Health and Community Services Department and Department for Growth, Housing and Environment: Allocation and Extension of Reserve Funding for Covid Response Initiatives in 2020

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A decision made on 18 December 2020

Decision reference: MD-TR-2020-0165
Decision Summary Title:	Allocation and Extension of Reserve Funding to HCS and GHE for funding for COVID response initiatives in 2020.		Date of Decision Summary:	18th December 2020
Decision Summary Author:	Specialist – Special Project Assurance		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title:	Allocation and Extension of Reserve Funding to HCS and GHE for Delivery of COVID response initiatives in 2020.		Date of Written Report:	18th December 2020
Written Report Author:	Specialist – Special Project Assurance		Written Report: Public or Exempt?	Public
Subject: The allocation in 2020 of up to £7,409,984 and up to £1,556,344 from the General Reserve to the Health and Community Services Department (HCS) and the Department for Growth, Housing and Environment (GHE) Heads of Expenditure respectively for the delivery of initiatives to manage and mitigate the impact of COVID-19.
Decision(s): The Minister approved a non-recurring allocation from the General Reserve in 2020 of up to £7,409,984 to HCS and up to £1,556,344 to GHE for the delivery of COVID-19 response initiatives.
Reason(s) for Decision: Article 15(3) of the Public Finances (Jersey) Law 2019 states that the approval by the States of a government plan authorises the Minister to direct how an approved appropriation for a reserve head of expenditure in the plan may be spent (including on another head of expenditure) in the first financial year covered by the plan. The current Policy for Allocations from the Reserve agreed by the Minister for Treasury and Resources (published as R.80/2020) sets the requirement that all proposed allocations from the General Reserve (Covid-19), once recommended for approval by the States Treasurer (taking into account comments from the Principal Accountable Office), are referred for review to either the Council of Ministers or the relevant Competent Authorities Ministers prior to submission to the Minister for approval. The Investment Appraisal Team has recommended this request for approval and further to these reviews the Treasurer of the States, having consulted with the Principal Accountable Officer and the Council of Ministers, recommends this allocation to the Minister subject to: - written confirmation by the Accountable Officer that the income lost and expenditure incurred is Covid-19-related expenditure; and - further evidence of actual spend at the year end.
Resource Implications: The HCS head of expenditure to increase by up to £7,179,562 in 2020 and the General Reserve to decrease by the same amount. Funding for HCS of up to £230,422 for Staff Accommodation will be met from the unspent allocation allocated under MD-TR-2020-0046. Funding for GHE of up to £1,556,344 will be met from the unspent allocation allocated to GHE by MD-TR-2020-0042. This decision does not change the total amount of expenditure approved by the States in the Government Plan 2020-2023.
Action required: The Head of Financial Governance to advise the Head of Investment Appraisal and the Head of Finance Business Partnering supporting HCS that this decision is approved and inform them of the requirement for the Department to provide evidence of actual expenditure at the year end and confirmation from the Accountable Officer that costs incurred were Covid-19 related.
Signature:		Position: Deputy S J Pinel Minister for Treasury and Resources
Date Signed:		Date of Decision:

Health and Community Services Department and Department for Growth, Housing and Environment: Allocation and Extension of Reserve Funding for Covid Response Initiatives in 2020

Treasury and Exchequer

Ministerial Decision Report

ALLOCATION and extension of Reserve Funding to HCS and GHE for DELIVERY OF Covid-19 RESPONSE INITIATIVES in 2020

Purpose of Report

To enable the Minister to approve the allocation of up to £7,409,984 and up to £1,556,344 from the General Reserve, in 2020, to the Health and Community Services Department (HCS) and the Department for Growth, Housing and Environment (GHE) Heads’ of Expenditure respectively for the delivery of initiatives to manage and mitigate the impact of Covid-19.

Background

Funding provisions were made in the Government Plan 2020-2023 in the General Reserve for funding needs that cannot be met from existing heads of expenditure in 2020. The Minister has increased the amount available in the General Reserve by transferring £65.3 million from the Treasury and Exchequer head of expenditure (MD-TR-2020-0035), approving an additional £99.99 million of expenditure (MD-TR-2020-0047) and making transfers of £28 million and £50 million from the Stabilisation Fund (MD-TR-2020-0055 and MD-TR-2020-0112).

