Get documents about "Appendix 5 Risk Analysis - Liverpool Primary Care Trust Homepage
Document Sample
Appendix 5
LIVERPOOL PRIMARY CARE TRUST FINANCIAL PLANS 2007/08 : RISK MONITORING SEPTEMBER 2007
Risk
POTENTIAL VARIANCES FROM PLAN Risk/Variance : (Surplus) / Deficit
Rating
Incorp in
Potential
Forecast Outturn - September Initial July Sept 2007 Revised
No. Budget Area Assumption in Plan Risk Further
2007 Update Plans 2007 Forecast Sept 2007
Variance
Outturn
£'000 £'000 £'000 £'000
Commissioners to work with NHS
provider (RLBUHT) to monitor
WET Age Related Macular Additional funding of £1m included Risk of significant additional
1 closely uptake of treatment. Risk 1,000 1,000 0 (1,000) G
Degeneration in 2007/08 plan. demand.
down rated to reflect budget
performance to date.
Additional non-rec funding of Failure to apply access criteria Continuing / Palliative Care
£2.5m applied to balance 2006/07 appropriately and / or procure expenditure continues to increase.
2 Continuing / Palliative Care 1,000 1,000 1,533 1,500 R
budget over-run. £1.5m only to be effectively leading to budget over- New criteria likely to add further
consolidated in 2007/08. run financial pressure.
Final Central Budgets Allocations
Shortfall on Central Budget PCT will receive a reduced level of
A range of assumptions based on from the Department of Health
3 allocation from Department of funding from the Department of 500 500 (1,900) 0 G
latest information. have now been confirmed and are
Health Health
greater than previously notified.
Cost of Activity capped at 2006/07 Continuation of upward trend in
4 Cost per case expenditure 500 500 0 0 G
level in real terms. cost per case expenditure.
Assumes new investment to Initial financial plans for 2007/08
Contract agreement has been
5 Sexual Health / GUM expand service and reduce waiting make no provision for continued 250 250 0 0 G
reached with Providers at less
times. increases in costs in these areas.
additional cost than was
envisaged. Services excluded
Cost of Activity capped at 2006/07 Continuation of trend in AIDS/HIV from PBR are being effectively
6 AIDS/HIV managed and controlled. 300 300 0 0 G
level in real terms. spend.
Continuation of upward trend in
Cost of Activity capped at
7 High Cost Drugs/PbR exclusions HCDs/PbR exclusions 500 500 0 0 G
2006/2007 level in real terms.
expenditure.
Less than 100% uptake of out-of- ISTC demand Model leading to Non Recurrent slippage on ISTC
Activity (ISTC investment) / area ISTC capacity assumed. higher or lower utilisation. pickup achieved. Further slippage
8 Specialist Commissioning Changes to investment figures Financial pressures emerge from achieved in respect of Wave 2 2,000 2,000 (1,738) 0 G
Stocktake assumed for Specialist move to usage on Specialist Diagnostics and Multi-Specialty
Commissioning Services. programmes.
Page 1 of 4
Appendix 5
Risk
POTENTIAL VARIANCES FROM PLAN Risk/Variance : (Surplus) / Deficit
Rating
Incorp in
Potential
Forecast Outturn - September Initial July Sept 2007 Revised
No. Budget Area Assumption in Plan Risk Further
2007 Update Plans 2007 Forecast Sept 2007
Variance
Outturn
£'000 £'000 £'000 £'000
Commissioning Team to work
closely with Practice Based
Plan assumes nominal £1m The level of savings assumed
Savings Generated by Practice Commissioning Groups to manage
9 savings in 2007/08 with 70% within the 2007/08 plan will not be 300 300 0 0 G
Based Commissioning demand and divert high system
reinvested in services. achieved in-year.
users into more appropriate
services.
Finance Team to work with Budget
Holder to optimise use of
resources. Action Plan arising out
Uplift set at 2006/07 out-turn +
of Audit Commission review to be In light of the latest information,
10 Primary Care Prescribing 7.2% - ie reduction of 1.8% from 1,500 1,500 0 0 G
implemented where appropriate. this risk has been downrated.
SHA guidance.
Scriptswitch decision support
software to be rolled out
imminently.
