Devo region generates extra £150m after 'very strong' financial performance

Its providers and commissioners reported an overall surplus of £237m for 2016-17, however around £90m of this relates to surpluses carried forward from previous years.

The health and care devolution arrangements for Greater Manchester came into effect at the start of 2016-17, and local leaders said in board papers the performance “reflects well for GM in future negotiations with national bodies”.

All 13 NHS providers in the region bettered their control total target for the year, triggering £60m of additional incentive cash from the national sustainability and transformation fund.

Almost half of this was accrued by Central Manchester University Hospitals Foundation Trust, which reported a surplus of £57m.

The 13 providers reported a combined surplus of £99m (see table below), which includes the STF benefit.

The region’s clinical commissioning groups delivered an in-year underspend of £46m, of which £43m related to the 1 per cent “risk reserve” all CCGs were forced to hold back. Trafford CCG was the only group to miss its plan.

A paper that went before the Greater Manchester Health and Social Care Partnership board last week said the outturn showed a “very strong financial performance despite significant local and national challenges”, and the additional cash would be retained for investment in buildings, infrastructure and IT projects.

Steve Wilson, the partnership’s finance lead, told HSJ the position was “as good as it looks in terms of in-year performance”. But he said much of the surplus was generated through one-off measures alongside the additional income.

He added: “There were a number of things on a non-recurrent basis that have improved the position but don’t contribute to the long term closing of the gap. Some of that is technical accounting and some is slippage of schemes [delayed expenditure].

“The extra STF is a real success story as that’s new money that has come into Greater Manchester that wouldn’t have been there otherwise and it can be spent on patient care. But we know that 2017-18 is still going to be incredibly challenging.”

Mr Wilson acknowledged the extra STF may have been received at the expense of other areas that missed their targets, which were dictated by national policy, but he said “we feel we’ve got the transformational plans in place to make good use of it”.

Greater Manchester was awarded a five year transformation fund worth £450m by NHS England, which is accounted for separately. The first investments from the fund were made last year, but Mr Wilson said it was too early for significant financial benefits to be realised within operating budgets.

The financial performance of the partnership, which is legally part of NHS England and had a carried forward surplus of £37m, was also included in the overall performance figure. Specialised services, which were £10m overbudget, were excluded.

The provider sector in England reported a £791m deficit last year, with CCGs expected to report an underspend of £250m once the £800m risk reserve is accounted for.

Table: Greater Manchester trusts’ financial performance in 2016-17