east ayrshire council cabinet: 17 june 2015 east …docs.east-ayrshire.gov.uk/crpadmmin/2012...

$: EAST AYRSHIRE COUNCIL CABINET: 17 JUNE 2015 EAST …docs.east-ayrshire.gov.uk/crpadmmin/2012 agendas...I:\Administration\Admin Officers\CABINET REPORTS\2015 reports\17 June\EAC Cabinet$
I:\Administration\Admin Officers\CABINET REPORTS\2015 reports\17 June\EAC Cabinet 17-6-15 - Due Diligence Process for Establishment of HSCP Budget.docx/SR

EAST AYRSHIRE COUNCIL

CABINET: 17 JUNE 2015

EAST AYRSHIRE HEALTH AND SOCIAL CARE PARTNERSHIP MEDIUM TERM FINANCIAL PLAN – DUE DILIGENCE AND RISKS

Report by Depute Chief Executive: Economy and Skills and Chief Financial Officer

PURPOSE 1. The purpose of this report is to advise Cabinet of the current position and potential

future financial implications relating to the 2015/16 to 2017/18 budget of the East Ayrshire Health and Social Care Partnership (EAHSCP).

BACKGROUND 2.

The EAHSCP was formally established on 2 April 2015. A report entitled ‘Due Diligence Process for the Establishment of the East Ayrshire Health and Social Care Partnership Budget’; Appendix 1 to this report was approved at the meeting of the Shadow Integration Board (SIB) on 26 March and endorsed by the Integration Joint Board (IJB) on 2 April 2015.

3. The purpose of the report was to provide assurance to the IJB that the resources allocated by NHS Ayrshire and Arran and East Ayrshire Council are sufficient to deliver on the outcomes contained within the Strategic Plan. The report confirmed that, subject to effective risk mitigation in respect of existing and future budget pressures, as well as the successful delivery of approved efficiency savings, the initial resource delegated to the EAHSCP is sufficient to deliver the Strategic Plan outcomes.

4. The Due Diligence Process is also important from the Council’s perspective to ensure that there is a clear understanding of the current and future risk associated with the EAHSCP. This report highlights the key issues which East Ayrshire Council requires to be alert to as EAHSCP develops operationally.

5.

In the lead up to formal establishment of EAHSCP, East Ayrshire Council had been working with the two other Ayrshire Councils developing all aspects of financial governance, planning and management in respect of the HSCP. Joint working was put in place to ensure, as far as possible, that a standard approach was taken across the three Ayrshire HSCPs.

HSCP BUDGET PRINCIPLES

6. There are three broad components to the HSCP budget:

Resources which are delegated to each partnership.

Services which are managed on a lead partnership basis. The most significant of these managed by EAHSCP relates to Primary Care Services, with EAHSCP accessing services managed by other partnerships e.g. Mental Health Services managed with North Ayrshire HSCP and Allied Health Professional Services managed by South Ayrshire HSCP.


An EAHSCP ‘set aside’ budget of £20m for relevant hospital services, which will continue to be managed by the NHS Ayrshire and Arran Director of Acute Services, with consumption and potential resources flows being managed between the acute sector and the HSCP.

7. A key element of financial governance and planning relates to all agencies, the NHS

Board, Council and the IJB, being satisfied, as far as possible, that sufficient resources have been delegated to the IJB to deliver it’s outcomes as set out in its Strategic Plan. To achieve this, a process of due diligence was carried out. The due diligence process analysed historic spend patterns, projected resource requirements and current efficiency initiatives to support a professional judgement on the adequacy of delegated resources to the HSCP. Detailed due diligence has been completed in respect of the first component of the budget. Projected outturn against annual budget will be subject to ongoing monitoring and review and will be reported to the Integrated Joint Board at regular intervals over the course of each financial year. This is a key component of the due diligence process as it ensures that the impact on resources from increased demand (e.g. demographic pressures and increased prevalence of long term conditions) and other planned and unplanned activity changes are monitored and reviewed on a regular and ongoing basis.

8. Further analysis of consumption and activity levels is required in respect of Lead Partnership and Acute Service budgets. To support effective financial planning, it will be essential that each HSCP receives regular updates on usage of both Lead Partnership and Acute Services to ensure that any resource implications are identified at the earliest opportunity. It has been agreed that rolling three year average usage will be applied to these services in recognition of the likelihood that actual usage will vary year on year. Any change in patterns of usage will require to be reflected in updates to the Strategic Plan and partner contributions.

