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