APPENDIX 1
Letter from Lord Warner to Andrew Lansley
Dear Andrew,
NHS Financial Management
Further to my previous letter (our ref: P05018391)
about your request for information under the Freedom of Information
Act, I am now in a position to respond more fully. Please accept
my apologies for the delay in responding substantively.
I was considering applying an exemption on the
release of the information under section 33(1)b for the Freedom
of Information Act. I have, however, had time to think about your
request for the 2004-05 control totals and have decided, upon
reflection, to release the information you have requested—please
see the enclosed table.
I will start by explaining the role of control
totals in the financial management of the NHS:
— We expect NHS organisations
to plan for and achieve financial balance each and every year,
including 2004-05.
— We monitor the financial performance
of NHS organisations throughout the year.
— There are 575 Primary Care Trusts
(PCTs) and NHS Trusts in the NHS, and in a minority of these organisations
financial management falls below acceptable standards.
— It is the responsibility of
Strategic Health Authorities (SHAs) to performance manage the
NHS, including financial management.
As part of the Department of Health's monitoring
process, as we approach the end of the financial year, we take
a view of the likely financial outturn for each SHA's health economy.
In order to achieve the best possible outcome—as close as
possible to financial balance—we agree a control total with
each SHA. The aim is for control totals to be challenging, but
achievable. We do not set control totals for the individual PCTs
and NHS Trusts within SHAs, although SHAs may set these locally.
I have attached the control totals agreed with
SHAs towards the end of the financial year. Irrespective of the
control totals set, SHAs carry forward deficits and surpluses
to the following financial year. This ensures organisations do
not benefit from having a deficit, and are not disadvantaged by
having a surplus.
Although the final audited accounts will not
be available until the Autumn, we expect the final position for
the NHS to be within a fraction of the funding available, The
NHS is currently forecasting a deficit for 2004-05 of around £140
million, which is 0.2% of overall resources. This is the first
time in five years that the NHS has forecast a deficit. We are
working with SHAs to restore financial balance.
We do not set specific savings targets for NHS
organisations, but funding assumptions include improvements in
cost efficiency of 1.7% in 2005-06 across the NHS. However, at
a local level, cost improvements may vary.
In relation to the Freedom of Information process,
if yob are unhappy with the way the Department has handled your
request, you may ask for an internal review. You should contact
the FOI Unit, 360c Skipton House, 80 London Road, London SE1 6LH
if you wish to do so.
If you are not content with the outcome of the
internal review, you have the right to apply directly to the Information
Commissioner for a decision. The Information Commissioner can
be contacted at:
Information Commissioner's Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Norman Warner
8 August 2005
Enc: 2004/05 Control Total and the Provision 2004/05
Outturn
2004-05 CONTROL TOTALS AND THE PROVISIONAL
2004-05 OUTTURN
| SHA Name | Control total Under/(Overspend)
|
| £000 |
| Norfolk, Suffolk and Cambridgeshire | (25,000)
|
| Bedfordshire and Hertfordshire | (20,000)
|
| Essex | 0 |
| North West London | (25,000)
|
| North Central London | 3,000
|
| North East London | 6,000 |
| South East London | 0 |
| South West London | 15 000 |
| Northumberland, Tyne and Wear | 10,000
|
| Count Durham and Tees Valle | 0
|
| Yorkshire and Northern Lincolnshire | 0
|
| West Yorkshire | 5,000 |
| Cumbria and Lancashire | (4,000)
|
| Greater Manchester | 10,000
|
| Cheshire and Merseyside | 3,000
|
| Thames Valley | 0 |
| Hampshire and Isle of Wight | (10,000)
|
| Kent and Medway | 0 |
| Surrey and Sussex | (15,000) 000
|
| South Avon, Gloucestershire and Wiltshire |
3,000 |
| South West Peninsula | (15,000)
|
| Dorset and Somerset | 5,000
|
| Trent | 6,000 |
| Leicestershire, Northamptonshire and Rutland
| 0 |
| Shropshire and Staffordshire | 0
|
| Birmingham and the Black Country | 0
|
| West Midlands South | 0 |
| |
|
