Primary care trusts have the responsibility to plan, develop and improve services to meet the needs of local people and to decide how available funding should best be spent. Investment in premises improvement will be considered alongside other priorities.
Funding that has been ring-fenced as grants to third parties, including primary care premises, must be spent for the purpose for which they were ring-fenced.
In order to monitor the implementation of turnaround plans for organisations within the turnaround cohort, the turnaround national programme office at the Department has developed a fortnightly reporting process which will capture, for example, the following information: risks/issues during implementation; progress against milestones; overall financial performance against plan: for example cost savings achieved; monthly run rate information1; year to date/outturn performance; and forecast full year deficit.
Following an independent baseline assessment of organisations with some of the largest deficits, 982 organisations were identified as those with significant deficits. These organisations, also known as the turnaround cohort were categorised in terms of their support requirements as follows:
Category 1: Immediate priority. Urgent intervention required to drive turnaround.
Category 2: Additional expertise/resource needed to support turnaround.
Category 3: Drive/focus. Maintain high priority of actions.
Category 4: Encourage to share what works and deliver easy wins.
Category 1 and 2 organisations were expected to secure additional turnaround support in order to assist them in the development of robust credible turnaround plans. Strategic health authorities (SHAs) and chief executives of organisations retain the responsibility for financial recovery. Over and above the central expectation for additional turnaround support for categories 1 and 2, triggers to fund external turnaround support are determined locally.
All national health service trusts and primary care trusts (PCTs) are required to submit financial forecasts to the Department on a monthly basis. SHAs may have additional reporting requirements.
1 Monthly balance of income and expenditure (run rate balance).
2 There are 102 (48 trusts and 54 PCTs) statutory organisations within the turnaround cohort but Ipswich PCT and Suffolk Coastal are under joint management and are treated as one organisation, as are Fareham and Gosport PCT and East Hampshire PCT, and three Cumbrian PCTs.