front sheet - kmpt...front sheet title of meeting trust board date 28 march 2019 title of paper...

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Page 1 of 2 Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy Director of Finance Executive Director Sheila Stenson, Executive Director of Finance Purpose: the paper is for: Delete as applicable Consideration: A report containing a positional statement relating to the delivery of the Trust’s functions for which the Board has a corporate responsibility but is not explicitly required to make a decision Recommendation: The committee is asked to consider the financial position for month 11 (February 2019). This is consistent with the position submitted to NHS Improvement in the Month 11 Return. Summary of Key Issues: No more than five bullet points The Trust has reported a loss of £1.7m at the end of February This is in line with the financial plan submitted to NHS Improvement and is a £0.4m surplus in month. Agency spend is £0.2m above cap. Spend is being driven by high levels of vacancies, which are mitigating the agency overspend financially. The Trust is no longer forecasting to deliver cap at the end of the year. The Cost Improvement Plan has achieved year to date savings of £5.6m, which is adverse to plan year to date. Total forecast CIPs are £6.1m against a target of £6.75m. Capital expenditure was £5.1m as at the end of February which is an underspend of £3.8m against plan. The Trust is now forecasting to underspend by £0.65m by the end of the year which relates to unused contingency. This has been notified formally to NHSI. Report History: None

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Page 1: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Page 1 of 2

Front Sheet

Title of Meeting Trust Board Date 28 March 2019

Title of Paper Financial Performance Report for February 2019 (Month 11)

Author Victoria French, Deputy Director of Finance

Executive Director

Sheila Stenson, Executive Director of Finance

Purpose: the paper is for: Delete as applicable

Consideration: A report containing a positional statement relating to the delivery of the Trust’s functions for which the Board has a corporate responsibility but is not explicitly required to make a decision

Recommendation:

The committee is asked to consider the financial position for month 11 (February 2019). This is consistent with the position submitted to NHS Improvement in the Month 11 Return.

Summary of Key Issues: No more than five bullet points

The Trust has reported a loss of £1.7m at the end of February This is in line with the financial plan submitted to NHS Improvement and is a £0.4m surplus in month. Agency spend is £0.2m above cap. Spend is being driven by high levels of vacancies, which are mitigating the agency overspend financially. The Trust is no longer forecasting to deliver cap at the end of the year. The Cost Improvement Plan has achieved year to date savings of £5.6m, which is adverse to plan year to date. Total forecast CIPs are £6.1m against a target of £6.75m. Capital expenditure was £5.1m as at the end of February which is an underspend of £3.8m against plan. The Trust is now forecasting to underspend by £0.65m by the end of the year which relates to unused contingency. This has been notified formally to NHSI.

Report History:

None

Page 2: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Page 2 of 2

Strategic Objectives: Select as applicable

☐ Consistently deliver an outstanding quality of care

☐ Recruit retain and develop the best staff making KMPT a great place to work

☒ Put continuous improvement at the heart of what we do

☐ Develop and extend our research and innovation work

☒ Maximise the use of digital technology

☐ Meet or exceed requirements set out in the Five Year Forward View

☒ Deliver financial balance and organisational sustainability

☐ Develop our core business and enter new markets through increased

partnership working

☐ Ensure success of our system-wide sustainability plans through active

participation, partnership and leadership

Implications / Impact:

Patient Safety: None

Identified Risks and Risk Management Action: Control total of £1.8m set for 2018/19 CRL and EFL limits set that can be under shot but not over shot.

Resource and Financial Implications: Loss of STF funding if the control total is not delivered

Legal/ Regulatory: Reconciles to NHS Improvement in the Key Data return Delivery of statutory targets

Engagement and Consultation: None

Equality: None

Quality Impact Assessment Form Completed: Yes/ No N/A

Page 3: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Trust Board

Financial Performance ReportFebruary 2019

1

Page 4: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Contents

Page

Executive Summary 3

Statement of Comprehensive Income

- Statement of Comprehensive Income - Trust 4

- Performance by Care Group 5

- Statement of Comprehensive Income - Run Rate 8

- Patient Care Income 9

- CQUIN 10

- Cost Improvement Programme 11

- Forecast 12

Statement of Financial Position

- Summary 13

- 12 month cashflow 14

- Capital Programme 15

Risks and Underlying Position

- Risk Schedule 16

- Underlying position 17

2

Page 5: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Executive Summary

Executive Summary for February 2019 G A R

Income and Expenditure G

Cash G

Agency Cap A

Capital Programme G

Metric DefinitionYTD

Plan

YTD

Actual Forecast

Capital Service CapacityDegree to which the provider's generated income covers its

financial obligations4 3 3

Liquidity (days)Days of operating costs held in cash or cash-equivalent forms,

including wholly committed lines of credit available for

drawdown

4 1 3

I&E Margin I&E surplus or deficit as a proportion of total revenue 3 3 3 Cost Improvement Programme A

Distance from financial planYear to date I&E surplus/deficit compared to year to date

plan1

Agency spend Distance from provider's cap 2 2 1

Rating for Use of Financial Resources 3 2 2

The Trust is performing better than planned at this point in the year and is now forecasting to deliver a score of 2 for

Use of Financial Resources, instead of the planned 3. This is due to forecasting a better I&E position by 31st March.