EAHSCP BUDGET 2015/16 to 2017/18

9. The report at Appendix 1 summarises the resources available to the EAHSCP for 2015/16. Section 19 of the report highlights the budget for HSCP services managed within East Ayrshire Council and reflects decisions taken by the Council when it set its budget for 2015/16 in December 2014. Section 29 in the report highlights the budget for HSCP services managed within NHS Ayrshire and Arran and reflects decisions taken by the NHS Board when it set its budget for 2015/16 in March 2015. These 2015/16 approved budget allocations are highlighted in Appendix 2 along with indicative funding levels for 2016/17 and 2017/18. These indicative years two and three budget allocations incorporate assumptions in respect of inflationary pressures and additional efficiency savings requirements. There are a number of significant 2015/16 funding adjustments highlighted in the tables at sections 19 and 29 of the report at Appendix 1 as follows:

Additional resources of £3.5m in reflecting underlying service pressures;

Additional resources that have been made available in from the Scottish Government’s Integrated Care Fund £2.470m. This funding will also be available in 2016/17 and 2017/18. It should be noted that this funding is partially offset by a reduction of £1.870m in Older People’s Change Fund funding from the Scottish Government;

Additional Scottish Government Delayed Discharges funding £0.741m;


Approved recurring efficiency savings totalling £4.159m (figure subsequently reduced to £4.064m);

The indicative budgets highlighted in Appendix 2 incorporate further recurring approved / anticipated efficiency savings of £3.561m in 2016/17 and £3.581m in 2017/18. Previously approved savings include: Efficiencies from investment in reablement and review within adult care services

£0.983m; Increased focus on reablement and promotion of independent living within care

at home services £1.583m; Rebalancing of externally commissioned foster care services £0.952m; Development of an integrated Educational and care provision for children and

young people with complex care needs £1.3m.

10. The 2014/15 draft final outturn position for the EAHSCP will be presented to the IJB on 18 June 2015 and will highlight a breakeven position for services managed within East Ayrshire Council and an overspend of £0.896m on services managed within NHS Ayrshire and Arran. This overspend represents a marginal variance of 0.45% on the approved annual budget £197.152m. It is important to emphasise that these draft final outturn figures are subject to external audit.

11. As the HSCP progresses into 2015/16, it is important to recognise that there are a number of pressures within the base budget arising from:

Core services that depend on non-recurring funding;

Historic overspends in services that require to be funded or services reduced in line with budget;

The need to achieve approved efficiency savings;

Unavoidable demand that has not been fully funded.

12. The HSCP Management Team with the support of the IJB will throughout the year seek to manage and monitor the budget and service implications through tight financial governance.

13. The HSCP Integration Scheme which was approved by the Cabinet Secretary for Health, Wellbeing and Sport on 2 March 2015 states that responsibility for correction of any errors in the baseline budget requires to be resolved by the original partner. This ensures that there is no cost shunting between partners as a result of the establishment of the HSCP. The Integration Scheme also outlines the process and funding responsibility for approved future year budget changes.

14. Further work is required to establish the final process for the establishment of future year budgets, reflecting the differing timescales and processes in place within the Council and NHS Board.

FINANCIAL MANAGEMENT AND REPORTING

15. The regular East Ayrshire Performs report which will be presented to Cabinet will include HSCP budget monitoring statements for services managed within both East Ayrshire Council and NHS Ayrshire and Arran. This will ensure that the Council is alert to the financial performance of the EAHSCP. It is anticipated that this will include budget monitoring information on Lead Partnership Services, regardless of which HSCP is the


Lead Partner. It is also anticipated that activity information will be provided in respect of Acute Services.

16. The approved Integration Scheme sets out the requirement for the EAHSCP to operate within approved resources and summarises action in the event of a number of scenarios:

Where an overspend is emerging there is a requirement to develop a recovery plan with there being a potential requirement for individual partner additional contributions if the IJB fails to contain expenditure within available resources;

In certain circumstances any underspend can be retained by the IJB in line with its Reserves Strategy;

Responsibility and funding for in year variations in Acute Services continue to sit with NHS Ayrshire and Arran;

Neither the Council nor the NHS Board may reduce it’s in-year payments without the agreement of the IJB and other party

FINANCIAL IMPLICATIONS

17. There are no direct financial implications arising from this report. The report summarises the process by which the initial IJB budget has been established, key elements from the approved Integration Scheme and financial risks faced by the IJB and the Council.

