NHS BOLTON CLINICAL COMMISSIONING GROUP AGENDA ITEM NO: ……9………………… Date of Meeting: ……14th June 2019……………………… TITLE OF REPORT:

Report of the Chief Finance Officer (Month 2).

AUTHOR:

Kelly Knowles, Deputy Chief Finance Officer

PRESENTED BY:

Ian Boyle, Chief Finance Officer

PURPOSE OF PAPER: (Linking to Strategic Objectives)

To provide the CCG Board with an update on the 2019/20 Financial Plan and Month 2 Budgets.

LINKS TO CORPORATE OBJECTIVES (tick relevant boxes):

Deliver the outcomes in the Bolton Joint Health and Care Plan.

Ensure compliance with the NHS statutory duties and NHS Constitution.

√

Deliver financial balance. Regulatory Requirement. Standing Item. √

RECOMMENDATION TO THE BOARD: (Please be clear if decision required, or for noting)

NHS Bolton Clinical Commissioning Group Board is asked to:- 1. Note the update to the 2019/20 Financial

Plan and associated budgets as at month 2. 2. Recognise the level of risk identified and

note the process in place by the Executive Team and Finance & QIPP Committee to review scenarios on a monthly basis.

COMMITTEES/GROUPS PREVIOUSLY CONSULTED:

The CCG Executive has discussed and supports the recommendations to the Board. The Finance & QIPP Committee has reviewed and discussed the reports at the meeting prior to the Board. The Board will be kept up to date on financial plans and QIPP delivery.

REVIEW OF CONFLICTS OF INTEREST:

N/A

VIEW OF THE PATIENTS, CARERS OR THE PUBLIC, AND THE EXTENT OF THEIR INVOLVEMENT:

Views of stakeholders will be obtained as part of the CCG commissioning plans.

EQUALITY IMPACT ASSESSMENT (EIA) COMPLETED & OUTCOME OF ASSESSMENT:

An EIA assessment is not required necessary for the report.

1

Report of the Chief Finance Officer May 2019

Ian Boyle Chief Finance Officer

1

1.1 Headlines 1.2 Financial Duties

1. Executive Summary

2.1 Allocation 2.2 Financial Position as at Month 2 2.3 Acute Commissioning 2.4 Non Acute Commissioning 2.5 Running Costs 2.6 Reserves 2.7 Financial Risk 2.8 Impact on 2020/21 Financial Plan

2. Finance and Contract Management

3.1 QIPP Performance 3.2 QIPP Scheme Overview

3. Efficiencies

4.1 Statement of Financial Position 4.2 Cash Limit Drawdown & Better Payment Code 4.3 Capital

4. Financial Control

5. Social Value

Contents

2

1.1 Headlines

For 2019/20, the CCG is required to spend in line with the allocation and therefore there is a control total of zero. Having contributed £4m to support the national position in 2018/19, the CCG has been approved to utilise £8m non-recurrently from the reported historic surplus in 2019/20. The Month 2 financial position is breakeven in line with the financial plan due to the minimal information available at this point in the financial year. Headlines for the data received so far are as follows: • SLAM plans are being validated with Providers, the initial Month 1 data indicates an over performance

of £48k. • The Funded Care financial position is reported at £260k over spent. Data is being analysed to assess

whether this is a true reflection of the recurrent position, however early analysis indicates a run rate over spend of £1.5m.

• Prescribing data and information relating to Primary Care additional PCN schemes has not yet been received.

Financial Performance

May 2019

Plan £000’s

Actual £000’s

Variance £000’s

Plan £000’s

Actual £000’s

Variance £000’s

Allocation (80,091) (80,091) 0 (490,706) (490,706) 0

Expenditure 80,091 80,091 0 490,706 490,706 0

Surplus/(Deficit) 0 (0) 0 0 0 0

YTD Forecast

3

1.2 Financial Duties

The CCG’s statutory financial duties and performance targets are a requirement of NHS England. More detailed updates on these duties are provided throughout the report.

Statutory Financial Duties and Performance Targets

Description Financial Performance Targets Expected Performance

Explanation of the Expected Performance

Revenue Position Operate within approved revenue resource allocation in each and every year. Hold a contingency of at least 0.5%.

Green The CCG has a financial plan that meets this target. Robust

processes are in place to ensure that this is closely monitored and reported through the appropriate CCG Governance.

