The following areas have significant elements of estimation, and could thus
impact on our year-end estimates.
a) Agenda for Change: Whilst 400 leavers’ arrears have been calculated,
the Trust currently is unable to progress these for payment as the
leaver has still to confirm their National Insurance number for security
clearance. In addition, approximately 1,200 staff successfully appealed
their agenda for change banding. Some £3.6million of reviews are
already progressed onto their regionally approved new banding as at
end of August 2012. There is a balance of £700,000 retained for
outcomes still to be confirmed.
b) Elective Care Reform: The Commissioner has confirmed 2012/13
funding of some £7million, for April – September 2012, of non-recurrent
funding. The financial position assumes that Elective Care Access
work will break-even. The Trust is, in conjunction with HSCB,
reviewing current activity. Failure to deliver on levels will result in a
retraction of the funds. SBA volumes are confirmed for the majority of
c) SBA Volumes: HSCB correspondence with the Trust has emphasised
the requirement to fully deliver on volumes (CORE work). Failure to
achieve this may result in financial sanctions.
d) Community Care Issues: PCCOPS and Mental Health/Disability
Directorates have agreed the apportionment of the 2012/13
demography funding. Fifty percent of the target is to be matched by productivity. We are currently assessing the growth in activity volumes
this year which are linked to demographic issues. Demography growth
has been identified at approx 6% for elderly/dementia services.
e) Additional Medical Costs: The European Working Time Directive
(EWTD) and new Specialist Doctors’ Contract will have a financial
impact on the Trust. EWTD relates primarily to the Hospital at Night
scheme in Antrim Hospital which is currently being reviewed by ISG
(circa £260,000 FYE) The Specialist Doctor’s Contract was costed by
DHSSPS; however the Trust has revisited these costs and believe that
recurrent emerging revenue costs in the region of some £350,000 will
impact on the Trust during 2012/13. DHSSPS have indicated that they
would not be able to cover these additional costs.
f) The balance of the 2011/12 Modernisation & Recovery Plans falling
into 2012/13 amounted to £4.216million. The recurrent breakeven
position requires these plans to be delivered in full.
g) The final recurrent costs associated with any potential AFC Clustering
issues are as yet unknown. HSCB have funded £1.1million recurrently
in anticipation of the settlement of these requests.
h) Carbon Reduction Commitment (CRC): The Trust is incurring a new
charge for CRC in 2012/13 (backdated to 2011/12 – payment in
arrears) which is a tax on usage. Whilst the Trust is able to cover the
2011/12 element of this charge, this is a new regional recurring cost
pressure which has been highlighted to the Commissioner for which the
Trust is seeking funding support.
i) Pseudomonas: The trust has incurred expenditure associated with the
March 2012 outbreak. A range of recommendations contained within
the Independent Review of Incidents of Pseudomonas Aeruginosa
infection in Neonatal Units in Northern Ireland has been implemented
this financial year; however there are further actions required. The
Trust has submitted a bid to support these new emerging recurrent
costs and awaits a decision from DHSSPS.
j) The year-end best estimates are primarily based on actual expenditure
patterns for six months and thus are subject to change.