HUMAN RESOURCE IMPLICATIONS

18. There are no human resource implications arising from this report.

LEGAL IMPLICATIONS

19. There are no legal implications arising from this report.

COMMUNITY PLANNING IMPLICATIONS

20. The Integration of Health and Social Care will contribute to the delivery of the Community Planning Partnership Wellbeing Delivery Plan.

EQUALITY IMPLICATIONS

21.

There are no equality implications arising from this report.

RECOMMENDATIONS

22.

It is recommended that Cabinet note: (i) The Due Diligence Process undertaken to establish the approved EAHSCP

budget for 2015/16 and indicative budgets for 2016/17 and 2017/18;

(ii) The risks associated with the current level of funding and the potential future financial implications for East Ayrshire Council;

(iii) The procedure for future financial monitoring and reporting and


(iv) Note that this report has also been submitted to the Governance and Scrutiny

Committee for their consideration; and

(v) Otherwise note the content of the report. Alex McPhee Depute Chief Executive & Chief Financial Officer Economy and Skills 9 June 2015

LIST OF BACKGROUND PAPERS

Nil

Members wishing further information should contact Craig McArthur, Head of Finance and ICT, Tel: 01563 576513.

IMPLEMENTATION OFFICER: CRAIG MCARTHUR

1 EAC Cabinet 17-6-15 - Due Diligence Process for Establishment of HSCP Budget - Appendix 1/SR

APPENDIX 1

EAST AYRSHIRE HEALTH AND SOCIAL CARE PARTNERSHIP SHADOW INTEGRATION BOARD

26 MARCH 2015

DUE DILIGENCE PROCESS FOR THE ESTABLISHMENT OF THE EAST AYRSHIRE HEALTH AND SOCIAL CARE

PARTNERSHIP BUDGET

Report by Executive Director of Finance and Corporate Support East Ayrshire Council and Executive Director of Finance NHS Ayrshire and Arran

PURPOSE

1. The purpose of this report is to provide details of the due diligence processes

that have been applied to the creation of the consolidated East Ayrshire Health and Social Care Partnership budget for the 2015/16 financial year. BACKGROUND

2. The Scottish Government established the Integrated Resources Advisory Group (IRAG) to consider the financial implications of integrating Health and Social Care and to help develop professional guidance. The due diligence process is required to ensure that resources delegated are sufficient for the Integration Joint Board to carry out its functions. A key element of the due diligence process is the 2015/16 budget being assessed against actual expenditure for the most recent three financial years.

3. The due diligence processes that have been applied to the 2014/15 shadow year budget will be carried forward to the 2015/16 budget to ensure consistency in approach, allow the identification of continuing pressures, demands and associated risks and enable relevant and necessary management action to be taken.

4. It is important that a process of due diligence is undertaken to ensure that the

budget provided for the Partnership is sufficient, identifies current and historical pressures and demands and allows the Partnership to proceed on a sound financial basis.

5. Due diligence will be informed by an overview, for both Council and Health aspects, of the following

2012/13 final expenditure

2013/14 final expenditure

2014/15 projected expenditure

2014/15 budget

2015/16 budget


6. Appendix 1 to this report provides this overview on a consolidated basis with Appendices 2 and 3 providing a separate breakdown of services managed within East Ayrshire Council and NHS Ayrshire and Arran respectively.

7. The Integration Joint Board is responsible for the production of a Strategic Plan setting out the services for their population over the medium term (3 years). To support this medium term financial planning process, East Ayrshire Council and NHS Ayrshire and Arran are required to provide indicative three year rolling funding allocations to the Integration Joint Board. Such indicative allocations would remain subject to annual approval by both organisations. It is the responsibility of the Chief Officer and the Integration Joint Board Financial Officer to develop a business case for the integrated budget based upon the Strategic Plan and to present this business case for consideration and agreement within the budget-setting processes of East Ayrshire Council and NHS Ayrshire and Arran. The ultimate objective is to ensure that the Strategic Plan meets the requirement for economy, efficiency and effectiveness in the use of the Integration Joint Board’s resources HSCP BUDGET

8. The budget for the Partnership will be derived from the funding allocated to the Integration Joint Board from East Ayrshire Council and NHS Ayrshire & Arran Health Board. In 2015/16 the funding will continue to be used as sourced but in future the Integration Joint Board may choose to use the funds to provide services in an alternative manner.