Running Costs Not to exceed the Running Cost Allowance of £6,322k. Green

The financial budget has been aligned to the financial plan. The CCG has committed to reducing running costs by 20%

within 19/20. Cash Operate within its approved annual cash draw-down

limit (ACDR) in each and every year. Green The CCG has a cash flow plan that meets this target. Processes are in place to monitor and report performance.

Business Conduct Comply with the Better Payments Practices Code of paying 95% of invoices within 30 days.

Green

The CCG has met the performance target in month for both value and number of invoices paid.

Statement of Financial Position

Net Current Assets matches Taxpayers Equity.

Green

The CCG has negative taxpayers equity which reflects the timing of cash flows compared to expenditure incurred over

time.

Quality, Innovation, Productivity & Prevention (QIPP)

Deliver an efficiency across the CCG’s expenditure baseline in order to meet the QIPP challenge. Amber The CCG has a QIPP target of £9.2m for 19/20. There is

currently £0.8m unidentified.

Financial Risk Financial risks and mitigating actions are identified and reviewed on a monthly basis. Amber Financial Risks have identified for 19/20 and these are

monitored monthly and reported in section 2.8

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2.1 Allocation

The budgets were uploaded as per the financial plan and then adjusted for any investments that have not yet been formally approved by the CCG Executive. The CCG is anticipating additional allocation adjustments for the following areas:

• Transformation Fund £3.8m • Primary Care 5YFV funding £1.1m • Mental Health 5YFV funding £0.5m

Allocation adjustments

Acute Contracts 228,899 0 228,899Mental Health 42,480 0 42,480Learning Disabilities 5,216 0 5,216Prescribing 46,197 0 46,197Community Services 46,520 0 46,520Continuing Care 16,729 0 16,729Primary Care 55,558 0 55,558Other Programme 42,785 0 42,785

Total Commissioning 484,384 0 0 0 484,384Running Cost 6,322 0 6,322

Total Allocation 2019-20 490,706 0 0 0 490,706

Total Adjustments

Month 2£000

Revised Allocation at

Month 2£000

Adjustments Month 2Allocation Changes 2019-2020

Baseline Allocation at

Month 1£000

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2.2 Financial Position at Month 2

1. £259k over spend YTD within Continuing Care to be assessed for validity – further information will be discussed in section 2.4.

2. Validate Acute and Provider Financial plans for 19/20. 3. Primary Care IT spend to be reviewed, which is the main driver of the Primary Care over spend.

Headlines & Actions

May 2019 Section

Plan £000’s

Actual £000’s

Variance £000’s

Plan £000’s

Actual £000’s

Variance £000’s

Allocation (80,091) (80,091) 0 (490,706) (490,706) 0

Acute Services 38,150 38,089 61 228,899 228,899 0 2.3

Mental Health 7,855 7,806 49 47,696 47,696 0 2.4

Community 7,753 7,752 1 46,520 46,520 0 2.4

Other Commissioning 5,747 5,706 41 30,697 30,697 0 2.4

Primary Care 16,748 16,767 (19) 101,755 101,755 0 2.4

Continuing Care 2,788 3,047 (259) 16,729 16,729 0 2.4

Running Costs 1,051 990 60 6,322 6,322 0 2.5

Reserves 0 (67) 67 12,088 12,088 0 2.6

Expenditure 80,091 80,091 0 490,706 490,706 0

Surplus/(Deficit) 0 0 0 0 0 0

Year to Date Forecast

6

2.3 Acute Commissioning – Provider View

• The Acute position at Month 2 is based on the Service Level Activity Monitoring (SLAM) provided by Acute and Community Trusts for April (Month 1). This means the May element of this year to date position is an estimate.

• At the time of reporting no SLAM information has been available for our main NHS Provider, Bolton FT. The overall position reported at Month 2 is a year to date underspend of £61k. The primary driver of this underspend to date is the non contracted activity.

• In the absence of any other data at this point in time, the forecast has set to equal the plan.

