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Paper 17

Ayrshire and Arran NHS Board Monday 7 October 2019

Financial Management Report for the five months ended 31 August 2019 Author: Rob Whiteford, Assistant Director of Finance – Operational Services Bob Brown - Assistant Director of Finance – Shared Services and Governance

Sponsoring Director: Derek Lindsay, Director of Finance

Date: 18 September 2019

Recommendation

The NHS Board are asked to note:

the financial position for the year to date;

the progress on delivering cost avoidance and cash releasing efficiency savings;

the adverse impact caused by delayed discharges; and

the positive impact in the month caused by non recurring benefits

Key Messages:

The Annual Plan is a deficit of £14.75 million.

NHS Ayrshire & Arran is £8.6 million overspent for the year so far.

The average monthly run rate to month 4 was an overspend of £1.8 million.

NHS Ayrshire & Arran was £1.3 million overspent in month five.

Acute benefitted from £0.9 million of non- recurring funding brought into the month 5 position.

£1.2 million of overspend on Primary Care Prescribing has been recognised following receipt of quarter 1 data.

£23.1 million of interventions and efficiencies were planned for the year. Achievement to date is £6.4 million, and NHS Ayrshire & Arran forecast achievement of £17.2 million.

In order to achieve the planned deficit NHS Ayrshire & Arran must deliver against the £23.1 million transformation and efficiency plan.

Glossary of Terms

CAR-T CRES TAVI Var WTE YTD

Cash releasing efficiency savings Chimeric antigen reception T-cell Transcatheter aortic valve implantation Variance Whole time equivalent Year to date

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1. Background 1.1 Scrutiny of all resource plans (revenue and capital) and the associated financial

monitoring is considered by the Corporate Management Team, the Performance Governance Committee, and the Board. This report summarises the revenue position for the five months ended 31 August 2019.

2. Revenue resource limit and overall financial position 2.1

The revenue budget for the year is £889.7 million. This comprises £763.1 million of allocations received (Appendix 3) and anticipated allocations of £126.6 million. Over £100 million of the anticipated allocation relates to Primary Care Contractors.

2.2

Funding allocations in August (listed on Appendix 3) include reductions in primary care prescribing budgets of £1.39 million and £1.55 million, allocations of £1.4 million for e-health and £1.1 million for Alcohol and Drugs Partnership, as well as £2 million tranche 1 of Primary Care Improvement Fund.

2.3 £0.9 million of non recurring benefit as agreed by Corporate Management Team is now included in the month 5 acute position. Others listed below will phase budget in to match spend. This benefit is summarised as follows:

Total Funding Benefit in Month 5

£000 £000

Chimeric antigen receptor T-cell (CAR-T) 500 0

Station 1 at Ayr costs for 4 months 336 336

Crosshouse winter pressures 44 44

34 care home places 400 0

HR investigation 30 0

Office 365 150 0

VAT on medical agency 600 500

Total 2,060 880 2.4 Primary Care prescribing is £1.2 million overspent after 5 months. This is based on

the extrapolation of actual data received for quarter 1 which showed a £0.7 million overspend. Prescribing volume growth was 2.65% in quarter 1, against a budgeted increase of 0.8%. Price per item is also above the level budgeted for after taking account of allocation reductions and cash releasing efficiency savings.

3.1 Acute Services

3.1.1 The annual budget for Acute Services is £331.8 million. The directorate is overspent by £5.5 million. (Appendix 2).

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Table 1

Annual

Budget

YTD

Budget YTD Actual YTD Var

Acute Services Division £000 £000 £000 £000

Pay 238,648 99,180 99,912 (732)

Non Pay 66,651 25,330 26,190 (861)

Other Operating Income (858) (384) (485) 101

Unallocated Savings (8,925) (3,698) 0 (3,698)

Healthcare Provided to Others (24,364) (9,955) (10,032) 78

Purchase Of Healthcare 60,681 25,100 25,481 (380)

331,832 135,573 141,065 (5,492) 3.1.2 Due to the £0.9 million non–recurring funding to acute in month 5 (paragraph 2.3),

the month five overspend was £0.2 million. The average overspend in the first four months was £1.325 million per month. The year to date overspend is a result of:

£8.9 million of unallocated annual savings which are £3.7 million overspent after 5 months.

