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									Appendix 3
Financial and Activity
Template
Introduction

This document provides the financial and activity templates which PCTs should complete as part of their Operating
Plan for 2007/08.

Instructions

Further detailed instructions for the completion of these templates will be provided following consultation with a
number of PCT Finance Directors. Comments are provided on the various worksheets to aid in completion.

Sheet descriptions
Summary financial forecast - this sheet is used to provide an overview of the current and future financial position of
the PCT and is critical to the evaluation of financial risk rating of the PCT.
Cash position overview - this sheet is used to provide a brief overview of the cash position of the PCT; this
information is not used in the risk rating of the PCT.
Secondary care - this sheet is used to provide an overview of the levels of activity that are being commissioned by
the PCT from acute care; it also allows evaluation of the impact of demand management initiatives on activity levels.
Commissioning efficiency plans - this sheet is used to provide details of demand management iniatives (across all
settings of care), together with their estimated financial impact.
CIPs and turnaround - this sheet is used to provide an overview of the impact of cost improvement programmes
and turnaround plans.
07 08 Operating Plan exhibit - this sheet is used to provide input to the exhibits within the 2007/08 operating plan
and is mostly a direct summary of the blue tabbed sheets, but requires some information to be directly input

Cell colour coding
PCTs must complete all pale yellow shaded cells in the template - they are the only unprotected cells.
White cells contain information calculated by the template
Results of check cells are shown in red where there is misalignment between inputs and should be corrected prior to
submission

Generic instructions
All financial figures should be entered in £'000
Please ensure all costs are entered as negative numbers actuals to December 2006 plus 3 month forecasts to
Forecast figures for 2006/07 should be based on 9 month
March 2007
Summary financial forecast
The figures you enter in this sheet will automatically populate the 2007/08 Operating Plan exhibit worksheet
Please ensure all costs are input as negative numbers


£'000                                                                               Plan           Forecast*      Forecast      Forecast   Forecast
                                                                                   2006/07          2006/07       2007/08       2008/09    2009/10
Income
Recurrent revenue allocation                                                           399961           407433        439087
Non-recurrent revenue allocation                                                        -6921           -37296        -46206
Other income (excluding income from provider activities)
Total income                                                                           393040           370137        392881
Expenses
Commissioning activities:
Primary care - GPs, prison healthcare, dentistry, and optometry:
   GP                                                                                  -40604            -43858        -43426
   Prescribing                                                                         -37063            -39355        -41124
   Other                                                                               -11191            -12079        -11704
Community and intermediate services                                                    -41376            -39846        -30292
                                                                                       -84741            -87397        -90132
Mental health commissioning, pooled arrangements or jointly funded commissioning
Secondary care
   Provided under PbR
        Inpatient elective                                                             -13341            -11964        -11989
        Day care elective                                                              -11503            -15596        -12786
        Inpatient non-elective                                                         -42179            -43690        -43082
        Outpatient                                                                     -21736            -22197        -19232
   Provided at local prices                                                             -9576            -11013        -16324
   Provided by third sector/not-for-profits
   Provided by independent sector
   A&E                                                                                  -9338             -7101         -6832
   Other                                                                               -42233            -20439        -47992
Ambulance services                                                                      -7553             -7691         -7883
Tertiary and specialist commissioning                                                   -7323             -7474         -8050
Total cost of commissioned services                                                   -379757           -369700       -390848
Provider Activities:
Pay expenditure                                                                        -29408            -30665        -27318
Non-pay expenditure                                                                    -15444            -16648        -14710
Less - provider income                                                                  44852             47313         42028
Net provider costs                                                                          0                 0             0
Other costs
Other pay expenditure                                                                   -5717             -5839         -4479
Other non-pay expenditure                                                               -4333             -2429         -2010
Depreciation and amortisation                                                               0                 0
Exceptional items                                                                       -3235             -9769
Total cost                                                                            -393042           -387737       -397337

PCT surplus/deficit in year                                                                  -2          -17600         -4456