DUE DILIGENCE PROCESS 2015/16 SOCIAL WORK BUDGETS

9. The projected final outturn position of the Social Work budgets which formed the Council’s element of the East Ayrshire Health and Social Care Shadow Year budget is important in respect of due diligence as it provides details of any overspend on the budget and enables scrutiny of the base budget prior to it becoming part of the Partnership.

10. The Council has a well established process for compiling departmental budgets and incorporating them into the overall Council’s budget process. The Finance Service update Accounting Policy Bulletin 4A (APB4A), annually and thereafter the document is issued to all Chief Officers and is the formal commencement of the annual budget preparation process. A copy of the 2015/16 APB4A is attached as Appendix 4 to this report.

11. The APB details the underlying assumptions that will form part of the budget

and also provides budget holders and managers with details of the relevant inflationary uplifts to be applied to the base budgets.

12. Payroll costs are built up using a process that captures all establishment approved posts, on a name by name basis, as at 1 September each year. This information derives from the payroll system and detailed work is undertaken by Corporate Accounting colleagues and culminates in a payroll budget being produced on a name by name basis and which has been


updated for individual increments, employer National Insurance contributions and employer superannuation contributions for each employee. Departmental budgets are updated for the movement in payroll costs arising from inflationary uplifts and the process concludes with a full name by name payroll budget based on the approved establishment for the Council’s element of employee costs within the Partnership budget.

13. The process to enable contract inflationary uplifts to be identified by budget holders is also noted in APB4A and a schedule is completed by each department and details the specific contracts and the inflation rate and relevant monthly uplift to be applied. Contract inflation is only awarded to those contracts which contain clauses stating that inflationary uplifts are required and detail the relevant rate and the month of application. Once this has been completed and assessed by the Finance Service then the contract inflationary uplifts are incorporated into the departmental budget.

14. The Council has an ambitious capital expenditure programme and consequently there are occasions when the capital builds are completed and assets become operational during the financial year. Colleagues in Property and Facilities Management services provide details of the capital programme projects that will become operational and revenue consequence of capital costs, which predominantly relate to additional staff costs and property costs, are included in the budget. APB4A provides guidance on the process to be used to quantify the recurring revenue costs to be included in the revenue budget to meet the costs of operating the asset.

15. Fees and charges income uplifts are detailed in the APB and an uplift of 2.4% representing the July 2014 RPI has been assumed in all fees and charges budgets. As in previous financial years, services will be free to determine a pricing strategy to achieve the overall increase. Estimated uplifts are included for recharges to NHS Ayrshire and Arran for various funded initiatives including Resource Transfer and Joint Planning projects.

16. The Council recognises that there is a significant increased demand for specific services and consequently an Unavoidable Demand template is also included in APB4A to allow departments to identify significant pressures and seek an additional contribution to their budget.

17. Once the contract inflation, revenue consequences of capital and unavoidable demand templates have been completed the submissions are presented to the Corporate Management Team for initial discussion, scrutiny and subsequent approval.

18. Appendix 2 to this report highlights a marginal projected overspend for the Social Work budget £0.414m for the 2014/15 shadow year. Work has been undertaken to provide assurance in respect of due diligence that the base budget updated for APB4A and which became the Council’s budget for the 2015/16 Shadow year is reliable, adequate and compiled using sound financial methodologies. This work includes detailed examination of all budget headings with medium term financial forecasts and associated assumptions


and risks being reviewed. This includes material non-recurring funding and expenditure budgets, budget pressures and approved savings and efficiency targets.

19. The movement in budget from 2014/15 to the draft budget for 2015/16 can be

analysed as follows:

£ million

Council budget 2014/15 as at December 2014 68.144

Baseline adjustments 2015/16 (0.512)

Estimated pay uplift plus increments * final pay award not yet agreed

0.878

Contractual Inflation uplift – variable 0.916

Fees and Charges / Income uplifts (0.231)

Additional funding - unavoidable demand pressures

1.400

Approved cash releasing efficiency savings (3.376)

Sub total 67.219

Outwith Placements budget transfer 4.413

Draft Council Budget 2015/16 71.632

20. Cash releasing efficiency savings totalling £3.376m have been approved for

2015/16. Appendix 5 to this report provides a breakdown of these approved savings and highlights risks (red – high / amber – medium / green – low). These risk classifications are based upon currently available information and work will be undertaken during the year to monitor and review the achievement of these savings over the course of the financial year. Progress will be highlighted in Financial Management Reports to the Integration Joint Board.

