Update on 2011/12

Financial Position at M3

Delivery Group

1 August 2011

2

3

2011/12 M03 Financial Position - Overview of year to date (YTD) and Forecast Outturn (FCOT)

Key:

10-11 Final Outturn Plan Actual

Variance from Plan

Variance from Plan at Month 2 Plan Actual

Variance from Plan

Variance from Plan at Month 2

£m £m £m £m £m £m £m £m £m

Trusts (19.1) (67.2) (78.3) (11.1) (6.8) (115.5) (106.8) 8.7 8.9- - - -

PCTs 134.6 29.7 25.3 (4.4) 1.3 122.3 122.4 0.1 -- - -Sub Total PCTs/Trusts 115.5 (37.4) (53.0) (15.5) (5.5) 6.7 15.5 8.8 8.9

MPET 40.8 2.6 2.6 - 10.0 10.0 -

SHA Admin (inc. MPET Admin) 3.8 - 2.1 2.1 - - -

Hosted Services 11.0 - 3.0 3.0 2.1 3.3 1.2

Carry Forward & Reserves 106.3 36.2 36.2 - 93.5 92.3 (1.2)

MTFS 95.3 23.6 23.6 - 94.3 94.3 -

SHA (inc MTFS) 257.2 62.4 67.6 5.2 - 199.9 199.9 (0.0) (0.7)

Total NHSL 372.7 25.0 14.6 (10.4) (5.5) 206.7 215.4 8.8 8.2

Year to Date at M3 Forecast Outturn at M3

Positive figure denotes a surplus/favourable movementNegative figure (X) denotes a deficit/adverse movement

4

2011/12 M03 Financial Position - I&E Variances Excl. Impairments (NHS Trusts)

Month 03

Plan YTDMonth 03

YTD Actual VarianceVariance at

Month 02 Trust SummaryFull Year

PlanFOT as at Month 03

Revised Variance

Over/ (Under) Plan YTD

Over/(Under) Plan FOT

£'000s £000s £'000s £'000s £'000s £000s £'000s £'000s £'000s

692 945 253 286 Central London Community Health* 2,777 2,775 (2) 1,255 340372 183 (189) (194) Ealing 2,217 2,217 1 (255)

(17,636) (16,791) 845 35 Imperial College Healthcare (30,000) (30,000) - (1,727) (20,191)(7,272) (7,997) (725) (654) North West London Hospitals (9,700) (9,700) - (53) -

334 337 3 1 West Middlesex 1,604 1,604 (0) (30) ()92 347 255 155 West London 2,533 2,533 (0) - -

(23,418) (22,976) 442 (371) Sub Total (30,569) (30,571) (2) (811) (19,851)

(2,369) (961) 1,408 1,374 Barnet & Chase Farm 3,000 3,000 - (351) (5,549)

(1,213) (2,005) (792) (654) Barnet Enfield & Haringey 1,884 1,885 1 (54) 1,300817 7 (810) (629) North Middlesex 500 500 - (183)

(1,010) (978) 32 26 Royal Free 6,673 6,676 3 (6) (20)599 102 (497) (641) Whittington 885 885 (0) (800) ()

(3,176) (3,835) (659) (524) Sub Total 12,942 12,946 4 (1,394) (4,269)

(10,837) (15,722) (4,885) (4,161) Barking Havering & Redbridge (39,800) (39,798) 2 (1,601) (12,077)(1,392) (3,091) (1,699) (656) Whipps Cross - - - (1,375) 28

(12,229) (18,813) (6,584) (4,817) Sub Total (39,800) (39,798) 2 (2,976) (12,049)

CIPs Variance

NCL

YTD Versus Plan - Excl. Impairments & IFRS

FOT Versus Plan - Excl. Impairments & IFRS

NWL

ONEL

5

2011/12 M02 Financial Position - I&E Variances Excl. Impairments (NHS Trusts)

Month 03

Plan YTDMonth 03

YTD Actual VarianceVariance at

Month 02 Trust SummaryFull Year

PlanFOT as at Month 03

Revised Variance

Over/ (Under) Plan YTD

Over/(Under) Plan FOT

£'000s £000s £'000s £'000s £'000s £000s £'000s £'000s £'000s

(8,455) (7,702) 753 136 Epsom & St Helier (19,324) (19,300) 24 (162)(1,091) (1,328) (237) (118) Kingston Hospitals 2,531 2,531 (0) (279) (711)

538 (964) (1,502) (644) Croydon Health Services 4,436 4,438 2 (815) (857)(3,820) (2,835) 985 1,384 St George's 7,919 7,919 - (208)

190 312 122 67 SW London & St George's 2,224 2,207 (17) - ()663 572 (91) (215) Hounslow and Richmond 1,639 1,639 0 - -

(11,975) (11,945) 31 609 Sub Total (575) (566) 9 (1,464) (1,568)

4,532 1,510 (3,022) (2,865) Barts and the London 2,600 2,600 - (2,669) (3,542)(502) (1,065) (563) (242) Newham 2,280 2,275 (5) (328) (1,162)4,030 445 (3,585) (3,107) Sub Total 4,880 4,875 (5) (2,997) (4,704)

