Month 12 Budget Update - NHS Hounslow CCG · September 2015) Total S&T projects £m £m £m...

North West London

Month 12 Budget Update SaHF & NWL Strategy and Transformation Programmes

April 2016

1

This paper provides the month 12 budget update for NWL-wide financial strategy/ SaHF

including Strategy & Transformation programmes.

The main points to note are:

1. Sources of funding and total budget, including split across the programmes, has

remained the same from last month;

2. The S&T year end position is an overspend of £0.2m due to a higher than expected bill

for staff retention payments from LNWH Trust.

The Collaboration Board are asked to:

a) Note the final 15/16 Year - end position;

Summary

2

Contents

Sources of funding

Applications of funding

Budget analysis

1

2

3

Year end outturn 4

5 Appendix A Consultancy contracts let

3

Sources of funding

Total resource available

CCGs contribution to the programme1 £55.1m

TOTAL

1 Hounslow CCG did not require the full £5.4m of Part C support and were able to return £1.7m. West London CCG did not require any funding back so Brent CCG as the other large contributor was refunded the surplus value, reducing their overall contribution to Part C from £10.2m to

£8.5m.

NHSE contribution (including extra £1m from NHSE to Support SaHF)

£14.6m

£69.7m1

The proposed application of this resource is as per the previous papers:

- £30m to Strategy & Transformation;

- £37.7m to Provider support; £2.5m to Harrow CCG.

The overcommitment of £0.5m is covered by carried forward underspend from 14/15. An update

on each of these areas is given in the following slides.

4

The budget allocations for Strategy and Transformation are shown in the table below:

Application of funds (1)

5

.

Total Budget

Central TeamReturned to

CCGs

(agreed

September 2015)

Total

S&T projects £m £m £m

Enhanced Integration/Whole

Systems3.3 6.8 10.0

Primary care transformation 2.3 2.0 4.3

SaHF implementation 6.8 6.8

Transforming Mental Health

Services1.5 1.0 2.5

Other costs (core team, non-pay,

events)6.4 6.4

Total 20.3 9.8 30.0

Plan

The provider support costs as at M12 is shown in the table below. The final outturn was an overspend of

£0.2m, due to a higher than expected bill for staff retention payments to London North West Hospitals

Trust. This was in relation to the maternity transition and was billed very late, thus had not been included

in previous forecasts.

Application of funds (2) Provider support

6

Provider support

Forecast

outturn at

M10

Actual

spend

M12 Variance

£m £m £m

Maternity* 6.8 7.0 (0.2)

Paediatrics* 5.9 5.9 0.0

Main SaHF

Double running:

a) THH 3.0 3.0 0.0

b) Chel West 2.3 2.3 0.0

c) LNWHT 11.0 11.0 0.0

- CW/ West Mid merger 4.0 4.0 0.0

ImBC costs 0.7 0.7 0.0

Trust support to CIP identification process 0.6 0.6 0.0

Trust ImBC support 3.3 3.3 0.0

Delivery Architecture 0.2 0.2 0.0

Total 37.7 37.9 (0.2)

*Further detail provided on next slide

Application of funds (3) Provider support

£m Reason for payment

Maternity costs:

WMUH 2.9 Lease on temporary maternity unit

ICHT 1.0 0.75m CNST, 0.25m midwife ramp up costs

THH 0.8 Midwifery ramp up costs, ward improvements

LNWHT (EHT) 1.3 Income support, medical rota support, agency premium for transition period

LNWHT (NWP) 0.3 Midwife support packages (inc. retention premia for transition)

WMUH 0.3 Midwifery ramp up costs

All trusts 0.4 Transitional estates costs to support new community clinics

Sub-total Maternity 7.0

Paediatric costs:

THH 3.3 Capacity investment to support paediatric changes

LNWHT 1.3 Capacity investment to support paediatric changes

WMUH 1.5 Paediatric investment support – PDC request refused

Sub-total Paediatrics 6.1

The following table provides a breakdown of the payments made to support the

maternity and paediatric transitions in 15/16:

Month 12 S&T budget report Year end outturn

Whole Systems Integrated Care

1

Primary Care Transformation

Acute Reconfiguration

3

Mental Health Transformation

4

Cross Cutting and Core Team

5

Transition and Shadow Running (to CCG’s)

Whole systems implementation

Workforce & Change Academy

TOTAL

Primary Care Network Support (to CCG’s)

