FINANCIAL REPORT TO THE GOVERNING BODY FOR THE ELEVEN MONTH PERIOD TO 29 FEBRUARY 2016 & FORECAST OUT-TURN TO 31 MARCH 2016

At A Glance KEY 1% Better than Plan On Plan 1% Worse than Plan Not Applicable Neutral awaiting information Statutory Duties Q1 Q2 Q3 Q4 YTD Revenue Resource Limit Cash Limit Better Payment Practice Code NHS Non NHS Financial Performance Q1 Q2 Q3 Q4 YTD 1% Surplus 2.5% Recurrent Surplus 2.5% NR Investment QIPP Performance – delivery of target QIPP Performance – delivery against identified schemes Main Provider Performance KEY MESSAGES Forecast Surplus position = £17.687m (on plan) QIPP schemes identified to £6.760m of £9m target ELHT reported as £4m overspend although actual forecast activity shows £5m over. Prescribing figures at month 11 show a £220k overspend, thus the year end forecast has been adjusted to £300k overspent. IPA - £1,850k forecast over spend

Statutory Duties Revenue Resource Limit (RRL) Expenditure MUST stay within the limits set for the financial year Cash Limit (CL) Cash spending must stay within the maximum cash drawdown allocated to the CCG for the year Limit £’000 On Target Notes Commissioning Budgets 574,106 P The figures reported are the total of notified and confirmed allocations. Adjustments have been actioned to reflect the transfer of commissioning responsibility for some specialist services. Running Costs 7,926  P Limit £’000 On Target Notes CCG Total 569,078 P The CCG is currently on target as regards spending being within the maximum allocated cash drawdown.

Cumulative Performance to Date Better Payment Practice Code (BPPC) The target is to pay ALL invoices within 30 days of receipt of a valid invoice Target Cumulative Performance to Date On Target for Year End Notes NHS Value 95% 99.9% P With regard to the Better Payment Practice Code, the CCG is currently exceeding target levels for both NHS and non-NHS invoices. Volume 99.0% Non-NHS 98.8%

Performance Measures 1% Surplus The CCG has to plan to deliver a 1% surplus Annual Surplus £’000 YTD Planned Surplus Actual reported YTD Surplus Confidence Dial Notes 17,687 7,046 17,046 The CCG has declared an additional £10m surplus to NHS England. This will be carried over for the CCG to draw down to invest in future years. Through the planning process we will be agreeing with NHS England the phasing of the drawdown

Monies owed to ELCCG at Month end Monies owed to ELCCG by NHS Organisations at month end. Monies owed to ELCCG by Non-NHS Organisations at month end. Monies owed to ELCCG as a percentage of ELCCG Annual Budget £’000 111 1,480 0.273% Number of customers 21 4 Average outstanding debt per customer£’000 5 370

Total QIPP Schemes – Achievement of target QIPP Scheme Delivery Analysis of identified QIPP schemes and delivery against savings plans to date Total QIPP Target £’000 Identified schemes QIPP Gap Confidence Dial Notes 9,000 6,460 2,540 The QIPP gap has increased slightly this month following the deterioration in the overall prescribing position. Confidence remains very low that the gap will be recurrently bridged in year Identified Schemes£’000 YTD Planned Savings £’000 Actual reported Savings Confidence Dial Notes 6,460 4,520 5,290 Of the identified QIPP schemes, confidence remains moderate to high that they will deliver.

Main Provider Activity (ELHT) Acute Services ONLY Annual Budget £’000 Plan YTD YTD Expenditure YTD Variance Forecast Out-turn Confidence Dial 209,814 192,321 197,405 5,084 4,000 Notes ELHT’s over-trade continues to increase. The forecast level has been maintained at£4m while the position is being investigated to validate ELHT’s figures, but also reflecting that a year end position has been agreed in advance with ELHT. The IBR for month 09 will give a detailed analysis of the activity and pressure areas, but by way of highlight the key pressure areas are, Vascular, Urology, Gastroenterology and Respiratory medicine Officers are working to understand the pressures in these particular areas and to mitigate the recurrent risks that this poses and to understand the recurrent impact that this might have.

Favourable variances are depicted in black and in brackets Adverse variances are depicted in red

Highlights and Risks Area Comment Best Case £’000 Likely Case Worst Case Acute SLA’s Whilst ELHT contract is forecasting significant over activity, other contracts (Airedale, Pennine and periphery providers) are compensating with forecast underspends There is however additional activity with the private sector, mainly orthopaedics, which is mitigated to a certain extent by an underspend in elective orthopaedic work with ELHT. -1,000 4,000 IPA The forecast overspend on IPA includes backdated charges for a particularly high package of care, which were accounted for in month 7, the position has improved slightly in month 1. -2,000 1,850 2,000 QIPP Failure to identify the balance of the in-year recurrent QIPP target 2,240 Prescribing M11 PPA prescribing figures show a large increase in expenditure which has resulted in a forecast overspend of £300k. This increase in expenditure has been mirrored by all Lancashire CCGs and is not therefore purely an East Lancashire issue. The position is being monitored. 300 1,000

Highlights and Risks Area Comment Best Case £’000 Likely Case Worst Case Primary Care Primary care is on target to breakeven by year end. The co-commissioning budget of £42.9m is forecast to underspend slightly. -300 300