Covid-19 has presented an unprecedented challenge for the Government of Jersey and has required a wide range of new initiatives across the public sector. As part of the Government’s response to the Covid-19 pandemic, HCS and GHE have implemented or intend to implement the initiatives detailed below.

The majority of these initiatives form part of the first wave response, although some costs will continue to be incurred as a result of the on-going response to the end of 2020. At the onset of the pandemic, departments were asked to collate Covid-related expenditure and to request additional funding if it was not possible to reprioritise existing funding. Given that it is likely HCS and GHE will not be able to fully fund these Covid-19-related projects from within existing budgets, it is necessary to provide additional funding to meet costs incurred to date and forecast requirements to the yearend.

PPE 90 Days Stock – up to £215,956

In preparation for an increase in cases of Covid-19, the Council of Ministers agreed a policy of holding 90 days’ worth of PPE in stock to ensure a continuous supply of PPE was available in the event of a further global shortage similar to that experienced in the first wave of Covid-19. In accordance with accounting standards, the equipment purchased will be accounted for as stock and expensed as it is consumed.

The amount of £215,956 is required in 2020 reflecting the cost of the PPE that will be utilised this year. The remaining costs will be incurred as the PPE stock is drawn upon in 2021.

HCS will be required to demonstrate how stock has been utilised and accounted for to ensure that PPE is drawn from Covid-19 supplies as appropriate.

Essential Staff Accommodation Extension - up to £230,422

HCS initiated the Staff Accommodation Project under (MD-TR-2020-0046) for the period April to June 2020 with a budget of £1,130,000. A need was identified to extend the project and a new business case submitted for the period 1 July to 31 December 2020. The project allows frontline workers that have tested positive for Covid-19, have come into contact with Covid-19 patients, or have arrived in the Island to safely isolate away from vulnerable family or household members. It also acts to support resilience within the health service by enabling health workers to be separated from other members of their household who may be required to self-isolate. As £855,383 remains unspent from the original allocation, no further funding is required to be allocated to enable the extension of the project to 31 December 2020.

Covid-19 vaccine – up to £293,400

Funding for set up costs and the initial rollout of the regulator-approved Covid-19 vaccine in Jersey. Islanders most at risk will be prioritised for this first phase of the vaccination programme. The wider mass-vaccination programme available to all Islanders will be conducted in 2021 and the associated project costs are provided for within the Government Plan 2021-2024.

HCS Covid-19 Digital Response – up to £490,905

To enable the HCS’ response to the pandemic digital investment was required. Additional funding was required to deliver the following:

- Additional software licences for new staff and GPs that were brought into an Urgent Treatment Centre

- IT infrastructure and software to enable staff to work from home where necessary

- Enhanced data analytics capability to provide information on occupancy to enable the health managers to optimise hospital operational performance

- Integration of systems with various other IT products including to UK systems performing Covid-19 testing

- Provide patients in hospital with devices to enable them to communicate with family not permitted to enter the hospital.

ITU Capacity – up to £776,308

Changes to the Jersey General Hospital Intensive Care Unit in response to the first wave of Coronavirus pandemic required the setting up and fitting out of fifteen additional Intensive Care Beds, along with 24/7 support from consultant intensivists and nursing staff. The changes to the operating model ensured the safety of patient care during the first wave and will assist Government’s on-going response for the remainder of the year.

Unscheduled Care – up to £825,393

Emergency Department, Ambulatory and Acute Care required operational changes to manage the risk and spread of Coronavirus. This involved changes to the Jersey General Hospital building estate, additional staffing and the set up of the Urgent Treatment Centre.

The changes to the operating model have been scaled back, however cost will continue to be incurred as part of the Department’s on-going response.