PCT normalised position (excluding exceptional items)                                   3233             -7831         -4456


* 9 month actuals plus 3 month forecasts
Cash position overview
This worksheet requests a brief overview of the PCT's cash position


£'000

Forecast cash limit 2007/08                                   409107
Return of 2006/07 loan (-ve) / deposit (+ve)                   -6000
                                                                6000
Forecast 2007/08 loan (+ve) / deposit (-ve) requirements
Total (Forecast cash utilisation)                             409107
Secondary care commissioning activity
This worksheet requests the PCT's secondary activity and cost forecasts. Note that this should reflect the PCT's best information about levels of activity
Please ensure all activity reductions are input as negative numbers
Please ensure all costs are input as negative numbers (cost savings will then appear as positive numbers)
£'000                                                                                                                                                                                      This is the 'in-year' reduction in activity due to demand
                                                                  These baseline figures represent what would occur should you not have                                                    management that needs to be entered by PCT
Spells, or attendances as appropriate                             any demand management initiatives from 07/08

                                                     Baseline Demand Forecast (excluding all demand                                                                                                                                             Net Demand Forecast (including all demand
                                                     management in 06/07, 07/08 and 08/09)                                                                   Impact of demand management (savings)                                              management)

                                                     Plan          Forecast                                                                                  Plan        Forecast                                                               Plan            Forecast
                                                     2006/07       2006/07     2007/08     2008/09   2009/10                                                 2006/07     2006/07     2007/08     2008/09    2009/10                             2006/07         2006/07     2007/08     2008/09   2009/10
Total Yearly Activity
       Inpatient elective                                      7           8           8                                                                             0           0           0                                                             7            7           8
       Day case                                               19          20          20                                                                             0          -1          -1                                                            19           18          19
       Inpatient non-elective                                 28          27          27                                                                            -2           0          -1                                                            27           27          26
       Outpatient (new and follow-up)                        243         245         245                                                                           -21         -16         -34                                                           222          229         211
       A&E attendances                                       122         123         123                                                                            -8           0         -14                                                           114          123         109

Cost
       Inpatient elective                                             -12573      -15448                                                                        -13341        609         3459                                                         -13341      -11964      -11989
       Day case                                                       -16067      -12970                                                                        -11503        471          184                                                         -11503      -15596      -12786
       Inpatient non-elective                                         -44239      -45275                                                                        -42179        549         2193                                                         -42179      -43690      -43082
       Outpatient (new and follow-up)                                 -23009      -23916                                                                        -21736        812         4684                                                         -21736      -22197      -19232
       A&E attendances                                                 -7252       -8067                                                                         -9338        151         1234                                                          -9338       -7101       -6833
       Other secondary costs                             -51809       -31452      -65609                                                                             0          0         1293                                                         -51809      -31452      -64316
       Total costs                                      (51,809) (134,592) (171,285)                                  Total cost savings                      (98,097)      2,592      13,047                                   Net cost         (149,906) (132,000) (158,238)
                                                                                                                      (before implementation cost)


                                                                                                                                                                                                                                 This is the gross cost impact of demand management (i.e
                                                                                                                                                                                                                                 excluding implementation costs)
Commissioning efficiency plans
(e.g., demand management and prescribing efficiencies)

The figures you enter in this sheet will automatically populate the 2007/08 Operating Plan exhibit worksheet
Please ensure all costs are input as negative numbers
Please ensure savings are input as positive numbers
£'000
Item                            Description of initiative     Gross forecast savings                              Implementation Costs                              Net forecast savings
                                                              Plan      Forecast                                  Plan     Forecast                                 Plan      Forecast
                                                              2006/07 2006/07 2007/08         2008/09   2009/10   2006/07 2006/07 2007/08       2008/09   2009/10   2006/07 2006/07 2007/08    2008/09   2009/10

