Managing the Money Finance Julie Lawreniuk Designate Chief Finance Officer
GP Consortia From April 2013, GPs are at the heart of the NHS •Direct responsibility for about 80% of the NHS budgets - £80bn •Tax payers money so comes with ‘strings’ attached •Needs to be well used and for its intended purpose •We will be accountable for how we spend GHCCG funds
From Department of Health to the Front Line Under PCTs •152 PCTs received allocations from the Department of health to purchase healthcare for local people •Formulae determined using a weighted capitation formula •Money used to buy services to patients by agreeing contracts for GPs, dentists, pharmacists and hospital trusts
From Department of Health to the Front Line Under CCGs •NHS Commissioning Board will allocate funds to CCGs •Key factor affecting the budget each consortium receives will be the number of patients registered with each practice •We will probably face a pace of change policy – which will move us from what we spend now to a fair share allocation
Resource Limits • The NHS Commissioning Board will be required to operate within an NHS resource limit for which they will be held to account • We will have a resource account limit for which we will be held to account
PCT Budget- NHS Kirklees
To be split 3 ways: •Commissioning Board •Local Authority Public health •Consortia (x 2) – GHCCG – NKCCG
Commissioning Board • − − − − − •
These are the areas we won’t be responsible for: Primary Care Dentistry Ophthalmic contracts Pharmacy contracts Specialised Commissioning These will be the responsibility of the Commissioning Board (approximately 18% of the current budget)
Public Health • Responsibility will transfer to either the Local Authority or the Commissioning Board • Allocation/budget will be top sliced • Local Authority: − − − −
Health Improvement (smoking cessation, nutrition, etc.) Drug/Alcohol Misuse Sexual health Children 5+
• Commissioning Board: − Non/Cancer Screening − Immunisation − Children 0-5/Health Visitors
Greater Huddersfield CCG • Main commissioning budget approximately £280m • Areas covered: − Acute Contracts − Mental Health Contracts − YAS − Continuing Care
Commissioning Budgets • • • • • • • • • − −
Acute Activity Prescribing Out of Hours NCAs – ISTC’s Aspire etc. Community Contract – District Nursing Intermediate Tier Children’s Cancer – End of Life Mental Health: LD IAPT
Reporting • Monthly report to Finance and Performance Committee • Working on splitting budgets/allocations to relevant parties • Annual financial plan − Draft in December to Clinical Commissioning Executive for information − Submitted to SHA/Commissioning Board – January − Financial plan approved by CCE in February/March
Management Costs • We will have a maximum allowance to cover management costs - £5.7m • Covers Management Team: − CCG Structure − CSU Costs − Governing Body Costs − Clinical Associate Costs − Non Pay Costs
How will we be held accountable for what we spend? Parliament
Secretary of State for Health NHS Commissioning Board GP Consortium Accountable Officer
How will we keep track of what’s been spent? To fulfill our role and demonstrate how taxpayers money has been spent, : •CCG and its constituent practices will plan its activities •Establish a budget to reflect the financial implications of the plans •Be expected to publish our plans
What is a budget and why is it important? • Enables an organisation to quantify its resources • Compare what actually happens • Helps us with what has been spent and where • Helps manage financial risks
Budget Review • Highlights areas in which action needs to be taken to bring finances back to original plan • Vital to ensure we stay within our resource limit • The NHS Commissioning Board stays within the overall limit • NHS as a whole does not overspend
Summary • Being stewards of so much public money comes with real challenges and responsibilities • but a real opportunity for us to influence the health outcomes of our local population • We need to make sure we are skilled in: − Commissioning and partnership working − Business planning − Budget setting and monitoring
to make sure we make the most of this opportunity