Field Hospital Operations (Nightingale Wing) – up to £1,190,600 for HCS and up to £1,556,344 for GHE

The construction and fit out of the Jersey Nightingale Wing was completed by GHE on 4th May 2020 and funding was provided for these costs for an initial period to 30th June 2020. Following the decision to retain the Nightingale Wing until Spring 2021, it is necessary to extend the scope of up to £1,556,344 of funding available in GHE and agree the funding for HCS’s operational costs that were not included in the funding allocation for the construction of field hospital. HCS operational costs of up to £1,190,600 include medical supplies, equipment, staffing, and security and fire services.

This allocation of funding does not increase the total anticipated cost for the Nightingale Wing in 2020 above the £14.4 million that was originally allocated for the establishment of the field hospital.

Additional premises and operational costs for the Nightingale Wing will be incurred in 2021 and are provided for in the Government Plan 2021-2024.

Income Deficit – up to £3,387,000

HCS generates income from private patient care and laboratory testing. During the first Covid-19 wave many of these services were suspended to protect the provision of essential care. The budgeted income enables the department to fund other initiatives which it would be unable to without this expected receipt. The temporary suspension of services has caused a deficit in the department funding for the three months April to June, and there an expectation of a further shortfall in December in-light of the impact the on-going Covid-19 response is having income generating on services.

A table summary of the allocations is set out below:

	HCS	GHE	Total
PPE 90 Days Stock	£215,956		£215,956
Covid-19 Vaccine	£293,400		£293,400
Covid-19 Digital Response	£490,905		£490,905
ITU Capacity	£776,308		£776,308
Unscheduled Care	£825,393		£825,393
Field Hospital Operations	£1,190,600	£1,556,344*	£2,746,944
Income Deficit	£3,387,000		£3,387,000
Staff Accommodation Extension	£230,422*		£230,422
TOTAL	£7,409,984	£1,556,344	£8,966,328

*These costs can be met from earlier allocations made for the same purpose under MD-TR-2020-0046 and MD-TR-2020-0042. The use of that unspent funding for will be enabled by this decision.

Recommendation

The Minister is recommended to approve the allocation of up to £7,409,984 and £1,556,344 from the General Reserve to the HCS and GHE heads of expenditure respectively in 2020 for the delivery of Covid-19 initiatives to mitigate the spread and impact of Covid-19.

This recommendation is made subject to:

- written confirmation by the Accountable Officer that the income lost and expenditure incurred are relevant Covid-19-related expenditure; and

- further evidence of actual spend at the year end.

Reasons for Decision

Article 15(3) of the Public Finances (Jersey) Law 2019 states that the approval by the States of a government plan authorises the Minister to direct how an approved appropriation for a reserve head of expenditure in the plan may be spent (including on another head of expenditure) in the first financial year covered by the plan.

The current Policy for Allocations from the Reserve agreed by the Minister for Treasury and Resources (published as R.80/2020) sets the requirement that all proposed allocations from the General Reserve (Covid-19), once recommended for approval by the States Treasurer (taking into account comments from the Principal Accountable Office), are referred for review to either the Council of Ministers or the relevant Competent Authorities Ministers prior to submission to the Minister for approval.

The Investment Appraisal Team has recommended this request for approval and further to these reviews the Treasurer, having consulted with the Principal Accountable Officer and the Council of Ministers recommends this allocation to the Minister.

5. Resource Implications

The HCS head of expenditure to increase by up to £7,179,562 in 2020 and the General Reserve to decrease by the same amount.

Funding for HCS of up to £230,422 for Staff Accommodation will be met from the unspent allocation allocated under MD-TR-2020-0046.

Funding for GHE of up to £1,556,344 will be met from the unspent allocation allocated to GHE by MD-TR-2020-0042.

This decision does not change the total amount of expenditure approved by the States in the Government Plan 2020-2023.

Report author: Specialist – Special Project Assurance	Document date : 18th December 2020
Quality Assurance / Review: Head of Financial Governance	File name and path: L:\Treasury\Sections\Corporate Finance\Ministerial Decisions\DS, WR and SD\2020-0165 - Reserve Funding to HCS and GHE for funding for Covid response initiatives in 2020
MD sponsor: Group Director, Strategic Finance