Trust Board papers November 2012 - Barking Havering and ...

Devolved income
Annual
Budget
Forecast
Variance
Forecast
Income overperformance
against plan
Income
attibuted to
Directorate
Net variance
after income
attribution
9
Difference
between
forecast
income overperformance
and income
attributed
Comment
Surgical Services
Anaesthetics 44,614 (2,476) (197) 479 (1,997) 676
Includes allocation from Surgical Business Units for
over/(under) performance
Specialist Surgery 16,166 (566) 2,569 439 (127) (2,130) Over‐performance primarily related to Out‐patient
Surgery 16,977 (351) 965 29 (322) (936) QiPP non‐delivery
Surgical Services Total 77,757 (3,393) 3,337 948 (2,445) (2,389)
Emergency Care, Gen Med & Neurosciences
Emergency Care 30,208 (1,476) 331 (162) (1,638) (493)
Neurosciences 13,724 (188) (817) (62) (250) 755 Adjustment for Drugs/devices & NEL activity
Medicine 44,561 (1,751) 7,894 1,438 (313)
Most of over‐performance associated with nondelivery
of QiPP as opposed to increase in activity
(6,456) from 2011/12
Emergency Care, Gen Med & Neuroscie 88,493 (3,415) 7,408 1,214 (2,201) (6,194)
Women's, Children & Support Services
Most of under‐performance associated with reclassification
of PAU activity from NEL to Outpatients,
Children 13,858 236 (1,347) 134 370 1,481
not reflected in contract
Support Services 10,779 (567) 172 (395) 172
Most of over‐performance associated with lower
Women 35,567 (660) 2,963 (170) (830) (3,133) reductions in births than planned
Women's, Children & Support Services 60,204 (991) 1,616 136 (855) (1,480)
Diagnostics & Specialist Medicine
Pathology 21,974 (1,455) 27 179 (1,276) 152
Radiology 19,509 (640) 1,088 832 192 (256) Includes allocation from other Business Units for
Specialist Medicine 41,488 (2,527) 3,758 1,259 (1,268) (2,499) support services
Diagnostics & Specialist Medicine Tota 82,971 (4,622) 4,873 2,270 (2,352) (2,603)
Total of above 309,425 (12,421) 17,234 4,569 (7,852)
Most of difference associated with non‐delivery of
(12,665) circa £10m QiPP reductions in contract
• The table above, gives a summary of the forecast outturn position for each business unit, and then builds in an appropriate share of over-performance income, as mitigation against the
increased marginal cost of the over-performance for each area.
• Business Unit budgets are funded to 2011/12 outturn levels (as forecast at Month 8), so the principle applied is as follows:
o Take the increase (or decrease) in activity from the 2011/12 outturn (as at Month 8 forecast) to the 2012/13 forecast outturn (as at Month 6)
o Apply 65% of the full tariff, as a proxy for marginal costs (this is also the level that commissioners are paying for over-performance and is commensurate with the average level
of direct & indirect costs, as calculated through SLR)
o Apply 50% of the 65% to Business Units in respect of direct costs, with the other 15% apportioned to clinical support services (e.g. Pathology, Radiology)
o Of the 50%, a proportion is then allocated to Operating Theatres, in respect of the surgical specialties.
o
• It is proposed to allocate budgets through the ledger on this basis for Month 7 and to review the allocation again at Q3 (Month 9) and Month 12.