Primary Care System Wide Support

Hub OBC Development

TOTAL

ImBC and OBC Development

Paediatric Implementation

Maternity Implementation

System Wide Support & Ops Leadership

TOTAL

Mental Health Wellbeing & Strategy

Mental Health Urgent Care

Mental Health Transformation (to CCG’s)

TOTAL

Communications and Engagement

5 Year Strategy

Core Team, non-pay, events

Informatics

TOTAL

Total

BUDGET

YTD

£m

ACTUAL

YTD

£m

VARIANCE

YTD

£m

-

(1.3)

(0.7)

(2.0)

-

0.4

(0.3)

0.1

0.7

0.1

-

(1.0)

(0.2)

-

0.2

-

0.2

0.4

1.1

0.2

0.2

1.9

0.0

6.8

1.2

-

8.0

2.0

1.4

1.0

4.4

4.4

1.4

0.8

-

6.6

-

1.7

1.0

2.7

1.4

1.6

4.4

0.9

8.3

30.0

6.8

2.5

0.7

10.0

2.0

1.0

1.3

4.3

3.7

1.3

0.8

1.0

6.8

-

1.5

1.0

2.5

1.0

0.5

4.2

0.7

6.4

30.0

BUDGET

ANNUAL

£m

2

8

6.8

2.5

0.7

10.0

2.0

1.0

1.3

4.3

3.7

1.3

0.8

1.0

6.8

-

1.5

1.0

2.5

1.0

0.5

4.2

0.7

6.4

30.0

M12 S&T budget report

Variances

1. Whole systems Integrated Support (£2m underspend):

• Change academy contract Phase 1 contract was not approved, thus preventing investment

in Phase 2;

• Planned investment in consultancy support was halted due to NHSE restrictions.

2. Primary Care transformation (£0.1m overspend):

• Underspend on Hub business cases due to length of time taken to get Business Case

approval was used to support CCGs in development of Primary Care Model of Care.

3. Acute reconfiguration (£0.2m underspend):

• System wide support budget was used to support the ImBC and OBC development costs.

4. Mental Health Transformation (£0.2m overspend):

• Overspend due to unaccrued costs from previous years.

5. Cross cutting and Core team (£1.9m overspend);

• Communications overspend due to initial high rate of interim staff, substantive recruitment

largely complete by March 2016;

• 5 year strategy overspend due to the increase in support required for 7 day services, both

within the central team and in provider Trusts. Also includes cost for support to the

Sustainability and Transformation Plan, Urgent and emergency care, and Community

Paediatric services;

• Core team costs overspend due to an increase in accommodation costs; and

• Informatics overspend due to increase in contract with SECSU to support the Whole

Systems Data Warehouse project.

North West London

Appendix A

Month 12 Budget Update Consultancy Contracts Let

SaHF & NWL Strategy and Transformation Programmes

April 2016

10

Contract

Let

Contract Value Provider Decision-making panel NHSE Contract Summary

Jun 2015 WSIC Early

Adopters Go

Live

£206,985

McKinsey

Single Tender Waiver1

Signed by C Parker (AO) and R O’Hare

(Chair)

Approved

Contract to support handover

of Data Warehouse from

McKinsey to CCG/Strategy

and Transformation team;

Jun 2015 SaHF ImBC

Development

- Joint PMOb

£190,500

Moorhouse



(Chair)

Approved

Contracts to support the

ImBC refresh in July/August;

Jun 2015 SaHF ImBC

Development

- Productivity

Analysis

£791,778

McKinsey



(Chair)

Approved



Jun 2015 SaHF ImBC

Development

- Financials

£203,145

NEL CSU

(Deloitte)



(Chair) – SLA signed by C Parker plus

Finance Director NELCSU

Approved



Jun 2015 SaHF ImBC

Development

- Re-write

£17,351

Carnall

Farrar

Signed by C Parker (AO)

N/A as

below £50k

threshold



Aug 2015 Portfolio and

PMO

Support for

S&T

Directorate

£863,604 PA

Consulting

Evaluation panel: Director of S&T

(acting), Deputy Director S&T, Deputy

Director Reconfiguration (S&T),

Programme Director Reconfiguration

(S&T), Deputy CFO CWHHE, and two

Lay Members

Approved Contract to support Portfolio

Management Office in

Strategy & Transformation to

March 16, to allow time for

recruitment to substantive

roles;

S&T consultancy contracts let since 1st April 2015 (1/6)

Contract

Let


Aug 2015

SaHF ImBC

Development

- Joint PMO

(extension to

Jun 2015

letting)

£35,200

Moorhouse


Signed by C Parker (AO)

N/A as below

£50k threshold


ImBC refresh in

July/August;

Aug 2015 Delivery

Architecture

£549,828

McKinsey

Evaluation panel: Director of S&T

(acting), Deputy Director Strategic

Financial Planning (S&T), Deputy

Director S&T (WSIC), Deputy Director

Reconfiguration (S&T), Lay Member.