(1,919) (2,477) (558) (394) Lewisham 1,090 1,090 - 179 (335)(19,912) (21,656) (1,744) (675) South London Healthcare NHS Trust (74,176) (65,176) 9,000 (873) ()(21,831) (24,133) (2,302) (1,069) Sub Total (73,086) (64,086) 9,000 (694) (335)

1,580 105 (1,475) (301) London Ambulance Service 2,738 2,412 (326) (1,908) (8)(411) 242 653 775 Royal National Orthopaedic 1,070 1,070 0 70 327

280 2,625 2,345 2,013 Great Ormond Street 6,880 6,880 (0) (129) -1,449 2,972 1,523 2,487 Sub Total 10,688 10,362 (326) (1,967) 319

(67,151) (78,285) (11,134) (6,792) Trusts Total (115,518) (106,838) 8,680 (12,302) (42,458)

Specialist/Pan London

SEL

INEL

CIPs Variance

SWL

YTD Versus Plan - Excl. Impairments & IFRS

FOT Versus Plan - Excl. Impairments & IFRS

6

Trust DeficitsCIPs YTD Variance

CIPs FOT Variance

Code Trust Name Month 2

YTD Month 3

YTD

Month 3 YTD Plan

M3 YTD Deficit/

YTD Income

(%)

Month 03 Actual

Month 03 Plan

Explanation FOT as at Month 03

Full Year Plan

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000

(208) 0 RYQ South London Healthcare (14,116) (21,656) (19,912) (21.4%) (7,540) (6,471)

SLHT is behind plan at month 3 by £1,744k. This is due to temporary staff costs, high drug and theatre costs. The Trust is indicating a FOT higher than planned by £9m made up of £4m additional CIP and £5m additional income.

(65,176) (74,176)

(1,601) (12,077) RF4 BHRT (11,873) (15,722) (10,837) (15.9%) (11,873) (3,125)

The YTD deficit has worsened broadly in line with slippage on CIP - now £1.6m behind plan.

YTD income has overperformed by £2.7m (£0.6m better than the trust's internal plan - which is £2.1m higher than the current submission). Against this income £2.3m of costs have been shown as well as costs of £1.5m to meet CQC requirements in midwifery and paediatrics.

The trust's breakeven position incorporates a significant level of risk, key of which are the forecasted £12.1m CIP shortfall and the additional £1.1m margin from £10m income overperformance and £4m additional CQC-related costs.

(39,798) (39,800)

(749) (5,505) RVR Epsom & St Helier (6,457) (7,702) (8,455) (9.8%) (6,457) (1,862)

Directorate overspends, CIP non delivery and the shortage of cash are the principal risks. Bi-weekly performance meetings have been established with overspending directorates to manage performance and finance. CIP's are being tracked through the PMO - it should be noted that the bulk of CIPS are planned to start from October so it is imperative that the milestones are met to ensure they are delivered. Cash - a detailed 13 week rolling cash flow has been prepared and cash support has been agreed with the Sector and NHS London. Following the appointment of the new Director of Finance the Trust reset its detailed budget by end May 2011 and although the overall plan is the same there are some differences in profiling from the FIMS plan.

(19,300) (19,324)

(53) - RV8 North West London Hospitals (6,413) (7,997) (7,272) (9.0%) (6,413) (1,513)

The trust is behind plan at Month 3 due to lower than planned non-PbR elective activity partly offset by above SLA non-elective activity. The trust has also overspent in agency staff costs to meet service requirements. The trust FOT assumes receipt of £9m of non-recurrent transitional funding from the NW Cluster - discussions to agree terms are ongoing.

(9,700) (9,700)

(732) (2,459) RYJ Imperial College Healthcare (11,896) (16,791) (17,636) (7.4%) (11,896) (5,705)

The trust is ahead of plan at month 3 by £845k principally due to activity overperformance offset by CIP slippage. The trust has risk assessed its cost savings program and reduced its forecast outturn for cost savings to £45m. The trust FOT assumes receipt of £15m of non-recurrent transitional funding from the NW Cluster - discussions to agree terms are ongoing

(30,000) (30,000)

(821) (306) RGC Whipps Cross (2,279) (3,091) (1,392) (5.1%) (2,279) 231

The trust in-month position has worsened by £0.8m, broadly due to QIPP shortfalls. Cost reductions have been hampered by higher than anticipated ISTC activity and readmissions (both £0.3m behind plan) as well as directorate-specific overspends (£0.3m). The trust's internal plans with revised phasing report the YTD position as £0.5m adverse. Unidentified QIPP has been reduced to £3.1m and further initiatives identified will reduce this to £2.7m albeit with inherent delivery risk.The Trust is continuing to work with the Cluster to ensure delivery against QIPP plans.