21. The draft 2015/16 budget includes £4.413m transferred to Social Work Children’s Services to fund future outwith authority schools placements. This budget was previously held within Educational Services and Social Work final / projected outturn figures for 2012/13, 2013/14 and 2014/15 presented in Appendix 2 have been adjusted to include these figures. The final / projected outturn position is highlighted in the following table. The Financial Management Report to the Shadow Integration Board on 24 February 2015 highlighted a projected overspend of £0.414m for 2014/15. Taking account of the £0.544m projected underspend in outwith placements, the revised projected variance is an underspend of £0.130m. It should be noted that additional funding has been allocated from the Council’s Budget Transformation Fund in both 2014/15 and 2015/16 to facilitate a full review of the looked after and accommodated children’s service. A cash releasing efficiency saving of £1.300m has been approved for 2016/17.


2012/13 £million

2013/14 £million

2014/15 £million

Annual Budget 4.101 4.222 4.363

Actual / Projected Expenditure 4.264 4.723 3.819

Actual / Projected Variance 0.163 0.501 (0.544)

DUE DILIGENCE PROCESS 2015/16 HEALTH BUDGETS

22. In Health there is a requirement to submit to the Scottish Government an interim financial plan in February each year with the final plan being due in late March. The Health Board will approve the budget for 2015/16 at its meeting on 30 March 2015.

23. Financial plans are created based on the current existing recurring Health budgets. The understanding of the current budget variances are assessed to determine if these are of a recurring or non-recurring nature and whether the cause of overspend is justifiable e.g. evidence of increased activity.

24. To arrive at the financial plan there is:

A review of existing over-commitments to determine if there is a requirement for additional funding.

An assessment of expected cost increases (e.g. pay uplifts, inflation, horizon scanning for the introduction of new drugs, implications of national agreements eg provision of tertiary paediatric beds).

A need to address any commitments made during the year (eg a need to increase the ADOC rates of pay to maintain services).

Consideration of the growth in demand e.g. volume increases for prescriptions in primary care are now at 2.5% although historically this has been 4%; an increase of 2.5% equates to a cost of almost £2 million. Other examples of growth are increased diagnostic tests, increased surgical procedures for cataracts or hip/knee replacement.

A requirement to meet Scottish Government access targets (e.g. apply Demand, Capacity, Activity and Queue Analysis to determine if the orthopaedic staffing levels are sufficient to manage access targets).

Determine shortfalls in existing staffing provision against tools such as the nursing workforce tool.

Consideration of services where there could be patient safety or health and safety issues.

25. The cost pressures requiring funding in the following financial year are

reviewed by a few multi-disciplinary groups to arrive at robust estimates to form the base of the financial plan:

Medicine Resource Group focuses on the cost and growth in drugs giving particular consideration to the emergence of new drugs.

Pay and Supplies group considers prior commitments e.g. Building for Better Care, pay award liability, changes to National Insurance and Superannuation contributions, supplies and contractual inflation and other


areas of existing commitment. Pay budgets are set at the pre-penultimate point on the salary scale.

The Workforce Prioritisation Programme Group reviews the service requirements for additional staffing and determines a priority in which any available funding should be applied.

The outcomes of these groups are reviewed by the Corporate Management Team (CMT) who require to prioritise across these competing demands.

26. The requirement to meet Cash Releasing Efficiency Savings (CRES) is determined by the extent of the cost pressures and the level of increased allocation from the Scottish Government. Directors are expected to identify potential sources for these savings and the risks associated with these plans. Not all budgets will be subject to CRES e.g. the budget for primary medical services is a separate allocation to the Board which funds nationally negotiated payments and is therefore exempt from CRES.

27. The outcome of the CMT deliberations reflecting the agreed cost pressures to be funded and the source of CRES is provided for consideration by the Performance Governance Committee before being submitted to the NHS Board for approval.