Capital spend is £5.1m as at the end of February against a planned spend of £8.9m. This

underspend remains due to delays in commencing IT projects, the timing of the completion of the

Boughton and Chartwell Scheme and the timing of schemes related to the reconfiguration of the

inpatient facilities aligned with the property sale. The forecast by the end of the year is to

undershoot CRL by £0.65m, which has been agreed with NHSI.

RAG ratings are based on assessment of the risks around delivery of the forecast outturn for each measure.

Single Oversight Framework - Use of Resources

The Trust reported on plan in month. There continues to be favourable variances across all Care

Groups. The contingency is £1.5m at the end of February. This will all be released in March and will

help to contribute to an expected performance better than plan.

The Trust is forecasting to deliver a £0.4m deficit, £1.4m better than its control total. This includes

underlying improvement of £0.7m matched by £1 for £1 funding from NHSI of £0.7m. This has been

reported formally this month following agreement at Trust Board in February.

The Trust has reported a £0.4m surplus in February, which is in line with the annual plan. Year to date is an

improved position of £1.7m deficit. The control total for 2018/19 is a £1.8m deficit and it has now been

formally notified to NHS Improvement that we are forecasting to deliver £1.4m better than this. This is due

to non recurrent items and not utilising all the held contingency, totalling £0.7m better than plan, which is

matched by expected £0.7m of funding from the NHSI year end bonus scheme.

The underlying position as the Trust nears the end of the financial year is still a £4.4m deficit, nearly £3m

better than the underlying position for 2017/18. This is due to delivery of recurrent efficiencies which has

reduced the gap. However as budgets are completed for 2019/20 the challenge for the organisation will be

how to progress to financial sustainability and breakeven on a recurrent basis, closing this £5m gap.

Agency spend will now not deliver within cap following an increase in medical vacancies and a need to

provide additional support to the Community Mental Health teams following the split between KCC and

KMPT. However additional agency spend is being mitigated financially by underspends on vacancies

elsewhere in the organisation.

The Single Oversight Framework for Use of Resources has improved to a 2 for the first time this year as the

deficit has reduced in line with plan. Liquidity remains a 1 following the sale of a building earlier in the year

The Trust has achieved year to date savings of £5.6m, which is adverse to plan by £0.3m year to

date. Of this, £2.7m has been delivered non recurrently as a result of vacancies or one off benefits.

Total forecast CIPs are £6.1m against a target of £6.75m. Of this £3m is non recurrent and will need

to be addressed in 2019/20 as part of the Trust's underlying deficit.

Focus within business planning is on developing Project Initiation Documentation for the ideas

proposed including key milestones and performance indicators, as well as quality impact

assessments.

The cash balance at the end of the month was £15.3m, which is £14.1m favourable to plan.

The forecast cash position has increased to £12.5m, an increase of £5.2m from the last report. This

is due to the assumption that invoices for the remainder of the capital programme and amounts

due to large creditors, where disputes are yet to be formally cleared will be paid in 2019/20.

The agency spend is £199k above cap year to date, which is a decreased overspend from January

but means that the Trust is now not expecting to deliver within the cap for 2018/19. There has

been an increase in medical agency cover in February and March and nursing agency required to

support the Community Mental Health teams.

3

Page 6: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Statement of Comprehensive Income - Trust

Comparison to Plan Income and Expenditure Commentary

Prior Year

In Month

Prior Year

YTD

Annual

NHSI Plan

Plan Actual Variance Actual Plan Actual Variance Actual Plan

£000 £000 £000 £000 £000 £000 £000 £000 £000

Income

Income from Activities (14,258) (14,739) (481) (14,199) (156,384) (158,313) (1,929) (154,764) (170,644)

Other Operating Income (961) (953) 8 (879) (9,128) (8,440) 689 (9,639) (10,091)

Total Income (15,220) (15,692) (472) (15,078) (165,513) (166,753) (1,240) (164,403) (180,735)

Substantive 10,171 10,030 (141) 9,858 116,429 109,507 (6,923) 107,930 126,691

Bank 408 937 529 859 4,745 10,289 5,544 10,105 5,153

Locum 28 104 76 76 310 1,257 947 845 338

Agency 513 487 (26) 567 5,668 5,867 199 6,325 6,181

Total Pay 11,121 11,558 437 11,360 127,152 126,920 (232) 125,205 138,364

Clinical supplies 140 210 71 186 1,532 1,610 78 1,631 1,672Drugs 269 219 (50) 210 2,953 2,663 (290) 2,793 3,222Other non pay 2,304 2,369 65 2,362 25,229 26,889 1,659 26,220 27,965Total Non Pay 2,713 2,798 86 2,758 29,715 31,162 1,447 30,644 32,859

Total Expenditure 13,833 14,356 523 14,118 156,867 158,082 1,215 155,849 171,223

EBITDA (1,386) (1,335) 51 (960) (8,646) (8,672) (25) (8,554) (9,512)

