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9 November 2015

Jonathan Bemrose Chief Finance Officer Clinical Commissioning Group E-mail: [email protected]

Dear Jonathan,

Re: Local Financial Deep Dive meeting – Rushcliffe CCG

We appreciated you and Ian taking the time to meet with Oliver Newbold, Brian Richards and myself on 2 November 2015. This meeting was set up following the emails and discussions as to whether Rushcliffe CCG should be the subject of the Regional Deep Dive process. The conclusion was that the review of the financial positon of the CCG would be picked up through the local North Midlands team.

At the meeting we discussed the latest financial positon of the CCG and the different issues and challenges faced by the CCG and the main acute provider University Hospital (NUH).

In summary we discussed;

 The delay in signing the contact with NUH and how that led to a change in the CCGs month 3 underlying position (by £0.4m) from that reported in the initial 2015/16 plans.  You reported that acute expenditure at NUH was under against plan which in part was linked to QIPP schemes such as the Care Homes.  You stated that the CCG had reserves of £2.4m (£1.7m risk reserve, £0.7m contingency) of which £0.5m had been used to balance the positon at month 6.  We briefly discussed the CIP target at NUH and the shortfall in their plans.  You informed us of the risk sharing agreements and support in place with other CCGs in relation to CHC, High Cost Patients costing greater than £80k, Significant Major Events and organisations in potential financial distress.  You confirmed that you had a high level of confidence that the CCG would achieve its financial control total in 2015-16.  You informed us that working was taking place on the impact of HRG4+ and the potential impact that could have on changes in coding.  We also discussed MRET and the request for information from the Trust in terms of where the funding was invested.

Following the meeting NHS North Midlands team are assured that the CCG does not require any additional monitoring in relation to the risks in CCG achieving its financial control total at the current time. We will therefore not be requesting any additional follow actions and the monitoring of the CCGs positon will follow the normal assurance processes.

Yours sincerely

Timothy Woodhead Deputy Director of Finance – North Midlands NHS England

Cc: Oliver Newbould, Locality Director – & North , NHS England Ian Livsey, Deputy CFO, Hardwick CCG Brian Richards, Assistant Head of Finance, NHS England – North Midlands