- -

7

Trust Deficits

CIPs YTD Variance

CIPs FOT Variance

Code Trust Name Month 2

YTD Month 3

YTD

Month 3 YTD Plan

M3 YTD Deficit/

YTD Income

(%)

Month 03 Actual

Month 03 Plan

Explanation FOT as at Month 03

Full Year Plan

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000

(815) (857) RJ2 Lewisham (1,962) (2,477) (1,919) (4.6%) (1,962) (351)

The Trust is £560K behind plan at the end of M3. This is primarily driven by overspends in the clinical divisions. There is approximately £102k of slippage against unidentified savings (internal plan) and £223k of slippage against identified schemes (internal plan). The plan now includes an income assumption of £6.8m over performance against plan. This is broadly being met.

1,090 1,090

(54) (802) RRP Barnet Enfield & Haringey (1,436) (2,005) (1,213) (4.2%) (1,436) (431)

The trust has had further underperformance against its cost and volume contracts - now £0.7m behind plan. However, CIP delivery has improved significantly and is now close to planned level. CIPs have now been fully identified and the board will sign off the revised plan on 25th July. Further work with the commissioners is being sought to clarify the agreement on CQUIN.

1,885 1,884

179 (335) RAX Kingston Hospitals (1,491) (1,328) (1,091) (2.8%) (1,491) 281

The Trust is expecting to meet its plan, although there has been a small element of CIP slippage in the first 3 of months of the financial year. The Trust is holding a recurrent £2.85m contingency which can be used to mitigate risks.

2,531 2,531

(328) (1,162) RNH Newham (757) (1,065) (502) (2.6%) (757) 13

The trust's YTD position has declined by £320k due to a number of one-off expenditure items. This is mitigated by a small (£39k) improvement in its CIP performance which remains £328k behind plan.

The FOT is on plan. Contingency CIP plans identified to mitigate the shortfall in CIP achievement.

2,275 2,280

(30) (0) RJ7 St George's (2,571) (2,835) (3,820) (1.9%) (2,571) 135

The Trust is £1.0m ahead of plan at M3. There are a number of risks that are not reflected within the year-to-date position, a summary of the actions for management in respect to these issues are as follows: Work closely with ACU and SHA colleagues as appropriate to ensure that issues are understood and that where possible contract and other flexibilities are secured to mitigate risks as far as is possible. Engage with other 3rd party stakeholders such as LPP, District Valuer and other parties to enable meaningful and robust dialogue. Involve clinical colleagues where required to secure robust clinical involvement in pertinent issues.

7,919 7,919

(255) 0 RJ6 Croydon Health Services (849) (964) 538 (1.7%) (849) 742

The Trust position as at June is a deficit of £964k which is £1,498k variance against plan, £491k of the variance relates to the slippage on CIPS YTD. The Trust income position is above plan, however operating expenditure is significantly above plan for Pay and pharmacy drug issues. The YTD expenditure position gives concern for the financial year, therefore the directorates have been tasked with identifying new CIPS and putting in place recovery plans for the remainder of the financial year.

4,438 4,436

8

Trust Deficits

CIPs YTD Variance

CIPs FOT Variance

Code Trust Name Month 2

YTD Month 3

YTD

Month 3 YTD Plan

M3 YTD Deficit/

YTD Income

(%)

Month 03 Actual

Month 03 Plan

Explanation FOT as at Month 03

Full Year Plan

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000

(351) (5,549) RVL Barnet & Chase Farm (1,388) (961) (2,369) (1.1%) (1,388) 393

Income from commissioners as at month 2 is reportedly £1.1m ahead of the profiled plan with over performance predominantly in period 2. Other income is performing ahead of plan. In spite of unachievement against some elements of the Trust QIPP plan, expenditure is in line with the plan.

3,000 3,000

(6) (20) RAL Royal Free (2,219) (978) (1,010) (0.7%) (2,219) 1,234

The YTD deficit is in-line with plan - £39k adverse variance relating to clinical supplies is offset by £46kCIP slippage recovered in M3.

The forecast out-turn position is unchanged at a surplus of £6.7m. The Trust has brought in additional expenditure controls in-year to mitigate against the risk of QIPP/CIP slippage during the year.

6,676 6,673

(183) 0 RAP North Middlesex (349) 7 817 0.0 % (349) 538

Activity has improved by £0.1m to £0.4m below that planned, despite in-sector overperformance of £0.4m. (PbR elective and non-elective overperformance of £0.7m offsets underperformance in other areas.) The YTD position also includes CIP slippage of £0.2m relating to the delay in the implementation of revised nursing rota and schemes related to demand management. There have been additional costs of £0.3m in M3 representing one-off pressures and costs required to generate extra capacity.

Executive-led weekly capacity meetings are focussed on recovering the lost income by managing capacity over future months. The revised control arrangements for saving plans are identifying the issues of slippage to ensure contingency plans are developed to recover the position.

500 500

- - RKE Whittington (417) 102 599 0.2 % (417) 375

The trust is no longer in YTD deficit but is still behind plan due to CIP underachievement, although work is progressing to identify further programmes. This is mitigated by underspends resulting from the additional expenditure controls put in place.