Post EBITDA

Depreciation 513 444 (69) 522 5,507 5,255 (252) 5,819 6,020

Interest (Receivable)/Payable 78 83 5 77 830 773 (56) 871 906

PDC Dividend 312 325 13 356 3,432 3,497 65 3,916 3,744(Profit)/Loss on disposal and contingent

rent64 63 (1) 68 702 969 267 725 766

966 915 (51) 1,023 10,470 10,495 24 11,331 11,435

Net (Profit) / Loss (420) (420) (0) 64 1,824 1,823 (1) 2,777 1,923

Technical Adjustments (8) (8) 0 (6) (86) (86) 0 (82) (94)

NHSI Control Total (Profit) / Loss (428) (428) (0) 58 1,738 1,737 (1) 2,696 1,829

Current Month - February 2019 Year to DateThe Trust was on plan in February, reporting a surplus

of £0.4m. This has reduced the year to date deficit to

£1.7m.

Income:

Income from Activities includes NHS England contract

above plan due to growth funding higher than

expected; winter pressures funding which is offset by

predominatly pay costs, and cost per case above plan in

month.

Other Operating Income reported on plan this month.

Pay:

Bank spend continues to be considerably above plan

due to high use to cover vacancies and pressures on the

inpatient units. Agency spend in month is marginally

below cap but not significantly enough to bring the year

to date overspend back in line with plan. The pay

overspend in month relates to higher CIP targets in the

latter part of the year.

Non Pay:

Other non pay is close to plan this month. No

contingency was released this month so the balance

remains at £1.5m, consisting of £1.0m planned

contingency and £0.5m unplanned contingency. This

will all unwind in March. Drug spend includes a credit

note from Lloyds for a price switch that hadn't been

actioned last year.

Post EBITDA:

Depreciation remains below plan due to delays in the

capital programme this year, in particular ward

refurbishments. Interest is favourable because the plan

included an assumption of borrowing, and resulting

interest charges, but the Trust has not had to borrow

any additional funds this year.

Technical Adjustments:

This reflects depreciation on donated assets, which is

excluded from the control total calculation.

4

Page 7: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Performance by Care Group

Comments Month on month YTD VARIANCE (£1,548k) Comments Month on month YTD VARIANCE (£1,062k)

Forensic & Specialist Services

The position for February is an underspend of £413k, with a year to date underspend of

£1,548k. This YTD position is due to underspends on pay of £765k, non pay of £269k and an

over-achievement of income of £515k.

Key factors to this position are as follows:

1. Forensic Services are £68k overspent in month (due to underachieved income due to the

delay in repatriation beds, and a pay overspend due to CIP for the Care Group showing

here.) However, FS are £215k underspent YTD. This underspend relates to vacancies only

partly filled with temporary staffing, and an overachievement of income from block

contract adjustments, secondments, FOLs funding, and a occupancy at Brookfield.

2. MHLD are £69k underspent in month, £166k YTD. This is due to vacancies in nursing and

psychology which have now been filled. The AMD costs were recoded to CRCG in February

which significantly increased the in month underspend.

3. Specialist Services are £411k underspent in month, increasing the YTD underspend to

£1,168k. Slippage in the MBU (£393k), MIMHS (£124k) and MHLD (£170k) services are only

partially offset by temporary staffing. Income has over achieved due to reclaimable work in

DSC for multi-processor knees of £174k

Note: In September there was a change to income reporting, with directly attributable

income devolved to the Care Group on a year to date basis.

The position for February is an overspend of £64k, reducing the year to date underspend

slightly to £1,062k.

This position is due to the following key areas:

1. Community Recovery Services - £2,479k vacancy slippage year to date across all staff

groups. Recruitment is ongoing and the vacancy levels are expected to reduce in future

months.This is offset by Agency which the year to date overspend is £981k. This is partially

due to Medical Agency covering vacancies. Recent recruitment means that Agency spend

will reduce in the new financial year. Nurse Agency is also high within the CMHTs due to

KCC caseload management following the KCC/KMPT transition. Drugs are underspent by

£22k in month, bringing the year to date underspend to £143k.

2. Personality Disorders - There is a YTD underspend of £101k. This is due to unfilled

vacancy slippage of £135k, offset by an overspend on Patient Travel Expenses of £25k.

3. Single Point of Access - SPOA is underspent by £299k YTD, mainly due to vacancy slippage

after Agency costs. There has been difficulty recruiting to these posts, so this is likely to

continue.

4. Community Recovery Management - There is a YTD overspend of £969k. £717k is due to

the non achievement of the Care Groups CIP target. £78k is due to the AMD cost YTD

moving from MHLD which now sits under Forensics. There are also several unfunded posts

on this cost centre which are being picked up as part of budget setting.

Community Recovery

-7,000

-5,000

-3,000

-1,000

1,000

3,000

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

£0

00

Budget

Actual

500

1,000

1,500

2,000

2,500

3,000

3,500

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

£0

00

Budget

Actual

5

Page 8: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Performance by Care Group

Th

e

Comments Month on month YTD VARIANCE (£1,171k) Comments Month on month YTD VARIANCE (£49k)

Acute Older People

The February position is an underspend of £151k, and the year to date position is now a

£1,171k underspend.