Year to Date Reported Acute Financial Position

7

Budget £000's Actuals £000's Variance £000's

Bolton NHS Foundation Trust 25,796 25,796 (0)

Manchester University Hospitals NHS Foundation Trust 2,021 2,011 10

Salford Royal NHS Foundation Trust 2,465 2,503 (38)

Wrightington Wigan and Leigh NHS Foundation Trust 1,077 1,035 42

NWAS - Ambulance Services 1,802 1,802 (0)

Independent Sector 3,434 3,457 (22)

Non Contracted Activity 443 353 90

Other Acute Expenditure 1,110 1,132 (22)

Total Acute Commissioning 38,150 38,089 61

Month 2 - Year to date May 2019

2.3 Acute Commissioning – POD View

• Note: The above table includes all NHS Main Acute contracts with the exception of Bolton FT. • No adjustments for challenges have been made to the Month 1 actuals whilst plans continue to be

validated. • The largest variance noted is with regards Adult critical care that presented at Pennine Acute above plan.

Adjustments

8

Plan No. Actual No. Variance No. Variance % Plan £000's Actual £000's Variance £000's Variance %

A&E 731 745 (14) (1.9%) 124 131 (7) (6.0%)

Non Elective 391 422 (31) (7.9%) 825 848 (23) (2.7%)

Elective 1,611 1,577 34 2.1% 1,489 1,461 28 1.9%

Outpatient First 1,588 1,511 77 4.8% 279 266 13 4.7%

Outpatient Follow ups 4,152 4,305 (153) (3.7%) 374 381 (7) (1.8%)

Outpatient Procedures 1,143 1,190 (47) (4.1%) 158 161 (3) (2.1%)

Critical Care 129 150 (21) (16.3%) 147 203 (56) (38.4%)

Maternity 21 21 0 0.0% 17 16 1 6.5%

Drugs and Devices £54 £55 (1) (2.0%)

CQUIN £47 £47 (0) (0.0%)

Other and adjustments £531 £525 7 1.3%

Total by POD 9,766 9,921 (155) (1.6%) 4,046 4,094 (48) (1.2%)

Activity Expenditure

2.4 Non Acute Commissioning – Funded Care

Continuing Care/FNC and Funded Care Team:

The Continuing Care policies and processes were re-audited in Q4 of 2018/19 by MIAA. The outcome of the audit was reported as Moderate Assurance and recommendations will be actioned throughout 19/20 with Patient Pathway Management being the focus of the Funded Care Team. The information that has contributed to the £213k YTD over spend is being validated. QIPP of £1m has been transacted within the Continuing Care budget with schemes to deliver this value delayed year to date. Actions put into place to deliver are below:

Liaison Review of packages

The CCG has arranged for Liaison to review the open packages of care that the CCG currently has “open”. The review will include: duplicate payments; over payments to providers (including deceased patients)and FNC/LA reconciliations

£TBC

Liaison Calculator

The CCG has approved the FCT to utilise the Liaison Package Calculator, which is a mechanism for calculating the indicative budgets for packages approved by the CCG.

£TBC

MIAA Recommend-

ations

QIPP delivery plans to include patient pathway management as cited as High Risk in the MIAA report £TBC

QIPP

May 2019

Plan£000’s

Actual £000’s

Variance £000’s

Plan£000’s

Actual £000’s

Variance £000’s

Continuing Care 2,637 2,850 (213) 15,822 15,822 0

Funded Care Team 151 197 (46) 906 906 0

Expenditure 2,788 3,047 (259) 16,729 16,729 0

Year to Date Forecast

9

2.4 Non Acute Commissioning – Mental Health May 2019

Plan £000’s

Actual £000’s

Variance £000’s

Plan £000’s

Actual £000’s

Variance £000’s

Mental Health 6,986 6,937 49 42,480 42,480 0

Learning Disabilities 869 869 (0) 5,216 5,216 0

Expenditure 7,855 7,806 49 47,696 47,696 0

Year to Date Forecast

Mental Health:

Learning Difficulties:

No current concerns for the LD budget. An horizon scanning exercise is underway to forecast any potential new patients who may transition under the Transforming Care Agenda.

Mental Health spend had reduced significantly for Out of Area Placements in the last half of 2018/19 with the introduction of new capacity into the locality and GM. This additional capacity has continued into 19/20 with further beds block booked with a key provider.

10

2.4 Non Acute Commissioning – Primary Care

There are the usual delays with the Prescribing data and therefore the budgets have been reported to plan. There is an invoice included in the position that is under investigation by the Finance team. This accounts for the £9k over spend.

GP Prescribing:

The Primary Care IT budget is £16k over spend YTD. The year to date position for Medicines Management is an £8k under spend which relates to non recurrent vacancies.

Primary Care:

The Primary Care Delegated budget has been reported to budget whilst the new DES plans are confirmed.