885 885

(6,006) (29,071) Total (66,473) (85,463) (75,475) (5.5%) (59,897) (15,515) (132,775) (141,800)

Total (deficits only) (66,473) (85,572) (77,428) (6.4%) (59,897) (19,457) (163,974) (173,000)

Total number of deficits 16 14 13 16 7 5 5

9

10

2011/12 M03 Financial PositionI&E Variances (PCTs)

Key:Positive figure denotes a surplus/favourable movementNegative figure (X) denotes a deficit/adverse movement

Month 03

Plan YTDMonth 03

YTD VarianceVariance at

Month 02YTD Planned

SupportYTD Actual

Support PCT SummaryFull Year

PlanFOT as at Month 03 Variance

Variance at Month 02

FOT Planned Support

FOT Actual Support

Over/ (Under) Plan YTD

Over/(Under) Plan FOT

£'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000sNWL

2,895 2,895 - 352 - - Brent 11,602 11,602 - - - - 162 180- - - 737 4,500 4,500 Harrow - - - - 18,000 18,000 (96) (1,519)

1,356 1,437 81 69 (557) (557) Hammersmith and Fulham 5,421 5,421 - - (2,228) (2,228) (265) -1,013 1,050 37 - (188) (188) Kensington and Chelsea* 5,527 5,527 - - (750) (750) 0 (0)2,811 2,855 44 - (518) (518) Westminster 12,577 12,577 - - (2,072) (2,072) 145 -1,026 1,027 1 - (1,056) (1,056) Hounslow 4,110 4,110 - - (4,225) (4,225) 1,030 5

- - - - (1,068) (1,068) Hillingdon - - - - (4,271) (4,271) (12) (77)1,520 1,526 6 (0) (1,114) (1,114) Ealing 6,105 6,105 (0) (0) (4,454) (4,454) 207 11

10,621 10,790 169 1,158 - - - 45,342 45,342 (0) - - 1,171 (1,401)

NCL

(4,300) (6,395) (2,095) 452 Barnet (17,186) (17,186) 0 0 (3,989) (710)5,525 5,399 (126) 206 Camden 22,804 22,804 0 0 (3,367) (125)

(4,822) (5,277) (455) (555) Enfield (18,835) (18,835) 0 0 (2,566) 8044,663 2,661 (2,002) 113 Islington 18,652 18,652 0 0 (2,343) 511

(5,115) (4,070) 1,045 243 Haringey (20,278) (20,278) 0 0 (1,973) (481)

(4,048) (7,682) (3,634) 459 - - Sub Total (14,843) (14,843) 0 0 - - (14,238) (1)

ONEL

551 (974) (1,525) (676) Barking and Dagenham 2,200 2,200 - - (255) (1,524)- (426) (426) (402) Havering - - - - (90) (730)

516 (147) (663) 314 Redbridge 2,000 2,000 - - (96) (1,092)- 441 441 790 Waltham Forest - - - - (83) (1,092)

1,067 (1,106) (2,173) 26 - - Sub Total 4,200 4,200 - - - - (523) (4,438)

YTD Versus Plan FOT Versus Plan CIPs Variance

11

2011/12 M03 Financial PositionI&E Variances (PCTs)

Key:Positive figure denotes a surplus/favourable movementNegative figure (X) denotes a deficit/adverse movement

Month 03

Plan YTDMonth 03

YTD VarianceVariance at

Month 02YTD Planned

SupportYTD Actual

Support PCT SummaryFull Year

PlanFOT as at Month 03 Variance

Variance at Month 02

FOT Planned Support

FOT Actual Support

Over/ (Under) Plan YTD

Over/(Under) Plan FOT

£'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000sSWL

2,110 2,110 - - Croydon 8,301 8,301 - - (1,294) (2,781)1,012 959 (53) (9) Kingston 3,963 3,959 (4) (0) (153) (289)1,044 1,044 - - Richmond and Twickenham 4,199 4,199 - - (342) (904)393 393 - - Sutton and Merton 3,240 3,240 - - (578) (578)

3,313 3,313 - - Wandsworth 12,322 12,322 - - (54) (587)7,872 7,819 (53) (9) - - Sub Total 32,025 32,021 (4) (0) - - (2,421) (5,140)

INEL

1,578 2,346 768 (98) City and Hackney 7,117 7,232 115 0 1 -2,419 2,699 280 (267) Newham 9,737 9,738 1 (0) (0) (0)1,998 2,008 10 9 Tower Hamlets 8,000 8,000 - - 2 (1)5,995 7,053 1,058 (356) - - Sub Total 24,854 24,970 116 (0) - - 2 (1)

SEL

- 50 50 - Bexley 2,245 2,245 - - 3,491 -774 774 - - Bromley 5,993 5,993 - - 74 -

1,137 1,308 171 - Greenwich 4,612 4,612 - - (25) -3,478 3,478 (0) 0 Lambeth 6,605 6,605 0 0 0 01,344 1,344 - - Lewisham 5,375 5,375 - - (478) (2,752)1,507 1,507 - - Southwark 5,857 5,857 - - (292) (1,790)8,240 8,461 221 0 - - Sub Total 30,687 30,687 0 0 - - 2,770 (4,542)

