FINANCIAL REPORT TO THE GOVERNING BODY FOR THE

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 Statutory Duties Q 1 Q 2 Q 3 Q 4 YTD On Plan Revenue Resource Limit 1% Worse than Plan Cash Limit Not Applicable Better Payment Practice Code Neutral awaiting information KEY MESSAGES Financial Performance Forecast Surplus position = £ 17. 687 m (on plan) Q 1 QIPP schemes identified to £ 6. 760 m of £ 9 m target ELHT reported as £ 4 m overspend although actual forecast activity shows £ 5 m over. Prescribing figures at month 11 show a £ 220 k overspend, thus the year end forecast has been adjusted to £ 300 k overspent. IPA - £ 1, 850 k forecast over spend Q 2 Q 3 Q 4 NHS Non NHS 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

Statutory Duties � Revenue Resource Limit (RRL) ◦ Expenditure MUST stay within the limits set for the financial year Limit £’ 000 Commissioning Budgets Running Costs � On Target 574, 106 P 7, 926 P Notes 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. Cash Limit (CL) ◦ Cash spending must stay within the maximum cash drawdown allocated to the CCG for the year Limit £’ 000 CCG Total 569, 078 On Target P Notes The CCG is currently on target as regards spending being within the maximum allocated cash drawdown.

� Better Payment Practice Code (BPPC) ◦ The target is to pay ALL invoices within 30 days of receipt of a valid invoice NHS Non. NHS Target Cumulative Performance to Date On Target for Year End Value 95% 99. 9% P Volume 95% 99. 0% P Value 95% 98. 8% P Volume 95% 99. 0% P Notes With regard to the Better Payment Practice Code, the CCG is currently exceeding target levels for both NHS and non-NHS invoices.

Performance Measures � 1% Surplus ◦ The CCG has to plan to deliver a 1% surplus YTD Planned Surplus £’ 000 Annual Surplus £’ 000 17, 687 Actual reported YTD Surplus £’ 000 7, 046 Confidence Dial Notes The CCG has declared an additional £ 10 m 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 17, 046 18, 000 16, 000 14, 000 12, 000 10, 000 8, 000 6, 000 4, 000 2, 000 0 1 2 3 4 5 6 7 8 9 10 11 12

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. £’ 000 111 1, 480 Number of customers 21 4 Average outstanding debt per customer£’ 000 5 370 Monies owed to ELCCG as a percentage of ELCCG Annual Budget 0. 273%

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

� Main Provider Activity (ELHT) Acute Services ONLY Annual Budget £’ 000 209, 814 Plan YTD £’ 000 192, 321 YTD Expenditure £’ 000 197, 405 YTD Variance £’ 000 Forecast Out -turn £’ 000 5, 084 4, 000 Confidence Dial Notes ELHT’s over-trade continues to increase. The forecast level has been maintained at£ 4 m 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 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. 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. QIPP Failure to identify the balance of the in-year recurrent QIPP target Prescribing M 11 PPA prescribing figures show a large increase in expenditure which has resulted in a forecast overspend of £ 300 k. 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. Best Case £’ 000 Likely Case £’ 000 Worst Case £’ 000 -1, 000 4, 000 -2, 000 1, 850 2, 000 0 2, 240 -1, 000 300 1, 000

Highlights and Risks Area Primary Care Comment Primary care is on target to breakeven by year end. The co-commissioning budget of £ 42. 9 m is forecast to underspend slightly. Best Case £’ 000 Likely Case £’ 000 Worst Case £’ 000 -300 0 300