This is due to the following key areas:

1. Inpatient Services are £1,025k underspent of which £456k relates to the wards. North

Kent wards continue to have pressures with observations as a result of more acutely unwell

patients being treated in the North. Vacancies are not necessarily being covered due to

difficulties obtaining temporary staff. Admin and Psychology are underspent due to

vacancies which the Care Group are having difficulties recruiting and covering.

2. The Liaison Teams and Management are underspent by £92k. The Management budget

contains the Non Recurrent savings achieved. The remainder is due to vacancies in

management which are in the process of being filled following the Management

restructure and vacancies within the Liaison Services which are not always covered due to

difficulties obtaining temporary staffing.

3. CRHT Teams are underspent by £276k. The NK teams are overspent due to high case

loads and supervising the POS teams which is offsetting underspends caused by vacancies

on the EK and WK teams whare are not always covered.

This is offset by the Place of Safety teams, which are £222k overspent. £210k of this relates

to the North Kent team, £4k relates to the East Kent Team and £7k relates to the West Kent

team.

The February position is an overspend of £7k, with a year to date underspend of £49k.

The year to date position is due to the following key areas:

1. Overspend on Management £176k (mainly due to Non Recurrent CIP achievement).

2. Underspends on Inpatient Services in particular on the wards totalling £135k.

3. Underspends in Community Services of £291k mainly due to unfilled vacancies.

4. Underspends in Psychology of £91k mainly due to vacancies.

This is offset by Continuing Healthcare which is overspent by £303k. The spot bed income

ceased in Sept 18. The number of available beds has not reduced as anticipated resulting in

the service overspend. Discussions are ongoing with the commissioners regarding this

service.

500

1,000

1,500

2,000

2,500

3,000

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

£0

00

Budget

Actual

500

1,000

1,500

2,000

2,500

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

£0

00

Budget

Actual

6

Page 9: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Performance by Care Group

Chief Executive and Board YTD VARIANCE £88k

Operations YTD VARIANCE (£59k)

Executive Nursing YTD VARIANCE (£388k)

Workforce & Org. Development YTD VARIANCE (£210k)

Medical Directorate YTD VARIANCE (£485k)

Finance and Resources YTD VARIANCE £1,557k

Transformation YTD VARIANCE £208k

Estates & Facilities YTD VARIANCE £927k IM&T YTD VARIANCE (£173k)

Risk Share YTD VARIANCE £1,939k Performance YTD VARIANCE (£218k)

The year to date variance of £1,557k is mainly due to a write off of assets within Corporate

Costs, and a shortfall of OATS income of £334k. There is an underspend on pay costs within

the Finance Department (£105k) mainly due to maternity leave and vacancy slippage. Most

of these vacancies have now been filled, with the final postholders due to commence in

April.

The year to date overspend of £927k, relates to £364k due to utilities. There are higher

costs due to the transfer of In House Maintenance to out-sourcing which started in July.

The winter months have seen a huge increase in Reactive Maintenance £301k. The position

includes £281k relating to the new Catering Contract where the budget is currently against

the wards. This is being addressed as part of budget setting.

Support Services

Risk Share Placements has a year to date overspend of £1,939k, this is caused by higher

placements than planned and high transport and specialling costs.

The year to date underspend is mainly due to unfilled vacancies within Workforce £111k

and Communications £59k. There is an underspend of £16k against Software Licences, and

we have received £20k in income for Mental Health Workforce Workstream Support.

IM&T has a year to date underspend of £173k. This includes unfilled staffing vacancies

£132k, depreciation underspend of £167k and income of £100k from KCC for Rio, and

Department of Health funding. This is offset by overspends of £176k on Software licences

and network cost. External Storage costs are also overspend by £20k, and there is an

overspend on Amortisation of assets of £22k.

The underspend position is mainly driven by higher PGME income and training posts left

vacant on rotation within this budget.

The year to date overspend of £88k is due to temporary cover for the Company Secretary

post, and providing other support until the end of March.

Operations has a year to date underspend of £59k, mainly due to vacancies within the

Admin & Discharge Team (Patient Flow).

The year to date overspend of £208k is due to £227k Moorhouse fees and £27k recruitment

fees for the new Executive Director, offset by £35k PMO vacancies which are currently

being recruited. There is also a £14k underspend on Training Expenses.

Executive Nursing and Quality has a year to date underspend of £388k. This is due to

vacancies across the service £154k, that are currently being recruited to, legal losses &

negligence claims provision underspend of £106k, and an over achievement on income of

£91k.

Performance is showing a year to date underspend of £218k as at February due to unfilled

vacancies and underspending in all the teams.

