ANNEX A to HSC Committee Paper – Scrutiny of Draft Budget.
Summary of Changes to ‘Action budget lines’ in 2016-17 when compared to revised Baselines for 2015-16.
1. Delivery of Core NHS Services
The Delivery of Core NHS Services is by far the largest Action in the MEG, with an annual revenue budget of £6 billion. The action provides the main funding for NHS care (hospital and community services). This funding is allocated to local health boards (LHBs) and NHS Trusts. It includes funding for primary care (GPs, dentists and pharmacists). There is a net increase of £258.926 million to this action as a result of the following transfers between Actions:
· £0.363 million from Hospice Support action into the Health Board revenue allocation in respect of funding transferring from Velindre Trust to Aneurin Bevan HB as a result of medical consultants costs transferring under TUPE arrangements.
· £0. 015 million fromthe Sponsorship of Public Health Bodies action in respect of funding for Dental Advisors into the Dental Contract Allocation.
· £(0.542) million to Sponsorship of Public Health Bodies action in respect of pay award funding for Public Health Wales
· £(0.503) million to Delivery of Targeted NHS Services action in respect of pay award funding for NHS Wales Shared Services Partnership.
· £(0.187) million to Delivery of Targeted NHS Services action in respect of pay award funding for NHS Wales Informatics Service
· £(0.118) million toDelivery of Targeted NHS Services action in respect of internal audit services for NHS Wales Shared Services Partnership
· £(0.062) millionto Sponsorship of Public Health Bodies action in respect of Diabetic Retinopathy Screening Services to Public Health Wales
· £(0.040) million toDelivery of Targeted NHS Services action for budgetary coverage for NHS Wales Shared Services Partnership in respect of future costs relating to the ESR contract
Additional Allocations
· £200.0 million additional investment in line with Welsh Government’s spending review priority to support the NHS in Wales
· £30.0 million to increase the Intermediate Care Fund to £50.0 million
· £30.0 million to increase funding for older people and mental health services
2. Delivery of Targeted NHS Services
This Action includes funding for specific primary care services (including Eye Care Initiatives), as well as funding for a range of other developments including: the delivery of information and technology (IM&T), solutions to the NHS in Wales and support for undergraduate Medical Education. The net decrease to this Action is
£ (14.075) millionin 2016-17. This is made up of:
Transfers between Actions:
· £0.187 million from Delivery of Core NHS Services action in respect of pay award funding for NHS Wales Informatics Service
· £(0.040) million from Delivery of Core NHS Services action for budgetary
coverage for NHS Wales Shared Services Partnership in respect of future
costs relating to the ESR Contract
MEG to MEG
3. Support Education & Training of the NHS Workforce
This Action supports programmes of education and in-service training for the development of the NHS workforce. There is a decrease of £(0.101) million to this action.
4. Support Mental Health Policies & Legislation
Core funding for mental health services is provided via the Delivery of Core NHS Services Action. In addition, this Action provides dedicated funding for the development and improvement of mental health services for child and adolescents, adults and older people in Wales in line with the Mental Health Strategy, the National Services Framework and legislation. It provides support, for example, for dementia services, eating disorders and the Veterans Service across Wales. There is no change to this Action.
5. Hospice Support
This Action provides funding for all Wales palliative care initiatives and also recurrent funding for voluntary hospices. The net decrease to this Action is £ (0.363) million in 2016-17 as a result of funding transferring to the Health Board revenue allocation.
6.Deliver the Substance Misuse Strategy Delivery Plan
This Action provides funding for the Substance Misuse Delivery Plan and related programmes to prevent substance misuse and support substance misusers, their carers and their families. There is no change to this action in 2016-17.
7. Sponsorship of Public Health Bodies
This Action provides funding for the Public Health Wales NHS Trust, which delivers; public health services that cover health improvement and protection, public health intelligence and research, and national screening programmes for the people of Wales. The net increase to this Action is £0.784 million in 2016-17 made up as follows:
Transfers between Actions:
· £0.062 million from the Delivery of Core NHS Services action in respect of Diabetic Retinopathy Screening Services to Public Health Wales
8. Foods Standard Agency
This is used to fund the Food Standards Agency Wales, an independent Government department set up to protect the public’s health and consumer interests in relation to food. There is no change to this action in 2016-17.