28. Appendix 3 highlights the Health expenditure in 2012/13 and 2013/14 on “in-scope” budgets; the annual budget for 2014/15; the projected expenditure for 2014/15 and the indicative budget for 2015/16. The indicative budget, which is reflected in the indicative allocation for the strategic plan, is based upon the current recurring budget, adjusted for an inflationary uplift on pay and assumes a requirement of CRES of 3%. It should be noted that the 2014/15 budget and projected expenditure vary from the figures previously reported to the Shadow Integration Board because the following are now included:

Funding for war pensioners at Hollybush House

Health care services in the prison and police cells.

Specific nursing cancer care services.

General community prescribing costs covering Community Oxygen services, Vaccines and costs associated with Prescribing in Primary Care e.g. discount recovered.

Reviewing Appendix 3 it is worth noting:

The Prescribing budget for 2015/16 is indicative pending allocation to a practice level. The full application of the current budget setting methodology reflects National Resource Allocation Formula, historic expenditure and achievement of certain prescribing indicators. The uplift assumes that there will be a fall in prices for those drugs where there have been issues with short supply.

The service strategy budget provides for HSCP management posts. The budget for 2015/16 has been increased to reflect the funding available.


There is a pressure on the budget at Kirklandside where the patients are more dependent than in the past with a need for higher levels of nurse staffing. There is some capacity with the underspend at East Ayrshire Community Hospital to manage the over-commitment at Kirklandside.

The Primary Care expenditure in 2012/13 was particularly high in the Family Health Services budget where the expenditure is funded in full. The transfer of health care services to people in prison cells was introduced in 2014/15. The over-commitment in 2014/15 relates to medical services on Cumbrae; increased demand for Primary Care Ophthalmic services; a shortfall in the discount recovery on Prescribing in Primary Care and high demand for enhanced services provided by GPs. These over-commitments are being addressed in 2015/16 either by provision of additional funding or consideration on how to manage increased demand within budget.

29. The movement in budget from 2014/15 to the draft budget for 2015/16 can be

analysed as follows:

£ m £ m

Health budget 2014/15 as at December 2014 124.655

War Pensioner 1.236

Health Services in Prison and Police cells 2.885

Cancer Care 0.143

Community prescribing 2.928 7.192

2014/15 Budget 131.847

Less non-recurring funding in 2014/15 (0.828)

Estimated pay uplift and Employer Superannuation 0.474

Additional funding for:

- ADOC 0.288

- Medical Services on the islands 0.192

- Primary Medical Services 0.274

- Frail Elderly bed closures 0.300

- Management Structure 0.589

- Prescribing uplift (including community prescribing)

0.468 2.111

Scottish Government Investment:

Integrated Care Fund 2.470

Change Fund (1.897) 0.573

Delayed Discharge 0.741

Efficiency savings identified (0.783)

Draft Health Budget 2015/16 134.135


The plans to achieve the CRES have still to be developed which is a risk for the Partnership. 30. In addition, there is the set aside budget for the large hospital budget. It has

been agreed that this will be managed by NHS Ayrshire & Arran with no in-year financial consequence on HSCPs, but would annually be reviewed as part of the Strategic Plan.

31. The introduction of Health and Social Care Partnerships in Ayrshire will see a number of services currently provided by Health being managed by one HSCP for the entire Ayrshire population. It is proposed that the East HSCP will deliver Primary Care (including Dental) Services as the lead Partnership, with Mental Health Services being delivered by the North Ayrshire HSCP and Allied Health Professionals Services being delivered by South Ayrshire HSCP. The due diligence process outlined in this report for NHS services will apply in Lead Partnership arrangements. ONGOING MONITORING AND REVIEW

32. Projected outturn against annual budget will be subject to ongoing monitoring and review and will be reported to the Integrated Joint Board at regular intervals over the course of the financial year. This is a key component of the due diligence process as it ensures that the impact on resources in respect of increased demand (e.g. demographic pressures and increased prevalence of long term conditions) and other planned and unplanned activity changes are monitored and reviewed on a regular and ongoing basis. The requirement for ongoing monitoring of and reporting of progress against approved efficiency savings is a further key component of the due diligence process. Financial Management Reports to the East Ayrshire Shadow Integration Board during 2014/15 highlighted the approved efficiencies which are challenging in terms of delivery in 2014/15 and this will continue in 2015/16. ASSURANCE STATEMENT

33. The processes detailed in this paper provide information on the financial management arrangements for the preparation of the East Ayrshire Partnership budget in the Shadow Year and going forward and highlight the procedures used to ensure that a financially sound and stable budget has been prepared.