                                                                        1567               3938
Initiative 1 - Demand Management Reduction in acute spend through demand management measures                                                                           1567        0    3938
Initiative 2 - Prescribing         Increasing generic usage             1735               1575                                                                        1735        0    1575
Initiative 3 - Commissioning Acute Contract controls                    2361               9109                                                                        2361        0    9109
                                                                        4935
Initiative 4 - Commissioning Other Mental health, continuing care and primary care savings 6740                                                                        4935        0    6740
Initiative 5 - Primary Care        Primary Care                                             844                                                                           0        0     844
Initiative 6 [please specify]                                                                                                                                             0        0       0
Initiative 7 [please specify]                                                                                                                                             0        0       0
Initiative 8 [please specify]                                                                                                                                             0        0       0
Initiative 9 [please specify]                                                                                                                                             0        0       0
Initiative 10 [please specify]                                                                                                                                            0        0       0
Other initiatives                                                                                                                                                         0        0       0

Total                                                             10598          0    22206                             0        0          0                         10598        0   22206
CIPs and turnaround plans
The figures you enter in this sheet will automatically populate the 2007/08 Operating Plan exhibit worksheet
Please ensure all costs are input as negative numbers
Please ensure savings are input as positive numbers
£'000
Item                           Description of initiative       Gross forecast savings                          Implementation Costs                              Net forecast savings
                                                               Plan      Forecast                              Plan     Forecast                                 Plan      Forecast
                                                               2006/07 2006/07 2007/08    2008/09   2009/10    2006/07 2006/07 2007/08       2008/09   2009/10   2006/07 2006/07 2007/08    2008/09   2009/10

                                 Reduction in provider spend and estates
Initiative 1 - PCT Provider Service                                   453          7156                                                                              453       0     7156
Initiative 2 - Internal          Management costs                    3053          2912                                                                             3053       0     2912
Initiative 3 [please specify]                                                                                                                                          0       0        0
Initiative 4 [please specify]                                                                                                                                          0       0        0
Initiative 5 [please specify]                                                                                                                                          0       0        0
Initiative 6 [please specify]                                                                                                                                          0       0        0
Initiative 7 [please specify]                                                                                                                                          0       0        0
Initiative 8 [please specify]                                                                                                                                          0       0        0
Initiative 9 [please specify]                                                                                                                                          0       0        0
Initiative 10 [please specify]                                                                                                                                         0       0        0
Other initiatives                                                                                                                                                      0       0        0

Total                                                              3506      0    10068                              0       0           0                          3506       0    10068
Financial template exhibits for 2007/08 Operating Plan

Summary of financial performance: comparison between planned and actual performance

                                       2006/07 plan        2006/07 forecast*       Variance
£'000
Income
Recurrent revenue allocation                    399961                 407433               7472
                                                 -6921                 -37296             -30375
Non-recurrent revenue allocation
Other income (excluding income                        0                        0                 0
from provider activities)
Total income                                    393040                 370137             -22903
Expenses
Commissioning activities:
Primary care - GPs, prison
healthcare, dentistry, and
optometry:
   GP                                            -40604                -43858                 -3254
   Prescribing                                   -37063                -39355                 -2292
   Other                                         -11191                -12079                  -888
Community and intermediate                       -41376                -39846                  1530
services
Mental health commissioning,                     -84741                -87397                 -2656
pooled arrangements or jointly
funded commissioning
Secondary care
   Provided under PbR
       Inpatient elective                        -13341                -11964                  1377
       Day care elective                         -11503                -15596                 -4093
       Inpatient non-elective                    -42179                -43690                 -1511
       Outpatient                                -21736                -22197                  -461
   Provided at local prices                       -9576                -11013                 -1437
   Provided by third sector/not-for-                  0                     0                     0
   profits
                                                      0                        0                 0
   Provided by independent sector
   A&E                                            -9338                 -7101                  2237
   Other                                         -42233                -20439                 21794
Ambulance services                                -7553                 -7691                  -138
Tertiary and specialist                           -7323                 -7474                  -151
commissioning
Total cost of commissioned                      -379757               -369700                 10057
services
Provider Activities:
Pay expenditure                                  -29408                -30665                 -1257
Non-pay expenditure                              -15444                -16648                 -1204
Less - provider income                            44852                 47313                  2461
Net provider costs                                    0                     0                     0
Other costs
Other pay expenditure                             -5717                 -5839                  -122
Other non-pay expenditure                         -4333                 -2429                  1904
Depreciation and amortisation                         0                     0                     0
Exceptional items                                 -3235                 -9769                 -6534
Total cost                                      -393042               -387737                  5305