Primary Care Co-Commissioning:

May 2019

Plan£000’s

Actual £000’s

Variance £000’s

Plan£000’s

Actual £000’s

Variance £000’s

GP Prescribing 7,700 7,709 (9) 46,197 46,197 0

Primary Care 2,008 2,015 (7) 13,313 13,313 0

Primary Care Co-Commissioning 7,041 7,043 (2) 42,245 42,245 0

Expenditure 16,748 16,767 (19) 101,755 101,755 0

Year to Date Forecast

11

2.4 Non Acute Commissioning – Other Commissioning

The SLAM planning work that is currently being undertaken will have an impact upon this budget under Bolton FT. All other providers are in line with budget.

Community:

The year to date underspend is within Exceptions and Prior Approvals, which is expected to spend to budget over the year.

Other Commissioning:

The Other Corporate budgets are reporting a year to date underspend due to vacancies within the Safeguarding and Nursing and Quality teams. Recruitment is underway for both areas.

Other Corporate:

May 2019

Plan £000’s

Actual £000’s

Variance £000’s

Plan £000’s

Actual £000’s

Variance £000’s

Community 7,753 7,752 1 46,520 46,520 0

Other Commissioning 5,580 5,556 24 29,698 29,698 0

Other Corporate 166 149 17 999 999 0

Expenditure 13,500 13,458 42 77,217 77,217 0

Year to Date Forecast

12

2.5 Running Costs

The CCG has committed to reduce running costs by 20% by 2020/21 in line with NHS England guidance. The CCG has included £400k on the QIPP Programme for 2019/20 to contribute to this requirement. The year to date underspend of £60k is derived through vacancies throughout the CCG. Although these are non recurrent savings in 2019/20, all vacancies will be reviewed as part of the running cost reduction.

Running Costs:

May 2019

Plan£000’s

Actual £000’s

Variance £000’s

Plan£000’s

Actual £000’s

Variance £000’s

Running Costs 1,051 990 60 6,322 6,322 0

Expenditure 1,051 990 60 6,322 6,322 0

Year to Date Forecast

13

2.6 Reserves

Commitments on Reserves are investments and pressures whereby funding has been approved by the CCG Executive. During 2018/19 annual accounts audit it was identified that the prescribing spend was actually lower than anticipated. The CCG have included £0.6m as a potential mitigation whilst all other year end balances are confirmed. The CCG has identified the 0.5% Contingency separately within Reserves.

Reserves:

Potential Spend£'000

Reserves £'000

Commissioning Reserve 9,8450.5% Contingency 2,243Total Reserves 12,088Commitment on Reserves (2,982)Remaining Reserves after Commitments 9,106Potential Commitment on Reserves (5,545)Remaining Reserves after potential commitments 3,561Potential CCG Mitigations 1,717Remaining Reserves after CCG mitigations 5,278Identified Risks (8,848)Remaining Reserves after identified risk applied (3,570)

14

2.7 Financial Risk

An evaluation of the financial risks to the delivery of a balanced plan has been undertaken. Ongoing close monitoring and review of these is taking place each month to ensure a balanced financial position is delivered.

Financial Risk:

Risk as per Financial Plan

Risk as at M2

£000s £000s

Failure to control demand

Failure to control demand within Acute and Independent Providers

3,000 H 3,000

QIPP programme established for service redesign and contractual efficiencies.Aligned Incentive Contract continues with BFT.Close contract monitoring of all other contracts with a refreshed challenge process established.

Increased costs of Continuing Health Care

Increase in high cost placements 1,000 H 1,500

Funded Care Team have updated the action plan to continue to review all placements and contracts with all providers.

MH/LD high cost placements.

Failue to control Out of Area Placements and the increase in high cost placements

2,000 M 1,000

Service redesign continued from 18/19, with local beds available.Continued joint working with GMMH to reduce high cost OOA placements.

Failure to control prescribing spend and deliver efficiency

Failure to control NCSO pressures.Failure to control demand.

600 H 600Bolton Quality Contract continues and medicine s management QIPP programme Full suite of monitoring in place.

Failure to control primary care spend

Failure to control spend requirements within LES and Primary Care IT

400 H 400 Regular review meetings with the CCG Primary Care team.

IT Risk relating to transition project

Specific risk relating to IT Transition project 500 H 500

Regular updates are made to the CCG Executive and with oversight via IT Transition Board

Failure to control spend within Primary Care Co-Commissioning

Failure to control spend within the Delegated budget.