Risk that final 2006/07 out-turn
Impact of commissioning 2006/07 Range of activity and costs based 2006/07 outturn fully covered
11 activity will exceed the level 500 500 0 0 G
outturn activity levels on detailed modeling work. within LDP provisions
estimated in the LDP.
Full repayment required in 2007
Continued availability of
12 NPC with no brokerage back to the Accumulated brokerage available 500 500 0 0 G
accumulated brokerage assumed.
PCT.
Cost of new CSSD service,
Unplanned delays in implementing
required to meet national Actual Costs will exceed current
13 Decontamination strategy the decontamination joint venture 500 500 (1,100) 0 G
standards, could exceed current estimates
proposal.
estimates.
Provision for increased cost LDP provisions will not be
LDP provisions sufficient to cover
incorporated in plan based on sufficient to cover the running
14 Primary Care Estate running costs of LIFT 500 500 0 0 G
assumed programme of new costs of LIFT developments
developments in 2007/08
development coming on stream in 2007/08.
Funding shortfall of up to £0.5m
projected initially in relation to
patient charge income in the new
Dental contract. 2006/07 outturn
Assumption made as to the likely Risk of additional costs over and
15 Dental Contracts position showed improvement in 500 0 0 0 G
impact of patient charges shortfall above funded levels.
recovery rates and lower than
expected UDA levels. Funding
carried forward into 2007/08
should eliminate financial risk.
Page 2 of 4
Appendix 5
Risk
POTENTIAL VARIANCES FROM PLAN Risk/Variance : (Surplus) / Deficit
Rating
Incorp in
Potential
Forecast Outturn - September Initial July Sept 2007 Revised
No. Budget Area Assumption in Plan Risk Further
2007 Update Plans 2007 Forecast Sept 2007
Variance
Outturn
£'000 £'000 £'000 £'000
Preliminary assessment of
additional resources required to
16 Proposed Provider Arm Separation No Variance assumed in Plan 0 0 0 200 R
progress the development of an
Arms Length Provider Unit.
Plans being considered include
Prevention/Rehabilitation,
Consideration of Future
Treatment Rooms, Community OT,
17 Development Plans to be delivered No Variance assumed in Plan 0 0 1,131 0 R
Children's Vaccination and
in 2007/08
Immunisation and District Nurse
Capacity
Assessment to accelerate
Additional Investment to support
18 No Variance assumed in Plan achievement of 18 week target in 0 0 1,440 0 R
18 week target acceleration
Audiology and Gynaecology
Overspend due to price changes
on the National Contract and has
19 Oxygen Contract No variance assumed in Plan 0 0 440 0 G
been based on actual activity data
up to 31st May
Technical adjustment in respect of
20 Other emerging pressures No variance assumed in Plan third-party grants that has now 0 0 597 0 G
been confirmed as a pressure.
Assessment of commitments
2007/08 Investment Plan
21 No variance assumed in Plan against 2007/08 £50m Investment 0 0 (106) (6,307) G
Proposals
Proposals
Need to be reviewed once
22 Restructuring Costs No variance assumed in Plan implementation of the PCT's new 0 0 (1,500) (1,500) G
structure is finalised.
Favourable variances on final
23 2006/07 Outturn Position No variance assumed in Plan 0 0 (3,811) 0 G
2006/07 outturn position
The underspend on development
allocations from 2006/07 is
Dental Contract and Development
24 No variance assumed in Plan continuing into 2007/08. A 0 0 (3,000 ) 0 G
Schemes
detailed review with the Service
Directorate is ongoing.
Page 3 of 4
Appendix 5
Risk
POTENTIAL VARIANCES FROM PLAN Risk/Variance : (Surplus) / Deficit
Rating
Incorp in
Potential
Forecast Outturn - September Initial July Sept 2007 Revised
No. Budget Area Assumption in Plan Risk Further
2007 Update Plans 2007 Forecast Sept 2007
Variance
Outturn
£'000 £'000 £'000 £'000
Slippage due to mismatch
25 GMS No variance assumed in Plan between receipt of allocations and 0 0 (3,000 ) 0 G
timing of planned developments.
Risk of non achievement due to
26 Planned Surplus As per planning guidance Planned surplus achieved 0 0 (1,674 ) 0 G
increased pressures
RISK SUMMARY (SURPLUS) / DEFICIT 10,350 9,850 (12,688) (7,107)
Page 4 of 4