£1.0 million overspend on nursing pay

£0.2 million overspend on medical staffing pay

£0.9 million on non pay

£0.4 million on externals

3.1.3 Unallocated Savings

The £8.9 million unallocated savings are £3.5 million brought forward from 2018/2019, £0.8 million of unachieved historic redesign savings plus additional savings targets in 2019/2020. This will cause an adverse variance of £0.75 million per month until resolutions are found.

3.1.4

Nursing Pay

The main components of the £1.0 million nursing pay overspend are £0.625 million in Crosshouse Medical Wards, £0.161 million at Ayr and £0.1 million in maternity. At Crosshouse the most material overspent areas are Ward 5d (£0.138 million), and the Combined Assessment Unit (£0.109 million). The latter had high use of supplementary staffing including agency in month 5.

Annual

Budget

YTD

Budget YTD Actual YTD Var

Crosshouse Medical Ward

Nursing Pay £000 £000 £000 £000

Chouse Ward 5d Ger Asst Nrs 1,412 588 726 (138)

Chouse Winter Pressures 44 44 50 (6)

Chouse Ward 3d Medicine Nrs 1,345 560 617 (57)

Chouse Ward 2f Medicine Nrs 1,312 547 582 (35)

Operational Patient Flow Team 360 150 195 (45)

Chouse Ward 3f A/Med Nrs 1,510 629 669 (40)

Chouse Combined Asst Unit Nrs 5,147 2,145 2,254 (109)

Chouse Ward 3b Medicine Nrs 1,474 614 646 (32)

Chouse A + E Dept Nrs 2,575 1,073 1,106 (33)

Chouse Discharge Lounge Nrs 204 85 115 (30)

Chouse Ward 4e Medicine Nrs 1,379 575 610 (35)

Chouse Ward 4f Medicine Nrs 1,294 539 566 (27)

Other smaller variances 12,109 5,057 5,094 (38)

30,165 12,606 13,231 (625)

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3.1.5 The 2019/2020 budget anticipated that all acute hospital beds were funded. However it has been necessary to open additional beds in response to demand and the number of delayed discharges. In Ayr Station 1, 24 beds have been open for most of the financial year, due to delays in discharge of South Ayrshire residents.

3.1.6 £0.275 million has been issued non recurringly to the Station 1 nursing budget at month 5. Similarly £44,000 was issued to “Crosshouse Winter Pressures” in order to fund additional capacity.

3.1.7 Capacity issues in Care Homes in North Ayrshire caused a spike in bed numbers during August. This was resolved in early September but has contributed to the ongoing nursing overspend at Crosshouse.

3.1.8 Acute Medical Agency

The acute medical budget was increased on a non-recurring basis in 2019/2020 by £3 million to reflect the extra costs of agency doctors being higher than vacant posts. Spend in the first five months of this year was £3.5 million. VAT paid on locum spend in months one to five was £0.5 million. This £0.5 million has been non recurringly funded in month 5, and a further £0.1 million will be available in month 6. With effect from 1 October a new HMRC compliant model will be introduced and we will be able to reclaim VAT again as in previous years. A £1.0 million target reduction in medical supplementary cost has been set in 2019/2020 which will require timeous implementation of direct engagement to achieve. High cost specialties for agency doctors include geriatrics, laboratory and acute medicine.

3.1.9 Non Pay

£0.25 million of the £0.9 million overspend on non-pay relates to payments to Medica who provide a radiology reporting service to substitute for consultant radiologist vacancies. There is an offsetting underspend against the budget medical staffing for consultant radiologists due to vacancies. £0.2 million is caused by laboratory consumables and £0.130 million on Orthopaedic theatre supplies.

3.1.10

Purchase of Healthcare

Externals are overspent by £0.4 million in the year to date. An increase in the number of paediatric bone marrow transplants has caused exclusions from Glasgow service level agreements (which are paid on a cost per case basis) to overspend by £0.3 million. These budgets were however on line in Month

3.2 Health and Social Care Partnerships

3.2.1 The total health budgets for the three Health and Social Care Partnerships are £412.8 million.

3.2.2 Combined partnership health budget overspends are £0.7 million overspent including the prescribing overspend referred to in section 2.4 above. The Health Board is responsible for funding prescribing. When this is done the overall partnership position is an underspend of £0.5 million.

3.2.3 On an underlying basis North Partnership are £0.232 million underspent, East £0.544 million underspent and South £0.277 million overspent. South are

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overspent on Biggart Hospital and District Nursing. East are underspent on Mental Health Services, Allied Health Professionals and Hospital and Community Care whilst North are underspent on Mental Health Services.