500 H 500 Regular review meetings with the NHSE finance team.

Estates Failure to control Estates spend including Avondale 500 H 500

Establish CCG Estates group with GP membership to report into CCG Executive and SEG

Unidentified QIPPValue of the QIPP programme that remains unidentified 2,551 M 848

QIPP workshop arranged for June 19, with regular monitoring meetings planned throughout the financial year.

Total 11,051 8,848

Risk Risk Description H/M/L Mitigating Actions

15

2.8 Impact on the 2020/2021 Financial Plan

The financial plan for 2020/21 is based on the allocations that have been shared by NHSE through the 19/20 planning round, which excludes any potential drawdown from the historic surplus. The CCG has used local intelligence gained through the internal planning meetings to estimate potential investments, growth assumptions and calculated cost pressures for 2020/21. The result of which is an estimated QIPP of £15.8m. The CCG 3 year plan is currently being refreshed and the 2020/21 QIPP requirement will be updated accordingly.

Financial Plan 2020/21:

£,000's2020/21 Allocation - Programme 451,593 2020/21 Allocation - Primary Care 43,921 2020/21 Allocation - Running Cost 5,578 Total 2020/21 Allocation 501,092 Expenditure 514,593 QIPP (15,787)0.5% Contingency 2,286 Total 501,092

16

3.1 QIPP Performance

The CCG had a QIPP target of £9.2m in 2019/20 which will be achieved through a variety of cost reduction and service redesign as well as running cost savings and risk management. There is £0.8m still to be identified. The majority of schemes are achieving the planned savings year to date. The schemes under Continuing Healthcare are currently in development and whilst these are under delivering YTD, it is expected that these will deliver over the remainder of the year. The Prescribing scheme is also under delivering due to a delay in the implementation of the Specialist Services work plan.

Headlines:

A Joint Savings Board is being established with membership from both the CCG and Bolton FT agreed. As such a new Joint Savings Report will be created to meet the requirements of this Board.

Shared Savings:

May 2019Plan

£000’sActual £000’s

Variance £000’s

Plan£000’s

Actual £000’s

Variance £000’s

Plan£000’s

Actual £000’s

Variance £000’s

Prescribing 175 133 (42) 350 267 (83) 2,100 2,100 0Running Costs 33 33 0 67 67 0 400 400 0Continuing Healthcare 83 0 (83) 167 0 (167) 1,000 1,000 0Estates 0 0 0 0 0 0 286 286 0Acute 42 42 0 83 83 0 500 500 0Other Acute 125 125 0 250 250 0 1,500 1,500 0Mental Health 58 58 0 115 115 0 690 690 0Partnership Prioritisation 142 142 0 284 284 0 1,703 1,703 0Contract savings 17 17 0 33 33 0 200 200 0Unidentified 71 0 (71) 141 0 (141) 848 848 0QIPP Total 745 549 (196) 1,490 1,099 (391) 9,227 9,227 0

In Month Year to Date Forecast

17

3.2 QIPP Scheme Overview In Development In Delivery

Stage 1 Ideas generation

Stage 2 Design and Planning

Stage 3 Delivery

Stage 4 Monitoring

CCG

QIP

P Sc

hem

es 1

9/20

• Repatriation • NWAS Contract

opportunities • Reduction in ambulance

conveyances • Community block

baselining • AQP • ?NEL growth • New ways of working • TF/investment mitigation • Community Glaucoma • Bridgewater contract

19/20 • Impact of new OP

commissioning principles

• CHC Night sits • CHC wider savings • CHC High Cost Cases • Medicines Specialist areas • A&E growth reduction • NWAS Type 3 & 4 callouts • Non BFT Contract challenges

• Running costs 2019/20

• Meds Optimisation work plan 2019/20

• MH Acute OAP’s • Contractual Efficiencies

2019/20 • Partnership Prioritisation

Join

t Ser

vice

re

desig

n sc

hem

es

(nil

finan

cial

val

ue)

• Joint commissioning • QIPP menu of

opportunities • Sharing back office

functions • Right Care

• Estates rationalisation • System wide prescribing –

Biosimilar Drug Switches

Miti

gatin

g op

port

uniti

es

19/2

0

• Prescribing outturn benefit • BQC underachievement

18/19

18

4.1 Statement of Financial Position

• The YTD Statement of Financial Position (SoFP) is summarised in the table above and compared to the position at the end of March 2019.