500

1,000

1,500

2,000

2,500

3,000

3,500

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

£0

00

Budget

Actual

7

Page 10: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Statement of Comprehensive Income - Run Rate

13 Month Run RateFeb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000

IncomeIncome from Activities (14,199) (14,168) (13,947) (13,988) (14,113) (14,814) (14,459) (14,230) (14,224) (14,372) (14,668) (14,758) (14,739)Other Operating Income (879) (2,464) (734) (734) (724) (830) (655) (761) (785) (846) (753) (663) (953)

Total Income (15,078) (16,632) (14,681) (14,722) (14,837) (15,645) (15,114) (14,992) (15,009) (15,218) (15,422) (15,422) (15,692)

ExpenditureSubstantive 9,858 10,233 9,826 9,879 9,790 10,439 9,927 9,926 9,903 9,816 9,874 10,097 10,030Bank 859 1,026 850 875 859 1,123 957 969 915 917 1,007 880 937Locum 76 74 82 87 96 83 89 91 136 244 110 135 104Agency 567 598 702 752 592 614 533 255 522 445 414 549 487Total Pay 11,360 11,931 11,460 11,593 11,338 12,259 11,505 11,240 11,476 11,423 11,404 11,662 11,558

Clinical supplies 186 161 106 130 134 162 83 142 164 165 158 155 210Drugs 210 209 259 241 211 240 234 265 220 278 236 260 219Other non pay 2,362 2,566 2,573 2,422 2,943 2,668 3,003 2,922 1,973 2,023 1,965 2,027 2,369Total Non Pay 2,758 2,936 2,938 2,793 3,288 3,070 3,320 3,330 2,357 2,466 2,360 2,442 2,798

Total Expenditure 14,118 14,868 14,398 14,386 14,626 15,329 14,825 14,570 13,834 13,889 13,764 14,103 14,356

EBITDA (960) (1,764) (282) (337) (211) (315) (289) (422) (1,175) (1,330) (1,657) (1,318) (1,335)

Post EBITDA 1,023 7,943 911 934 823 945 924 921 926 947 1,318 930 915

Net (Profit) / Loss 64 6,178 628 598 612 630 635 500 (249) (383) (339) (388) (420)

Commentary:

Income from Activities has remained consistent in the past few months. Other Operating Income decreased in January due to aged debt write offs, for which the provision was included

under non pay. This has now reverted back to the previous trend in February.

Substantive staffing continues on trend, with a slight decrease from January following the bank holiday enhancements paid for the Christmas period. July included the impact of the

first four months of the pay award. Agency spend has decreased again in February and this relates to nursing staff, particularly in Acute. Shifts are either being covered by bank or

agency workers and this is fluctuating month on month.

Other non pay includes the contingency which remains at £1.5m at the end of February, as well as one off consultancy costs for PMO support.

Post EBITDA is back to normal levels following the increase in December relating to property disposal costs. The March 2018 Post EBITDA figure includes a £3.2m Land Impairment due

to the MEA alternative site adjustment and a £0.5m impairment for the St. Martins Hospital site.

8

Page 11: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Patient Care Income

Annual

Budget* Actual Variance Budget* Actual Variance Budget

£000 £000 £000 £000 £000 £000 £000 £000

NHS Ashford CCG (803) (798) 5 (803) (8,838) (8,781) 57 (9,642)

NHS Canterbury & Coastal CCG (1,553) (1,543) 10 (1,553) (17,088) (16,976) 111 (18,641)

NHS South Kent Coast CCG (1,546) (1,536) 10 (1,546) (17,007) (16,896) 111 (18,553)

NHS Thanet CCG (1,361) (1,479) (118) (1,369) (14,993) (15,064) (72) (16,355)

NHS Medway CCG (1,712) (1,652) 61 (1,711) (18,835) (18,717) 118 (20,548)

NHS Swale CCG (675) (713) (37) (675) (7,428) (7,465) (37) (8,103)

NHS Dartford, Gravesham & Swanley CCG (1,277) (1,277) 0 (1,277) (14,047) (14,047) 0 (15,324)

NHS West Kent CCG (2,672) (2,677) (5) (2,632) (29,387) (29,134) 253 (32,058)

LD Alliance (349) (349) 0 (349) (3,844) (3,844) 0 (4,194)

NHS England (1,960) (2,175) (214) (1,726) (21,099) (21,392) (293) (23,059)

Block Contract - Other (272) (328) (57) (28) (2,823) (3,048) (225) (3,094)

Total Fixed value contracts (14,181) (14,527) (346) (13,671) (155,388) (155,365) 23 (169,571)

Clinical Partnerships providing mandatory services

(including S75 agreements)(95) (18) 77 (71) (1,048) (661) 387 (1,143)

Short term episodic treatment - Cost and Volume

Contract Revenue(64) (107) (43) (84) (701) (989) (288) (765)

Other - Cost and Volume Contract Revenue (166) (86) 80 (122) (1,816) (1,299) 517 (1,982)

Total Cost Per Case (230) (193) 37 (206) (2,517) (2,288) 229 (2,747)

Total Patient Care Income (14,507) (14,739) (232) (13,947) (158,953) (158,313) 639 (173,461)

Top 4 Commissioning areas against Budget

Commentary

Fixed value contracts YTD variance £23k adverse

Contracts have been varied to remove Incentivisation funding (East) and to

include demographic growth above plan (NHSE). All contract values have been

confirmed through the STP contract alignment exercise.

Delays in new developments have created adverse variances for MBU and Core

24 income.

Additional new developments include further Perinatal Mental Health funding

and funding to extend CJLADs provision to magistrate's courts (both recurrent),

funding for winter pressures and Suicide Prevention projects and additional

Forensic Aftercare contracts (all non-recurrent).