3.3 Other Clinical Services

3.3.1 The total budget for Other Clinical services was £24.4 million and it is underspent by

£0.2 million. This area includes the budgets for the Pharmacy teams, the New Medicines Fund and activity such as brain injuries and transcatheter aortic valve implantation (TAVI) replacements. The underspend is mostly as a result of vacancies in the central pharmacy team. The New Medicines Fund is operating in line with budget, although £0.5 million has been funded non recurrently to address expected additional spend on Chimeric antigen reception T-cell (CAR-T) patients.

3.4 Clinical and Non-Clinical Support Services

3.4.1 Support service departments have annual budgets totalling £118.8 million, with a £0.5 million underspend for the year to date.

3.5 Corporate Resource and Reserves

3.5.1 Reserves are £3.1 million overspent for the five months to August. This is largely as a result of the underlying deficit being held centrally, and we can expect an underlying £0.8 million charge each month from reserves.

4. Efficiency and Transformation Programme

4.1 The target for cash releasing savings in the 2019/2020 revenue plan was £23.1 million. We have achieved £6.4 million (28%) by the end of month five. Appendix 4 forecasts achievement of £17.2 million. Ensuring delivery of the remaining target is key to achieving our financial targets in 2019/2020.

4.2 The main schemes which are behind plan are Acute Operational CRES, adhering to the Nursing Budget and Intermediate Care and Rehabilitation. An evaluation of Intermediate Care and Rehabilitation indicates that it has prevented some emergency admissions however no cash releasing savings have been achieved as no hospital beds have closed to high numbers of delayed transfer of care.

5. Workforce

5.1 Against a funded establishment for the whole organisation of 9,526 whole time equivalent staff, hours worked in August 2019 amounted to 9,494.

5.2 The table below shows the WTE staff used in each month from April to August 2019. The average is then compared with the average from April to August 2018. This shows an overall reduction of 42 WTE staff.

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Apr-19 May-19 Jun-19 Jul-19 Aug-19

Apr -

Aug

2019

average

Apr -

Aug

2018

average

WTE WTE WTE WTE WTE WTE WTE

Contracted Hours 8,795 8,849 8,747 8,808 8,853 8,810 8,890

Excess Part Time Hours 349 216 332 258 272 285 293

Overtime 122 85 91 94 90 96 96

Bank Staff 192 211 218 244 257 224 183

Agency Staff 51 59 47 67 54 56 53

Total WTE 9,509 9,420 9,435 9,471 9,526 9,472 9,515 5.3 The graph below shows the trend for nursing staff. We have seen a decrease since

March; however we used 29 WTE staff above our establishment.

5.4 The year to date nursing agency spend of just over £0.6 million is above 2018/2019

levels. We spent £0.159 million in month 5, which is the highest in this year so far.

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5.5 We used 801 WTE medical staff, including locums and agency, which is 21 below

the establishment.

5.6

The graph shows medical agency spend fell below £0.7 million for the first time since April. The spend is higher than in previous years other than 2016/2017, however the 2019/20 spend includes VAT which is not reclaimable from April to September.

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5.7 All NHS Boards formally report consultant vacancies on a quarterly basis.

Consultant vacancies are a main driver for medical agency expenditure. The chart below illustrates the trend of consultant vacancies within NHS Ayrshire & Arran over the last seven years.

8.8

15

27.6

41.4

50.1

45.4 45.7

0

10

20

30

40

50

60

Mar-13 Mar-14 Mar-15 Mar-16 Mar-17 Mar-18 Mar-19

Wh

ole

tim

e e

qu

iva

len

ts (

WT

Es)

Consultant Vacancies (from ISD quarterly census)

5.8 Staff sickness absence from work has organisational impact beyond the individual

staff member, affecting other staff, service delivery, productivity and cost, where backfill arrangements have to be put in place.

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5.9 Driven by the Board’s People Strategy, the Health, Safety & Wellbeing Improvement Plan identifies the programme of work being undertaken to improve staff health and wellbeing and, through the Promoting Attendance Policy, to have a clear process for appropriately managing staff sickness absence.

5.10 A national standard for sickness absence of 4% exists across NHS Scotland. The graph below shows our performance against this target. We have averaged 4.72% in the year so far.

6. Risk assessment and mitigation

6.1 The Strategic Risk Register has set out a risk for financial performance as very

high. The Board has taken a number of steps to mitigate this position.