Approved


creation of the NWL

Delivery Architecture to

allow the delivery of pan-

NWL savings across

agreed areas of joint

working;

Sept 2015 SaHF ImBC -

Additional

Support for

Finance Plans

for 8 NWL

CCGs

£50,000

Deloitte LLP


Signed by Clare Parker

N/A as below

£50k threshold

Contract to create model

required to allow

consolidation of 8 CCG

5-year financial plans;

Oct 2015 Supporting

SaHF

Programme –

CCG QIPP

Plan for

CWHHE and

BHH

£208,733 GE

Healthcare

Finnamore


Signed by Clare Parker, CFO, and

Chair, CLCCG

Approved Contract to support

consolidation of QIPP

plans and benefits

realised to support ImBC

process;


Contract

Let


Oct 2015 Delivery Architecture -

Bridging to

Implementation

£263,250

McKinsey &

Company


Signed by Clare Parker

Approved

Contracts to support the creation of

the NWL Delivery Architecture to

allow the delivery of pan-NWL

savings across agreed areas of joint

working;

Oct 2015 Change Academy £690,921

GE

Healthcare

Finnamore

Contract - Evaluation panel:

Director of S&T (acting),

Deputy Director S&T, Work

Force Lead S&T, Head of

Education Transformation

ICH, Clinical lead HENWL

and one Lay Member

Not

approved

Contract to support Organisational

Development for new ways of working

in an Whole Systems environment.

(NOT AWARDED)

Oct 2015 New Models of

Primary Care

£471,645 PA

Consulting

Contract – Evaluation Panel:


Deputy Director Strategic

Financial Planning, Deputy

Director S&T, MD, West

London CCG, 2 Lay members

Not

approved

Contract to support development of

locally-designed primary care offer

initially taking forward the work of 3

NWL CCGs focusing on the design

and roll-out of new models of primary

care, aligned to the Strategic

Commissioning Framework

(NOT AWARDED)

Nov 2015 Support to ImBC Out

of Hospital Plans

£49,900 GE

Healthcare

Finnamore

Single Tender Waiver2 N/A as

below £50k

threshold

Contract to Support the development

of Strategic Outline Case level

models for OOH delivery

Nov 2015 Review of the 2015

Maternity Services

Transition in North

West London

£49,750 GE

Healthcare

Finnamore



Programme Director

Reconfiguration, Deputy

Director Reconfiguration.

N/A as

below £50k

threshold

Contract to conduct a review of the

changes as a result of the planned

closure of birthing services at Ealing

Hospital.

Nov 2015 Support to S&T-

Supporting SaHF

programme

£49,000 GE

Healthcare

Finnamore



Programme Director

Reconfiguration, Deputy

Director Reconfiguration.

N/A as

below £50k

threshold

Contract to provide strategic support

to the reconfiguration programme by

K. Atkin


Contract

Let


Nov 2015 Support to S&T-

Supporting SaHF

programme

£49,000 GE

Healthcare

Finnamore

Contract - Evaluation

panel: Director of S&T

(acting), Programme

Director Reconfiguration,

Deputy Director

Reconfiguration.

N/A as

below £50k

threshold

Contract to provide strategic support

to the reconfiguration programme by

K. Atkin

Nov 2015 Equalities Review for

Paediatric Transition

£29,918 Deloitte LLP Contract – Evaluation

Panel:


Assistant Director

Communications and

Engagement

N/A, as

below £50k

threshold

Contract to provide support for the

transition of paediatric in-patient

services from Ealing Hospital,

specifically with regard to the impact

on protected characteristics,

inequality of access and inequality of

outcomes.

