HFMA South West Conference National Finance Update
Description: HFMA South West Conference National Finance Update Simon Currie NHSE Director of Financial Oversight Delivery 202324 financial position 2324 revenue outturn Pressuresissues we had to absorb: High headcount growth High inflation
Related Topics
Download Presentation
"HFMA South West Conference National Finance Update" is the property of its rightful owner. Permission is granted to download and print the materials on this website for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Presentation Transcript
slide1. HFMA South West Conference National Finance Update Simon Currie
NHSE Director of Financial Oversight & Delivery<br>
slide2. 2023/24 financial position<br>
slide3. 23/24 revenue outturn Pressures/issues we had to absorb:
High headcount growth
High inflation
Industrial action
ERF earnings
VPAS scheme close
Specialised high-cost drugs
Significant pay increases
New depreciation funding regime
PFI PDC dividend windfall
Interaction of depreciation and IFRS16 changes<br>
slide4. 23/24 System Performance<br>
slide5. Workforce growth<br>
slide6. Profile of system risk in 23/24<br>
slide7. Planned £2.3bn deficit for 24/25 To ‘buy out’ all overspends at level of the highest would cost a further £7.9bn If we distributed the deficit funding on a fair shares basis, we would still have a further £800m of overspends to cover<br>
slide8. Incentives and disincentives Designed to rebalance systems to fair shares position (over two years)
Calculated a ‘fair share’ of the total £2.3bn deficit
Took the difference between this & the system CT
Produced three distinct groups:
Deficit CT above fair share – capital deductions & future year repayments
Deficit CT below fair share – no deductions, no bonuses
Breakeven CT – capital bonus this year, capital and revenue next year<br>
slide9. Investigation & Intervention Process Implemented for the first time this year
Currently 12 systems being supported
Designed for short, sharp intervention to reduce spend rate
Focus on plan delivery, not longer term recovery
Requires very swift mobilisation
External consultancy support for delivery
Supported by NHSE-appointed senior leader<br>
slide10. I&I Key Observations Workforce controls
Follow through of workforce issues
Involvement of ops, medical, nursing, HR
Non-pay controls
CHC review processes
Demand management incl. patient decision aids
Role of the ICB not always clearly understood
Lack of focus on actions and delivery
Learning being shared via the ‘Finance playbook’<br>
slide11. Diagnosis Plan Improvement tools Transition Highlights areas considered highest priority.
Timing of diagnosis and improvement will vary depending on organisational circumstances.
Likely overlap between diagnosis, plan and improvement phases with opportunity for continuous improvement cycle. Finance playbook at a glance The full finance playbook and supporting tools can be found in the finance section of the National Recovery Support NHS Futures site:
National Recovery Support - FutureNHS Collaboration Platform<br>
slide12. What’s coming next? Darzi review published already, 10 year plan to follow
Re-engage staff and re-empower patients
Lock in the shift of care closer to home
Simplify and innovate care delivery for a neighbourhood NHS
Drive productivity in hospitals
Tilt towards technology
Contribute to the nation’s prosperity
Reform to make the structure deliver
Short term no big changes? – elective, A&E, dental wait times
25/6 department budgets to be set in October
Spring sending review to set for later years<br>
slide13. Planning for 2025/26 Possible earlier publication of some elements Multi year planning round unlikely Continuation of ERF to support elective recovery Funding for future years TBC, big increases unlikely What needs to be true to complete planning earlier? Expect current finance regime to continue Expect similar efficiency challenge to current year No additional funding for 24/5 overspends Continued focus on financial grip, and productivity Not likely to make big pricing changes Allocations refinements for eg maternity, rurality Need to start looking at fixed payment element<br>
slide14. Thank You!<br>
slide15. Ask a question by scanning the QR code (or by going to slido.com and entering the code #3918173)<br>
NHSE Director of Financial Oversight & Delivery<br>
slide2. 2023/24 financial position<br>
slide3. 23/24 revenue outturn Pressures/issues we had to absorb:
High headcount growth
High inflation
Industrial action
ERF earnings
VPAS scheme close
Specialised high-cost drugs
Significant pay increases
New depreciation funding regime
PFI PDC dividend windfall
Interaction of depreciation and IFRS16 changes<br>
slide4. 23/24 System Performance<br>
slide5. Workforce growth<br>
slide6. Profile of system risk in 23/24<br>
slide7. Planned £2.3bn deficit for 24/25 To ‘buy out’ all overspends at level of the highest would cost a further £7.9bn If we distributed the deficit funding on a fair shares basis, we would still have a further £800m of overspends to cover<br>
slide8. Incentives and disincentives Designed to rebalance systems to fair shares position (over two years)
Calculated a ‘fair share’ of the total £2.3bn deficit
Took the difference between this & the system CT
Produced three distinct groups:
Deficit CT above fair share – capital deductions & future year repayments
Deficit CT below fair share – no deductions, no bonuses
Breakeven CT – capital bonus this year, capital and revenue next year<br>
slide9. Investigation & Intervention Process Implemented for the first time this year
Currently 12 systems being supported
Designed for short, sharp intervention to reduce spend rate
Focus on plan delivery, not longer term recovery
Requires very swift mobilisation
External consultancy support for delivery
Supported by NHSE-appointed senior leader<br>
slide10. I&I Key Observations Workforce controls
Follow through of workforce issues
Involvement of ops, medical, nursing, HR
Non-pay controls
CHC review processes
Demand management incl. patient decision aids
Role of the ICB not always clearly understood
Lack of focus on actions and delivery
Learning being shared via the ‘Finance playbook’<br>
slide11. Diagnosis Plan Improvement tools Transition Highlights areas considered highest priority.
Timing of diagnosis and improvement will vary depending on organisational circumstances.
Likely overlap between diagnosis, plan and improvement phases with opportunity for continuous improvement cycle. Finance playbook at a glance The full finance playbook and supporting tools can be found in the finance section of the National Recovery Support NHS Futures site:
National Recovery Support - FutureNHS Collaboration Platform<br>
slide12. What’s coming next? Darzi review published already, 10 year plan to follow
Re-engage staff and re-empower patients
Lock in the shift of care closer to home
Simplify and innovate care delivery for a neighbourhood NHS
Drive productivity in hospitals
Tilt towards technology
Contribute to the nation’s prosperity
Reform to make the structure deliver
Short term no big changes? – elective, A&E, dental wait times
25/6 department budgets to be set in October
Spring sending review to set for later years<br>
slide13. Planning for 2025/26 Possible earlier publication of some elements Multi year planning round unlikely Continuation of ERF to support elective recovery Funding for future years TBC, big increases unlikely What needs to be true to complete planning earlier? Expect current finance regime to continue Expect similar efficiency challenge to current year No additional funding for 24/5 overspends Continued focus on financial grip, and productivity Not likely to make big pricing changes Allocations refinements for eg maternity, rurality Need to start looking at fixed payment element<br>
slide14. Thank You!<br>
slide15. Ask a question by scanning the QR code (or by going to slido.com and entering the code #3918173)<br>