Financial performance during 2021-22 has been undertaken with the continuation of the national regime introduced in March 2020 in response to the COVID-19 pandemic. The CCG has operated within the cell structure environment and the finance regime altered to the revised ways of working required to free up staff time for the pandemic response. During 2021-22, the CCG has been operating within a system planning environment approach with key finance decisions being evaluated and discussed by the Lancashire & South Cumbria system healthcare organisations.
During 2021-22, in preparation for the introduction of International Reporting Standard IFRS16, the CCG has been securing information on the number, value and types of leases held. IFRS 16 is to be introduced for the healthcare sector with effect from 1 April 2022 and will be reported on in the next financial year.
As part of the CCG financial monitoring, the progress of our service providers (for example local hospitals, community services, primary care practices) are tracked against several national outcomes indicators and ensure that patient rights within the NHS Constitution are maintained. Financial performance reports are presented to and scrutinised by every meeting of the Governing Body (papers for these are available from the CCG website).
The CCG’s performance is measured against a number of financial key performance indicators as outlined below:
|Key performance indicator||Target||Actual||Result|
|Revenue resource use does not exceed the amount specified in Directions||Maintain expenditure within the allocated resource of £334.9m||Total expenditure £334.9m||Achieved|
|Delivery of a control total of breakeven||Deliver a control total of breakeven||Total position £17k underspend||Achieved|
|Achieve the Mental Health Investment Standard||Deliver growth in Mental Health expenditure||Total expenditure £37.2m||Achieved|
|Maintain expenditure within the Annual Cash Drawdown Requirement||Annual Cash Drawdown Requirement total £339.3m||Total cash outflow £339.3m||Achieved|
|Revenue administration resource use does not exceed the amount specified in Directions||Maintain administration (running costs) expenditure within the allocated resource of £3.32m||Total administration (running costs) expenditure £3.31m||Achieved|
|QIPP savings targets identified, and savings achieved||No QIPP savings targets were set due to the amended financial regime in place as a result of the COVID-19 pandemic||No QIPP savings targets were set due to the amended financial regime in place as a result of the COVID-19 pandemic||N/A|
|Maintain capital expenditure on primary care IT within the limits set by NHSEI||Maintain expenditure within the allocated primary care IT capital allocation of £0.599m||Total primary care IT expenditure £0.484m||Achieved|
|Comply with the Better Payment Practice Code (BPPC)||Ensure 95% (by number and volume) of all valid invoices are paid by the due date or within 30 days of receipt of a valid invoice, whichever is later||Non-NHS payables 99% by number, 97.4% by value
NHS payables 96.2% by number, 99.9% by value
Due to the COVID-19 pandemic, a level 4 national incident was declared, resulting in NHSEI introducing temporary measures in late March and early April 2020 that impacted on the current ways of working, and in particular the NHS finance regime.
These measures included:
- moving to a nationally determined monthly ‘block’ contract payment; subsidised with a top-up payment where necessary
- cash management supporting faster payment to providers
- changes to monthly revenue reporting
- revisions to the resource allocation process.
The following section provides a brief overview of the CCG’s financial performance in 2021/22. The financial accounts have been prepared under a Direction issued by NHSEI under the National Health Service Act 2006 (as amended).
The total allocation to Fylde & Wyre CCG for 2021/22 was divided into the following categories:
- We received allocations totalling £301.17m for commissioning NHS services for the local community
- We received a further allocation of £30.21m for delegated commissioning of primary care medical services
- We received a further allocation of £3.32m from which we were expected to cover all our running costs
The CCG’s performance against each of its financial duties, as reported in Note 41 to the Accounts, for the 2021/22 financial year was as follows:
- The CCG achieved its expected in year financial position
- The CCG remained within the cash limit
- The CCG achieved the Mental Health Investment Standard
- The CCG maintained its administration expenditure within its Running Costs Allowance.
The CCG’s accounting policies are shown in full in Note 1 to the Annual Accounts. The Annual Accounts have been prepared on the ‘going concern’ basis (Note 1.1 to the Accounts provides further detail on the adoption of the going concern assumption). This policy allows for the planned organisational transfer to the Lancashire & South Cumbria Integrated Care Board during 2022/23. The accounting policies follow International Financial Reporting Standards (IFRS) to the extent that they are meaningful and appropriate to the NHS, as determined by HM Treasury.