29,746 25,335 (4,412) 1,278 - - PCT Totals 122,265 122,377 112 0 - - (13,238) (15,522)

YTD Versus Plan FOT Versus Plan CIPs Variance

12

PCT Deficits

QIPP YTD Variance

QIPP FOT Variance

Code PCT Name Month 2

YTD Actual

Month 3 YTD

Actual

Month 3 YTD Plan

M3 YTD Deficit/

Plan RRL (%)

Month 3 Actual

Month 3 Plan

Explanation FOT as at Month 03

Full Year Plan

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000

(3,989) (710) 5A9 Barnet (2,416) (6,395) (4,300) (4.5%) (3,979) (1,432)

The PCT is reporting under performance against its QIPP plan of £4m, with £3.7m of this relating to demand management and decommissioning schemes. However, the PCT suggests that against the revised internal phasing of plans it is £1.7m behind its QIPP target YTD. The PCT is reporting acute over performance of c.£3.4m (c.£1m with B&CF, c.£0.4m with GOSH), mainly against elective, non-elective and outpatient spells. It is reviewing the data to understand specifically the areas in which the over performance arises and the causes. It has released approximately an eighth of its contingency against the YTD position and factored in claims and challenges against the acute position.

(17,186) (17,186)

(2,566) 804 5C1 Enfield (3,770) (5,277) (4,822) (4.4%) (1,507) (1,607)

Enfield has seen over performance against planned acute activity, principally from within the sector, which has been largely offset by contingency/reserve release and underspends against other budgets. It is reporting QIPP being £2.6m behind plan, relating mainly to demand management/decommissioning failure.

(18,835) (18,835)

(1,973) (481) 5C9 Haringey (3,172) (4,070) (5,115) (3.4%) (898) (1,700)Acute activity is in line with/marginally ahead of plan whilst other non-acute budgets are underspent (principally mental health). (20,278) (20,278)

(255) (1,524) 5C2 Barking and Dagenham (309) (974) 551 (1.2%) (665) 184

The acute position (using month 2 data) indicates an overspend of c.£1.5m, principally within emergency/non-elective. There has also been a YTD overspend against corporate budgets totalling c.£340k. These overspends are offset by underspends against some other budgets (primary care and non-acute contracts) together with use of a quarter of the 0.5% contingency.

Actions to mitigate the deficit include utilisation of the remainder of the contingency; a further review and scrutiny of all budgets and contracts, with the expectation that this will contribute further savings.

2,200 2,200

(90) (730) 5A4 Havering (402) (426) - (0.4%) (24) -

The PCT is behind plan as a result of acute over performance (£300k), corporate overspend (£560k) and provider arm QIPP slippage (£200k). This is offset via primary care underspends (£216k) and use of contingency (£500k).

Actions to mitigate the deficit include utilisation of the remainder of the contingency; a further review and scrutiny of all budgets and contracts, with the expectation that this will contribute further savings.

- -

(96) (1,092) 5NA Redbridge 664 (147) 516 (0.2%) (811) 166

The PCT is behind plan as a result of acute over performance (£1.3m), mainly in elective and non-elective. This is partially offset through use of contingency.

Actions to mitigate the deficit include utilisation of the remainder of the contingency; a further review and scrutiny of all budgets and contracts, with the expectation that this will contribute further savings.

2,000 2,000

(8,969) (3,733) Total (9,405) (17,289) (13,170) (1.7%) (7,884) (4,389) (52,099) (52,099)

Total (deficits only) (10,069) (17,289) (14,236) (1.8%) (7,884) (4,739) (56,299) (56,299)

Total number of deficits 5 6 3 6 3 3 3

13

Trust CIPs

Plan YTDActual

Savings Variance % AchievedPlanned Savings

Forecast Savings Variance % Achieved

Unidentified Savings

Unidentified savings as % of FOT

% Delivered YTD of FOT

FOT as % of Turnover

£'000s £'000s £'000s £'000s £'000s £'000s £'000sAcute

3,919 2,318 (1,601) 59.2% Barking Havering & Redbridge 28,375 16,299 (12,077) 57.4% - 0.0% 14.2% 4.1%2,057 1,706 (351) 82.9% Barnet & Chase Farm 16,977 11,428 (5,549) 67.3% 2,303 20.1% 14.9% 3.3%5,866 3,197 (2,669) 54.5% Barts and the London 41,224 37,682 (3,542) 91.4% - 0.0% 8.5% 5.5%1,475 2,730 1,255 185.0% Central London Community Health 10,452 10,791 340 103.2% - 0.0% 25.3% 5.8%1,759 1,504 (255) 85.5% Ealing 12,684 12,684 100.0% - 0.0% 11.9% 5.7%1,385 1,223 (162) 88.3% Epsom & St Helier 18,700 18,700 100.0% - 0.0% 6.5% 5.9%2,223 2,094 (129) 94.2% Great Ormond Street 9,887 9,887 - 100.0% - 0.0% 21.2% 2.9%8,767 7,040 (1,727) 80.3% Imperial College Healthcare 65,191 45,000 (20,191) 69.0% - 0.0% 15.6% 5.0%2,080 1,801 (279) 86.6% Kingston Hospitals 11,495 10,784 (711) 93.8% - 0.0% 16.7% 5.5%1,659 1,838 179 110.8% Lewisham 12,339 12,004 (335) 97.3% - 0.0% 15.3% 5.4%2,891 2,076 (815) 71.8% Croydon Health Services 13,429 12,572 (857) 93.6% 360 2.9% 16.5% 5.5%981 654 (328) 66.6% Newham 7,178 6,016 (1,162) 83.8% - 0.0% 10.9% 3.7%