PCT surplus/deficit in year                           -2               -17600             -17598
2007/08 in-year breakdown of income and cost
£'000                            M1    M2       M3      M4      M5      M6      M7      M8        M9       M10     M11     M12     Total               Check to summary financial
                                                                                                                                                       forecast
Income                           32740 32740 32740 32740 32740 32740 32740 32740 32740 32740 32740 32741                                      392881                          392881
Total cost of commissioned      -32956 -32536 -32535 -32534 -32534 -32554 -32553 -32553 -32552 -32552 -32552 -32437                          -390848                         -390848
services
Net provider costs                                                                                                                                 0                               0
Other costs                       -564   -567    -567    -544    -544    -544    -433     -545      -545    -545    -545    -546               -6489                           -6489
Surplus/deficit                   -780   -363    -362    -338    -338    -358    -246     -358      -357    -357    -357    -242               -4456                           -4456

Income - comparison between historical achievement and current plan
£'000                                   Plan               Forecast                                          Current plan
                                       2006/07              2006/07                     2007/08                 2008/09            2009/10
Recurrent revenue allocation                   399961               407433                        439087
                                                -6921               -37296                        -46206
Non-recurrent revenue allocation
Other income (excluding income                      0                    0                             0
from provider activities)
Total                                          393040               370137                        392881

Commissioning expenses – comparison between historical achievement and current plan
                                     Plan                Forecast                                            Current plan
£'000                                     2006/07         2006/07              2007/08                          2008/09            2009/10
Primary care - GPs, prison
healthcare, dentistry, and
optometry:
   GP                                             -40604          -43858               -43426
   Prescribing                                    -37063          -39355               -41124
   Other                                          -11191          -12079               -11704
Community and intermediate                        -41376          -39846               -30292
services
Mental health commissioning,                      -84741          -87397               -90132
pooled arrangements or jointly
funded commissioning
Secondary care
   Provided under PbR
        Inpatient elective                        -13341          -11964               -11989
        Day care elective                         -11503          -15596               -12786
        Inpatient non-elective                    -42179          -43690               -43082
        Outpatient                                -21736          -22197               -19232
   Provided at local prices                        -9576          -11013               -16324
   Provided by third sector/not-for-                   0               0                    0
   profits
                                                       0               0                    0
   Provided by independent sector
   A&E                                             -9338           -7101                -6832
   Other                                          -42233          -20439               -47992
Ambulance services                                 -7553           -7691                -7883
Tertiary and specialist                            -7323           -7474                -8050
commissioning
Total cost of commissioned                      -379757         -369700              -390848
services
Commissioning activity plan – total
'000 spells, net of demand
forecast
(attendances – outpatients,              Plan            Forecast                                    Current plan
A&E)
                                        2006/07          2006/07                   2007/08              2008/09     2009/10
Inpatient elective                               7.367     7.283709288                7.50571324
Day case                                         18.61     18.47129071               19.03428676
Inpatient non-elective                          26.615           27.046                    26.335
Outpatient (new and follow up)                 222.083          229.488                   210.597
A&E attendances                                113.956          122.729                   109.027
Commissioning activity plan 2007/08 – by trust
'000 spells                                                         Top 4 trusts                                    Remaining activity

(attendances – outpatients,             Trust 1          Trust 2                   Trust 3              Trust 4             Other                        Total                   Check to Secondary
A&E)                                                                                                                                                                                    care
Inpatient elective                        3.301            0.614                    1.395                0.371                       1.823                               7.504             7.50571324
Day case                                 10.135            1.492                    3.426                0.884                       3.096                              19.033           19.03428676
Inpatient non-elective                   17.375            1.818                    3.528                1.245                       2.367                              26.333                  26.335
Outpatient (new and follow up)          103.347           11.041                   46.732               12.241                      37.234                             210.595                 210.597
A&E attendances                         109.027                                                                                                                        109.027                 109.027