9. Deliver Targeted Health Protection & Immunisation Activity
This provides funding for vaccines for the preventable diseases programme. It also funds a range of public information campaigns, as well as initiatives to tackle healthcare associated infections. There is no change to this action in 2016-17.
10. Promote Health Improvement & Healthy Working
This supports initiatives and action being developed to support Our Healthy Future including the tobacco control strategy and the provision of nurses in secondary schools. There is a decrease to this action of £(0.450) million in respect of the Welsh Health Survey transferring to the CSA MEG as a result of integrating several well established large scale surveys into one.
11. Tackle Health Inequalities & Develop Partnership Working
This supports the Inequalities in Health Fund and the Healthy Start programme. There is no change to this action in 2016-17.
12. Effective Emergency Preparedness Arrangements
Funding in this Action is directed towards establishing and maintaining strategic stockpiles of pre-pandemic vaccines, antivirals, antibiotics, facemasks, respirators and consumables. Funding is also provided for the development and maintenance of other health countermeasures stockpiles to respond to accidental or deliberate release of chemical, biological radiological, nuclear and explosive substances.
This budget also funds the Hazardous Area Response Team (HART), which enables the ambulance service to provide treatments in contaminated environments or where access is difficult. There is no change to this action in 2016-17.
13. Develop & Implement Research and Development for Patient & Public Benefit
This Action funds the work of the National Institute for Social Care & Health Research (NISCHR), which aims to support the creation of high-quality evidence to both inform policy and benefit patients and the public. There is no change to this action in 2016-17.
14. Children’s Social Services
This funds a range of programmes and policy developments to support vulnerable children, and work on safeguarding and protection. There is no change to this action in 2016-17.
15. Adult and Older People
This Action provides funding for the implementation of the Older People’s Strategy. It also funds commitments in relation to delivery of strategy and policy relating to Carers. There is an increase of £ 0.170 million to this action following savings released from the Older People’s Commissioner Budget.
16. Social Services Strategy
This supports the implementation of the Social Services Strategy for Wales. The funding here will play an important role in developing new models of care and supporting the transformation of services. This Action includes grant scheme funding to local authorities for the workforce development programme for the whole sector and support for the Association of Directors for Social Services Cymru (ADSS Cymru), the Social Services Improvement Agency (SSIA) and the Social Care Institute for Excellence (SCIE). There is a decrease of £(0.075) million to this action as a result of a transfer of funding, to the core budget of NHS Wales Informatics Service (NWIS), for ongoing support of the Wales Accord for Sharing Personal Information (WASPI).
17. Care Council for Wales
The Care Council for Wales (CCW) is the social care workforce regulator in Wales responsible for promoting and securing high standards across the social services and social care workforce. There is no change to this action of in 2016-17.
18. Older People’s Commissioner
This provides funding for the Older People’s Commissioner. This is an independent post – the first of its type in the world - which was established to ensure that the interests of older people in Wales, who are aged 60 or more, are safeguarded and promoted. There is a decrease of £(0.170) million to this action which reflects the Welsh Government’s consistent expectation that savings can be achieved across all commissioner posts in 2016-17.
19. CAFCASS Cymru Programmes
CAFCASS CYMRU is a child-focused social work organisation, which provides expert social work advice to family proceedings courts, the County Courts and the High Court. Funding here supports the organisation’s core duties, as well as obligations under the Children & Adoption Act 2006 including the provision of contact centres and contact activities. There is no change to this Action.
20. Capital
The NHS Capital Programme is supporting the delivery of 21st Century Healthcare through improving health outcomes by ensuring the quality and safety of services is enhanced; improving access and patient experience; and preventing poor health and reducing health inequalities. Examples include funding for ambulance vehicles and primary care resource centres, as well as new community hospitals and wellbeing centres. There is an increase in capital funding of £33.5 million.