CQUIN is currently accounted for at full value but this remains a risk to the

financial position and a level of failure has been built into the forecast.

Clinical Partnerships YTD variance £387k adverse

Detox services lower than plan (£152k) due to occupancy below plan. This could

be mitigated by selling beds as private patient income.

TGU Guernsey income ceased end July, mitigated by the charging of one

additional bed on TGU as repatriation income.

Short term episodic treatment YTD variance £288k favourable

Brookfield occupancy remains above plan

Frank Lloyd Spot Bed income has been a non-recurrent favourable variance

Other - Cost and Volume Contracts YTD £517k adverse

OATS activity lower than plan £249k

Patient Care Income by Type

In monthPrior

Month

Year to date

*NOTE: The Budget used here is the ledger budget. This is to reflect in year changes and will differ from the Annual Plan values used in other areas of this report

0

1,000

2,000

3,000

4,000

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

Mo

nth

ly in

com

e

(£0

00

)

North Kent CCGs

Budget

Actual

0

1,000

2,000

3,000

4,000

5,000

6,000

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

Mo

nth

ly in

com

e

(£0

00

)

East Kent CCGs

Budget

Actual

0

500

1,000

1,500

2,000

2,500

3,000

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

Mo

nth

ly in

com

e (

£0

00

)

West Kent CCGs

Budget

Actual

0

500

1,000

1,500

2,000

2,500

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

Mo

nth

ly in

com

e (

£0

00

)

NHS England

Budget

Actual

9

Page 12: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

CQUIN Position

CQUIN Summary 2018/19

Quarter 1 Quarter 2 Quarter 3 Quarter 4 Total RAG

Total Risk

identifiedPercentage

Risk

Risk already

realised

£000 £000 £000 £000 £000 RATING £000 % £000

Length of Stay 111 111 111 111 442 G 0 0% 0

1a Staff Health and Wellbeing 0 0 0 136 136 R 136 100% 0

1b Healthy Food 0 0 0 136 136 G 0 0% 0

1c Flu vaccine 0 0 0 136 136 A 102 75% 0

3a Cardio metabolic assessment 35 0 0 291 325 A 163 50% 0

3b Collaboration with primary care 16 41 8 16 81 A 41 100% 65

4 MH in A&E 0 81 0 325 407 A 102 25% 0

5 Transition from CAMHS 20 183 0 203 407 A 203 50% 203

9a Tobacco screening 5 5 5 5 20 G 0 25% 0

9b Tobacco advice 20 20 20 20 81 A 20 25% 15

9c Tobacco referral 25 25 25 25 102 A 25 25% 19

9d Alcohol screening 25 25 25 25 102 A 25 25% 19

9e Alcohol advice and/or referral 25 25 25 25 102 A 25 25% 19

STP Engagement 0 0 0 1,356 1,356 G 0 0% 0

Total 283 517 220 2,811 3,832 843 22% 341

Comments:

The SLA Team are in the process of meeting with all commissioners regarding the Q3 milestone submissions. The meeting with East Kent CCGs was positive as KMPT achieved all

but one of Q3 milestones around Tobacco Brief Advice. As in previous months the main elements of the CQUIN programme relate to Q4 evidence and as such the financial

forecast is relatively unchanged. The slight increase from last month's forecast will be managed within the overall position.

The main areas to note are :-

• Staff Health and Wellbeing -. The result of the staff survey has now been published and report shows a decline in the scores for the CQUIN.

• Flu Vaccine – the Trust vaccinated 54% of the applicable staff members in 2018/19, this equates to an achievement of 25% of the overall CQUIN funds available.

• Cardio metabolic – KMPT is forecasting to meet the Acute element in full and partially achieve the community and EIP elements – this is expected to deliver 50% of the funds

available

• GP Comms – The CQUIN team and Assistant Medical Director have engaged with GP leads across the county to work on a major element of the CQUIN which is around shared

care protocol. The protocol is underway. It is anticipated that the Trust will achieve at least 50% of the CQUIN value.

• CAMHS – the historic issues have been focussed on and the team are confident they will be met going forward. The risk already realised relates to Q1-3 activities.

• MH in A&E- This is a new risk. Acute Hospitals in the North and West part of the county may not achieve one of milestones in Q4 relating to ECDS coding. This is a shared CQUIN

with the Acute provider and this element relates to clinical coding with the ED department. There are on going discussions with commissioners to reduce target improvement for

ECDS coding as non compliance will lead to 25% loss of CQUIN income.