1,824 1,641 (183) 90.0% North Middlesex 8,410 8,410 100.0% - 0.0% 19.5% 4.8%2,332 2,279 (53) 97.7% North West London Hospitals 19,550 19,550 - 100.0% 1,774 9.1% 11.7% 5.3%4,759 3,886 (873) 81.7% South London Healthcare 26,593 26,593 () 100.0% - 0.0% 14.6% 6.6%5,462 5,456 (6) 99.9% Royal Free 32,498 32,478 (20) 99.9% - 0.0% 16.8% 6.0%395 465 70 117.7% Royal National Orthopaedic 4,020 4,347 327 108.1% - 0.0% 10.7% 4.2%

4,364 4,156 (208) 95.2% St George's 27,270 27,270 100.0% 154 0.6% 15.2% 4.5%1,986 1,956 (30) 98.5% West Middlesex 12,200 12,200 () 100.0% 2,176 17.8% 16.0% 8.5%3,527 2,152 (1,375) 61.0% Whipps Cross 26,296 26,324 28 100.1% - 0.0% 8.2% 11.2%4,025 3,225 (800) 80.1% Whittington 19,600 19,600 () 100.0% 4,057 20.7% 16.5% 7.4%563 563 - 100.0% Richmond and Hounslow 3,910 3,910 - 100.0% 1,558 39.8% 14.4% 7.3%

Mental health1,721 1,667 (54) 96.9% Barnet Enfield & Haringey 13,953 15,253 1,300 109.3% - 0.0% 10.9% 8.0%2,143 2,143 - 100.0% SW London & St George's 10,018 10,018 () 100.0% - 0.0% 21.4% 5.9%2,616 2,616 - 100.0% West London 11,172 11,172 - 100.0% - 0.0% 23.4% 4.5%

Ambulance Services3,387 1,479 (1,908) 43.7% London Ambulance Service 14,847 14,839 (8) 99.9% - 0.0% 10.0% 5.2%

74,167 61,865 (12,302) 83.4% Trusts Total 478,268 435,810 (42,458) 91.1% 12,382 2.8% 14.2% 5.5%

YTD Versus Plan FOT Versus Plan

14

PCT QIPP – Year to Date

PCT Financial PositionSavings

PCT2011/12 CIPS

Plan2011/12

CIPS Actual Variance DM Plan DM Actual VarianceDecomm.

PlanDecomm.

Actual VarianceYTD Total

PlanYTD Total

Actual Variance

£'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s

NWLBrent 0 0 - 2,151 2,293 142 1,221 1,241 20 3,372 3,534 162Ealing 2,900 1,265 (1,635) 2,127 3,969 1,842 - - - 5,027 5,234 207Hammersmith and Fulham 3,171 2,938 (233) 471 439 (32) - - - 3,642 3,377 (265)Harrow 0 0 - 2,163 1,993 (170) 300 374 74 2,463 2,367 (96)Hillingdon 1,070 1,039 (31) 59 - (59) 201 279 78 1,330 1,318 (12)Hounslow 44 1,059 1,015 978 993 15 - - - 1,022 2,052 1,030Kensington and Chelsea 1,382 268 (1,114) 629 832 203 1,534 2,446 912 3,545 3,545Westminster 386 531 145 3,516 3,516 - 924 924 - 4,826 4,971 145

Sub Total 8,953 7,100 (1,853) 12,094 14,034 1,940 4,180 5,264 1,084 25,227 26,398 1,171

NCLBarnet 2,353 2,101 (252) 568 513 (55) 3,876 194 (3,682) 6,797 2,808 (3,989)Camden 1,221 1,577 356 660 146 (514) 3,284 75 (3,209) 5,165 1,798 (3,367)Enfield 1,783 2,110 327 376 123 (253) 2,793 153 (2,640) 4,952 2,386 (2,566)Islington 2,307 1,896 (411) 200 1,197 997 2,986 57 (2,929) 5,493 3,150 (2,343)Haringey 2,455 1,960 (495) 436 1,180 744 2,302 80 (2,222) 5,193 3,220 (1,973)

Sub Total 10,119 9,644 (475) 2,240 3,159 919 15,241 559 (14,682) 27,600 13,362 (14,238)

