Clinical commissioning groups are dipping into funds intended to be set aside for making one-off investments in order to stay in the black, an HSJ investigation has found.

Returns from 143 non-integrated single financial environment reports produced by CCGs for NHS England give details of how groups plan to use the 2 per cent of their budget that NHS England requires them to set aside for non-recurrent spending.

Seventeen of the CCGs HSJ gathered data from have set aside some or all of their 2 per cent fund to support their organisation’s bottom line.

A further nine are planning a non-recurrent fund of less than 2 per cent.


CCGs failing to set aside 2% of budget for non-recurrent uses and the proportion set aside

Dorset: 0.0%

Hastings and Rother: 0.6%

Eastbourne, Hailsham and Seaford: 0.7%

Croydon: 0.8%

Basildon and Brentwood: 1.0%

Horsham and Mid Sussex: 1.0%

Crawley: 1.0%

Bristol: 1.0%

Surrey Heath: 1.7%

CCGs using their 2% nonrecurrent fund to ‘support their bottom line’ and the proportion of their overall allocation used in this way

Eastern Cheshire: 2.0%

South Eastern Hampshire: 2.0%

South Lincolnshire: 2.0%

Enfield: 1.76%

North East Hampshire and Farnham: 1.76%

Waltham Forest 1.72%

High Weald Lewes Havens 1.58%

Castle Point and Rochford: 1.00%

Mid Essex: 1.00%

Southend: 0.98%

Haringey: 0.92%

Aylesbury Vale: 0.76%

Fareham and Gosport: 0.66%

South Worcestershire: 0.50%

Shropshire: 0.48%

North Tyneside: 0.46%

Mansfield and Ashfield: 0.04%

CCGs in these categories are not distributed evenly around England. Six are in the Surrey and Sussex health economy, four are in outer London, four are in Essex and another four are in Hampshire.

HSJ is also aware of other examples. Hounslow CCG, which did not provide full data, has elsewhere reported it is using its non-recurrent fund to deliver a balanced budget plan.

The CCG’s board papers said that its finances in 2013-14 are “incredibly tight”, and note that using the non-recurrent fund to break even “means there is very little contingency to respond to risks”.

Its financial plan adds that the CCG inherited a “weak” financial position from its predecessor primary care trust. On top of this, elements of the budget that had supported the PCT recurrently had been transferred to NHS England.

Our investigation found examples of CCGs mixing their non-recurrent fund with their required 1 per cent surplus. These included Thurrock CCG, whose surplus is planned to come out of its non-recurrent fund, and Vale of York CCG, which is planning a “non-recurrent use” of its surplus.

Meanwhile, Coventry and Rugby CCG is planning to make a “non-recurrent contribution” to its 1 per cent surplus from its 2 per cent fund.


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