Finance Report as at 31 st May 2014 Durham Dales, Easington and Sedgefield Clinical Commissioning Group 1

Executive Summary as at 31 st May 2014  Income & Expenditure The CCG is reporting an underspend year-to-date (YTD) and forecast outturn position.  Capital No allocations have been announced to date however indications are that minimal funds are available.  Cash The forecast cash drawdown is in line with the anticipated cash limit.  Quality, Innovation, Productivity & Prevention (QIPP) Current QIPP forecasts show full delivery against target.  Better Payment Practice Code (BPPC) The CCG is exceeding its target of paying 95% of valid invoices within 30 days. Durham Dales, Easington and Sedgefield Clinical Commissioning Group 2 TargetForecast £22,755K

Budget to Actual Variances as at 31 st May 2014 Durham Dales, Easington and Sedgefield Clinical Commissioning Group 3

Overview of Financial Position as at 31 st May 2014  The current position shows a year to date under-spend of £915K and a forecast outturn under-spend of £5,490K against a total expected allocation of £424,023K. This is in line with the Financial Plan submitted to NHS England.  The CCG’s financial position is under continual review and the current position shows the organisation to be on track to achieve its key financial targets. However for much of the programme activity it is too early to form an accurate position and work is on-going to scrutinise activity and data received.  Notable exceptions to this include Continuing Healthcare and Community Services budgets.  Continuing Healthcare is showing a year to date under-spend due to the risk share arrangements across the County Durham and Darlington CCG’s not currently being transacted.  Pressure is currently being observed within community services, relating to County Durham and Darlington NHS Foundation Trust out of contract items, including continence. Durham Dales, Easington and Sedgefield Clinical Commissioning Group 4

Financial Position as at 31 st May 2014 Durham Dales, Easington and Sedgefield Clinical Commissioning Group 5

Acute Commissioning as at 31 st May 2014 Limited data is available at this point in the year as submissions by acute providers are completed as part of the national timetable. It is anticipated that this information will be received in June as per the national activity submission guidelines and will enable the month three position to be reflective of this. In the intervening period, budgets are assumed to perform in line with the planning assumptions on which contract values have been set. The majority of acute contracts have financial plans in place and are agreed with providers, although contracts are not formally signed. Contracts with County Durham and Darlington NHS Foundation Trust are not yet finalised and negotiations are ongoing to resolve the outstanding issues. Durham Dales, Easington and Sedgefield Clinical Commissioning Group 6

Community Services as at 31 st May 2014 As expected at this early stage of the year limited information is available. It is anticipated that information will be available for June 2014 which will facilitate more accurate and detailed reporting. Contractual positions are therefore showing breakeven. Other NHS above includes out of contract charges relating to County Durham and Darlington Foundation Trust which show as a pressure year to date. Specifically included are Orthotics, Continence and Patient Transport, which are intended to be incorporated into the contract during 2014/15 financial year. Durham Dales, Easington and Sedgefield Clinical Commissioning Group 7

Continuing Healthcare as at 31 st May 2014 Continuing Healthcare (CHC) costs are based on expected year-to-date and forecast outturn from the CHC database. The position includes an estimate of growth in packages for the 2014/15 financial year of £947k, which has been reflected in the budget. The risk share arrangements for high cost cases within CHC across the County Durham and Darlington CCGs is currently not being applied, pending agreement for the 2014/15 financial year. The financial position is based upon 650 approved packages of care which are confirmed as being delivered to patients. There have been 103 new or changed packages so far this year.. Durham Dales, Easington and Sedgefield Clinical Commissioning Group 8

Mental Health as at 31 st May 2014 As expected at this early stage of the year limited information is available. It is anticipated that information will be available for June 2014 which will facilitate more accurate and detailed reporting. Positions are therefore showing breakeven. Durham Dales, Easington and Sedgefield Clinical Commissioning Group 9

Primary Care as at 31 st May 2014 As expected at this early stage of the year limited information is available. It is anticipated that information will be available for June 2014 which will facilitate more accurate and detailed reporting. Positions are therefore showing breakeven. Durham Dales, Easington and Sedgefield Clinical Commissioning Group 10

Other and Programme Reserve as at 31 st May 2014 As expected at this early stage of the year limited information is available. It is anticipated that information will be available for June 2014 which will facilitate more accurate and detailed reporting. Reserves include the 2.5% non recurrent spend, earmarked reserves and contingency to be deployed during the course of the year. Durham Dales, Easington and Sedgefield Clinical Commissioning Group 11

Running Costs as at 31 st May 2014 Running costs are currently showing a year-to-date underspend of £51k and a break-even forecast outturn position. Approximately £82k of accruals were incorporated into the year-to-date position, mainly in relation to audit fees / external consultancy fees that have not yet been invoiced. No risks have been identified at month two but budget and actual spend will be regularly monitored to ensure that any potential risks are promptly identified. There is a budget of £692k in the General Reserve to be deployed on CCG priorities throughout the year. Durham Dales, Easington and Sedgefield Clinical Commissioning Group 12

Quality Innovation Productivity & Prevention (QIPP) as at 31 st May 2014 Durham Dales, Easington and Sedgefield Clinical Commissioning Group 13 The table below summarises the latest forecast savings by key programme areas as at 31 st May 2014, compared to the original QIPP plan for the year. A number of red rated schemes remain owing to ongoing contract negotiations. This has slowed QIPP delivery against plan for the first two months of the year, although forecasts remain at target levels.

Better Payment Practice Code (BPPC) at 31 st May 2014 The Better Payment Practice Code (BPPC) requires NHS organisations to pay all invoices by the due date or within 30 days of receipt of a valid invoice, whichever is later. Durham Dales, Easington and Sedgefield Clinical Commissioning Group 14

Prescribing Analysis 31 st May 2014 Durham Dales, Easington and Sedgefield Clinical Commissioning Group 15