ONELBarking and Dagenham 906 906 - 585 330 (255) 53 53 - 1,544 1,289 (255)Havering 210 205 (4) 605 523 (82) 182 178 (4) 997 907 (90)Redbridge 164 163 (1) 637 541 (95) 213 213 () 1,013 918 (96)Waltham Forest 481 481 - 756 673 (83) 319 319 - 1,556 1,473 (83)

Sub Total 1,761 1,756 (5) 2,582 2,068 (515) 768 764 (4) 5,111 4,587 (523)

2011/12 Year To Date

15

PCT QIPP – Year to Date

PCT Financial PositionSavings

PCT2011/12 CIPS

Plan2011/12

CIPS Actual Variance DM Plan DM Actual VarianceDecomm.

PlanDecomm.

Actual VarianceYTD Total

PlanYTD Total

Actual Variance

£'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000sSWL

Croydon 0 0 - 1,262 114 (1,148) 1,649 1,503 (146) 2,911 1,617 (1,294)Kingston 93 81 (12) 386 161 (225) 1,083 1,167 84 1,562 1,409 (153)Richmond and Twickenham 125 7 (118) 462 358 (104) 653 533 (120) 1,240 898 (342)Sutton and Merton 6 0 (6) 1,650 1,650 - 1,279 707 (572) 2,935 2,357 (578)Wandsworth 1,379 1,159 (221) 175 342 167 976 976 - 2,530 2,476 (54)

Sub Total 1,603 1,247 (357) 3,935 2,624 (1,311) 5,640 4,886 (754) 11,178 8,757 (2,421)

INELCity and Hackney 1,933 1,933 1,392 1,392 1 1,745 1,745 () 5,070 5,070 1Newham 2,393 2,393 () 1,054 1,054 - 343 343 - 3,790 3,790 ()Tower Hamlets 1,420 1,422 2 565 564 (1) 1,478 1,479 1 3,463 3,465 2

Sub Total 5,746 5,748 2 3,011 3,010 (1) 3,566 3,567 1 12,322 12,325 2

SELBexley 306 3,797 3,491 687 687 - 369 369 - 1,362 4,853 3,491Bromley 296 496 200 1,278 1,152 (126) 490 490 - 2,064 2,138 74Greenwich 513 582 69 759 665 (94) 1,380 1,380 - 2,652 2,627 (25)Lambeth 0 0 - 858 858 () 1,898 1,898 2,756 2,756Lewisham 675 426 (249) 675 676 1 1,053 823 (230) 2,403 1,925 (478)Southwark 2,165 2,022 (143) 348 221 (127) 47 25 (22) 2,560 2,268 (292)

Sub Total 3,955 7,323 3,368 4,605 4,259 (346) 5,237 4,985 (252) 13,797 16,567 2,770

PCT Totals 32,137 32,817 681 28,467 29,154 687 34,631 20,025 (14,606) 95,235 81,996 (13,238)

2011/12 Year To Date

16

PCT QIPP – Forecast

PCT2011/12

CIPS Plan

2011/12 CIPS

Actual Variance DM Plan DM FOT VarianceDecomm.

PlanDecomm.

FOT Variance Total Plan Total FOT Variance

% Delivered

YTD of FOT

FOT % of Annual

PlanFOT as %

of RRL

£'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s

NWLBrent - - - 9,008 9,139 131 4,878 4,927 49 13,886 14,066 180 25.1% 101.3% 2.7%Ealing 13,899 9,604 (4,295) 17,036 19,293 2,257 2,565 4,614 2,049 33,500 33,511 11 15.6% 100.0% 5.8%Hammersmith and Fulham 12,690 12,673 (17) 1,877 1,894 17 - - - 14,567 14,567 - 23.2% 100.0% 4.2%Harrow - - - 11,882 10,321 (1,561) 2,123 2,165 42 14,005 12,486 (1,519) 19.0% 89.2% 3.8%Hillingdon 6,987 7,059 72 3,465 4,254 789 2,863 1,925 (938) 13,315 13,238 (77) 10.0% 99.4% 3.3%Hounslow 368 6,101 5,733 18,195 9,473 (8,722) - 2,994 2,994 18,563 18,568 5 11.1% 100.0% 4.9%Kensington and Chelsea 5,657 1,071 (4,586) 2,879 3,851 972 6,187 9,801 3,614 14,723 14,723 () 24.1% 100.0% 4.1%Westminster 1,559 1,559 - 14,530 14,530 - 3,698 3,698 - 19,787 19,787 - 25.1% 100.0% 4.2%

Sub Total 41,160 38,067 (3,093) 78,872 72,755 (6,117) 22,314 30,123 7,809 142,346 140,945 (1,401) 18.7% 99.0% 4.2%

