIED HEALTH PROFESSIONALS 0 0 0 August 2025 - month 3 report No cost reduction proposed but the service need to maintain the current position. CHIEF SOCIAL WORK OFFICER 0 0 0 August 2025 - month 3 report No cost reduction proposed but the service need to maintain the current position. MANAGEMENT AND SUPPORT a) Payroll turnover (200) 0 (200) August 2025 - month 3 report Increase to the current projection based on dragging vacancies for 4 weeks after vacancy scrutiny approval. b) Transition slippage (100) (100) 0 August 2025 - month 3 report Based on historic slippage. c) Contractual inflation (100) (100) 0 August 2025 - month 3 report d) Service Redesign Fund (100) (100) November 2025 - moth 6 report TOTAL (500) (200) (300) OTHER AREAS b) Agenda for Change - assume fully funded (838) 0 (838) August 2025 - month 3 report Based on 100% cost of the half hour reduction in working week being funded. (838) 0 (838) TOTAL RECOVERY ACTION (4,159) (806) (3,353) Remaining projected overspend 1,604
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Bank and Agency Costs to Month 6 Appendix F 1) NHS 4863 (Registered) 4864 (Unregistered) 4853 (Registered) 4854 (Unregistered) TOTAL Average per month AAC074 North Core Slt Adult 3,098 3,098 516 AAC403 Ward 1 Woodlands View 23,100 173,772 196,872 32,812 AAC406 Ward 2 Woodlands View 15,431 230,267 245,698 40,950 AAC410 Ach Redburn Rehab Ward Nrs 17,929 110,872 128,801 21,467 AAC412 Ach Douglas Grant Rehab Wd Nrs 15,320 29,379 44,699 7,450 AAD401 Ward 3 Woodlands View Nursing 5,472 223,152 228,624 38,104 AAD402 Ward 4 Woodlands View Nursing 870 22,234 23,104 3,851 AAH047 New Clonbeith Nursing(jura) 60,239 65,250 125,489 20,915 AAH415 Wview The Glen Ect 3,133 4,013 7,146 1,191 AAH417 Wview Ward 10 Acute Mh Nrs 2,991 192,253 195,244 32,541 AAH423 Wview Ward 8 Acute Mh Nrs 13,583 510,635 524,218 87,370 AAH460 Ward 5 Woodlands View 1,821 9,955 11,776 1,963 AAH466 Wview Ward 7b Rehab Mh Nrs 2,302 2,302 384 AAH492 New Dunure Nursing(clonbeith) 21,653 94,990 116,643 19,441 AAH494 Mh Bed Management 16,565 16,565 2,761 AAT001 Trindlemoss 37,950 147,097 185,047 30,841 AAW047 Arran Hospital Nursing 40,072 32,879 72,951 12,159 ACA405 Camhs Management 1,944 1,944 324 ACA412 Camhs Unscheduled Care 801 801 134 ACF001 Early Yrs-c/f Team 1 923 923 154 ACF003 Early Yrs-c/f Team 3 974 974 162 ACF051 Immunisation Nursing 5,751 867 6,618 1,103 ACN047 Arran Dn 13,607 13,607 2,268 ACN012 Package Of Care (p) - Amg 80,863 80,863 13,477 ACN013 Package Of Care (p) - Lmo 312 312 52 ACP002 Nc Poc Team 2 990 990 165 ACP003 Nc Poc Team 3 3,271 3,271 545 ADN000 Three Towns Dn -101 -101 -17 ADN033 Irvine Dn 16,516 16,516 2,753 ADN042 North West Coast Dn 25,545 25,545 4,258 ADN075 Garnock Valley Dn 40,739 40,739 6,790 AHM154 North Ahp Management Team 7,329 7,329 1,222 ALA047 Lady Margaret Nursing 7,662 3,543 11,205 1,868 AMA408 Prevention + Services Spt Team 2,397 2,397 400 AML146 Ld Health Checks 12,238 12,238 2,040 AML392 North Cldt 5,777 164 5,941 990 AML402 Lds Management 2,286 2,286 381 AML429 Mhanps Mh Unscheduled Care 1,931 57 1,988 331 AML500 Mhs Inpatient Mgt 13,288 210 13,498 2,250 AMN412 Cmht Nursing-north Ayrshire 2,988 2,988 498 AMN415 Wview Ward 7c Forensic Rehab N 6,593 88,175 94,768 15,795 AMN425 Intensive Community Nursing Team 24,761 1,556 26,317 4,386 AMN431 Adult Mental Health Liasion Team 21,271 21,271 3,545 AMN433 Pcmht North 1,798 1,798 300 AMN446 Wview Ward 6 Low Secure Nrs 25,182 88,548 113,730 18,955 AMN454 Warrix Ave 56,387 52,694 109,081 18,180 ANU632 Icfn - Community Phlebotomy 6,278 6,278 1,046 AMN468 Action 15 - Adult Liaison 0 0 AMY415 Forensic Psychology 3,248 3,248 541 ASC001 Child Health Admin 1,083 1,083 181 AWV438 Wview Ward 7a Ld A+t Nrs 25,610 425,962 1,804 14,532 467,908 77,985 AXC407 Wview Ward 9 Acute Mh Nrs 13,199 199,604 226 213,029 35,505 AXC418 Wview Ward 11 Acute Mh Nrs 21,540 126,730 148,270 24,712 630,298 2,941,070 2,030 14,532 3,587,930 2) SOCIAL CARE £ 217,700 271,857 108,382 597,939 Bank Agency Montrose House LD - Asessment and Care Management MH - Asessment and Care Management