1. Finance Eve Baker Director of Finance Debbie Fraser Deputy Director of Finance

2. 3 Questions What skills will you need at your disposal to deliver the finance management agenda? What can you do differently on a daily basis to deliver QIPP? How many Finance Directors does it take to change a light bulb?

3. How is the PCT Funded PCT Allocation is based on Responsible Population ONS +/- patients registered with one practice while resident in another PCT area + All Prisoners irrespective of the time in prison + Armed Forces + Asylum seekers This is then adjusted for age, need and MFF Add Primary Dental, Ophthalmic and Pharmaceutical funding Add Funding Support for Social Care

4. Funding per crude head of population – including Funding for Social Care Exposition Book March 2011 Lowest - Berkshire West - £1,367 Highest - Islington - £2,350 Average allocation - £1,693 NHS Berkshire East - £1,451 - 9 th Lowest Additional allocation if avge per head £98m

5. How will GPC be funded Indicative Figures£m PCT Allocation582 Less -Specialist Commissioning 30 – Public Health & Mgt Cost Reductions 6 -GMS/PMS & QOF 74 Commissioned Services & Running Costs472

6. 3 Year View – Income

7. 3 Year View – Expenditure

8. Remaining Risks 2010/11 With SIRF Borrowing support should break even Legacy Risks resolved Disputes with HWP over - Data Challenges - Readmission Thresholds Attempting a negotiated settlement Frimley & RBFT smaller risks

9. Key Risks 2011/12 Recurrent overspend B/fwd Repayment of support in 2011/12 Delivery of QIPP- Big Hitters - Urgent Care - Managing the order book - PLCV - Intermediate care and EOL Changes in Provider Market Share Impact of QIPP on Providers

10. Impact of QIPP by Provider

11. The Finance Function

12. What does PCT Finance currently do? Financial and Statutory Reporting Balance Sheet Capital Asset Accounting Cash and Treasury Raising invoices and debt collection

13. What does PCT Finance currently do? Creditors (BPPC)/Procurement Management accounting and reporting Financial Planning (operating plan/medium term plans) QIPP VAT accounting Payroll and Staff Expenses

14. What finance functions are GP Consortia likely to require? Emerging guidance is giving indications… Keep Proper Accounts/Annual Audit In year reporting against budgetary/parliamentary controls to NHS CB (financial and other data) Budgeting

15. What finance functions are GP Consortia likely to require? Monitoring of budgets Managing Revenue Resource Limit to achieve breakeven Managing Capital Funding (consortium premises/IT) Developing and delivering operational plans Longer term financial plans

16. What finance functions are GP Consortia likely to require? Monitoring of admin costs so not to exceed running cost allowance Use prescribed banking service (Government banking system) to manage consortium’s funds –Request funds in advance –No significant month end balance

17. Support to GPCC in Transition Restructure across the Cluster – Finance, Contracts, Information Move to shadow CSU over time Maintain core specialist functions and transaction processes Create customer facing roles so that each consortia knows where it will access specialist support Draft structures for comment as soon as possible following appointment of SAO and SFO

18. What might a CSU include? Finance – Separate Consortia allocations and business entities Contracts – 1 Specialist team per provider to consolidate Consortia Commissioning Intentions. Berkshire wide Informatics framework – supporting commissioning, contracting, planning, reporting BSS services – CSU infrastructure, CSU Transaction processes, Procurement services, GP Premises, GP IT. Primary Care Agency Discussion paper under preparation