6.2 £4.5 million of 2019/2020 acute CRES are the subject of ongoing dialogue. The £1.4 million forecast achievement is high risk.

6.3 A new cost pressure emerged in the first quarter following the rise in delayed discharges. This resulted in not living within nursing budget as additional beds require to be staffed. This pressure continued in August and is now evident at Crosshouse as well as Ayr.

6.4 The Chief Executive agreed to fund 34 care home places at a cost of £0.4 million to improve patient flow and unblock delayed discharges at Ayr and Biggart Hospitals. This funding is non recurrent and on a specific patient basis. In addition to improving care for our patients this will cause the nursing spend being incurred for the additional beds to reduce. This funding has now been issued to the South Partnership. Patients have been moved to Care Homes during the course of the month.

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6.5 Based on the first quarter of Primary Care prescribing data there is a risk of an annual overspend of £3.0 million. Volume growth has averaged 2.65% whilst 0.8% was provided for in budgets.

7. Conclusion

7.1 The revenue plan approved by the Board was a deficit of £14.75 million.

7.2 After the first five months the Board is £8.6 million overspent.

7.3 Additional beds resulting from operational pressure and delayed discharges, combined with high primary care prescribing costs are the main reasons for the overspend being higher than expected. This has been offset in part by non recurring funding issued in Month 5.

7.4 Increased progress on efficiency and transformation together with action to address the pressure from additional beds will be required in order to achieve our financial targets.

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Appendix 1

Budget Expenditure Variance Budget Expenditure Variance Budget Expenditure Variance

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000

Acute £238,648 £99,180 £99,912 (£732) £93,184 £36,393 £41,154 (£4,760) £331,832 £135,573 £141,065 (£5,492)

East Hscp £45,147 £17,979 £18,736 (£758) £131,100 £54,926 £54,015 £910 £176,246 £72,904 £72,752 £152

North Hscp £70,443 £29,454 £29,262 £192 £78,827 £32,669 £33,090 (£421) £149,270 £62,122 £62,352 (£229)

South Hscp £25,416 £10,686 £11,053 (£367) £61,852 £25,771 £26,048 (£277) £87,268 £36,457 £37,101 (£644)

Other Clinical Services £9,302 £3,873 £3,518 £355 £15,550 £5,700 £5,870 (£170) £24,852 £9,573 £9,388 £185

Hospital Community and Family

Health Services (section 1) £388,956 £161,171 £162,481 (£1,310) £380,513 £155,459 £160,176 (£4,718) £769,468 £316,630 £322,657 (£6,028)

Chief Executive £1,114 £464 £428 £36 £45 £18 £21 (£3) £1,159 £482 £449 £33

Director Public Health £5,032 £2,115 £2,020 £95 £900 £393 £327 £65 £5,931 £2,508 £2,347 £161

Medical Director £3,760 £1,610 £1,489 £120 (£2,755) (£1,291) (£1,212) (£79) £1,005 £318 £277 £41

Nursing Director £4,753 £1,966 £1,854 £112 £127 £29 £44 (£15) £4,880 £1,995 £1,897 £98

Corporate Support Services £37,516 £15,500 £15,401 £100 £57,142 £20,376 £20,561 (£185) £94,658 £35,876 £35,962 (£86)

Finance £4,169 £1,737 £1,643 £94 (£680) (£307) (£253) (£53) £3,489 £1,430 £1,389 £41

ORG and HR Development £4,493 £1,869 £1,789 £79 £241 £89 £82 £7 £4,734 £1,958 £1,871 £86

West Of Scotland Region Ce £0 £0 £134 (£134) £1,450 £138 £4 £134 £1,450 £138 £138 £0

Transformation+sustainability £1,405 £574 £424 £150 £100 £19 £19 £0 £1,505 £593 £443 £151

Clinical and Non Clinical Support

Services (Section 2) £62,242 £25,834 £25,181 £653 £56,570 £19,464 £19,592 (£128) £118,812 £45,298 £44,773 £525

Corporate Income (non RRL) £424 £424 £424 £0 £3,450 (£165) £9 (£174) £3,874 £259 £433 (£174)

Corporate Reserves £3,840 £0 £0 £0 (£6,326) (£2,967) £0 (£2,967) (£2,486) (£2,967) £0 (£2,967)