34. It is the opinion of the nominated Integration Joint Board Chief Financial Officer that the initial budget allocated to the Partnership is sufficient to deliver on the outcomes highlighted within the Strategic Plan. Given the needs led nature of Health and Social Care services, it is possible that there will be deviations from original plans over the course of the financial year. Robust budgetary control, monitoring and reporting procedures are in place and any budget variances arising during the financial year and remedial proposals will be brought to the attention of the Integration Joint Board at the earliest opportunity.


35. Section 31 highlights that the due diligence process will apply to Lead Partnership arrangements across the three Ayrshire Health and Social Care Partnerships. It is important to consider that there is the potential for future financial implications arising from budgets managed under these Lead Partnership arrangements. There is a requirement for the Lead Partnership to produce periodic management accounts for their lead service and to provide this information to the other two Partnerships on a regular and ongoing basis. This will ensure that any such financial implications can be included in Financial Management reports to the individual Integration Joint Boards, as part of the agreed reporting cycle.

RECOMMENDATION

36. It is recommended that the Shadow Integration Board: i) Notes the due diligence processes that have been applied to the

creation the consolidated East Ayrshire Health and Social Care Partnership budget for the 2015/16 financial year.

ii) Notes that this report will be tabled at the first meeting of the Integration Joint Board on 2 April 2015 for endorsement and

iii) Otherwise notes the content of the report.

Person to Contact Alex McPhee, Executive Director of Finance and Corporate Support, East Ayrshire Council,

East Ayrshire Council Headquarters, London Road, KILMARNOCK, KA3 7BU: Tel – 01563

576279: e-mail: [email protected]

Derek Lindsay, Executive Director of Finance, NHS Ayrshire and Arran, Greenan House,

Ailsa Hospital, Dalmellington Road, AYR, KA6 6AB: Tel – 01292 – 513326: e-mail:

[email protected]

AMcP

20 March 2015

mailto:[email protected]

mailto:[email protected]

Indicative Health & Social Care Partnership Budgets: East

2015/16 2016/17 2017/18 2015/16 2016/17 2017/18

Budget Budget Budget Budget Budget Budget

HSCP HSCP HSCP Health Health Health

£'000 £'000 £'000 £'000 £'000 £'000Level One Core

Learning Disabilities 11,489 10,683 11,431 473 469 480

Physical Disabilities 617 714 709 0 0 0

Mental Health 4,391 4,395 4,419 1,889 1,874 1,916

Addiction 1,150 1,146 1,166 967 959 981

Adult Support and Protection 459 0 0 0 0 0

Older People 31,142 31,743 31,581 0 0 0

Sensory 165 167 165 0 0 0

Community Nursing 4,693 4,655 4,760 4,693 4,655 4,760

Prescribing 23,567 23,774 24,725 23,567 23,774 24,725

General Medical Services 14,926 15,001 15,076 14,926 15,001 15,076

Service Strategy (Partnership Management) 4,629 4,380 4,366 602 616 630

Social Work Transport 435 510 507 0 0 0

Integrated Care Fund 2,470 0 0 2,470 0 0

Resource Transfer, Change Fund, Admin 10,511 11,675 11,676 10,511 11,675 11,676

Total Level One 110,643 108,844 110,580 60,097 59,023 60,244

Level Two - Non District General Hospitals

East Ayrshire Community Hospital 2,751 2,729 2,792 2,751 2,729 2,792

Kirklandside Hospital 1,119 1,110 1,136 1,119 1,110 1,136

Total Level Two 3,870 3,840 3,928 3,870 3,840 3,928

Level Three - Hosted Services

Primary Care (Including Dental) 68,127 69,379 70,792 68,127 69,379 70,792

Out of Hours Social Work Services 233 241 240 0 0 0

Total Level Three 68,360 69,620 71,032 68,127 69,379 70,792

Level Four - Children's Services

C&F Social Work inc Criminal Justice 20,853 19,048 20,198 0 0 0

Health Visiting 2,041 2,025 2,072 2,041 2,025 2,072

Total Level Four 22,894 21,073 22,270 2,041 2,025 2,072

Partnership Total 205,767 203,377 207,810 134,135 134,267 137,036

east ayrshire council cabinet: 17 june 2015 east …docs.east-ayrshire.gov.uk/crpadmmin/2012...

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