10

Page 13: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Cost Improvement Programme

Care GroupPlan

(£000)

Actual

(£000)

Variance

(£000)

Plan

(£000)

Actual

(£000)

Variance

(£000)

Plan

(£000)

Forecast

(£000)

Variance

(£000)Acute 155 72 (83) 1,176 1,261 85 1,331 1,322 (9)OPCG 196 43 (153) 1,018 1,000 (18) 1,214 1,043 (171)FSSCG 109 77 (32) 1,051 1,048 (3) 1,160 1,147 (13)CRCG 131 54 (77) 1,263 760 (503) 1,394 837 (557)IM&T 18 16 (2) 172 176 4 193 192 (1)Estates 46 72 26 303 240 (63) 353 320 (33)

Facilities 46 33 (13) 291 211 (80) 337 251 (86)

Finance 19 26 7 76 290 214 91 316 225

Performance 4 4 0 44 45 1 49 49 0

Workforce & OD 10 11 1 109 125 16 117 136 19

Transformation 5 1 (4) 52 15 (37) 57 17 (40)

C.O.O. 5 7 2 39 75 36 44 82 38

Exec Nursing 22 17 (5) 185 189 4 207 206 (1)Medical 17 17 (0) 187 186 (1) 205 203 (2)

Total 783 451 (331) 5,966 5,619 (347) 6,752 6,119 (632)

Recurrent 651 273 (378) 4,504 2,878 (1,626) 5,157 3,181 (1,977)Non Recurrent 132 179 47 1,462 2,741 1,279 1,595 2,939 1,344

The Trust

has

In Month Year to Date Commentary:

In February the Trust reported £331k adverse to plan in

month, and £347k adverse year to date. The current forecast

outturn is £6,119k, which is 91% of the total 4% CIP target

and an adverse variance of £632k. The total savings plan of

£6,752k includes non recurrent schemes of £1,595k that

have a forecast of £2,939k against them rather than the

initial recurrent schemes planned. This has an impact on the

underlying deficit of the Trust because these savings are not

expected to feature in 2019/20 position and therefore have

to be funded back.

Key areas of variance year to date sit within OPCG, CRCG and

Estates and Facilities. CRCG had anticipated savings from a

review of staffing that has not yet commenced. Estates were

planning to deliver benefits from consolidating buildings and

rental charges that have not materialised. In Facilities, the

catering outsource was planned to occur sooner in the

financial year so this slippage will be recovered in 2019/20

as full year effect.

CIP meetings have recently taken place where Care Groups

have been tasked with planning services within their

2019/20 financial envelope including identifying their 4% CIP

schemes. Draft PIDs have been sent out and are exprected

to be completed with detailed plans to support the

overarching annual plan submitted to NHSI on 4th April

2019.

Forecast

11

Page 14: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Forecast

Prior Year Actual Forecast2017/18

Outturn Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Outturn Plan Variance

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000Income

Clinical income (166,831) (13,947) (13,988) (14,113) (14,814) (14,459) (14,230) (14,224) (14,372) (14,668) (14,758) (14,739) (13,838) (172,151) (170,644) (1,507)

Other Operating Income (10,323) (734) (734) (724) (830) (655) (761) (785) (846) (753) (663) (953) (782) (9,222) (10,091) 869

Total Income (177,154) (14,681) (14,722) (14,837) (15,645) (15,114) (14,992) (15,009) (15,218) (15,422) (15,422) (15,692) (14,620) (181,373) (180,735) (638)

Expenditure

Substantive 118,163 9,826 9,879 9,790 10,439 9,927 9,926 9,903 9,816 9,874 10,097 10,030 10,082 119,588 126,691 (7,103)

Bank 11,131 850 875 859 1,123 957 969 915 917 1,007 880 937 945 11,234 5,153 6,081

Locum 919 82 87 96 83 89 91 136 244 110 135 104 102 1,359 338 1,021

Agency 6,924 702 752 592 614 533 255 522 445 414 549 487 561 6,428 6,181 246

Total Pay 137,136 11,460 11,593 11,338 12,259 11,505 11,240 11,476 11,423 11,404 11,662 11,558 11,690 138,609 138,364 246

Clinical supplies 1,792 106 130 134 162 83 142 164 165 158 155 210 142 1,752 1,672 80

Drugs 3,002 259 241 211 240 234 265 220 278 236 260 219 243 2,906 3,222 (316)

Other non pay 26,325 2,589 2,422 2,943 2,668 3,003 2,922 1,973 2,023 1,965 2,027 2,369 1,065 27,969 27,965 4

Total Non Pay 31,119 2,954 2,793 3,288 3,070 3,320 3,330 2,357 2,466 2,360 2,442 2,798 1,449 32,627 32,859 (232)

168,256 14,414 14,386 14,626 15,329 14,825 14,570 13,834 13,889 13,764 14,103 14,356 13,139 171,236 171,223 13

EBITDA (8,898) (267) (337) (211) (315) (289) (422) (1,175) (1,330) (1,657) (1,318) (1,335) (1,481) (10,137) (9,512) (624)

Post EBITDA 12,321 911 934 823 945 924 921 926 947 1,318 930 915 904 11,399 11,435 (36)

Net (Profit) / Loss 3,423 644 598 612 630 635 500 (249) (383) (339) (388) (420) (576) 1,262 1,923 (661)

Donated Depreciation (589) (8) (8) (8) (8) (8) (8) (8) (8) (8) (8) (8) (8) (94) (94) 0

Adjusted Net (Profit) / Loss 2,834 636 590 604 622 627 492 (257) (390) (347) (396) (428) (584) 1,169 1,829 (661)

Monthly Profile

Commentary:

The Trust is now forecasting to deliver better than its control total as agreed with NHS Improvement, albeit with a marginal breach to the agency cap of £246k. This is as a result of one off non recurrent

benefits taken during 2018/19 which has included addressing the £458k gap created by the pay award funding being insufficient to cover costs, reviewing bad debt provisions and receiving additional

income for previously unfunded services such as Community Forensic teams of £0.7m.