Corporate Resource and Reserves £4,264 £424 £424 £0 (£2,876) (£3,132) £9 (£3,141) £1,388 (£2,708) £433 (£3,141)

NHS A&A Total £455,461 £187,429 £188,086 (£657) £434,207 £171,791 £179,778 (£7,987) £889,669 £359,220 £367,864 (£8,644)

Income and Expenditure Summary for Health Services : Financial Year 2019 5 months to August

Salaries Supplies Total

Annual

Budget

Year to Date

Annual

Budget

Year to Date

Annual

Budget

Year to Date

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Appendix 2

Budget Expenditure Variance Budget Expenditure Variance Budget Expenditure Variance

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000

Surgical - Ayr £34,294 £14,328 £14,310 £18 £11,640 £4,858 £5,168 (£310) £45,934 £19,186 £19,478 (£292)

Medical - Ayr £29,188 £12,396 £12,558 (£162) £2,312 £979 £1,362 (£383) £31,500 £13,375 £13,920 (£545)

Surgical - Chouse £45,841 £19,105 £19,178 (£74) £8,355 £2,487 £2,924 (£438) £54,196 £21,591 £22,103 (£512)

Medical - Chouse £48,889 £20,516 £21,611 (£1,095) £10,659 £4,489 £5,256 (£768) £59,548 £25,004 £26,867 (£1,863)

Women + Childrens £33,059 £13,754 £13,886 (£132) £2,642 £879 £1,276 (£397) £35,701 £14,633 £15,162 (£529)

Diagnostic Svs £27,663 £11,506 £10,910 £597 £5,837 £2,340 £2,827 (£487) £33,500 £13,846 £13,736 £110

Other £12,732 £4,640 £4,681 (£42) £51,897 £20,455 £22,271 (£1,817) £64,629 £25,094 £26,953 (£1,858)

Acute Medical Records £6,938 £2,891 £2,778 £113 (£113) (£49) £68 (£117) £6,824 £2,842 £2,846 (£4)

Acute £238,604 £99,135 £99,912 (£777) £93,229 £36,438 £41,154 (£4,716) £331,832 £135,573 £141,065 (£5,492)

Total

Annual

Budget

Year to Date

Income and Expenditure Summary for Health Services : : Financial Year 2019 Period 5

Salaries

Annual

Budget

Year to Date

Supplies

Annual

Budget

Year to Date

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Appendix 3 Appendix 3

Ref Description

Baseline

recurring

£

Earmarked

recurring

£

Non-

recurring

£

Total

£

2 Initial baseline including uplift 719,959,000 719,959,000

3Adjustment for 2018-2019 recurring allocations 2,167,948 2,167,948

8 Healthcare Science Innovation Fund - Refund (10,000) (10,000)

9 Continuation of the Preoperative Anaemia

workstream28,438 28,438

13 Implementation costs for HPV boys

vaccination19,365 19,365

18 Professional Careers Programme salary

contribution15,800 15,800

21 SLA Children’s Hospices Across Scotland

(Year 3 / 5)(443,595) (443,595)

25 Action 15 of the Mental Health Strategy

2017/202725,798 25,798

26 S28 Carers (Scotland) Act 2016 - tests of

change/evaluation75,972 75,972

38 TEC funding to support local scale up) 0

35 Realistic Medicine Clinical Leads - Year 2 30,000 30,000

36 Elective activity as per AOPs 4,153,340 4,153,340

37 To implement recommendations in Best Start 387,116 387,116

40 6EA -Unscheduled Care 550,000 550,000

54 Healthy Start Vitamins 22,750 22,750

55 Open University Nursing Students Q3 & 4 75,000 75,000

57 Implementation of type 2 diabetes prevention 289,000 289,000

58 Outcomes Framework 2019-20 3,869,280 3,869,280

61 Employer Pension Contributions 17,680,000 17,680,000

75 General Dental Sevices element of the Public

Dental Service1,950,000 1,950,000

76 Implementation - Child Weight Management

Services Standards83,000 83,000

79 FASD Project 192,084 192,084

80 Family Nurse Partnership programme 770,759 770,759

81 Breastfeeding PfG year 2 project funding 194,500 194,500

82 PASS contract (42,343) (42,343)

89 Transforming NHS Services 1,050,000 1,050,000

93 Excellence in Care 70,000 70,000

94 Excellence in Care, E-health 24,500 24,500

102 Embedding advice services in health settings 62,500 62,500

104 Cancer and diagnostics activity in 2019/20 394,000 394,000

106 Mental Health Strategy Action 15 Workforce -

First Tranche639,798 639,798

108 Discovery (top slice) (41,599) (41,599)

418 Community Pharmacy Practitioner

Champions21,420 21,420

421 £20m (2018-19) tariff reduction to global sum (1,391,389) (1,391,389)