2007/08 in-year breakdown of activity plan
’000 spells                                Q1              Q2                        Q3                   Q4        Total                    Check to secondary care
(attendances – outpatients,
A&E)
Inpatient elective                        1.876            1.876                    1.876                1.876                    7.504                           7.50571324
Day case                                  4.758            4.758                    4.758                4.759                   19.033                          19.03428676
Inpatient non-elective                    6.584            6.584                    6.584                6.583                   26.335                                26.335
Outpatient (new and follow up)           52.649           52.649                   52.649               52.648                  210.595                               210.597
A&E attendances                          27.257           27.257                   27.257               27.256                  109.027                               109.027

Cost improvement/turnaround plans
£'000                                                                         Net saving
                                         Plan            Forecast                                    Current plan
                                        2006/07          2006/07                   2007/08              2008/09     2009/10
Initiative 1 - PCT Provider Service               453                   0                    7156

Initiative 2 - Internal                           3053                  0                     2912
Initiative 3 [please specify]                        0                  0                        0
Initiative 4 [please specify]                        0                  0                        0
Initiative 5 [please specify]                        0                  0                        0
Initiative 6 [please specify]                        0                  0                        0
Initiative 7 [please specify]                        0                  0                        0
Initiative 8 [please specify]                        0                  0                        0
Initiative 9 [please specify]                        0                  0                        0
Initiative 10 [please specify]                       0                  0                        0
Other initiatives                                    0                  0                        0
Total                                             3506                  0                    10068
Commissioning efficiency plans (e.g., demand management, prescribing efficiencies)
£'000                                                                           Net saving
                                         Plan             Forecast                                 Current plan
                                        2006/07            2006/07                 2007/08            2008/09     2009/10
Initiative 1 - Demand Management                1567                     0                 3938

Initiative 2 - Prescribing                       1735                    0                 1575
Initiative 3 - Commissioning Acute               2361                    0                 9109

Initiative 4 - Commissioning Other               4935                    0                 6740

Initiative 5 - Primary Care                          0                   0                   844
Initiative 6 [please specify]                        0                   0                     0
Initiative 7 [please specify]                        0                   0                     0
Initiative 8 [please specify]                        0                   0                     0
Initiative 9 [please specify]                        0                   0                     0
Initiative 10 [please specify]                       0                   0                     0
Other initiatives                                    0                   0                     0
Total                                            10598                   0                 22206

Provider income – comparison between historical achievement and current plan
£'000                                  Plan               Forecast                                 Current plan


                                       2006/07              2006/07              2007/08              2008/09     2009/10
Provider income                                  44852                47313                42028

Provider operating expenses – comparison between historical achievement and current plan
£'000                                  Plan                 Forecast                               Current plan
                                      2006/07               2006/07              2007/08              2008/09     2009/10
Pay                                           -29408                -30665               -27318
Non-pay                                       -15444                -16648               -14710
Total provider operating cost                 -44852                -47313               -42028

Investment and disposal strategy – comparison between historical achievement and current plan
£'000                                   Plan               Forecast                                Current plan
                                       2006/07              2006/07               2007/08             2008/09     2009/10
Investment in fixed assets (non-        1000                    0                   1000
maintenance)
Investment in fixed assets              1500                  1700                  1250
(maintenance)
Investment in other assets               500                   500                   750
Asset disposals                                               4000                 25400
Risk rating metrics*


                                         Weight   Metric value
Projected Outturn                         50%         -1%

Previous years cost deviations            25%         1%
from plan (including CIP)
Previous years activity level (acute      25%         0%
spells**), deviations from plan

*to be finalised during consultation

**for this indicative calculation only
acute spells (inpatient and
daycase) are included

								
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