Dec 2015

Development of PIDs,

Option Appraisal and

OBC’s for OOH Hubs

£499,999

PA Consulting Contract (Signing in

process) – Evaluation

Panel:

Deputy Director of

Reconfiguration (S&T),

Head of Strategic Estates

Development CLCCG,

Deputy Director of Strategic

Financial Planning

Approved Contract to improve condition of OOH

estates, expand hospital capacity,

maximise benefits of co-location of

health and social care services and

continue consistency of care and

improved clinical standards

Dec 2015 PTS Survey £35,544 365Response Contract – Evaluation

Panel:

Assistant Director

Communications &

Engagement, Travel &

Transport Lead, Travel

Adviser

N/A, as

below the

threshold of

£50k

Contract to provide survey In the area

of patient travel services, data

capture, handling of patients, collate

and analyse patient travel

experiences.


Contract

Let


Dec 2015 Finance and

Activity work

stream for the

SaHF ImBC

(through

Hammersmith

& Fulham

CCG)

£585,000 Deloitte Contract – Evaluation Panel:

CFO for BHH, Lay Member,

Financial Adviser SaHF, Director of

Financial Strategy NHSE

Approved Contract to provide services in

the following key activities:

• preparation/planning phase

• collection and analysis to feed

into the ImBC

• support to post-ImBC

submission response to

queries etc.

Dec 2015 Like Minded –

Children and

Young People

(through West

London CCG)

£352,687 The Anna

Freud

Centre

Contract – Evaluation Panel:

Senior Children’s Joint

Commissioning Manager (West,

Central H&F CCGs), CAMHS

Project Lead, Assistant Director,

WSIC, Lead CYP, Central London

GP Clinical Lead, Deputy Head

Teacher Cannon’s High School,

Headteacher Roxeth Primary

School, Children’s Commissioner

Harrow LA.

Submitted to

NHSE on

18/02/2015 –

decision

awaited

Contract to provide services for:

• Children and Young People’s

Mental Health and Wellbeing

needs assessment, supporting

co-production, workforce

development & training,

redesigning pathways,

support for learning

disabilities, crisis and urgent

care pathways

• children and young people’s

workforce training and

development needs analysis

Feb 2016 Health

Coaching –

Training

Existing

Trainers and

Coaches

£36,990 Osca

Agency

Contract Evaluation Panel:

Assistant Director Workforce and

OD (S&T), Workstream Lead (Darzi

Fellow) S&T, Lay Partner, Clinical

Lead for Self Care CLCCG

N/A, as below

the threshold

of £50k

Training programme to ‘convert’

current clinicians who have

Coach Trainer qualifications to

become Health Coach Trainers

able to train people to become

Health Coaches and Health

Coaches Trainers


Contract

Let

Contract Value Provid

er

Decision-making panel NHSE Contract Summary

Feb 2016 Health Coaching –

Training the Clinicians

£49,840 Osca

Agency

Contract Evaluation Panel:

Assistant Director Workforce

and OD (S&T), Workstream

Lead (Darzi Fellow) S&T, Lay

Partner, Clinical Lead for Self

Care CLCCG

N/A, as

below the

threshold of

£50k

To create a sustainable programme

that equips our front line clinicians

with coaching skills so they can

have better conversations with their

patients to empower them to make

more meaningful changes to their

health related behaviours and

lifestyle to lead to better health

outcomes

March

2016

Support for

Paediatric Transition

Activity Model Review

£19,999 Deloitte

LLP

Deputy Director

Reconfiguration, Programme

Director, Assurance Lead,

Head of Reconfiguration

NHSE

N/A – below

the

threshold of

50K

Changes, as part of the SaHF

programme, were agreed relating to

maternity, paediatrics and

gynaecology services. The

proposals included:

Consolidation of maternity and

neonatal services from seven to six

sites to provide comprehensive

obstetric and midwife-led delivery

care and neonatal care.

Consolidation of paediatric inpatient

services from six sites to five sites

to incorporate paediatric

emergency care, inpatients and

short stay /ambulatory facilities.

TOTAL (including

awarded contracts

only)

£5,188,001


Single Tender Waivers have been agreed in line with the CLCCG Prime Financial Policies section 14 for the following

reasons: 1 When the task is essential to complete the project, and arises as a consequence of a recently completed

assignment and engaging different consultants for the new task would be inappropriate (Para 14.8.7);

2 Where the timescale genuinely precludes competitive tendering (Para 14.8.5).

Month 12 Budget Update - NHS Hounslow CCG · September 2015) Total S&T projects £m £m £m...

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