422 £20m (2019-20) tariff reduction to global sum (1,550,290) (1,550,290)

425 Disestablishment of 4 year GPST

programmes 475,566 475,566

441 Additional funding for elective activity as per

AOPs60,000 60,000

444 eHealth Strategic Fund 1,401,988 1,401,988

445 Integrated Primary and Community Care 591,200 591,200

451 Employer Pension Contributions - second

instalment427,000 427,000

457 IV Fluids Improvement Programme 40,429 40,429

474 Alcohol & Drug Partnership - Local

Improvement Fund1,108,932 1,108,932

486 Woodhill Unitary Charge 4,271,861 4,271,861

489 Draw down of 2018/19 carry forward 494,000 494,000

497 NDC Top slice (966,687) (966,687)

498 Primary Care Improvement Fund 2019-20 Tranche 1 2,026,931 2,026,931

504 Draw down of 2018/19 carry forward 1,032,500 1,032,500

506 GP Out of Hours (OOH) Fund 369,663 369,663

510 Contribution to Pharmacy Global Sum (203,200) (203,200)

514 Enhanced Recovery Programme 10,000 10,000

522 CSO - support for research infrastructure 661,000 661,000

523 CHAS Employer Pension Recharge to NHSL (14,000) (14,000)

740,219,948 13,862,423 9,026,964 763,109,335

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Appendix 4

Plan Area Plan Forecast M5 Variance YTD Savings

Month1

Savings

Month 2

Savings

Month 3

Savings

Month 4

Savings

Month 5

Savings

Acute Operational 4,500 1,403 (3,097) 155 31 31 31 31 31

Reduce Medical Agency 1,000 950 (50) 405 43 43 183 60 78

External SLAs 2,000 2,000 0 833 167 167 167 167 167

Corporate Support Services 1,360 1,360 0 491 67 67 109 124 124

Intermediate care and rehab 1,000 - (1,000) - - - - - -

Close Unfunded Beds 1,300 1,300 0 542 108 108 108 108 108

Corporate Dept CRES 880 820 (60) 342 68 68 68 68 68

Outpatient Paperlite 100 90 (10) 20 - - - 10 10

Cardiac ward reconfiguration 450 412 (38) 167 33 33 33 33 33

Energy 100 100 0 42 8 8 8 8 8

Estate Rationalisation 200 200 0 83 17 17 17 17 17

Adherence to Nursing Budget 2,300 330 (1,970) - - - - - -

Stop Nurse pool 200 200 0 200 67 67 67 - -

Redeployment Pool 400 690 290 207 - - 69 69 69

Primary Care Prescribing 2,773 2,773 0 1,169 237 237 237 230 230

Acute Prescribing 3,000 3,000 (0) 1,250 250 250 250 250 250

Mental Health Legacy CRES 1,600 1,600 0 525 105 105 105 105 105

Total 23,163 17,228 (5,935) 6,430 1,200 1,200 1,452 1,280 1,298

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Monitoring Form

Policy/Strategy Implications

Overspending areas in acute services could adversely impact the delivery of the strategic direction for the Board in moving investment towards community based.

Workforce Implications

Informs the forward workforce plan.

Financial Implications

Corrective action required for the Board to be operating in line with the statutory target to operate within the revenue and capital resource limits.

Consultation (including Professional Committees)

Directorates receive monthly financial reports. Financial reports are received at Corporate Management Team and Performance Governance Committee.

Risk Assessment

The risk tolerance agreed for investment is “medium” which includes “prepared to accept possibility of some limited financial loss, but value for money is still the primary concern.

Best Value

Vision and leadership

Effective partnerships

Governance and accountability

Use of resources

Performance management

Confirms ongoing, effective use of resources and management in year of risks and issues in relation to achieving agreed financial performance targets.

Compliance with Corporate Objectives

Delivery of efficient and effective services within budget and to develop a culture of continuous improvement.

Single Outcome Agreement (SOA)

Not applicable.

Impact Assessment This report is a monitoring report therefore does not require an equality and diversity impact assessment (EDIA).