Customer and Local Services in 2020: To facilitate and enhance flu vaccination programme: Allocation of Reserve Funding

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A decision made on 30 September 2020

Decision reference: MD-TR-2020-0123
Decision Summary Title:	Allocation of Reserve Funding to CLS in 2020 to facilitate an enhanced flu vaccination programme		Date of Decision Summary:	30 September 2020
Decision Summary Author:	Specialist – Business Cases		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title:	Allocation of Reserve Funding to CLS in 2020 to facilitate an enhanced flu vaccination programme		Date of Written Report:	30 September 2020
Written Report Author:	Specialist – Business Cases		Written Report : Public or Exempt?	Public
Subject: The allocation of up to £730,800 in 2020 from the General Reserve to CLS (Customer and Local Services) for the delivery of an enhanced flu vaccination programme to Islanders aged 50-64.
Decision(s): The Minister approved a non-recurring allocation from the General Reserve in 2020 of up to £730,800 to CLS to enable the delivery of an enhanced flu vaccination programme to Islanders aged 50-64. Such decision being related to the impact of Covid-19. Up to £730,800 can be drawn down as follows: Up to £90,000 immediately to cover the costs of Government purchasing 20,000 doses of flu vaccine to facilitate the expanded programme Up to £493,416 to be drawn down to facilitate the vaccination of up to 15,600 Islanders aged 50-64 year olds A further amount of up to £147,384 may be drawn down should the vaccination programme succeed in vaccinating in excess of 15,600 50-64 year olds
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, having consulted with the Principal Accountable Officer (who, whilst noting his concerns over value for money and contractual oversight of the programme, has noted the urgent need to deliver this programme) and noting that this programme has already been considered by the Competent Authorities Ministers, recommends this allocation to the Minister. Despite the urgency of delivery of the vaccination programme resulting in departments not being able to demonstrate the most cost-effective means of delivery, there exists a health policy imperative to deliver the vaccine programme on a timely basis and to reduce the risks of ill-health arising from the combination of winter flu and Covid-19.
Resource Implications: The CLS head of expenditure to increase by up to £730,800 in 2020 and the General Reserve to decrease by the same amount. 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 Specialist – Business Cases and the Heads of Finance Business Partnering of CLS that this decision is approved. The Treasurer concurs with the view of other officers that the most health and cost effective means of delivering the Covid-19 vaccination programme be developed well in advance. The Treasurer, the Principal Accountable Officer and relevant Accountable Officers are to work promptly to identify the optimal and cost effective delivery method for the Covid-19 vaccination programme to maximise the best health outcomes for Islanders.
Signature:		Position: Deputy S J Pinel Minister for Treasury and Resources
Date Signed:		Date of Decision:

Customer and Local Services in 2020: To facilitate and enhance flu vaccination programme: Allocation of Reserve Funding

Treasury and Exchequer

Ministerial Decision Report

ALLOCATION of Reserve Funding to CLS for the EnCHANCED FLU VACCINation PROGRAMME

due to the impact of COVID-19

Purpose of Report

To enable the Minister to approve the allocation of up to £730,800 in 2020 from the General Reserve to the Customer and Local Services (CLS) department for the Enhanced Flu Vaccination Programme in 2020.

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) and approving an additional £99.99 million of expenditure (MD-TR-2020-0047) and approving the transfer of £28 million from the Stabilisation Fund, with associated authority to spend from the General Reserve (MD-TR-2020-0055).

Enhanced Flu Vaccine Programme – up to £730,800

The Business Case seeks to secure funding to meet the additional costs of providing an Enhanced Flu Vaccine Programme to the Island’s population as part of the Island wide preparations for a possible second wave of COVID-19 during the winter months.

The three main principles, from a COVID-19 perspective, of supporting the enhanced flu vaccination programme include:

Protecting high risk Islanders, where the impact of contracting both flu and coronavirus is unknown
Reducing ‘winter pressures’ on the general hospital and across the health and care sector, preserving capacity to respond to a potential spike of coronavirus
Reducing the risk that coronavirus activities are misdirected to cases of influenza, which may be indistinguishable.

The enhanced vaccination programme will be available to all eligible persons, whose vaccination is funded from the Health Insurance Fund (HIF), and is expanded to include persons between the age of 50-64.

The increased costs of vaccinating those Islanders included in the original programme will be funded entirely through the HIF. However, the costs of expanding this programme to those aged 50-64 who would not ordinarily be included in the flu vaccination programme is not a cost to the HIF and is a cost pressure of CLS.

An options appraisal has been undertaken to assess a suitable route for delivery of the flu vaccine to an expanded proportion of the Island’s population. The preferred option is utilising the current flu vaccine programme delivered through General Practitioners and Pharmacies and expanding this to include the additional eligible Islanders. Islanders will continue to use a service that is well established and requires no significant resource input from Health and Community Services as the department prepares for a potential second wave of COVID-19 infection.

It is noted that the urgency of delivery of the vaccination programme, together with the additional precautions required to deliver the programme during the Covid-19 pandemic, has resulted in programme cost pressures that may not represent best value means of delivering the programme. The Health and Community Services Department and the Customer and Local Services Department are requested to review lessons learned from the development of this enhanced programme when developing the proposed Covid-19 vaccination programme.

Recommendation

The Minister is recommended to approve the allocation of up to £730,800 from the General Reserve to the CLS head of expenditure in 2020 for the Enhanced Flu Vaccine Programme due to the impact of COVID-19.

The recommendation is that funding be drawdown as follows:

Up to £90,000 immediately to cover the costs of Government purchasing 20,000 doses of flu vaccine to facilitate the expanded programme
Up to £493,416 to be drawn down to facilitate the vaccination of up to 15,600 Islanders aged 50-64 year olds
A further amount of up to £147,384 to be drawn down should the vaccination programme succeed in vaccinating in excess of 15,600 50-64 year olds

All amounts drawn down must be for actual costs incurred in the delivery of flu vaccinations to 50-64 year olds under this enhanced flu vaccination programme during 2020.

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 (who, whilst noting his concerns over value for money and contractual oversight of the programme, has noted the urgent need to deliver this programme) and noting that this programme has already been considered by the Competent Authorities Minister, recommends this allocation to the Minister.

5. Resource Implications

The CLS head of expenditure to increase by up to £730,800 in 2020 and the General Reserve to decrease by the same amount. This decision does not change the total amount of expenditure approved by the States in the Government Plan 2020-2023.

Report author: Specialist – Business Cases	Document date: 30th September 2020
Quality Assurance / Review: Group Director, Strategic Finance	File name and path: L:\Treasury\Sections\Corporate Finance\Ministerial Decisions\DS, WR and SD\2020-0123 Reserve Funding to CLS - Flu vaccination enhanced programme
MD sponsor: Treasurer of the States