NCLBarnet 17,850 30,178 12,328 2,325 2,862 537 16,008 2,433 (13,575) 36,183 35,473 (710) 7.9% 98.0% 6.4%Camden 4,923 14,197 9,274 2,694 5,366 2,672 13,343 1,272 (12,071) 20,960 20,835 (125) 8.6% 99.4% 4.4%Enfield 15,519 24,267 8,748 1,532 3,084 1,552 11,485 1,989 (9,496) 28,536 29,340 804 8.1% 102.8% 6.4%Islington 9,276 16,001 6,725 822 5,724 4,902 12,244 1,128 (11,116) 22,342 22,853 511 13.8% 102.3% 5.3%Haringey 18,197 21,969 3,772 1,760 5,545 3,785 9,423 1,385 (8,038) 29,380 28,899 (481) 11.1% 98.4% 6.5%

Sub Total 65,765 106,612 40,847 9,133 22,581 13,448 62,503 8,207 (54,296) 137,401 137,400 (1) 9.7% 100.0% 5.8%

ONELBarking and Dagenham 7,381 7,381 - 4,763 3,240 (1,524) 435 435 - 12,580 11,056 (1,524) 11.7% 87.9% 3.5%Havering 1,589 1,545 (44) 4,530 3,881 (648) 1,380 1,342 (38) 7,498 6,768 (730) 13.4% 90.3% 1.7%Redbridge 1,265 1,266 4,913 3,820 (1,093) 1,642 1,641 () 7,820 6,727 (1,092) 13.6% 86.0% 1.7%Waltham Forest 3,013 3,013 - 4,736 3,644 (1,092) 2,002 2,002 - 9,751 8,659 (1,092) 17.0% 88.8% 2.1%

Sub Total 13,248 13,204 (44) 18,942 14,586 (4,356) 5,458 5,420 (38) 37,648 33,210 (4,438) 13.8% 88.2% 2.2%

2011/12 Forecast Year End

17

PCT QIPP – Forecast

PCT2011/12

CIPS Plan

2011/12 CIPS

Actual Variance DM Plan DM FOT VarianceDecomm.

PlanDecomm.

FOT Variance Total Plan Total FOT Variance

% Delivered

YTD of FOT

FOT % of Annual

PlanFOT as %

of RRL

£'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000s £'000sSWL

Croydon - - - 5,955 3,757 (2,198) 6,596 6,012 (584) 12,551 9,769 (2,781) 16.5% 77.8% 1.8%Kingston 375 363 (12) 2,008 1,441 (567) 4,426 4,716 290 6,809 6,520 (289) 21.6% 95.8% 2.5%Richmond and Twickenham 500 407 (93) 1,853 1,505 (348) 2,815 2,352 (463) 5,168 4,264 (904) 21.1% 82.5% 1.5%Sutton and Merton 32 26 (6) 6,598 6,598 - 7,084 6,512 (572) 13,714 13,136 (578) 17.9% 95.8% 2.1%Wandsworth 4,873 3,976 (897) 1,237 1,547 310 976 976 - 7,086 6,498 (587) 38.1% 91.7% 1.3%

Sub Total 5,780 4,772 (1,008) 17,651 14,848 (2,803) 21,897 20,568 (1,329) 45,327 40,188 (5,140) 21.8% 88.7% 1.8%

INELCity and Hackney 7,731 7,731 - 5,566 5,566 - 6,981 6,981 - 20,278 20,278 - 25.0% 100.0% 4.1%Newham 9,572 9,572 4,216 4,216 () 1,371 1,371 - 15,159 15,159 () 25.0% 100.0% 2.8%Tower Hamlets 5,680 5,679 (1) 2,444 2,444 - 5,920 5,920 - 14,044 14,043 (1) 24.7% 100.0% 3.0%

Sub Total 22,983 22,982 (1) 12,226 12,226 () 14,272 14,272 - 49,481 49,480 (1) 24.9% 100.0% 3.3%

SELBexley 1,230 1,230 - 2,808 2,808 - 1,594 1,594 - 5,632 5,632 - 86.2% 100.0% 1.7%Bromley 1,184 1,687 503 5,850 5,347 (503) 1,960 1,960 - 8,995 8,995 - 23.8% 100.0% 1.8%Greenwich 2,878 3,157 279 6,343 6,064 (279) 5,619 5,619 - 14,840 14,840 - 17.7% 100.0% 3.3%Lambeth - - - 3,433 3,433 () 10,193 10,193 13,626 13,626 20.2% 100.0% 2.2%Lewisham 2,968 1,968 (1,000) 2,980 2,807 (173) 6,381 4,802 (1,579) 12,329 9,577 (2,752) 20.1% 77.7% 1.9%Southwark 9,686 9,119 (567) 3,748 2,751 (997) 479 253 (226) 13,913 12,123 (1,790) 18.7% 87.1% 2.3%

Sub Total 17,946 17,161 (785) 25,162 23,210 (1,952) 26,226 24,421 (1,805) 69,334 64,793 (4,542) 25.6% 93.4% 2.2%

PCT Totals 166,882 202,799 35,917 161,987 160,205 (1,781) 152,669 103,011 (49,658) 481,538 466,016 (15,522) 17.6% 96.8% 3.4%

2011/12 Forecast Year End