• The CCG has negative taxpayers equity which reflects the timing of cash flows compared to expenditure incurred over time. There are no significant issues or movements to report.

Headlines:

Statement of Financial Position March 2019 May 2019 Commentary£000 £000

Non current assets 328 328 Property Plant and EquipmentTrade & other receivables 1,373 878 Monies owing to CCG by other organisationsPrepayments and accrued income 1,541 2,236 Expenditure paid in advance /income not yet invoicedCash & cash equivalents 27 211 Cash at bank/in handTotal current assets 2,941 3,325 Total monies owed to CCG plus cash /bank

Trade & other payables (6,561) (7,884) Invoices received from providers/suppliers but not yet paidAccruals & deferred income (23,221) (22,037) Expenditure for services received not yet invoiced by provider/supplierProvisions (957) (957) Liabilities relating to past eventTotal current liabilites (30,739) (30,878) Total monies owed by CCG

Net assets/(liabilities) employed (27,470) (27,225) Total monies owed by CCG net of total monies owing to the CCGTaxpayers equityGeneral fund (27,470) (27,225) Total Investment by Taxpayers

19

4.2 Cash Utilisation & BPPC

• The CCG’s Annual Cash Drawdown Requirement (ACDR) for 2019-20 is set based on the Allocation. The CCG has an annual ACDR of £490m and has received £80.3m cash to the end of May 2019, representing 16.67% of the ACDR.

• The cleared bank balance target is measured at the end of the year, performance for this is shown above.

Cash:

• The CCG achieved the Better Payment Practice Code (BPPC) target paying over 95% of invoices by volume and value within 30 days. The performance is shown in the table above.

BPPC:

Performance of month end cash position Target Actual Trend

Cleared bank balance £459.7 £291.00

% of monthly draw down <1.25% 0.81%

£0£100£200£300£400£500

April

May

June July

Augu

stSe

ptem

ber

Oct

ober

Nov

embe

rDe

cem

ber

Janu

ary

Febr

uary

Mar

ch

£m

Cash utilisation

Cash Plancumulative

Cash Actualcumulative

% of invoices paid within payment terms

Target Actual Trend

By Value 95.00% 98.69%

By Volume 95.00% 96.49%

YTD Cash flow Statement May-19£000

YTD Allocation 80,091(Increase)/decrease in trade & other receivables (200)Incease/(decrease) in trade & other payables 139Increase/decrease in Provisions 0Provisions utilised 0accruals for PPE 121Increase/(decrease) in cash 184YTD Cash drawn 80,335

20

4.3 Capital Programme

CCG relocation from St Peters House to Bolton Town Hall and Lever Chambers • Phase 1 - relocating 2 teams to Bolton Town Hall complete • Phase 2 - relocate further 3 teams to Bolton Town Hall – Summer 2019 • Phase 3 – relocate patient facing teams to Lever Chambers – Autumn 2019

Bolton CCG HQ relocation:

Development of combined library and health centre in Little Lever at the former Tesco site. The scheme is led by Bolton Council – expected completion in 2020-21.

Little Lever Health Centre development:

Business as Usual (BAU) and Estates Technology and Transformation Fund (ETTF) capital funding is provided from NHS England for primary care projects. • 7 GP applications in progress totalling c£1.6m • 1 Primary Care IT scheme in progress for one clinical systems and 1 Primary Care IT application in

progress.

Primary Care Schemes:

21

5.0 Social Value

Workforce

Bolton

GreaterManchester

Other regions

Payments to local economy

Bolton

GreaterManchester

Other regions

VCSE grants

Bolton

GreaterManchester

• Social value describes the social benefits achieved from public services and not limited to financial transactions. The CCG can measure its financial impact on social value as: • Payments to the local economy – 68% of payments made in April and May 2019 were to Bolton

based Providers and suppliers and a further 24% to providers and suppliers in other regions within Greater Manchester.

• 51% of the workforce live in Bolton. • 89% of grant payments made were to Bolton based Voluntary Community Social Enterprise (VSCE)

sector and 11% to other Greater Manchester VSCE sector.

Social Value – Financial impact:

22

6.0 Action Requested

• Note the CCG financial position as at Month 2. • Recognise the level of risk identified and note the process in place for the CCG Executive Team and

Finance & QIPP Committee to review scenarios on a monthly basis.

Action Requested

23