The over achievement of clinical income includes £2.2m funding for the 2018/19 pay award and £0.7m income received from NHS England for Community Forensic teams, offset by provisions for disputes

£1.0m and CQUIN failure £1.2m relating to both 2017/18 and 2018/19 anticipated.

Pay is forecast to be over spent by £0.8m due to the pay award (mostly funded), offset by an underspend on vacancies not being filled in Support Services.

Non pay includes use of the planned £1.8m contingency to support unfunded pressures and reversal of £1.4m prior year doubtful debt accruals.

The EBITDA variance is mainly due to an underspend on depreciation following slippage on capital schemes, as well as the write off of Assets under Construction in December.

12

Page 15: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Statement of Financial Position - Summary February 2019

Opening 17-18 Actual Movement Year End Plan£ '000 £ '000 £ '000 £ '000

Non-current assets

Property Plant and Equipment 139,906 133,497 6,409 135,659 135659

Intangible Assets 984 668 316 522 522

Other non-current receivables 533 450 83 437 437

Total non-current assets 141,423 134,616 6,807 136,618 136618

Current Assets

Trade and other receivables 8,523 6,562 1,961 7,126 7126

Assets Held for Sale 5 0 5 0 0

Cash and cash equivalents 5,083 14,367 (9,284) 3,639 3639

Total current assets 13,611 20,929 (7,318) 10,765 10765

Current Liabilities

Trade and other payables (15,131) (17,881) 2,750 (13,850) -13850

Provisions (672) (637) (35) (524) -524

Borrowings (833) (818) (15) (817) -817

DH Capital Loan (800) (800) 0 (800) -800

Total current liabilities (17,436) (20,137) 2,701 (15,991) -15991

NET CURRENT ASSETS (3,825) 792 (4,617) (5,226)

Total non-current liabilities (17,354) (15,638) (1,716) (15,656) -15656

TOTAL NET ASSETS 120,244 119,769 475 115,736 115736

TOTAL TAXPAYERS EQUITY (120,244) (119,769) (475) (115,736) 115736

Statement of Financial Position Commentary Over 90 Day Debt

Principal Aged Debts

13/14 Total £ 542k 14/15 Total £58k 15/16 Total £146k 16/17 Total £96k

- £ 479k EK QIPP - £ 58k High Weald - £ 93k Medway Overseas - £ 18k Medway Overseas

- £ 46k EK Section 117 - £ 53k High Weald - £ 78k High Weald

- £ 17k High Weald

The Medway CCG overseas debt has now been agreed with payment expected in March.

Aged Debt Analysis 2018-19

Current Assets:

The largest elements of the movement of £1,961k in trade and other receivables remains a reduction in debtors of

£2,448k relating to growth funding, incentivisation funding and continuing health care, £1,817k of STF funding relating the

17/18 Q4 payment and the £338k PDC Dividend Receivable reduction as the September payment was reduced to unwind

the amount owed from 2017/18.

Current Liabilities:

The movement of £2,701k remains predominately due to a £2.3m reduction in Capital expenditure accruals since the

beginning of the year, offset by £1.4m of outstanding amounts owed to NHS Property Services, currently on hold pending

formal confirmation of the services provided, and the accrual for the March 2019 dividend payment currently of £1.6m.

Creditor payments:

We carefully review each payment run and majority of outstanding invoices are paid on time.

External Financing:

• The Trust received £1.35m PDC funding for the Mother and Baby Unity capital scheme during August.

• Variances to plan for Property, Plant and Equipment are detailed on page 15 of this report.

• Detailed explanation with regards to movement in Cash and Cash Equivalents is on page 14

The target for over 90 day debt for the Trust is that over 90 day debt must be less than 5% of overall debt. This

target has not been achieved in February 2019.

2287

954 581 734 831 593

964 938 570 657

2287

1038

0

944

914

386 591 371 606

454 595

540

117

856

0

1174

825

292

208 105 95

425 361

767

443

79

0

831

995

283 263

64 47

93 331

193 221

244

0

2204

2906

2603

2799

2876 2709

2624 2413

2575 2631

3102

1998

0 0

1000

2000

3000

4000

5000

6000

7000

8000

> 90 Days

61-90 Days

31-60 Days

< 30 Days

Current

13

Page 16: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

12 Month Cashflow

Cash flow as at February 2019

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 £ '000

Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Forecast Opening Cash Balance 5,083

£000's £000's £000's £000's £000's £000's £000's £000's £000's £000's £000's £000's Deficit 18/19 (1,923)

TOTAL CASH B/FWD 5,083 5,079 5,458 4,876 9,181 10,040 8,306 8,259 8,187 13,499 13,908 15,280 Add back depreciation and impairment 6,020Operating Cash flow - inflow/(outflow) 4,097

Revenue Receipts 15,489 16,834 13,913 17,088 16,839 15,040 15,637 15,767 14,764 14,925 15,979 17,901 Capital Programme 18/19 (10,260)

STP Funding 0 0 0 1,817 0 0 0 0 309 0 0 464 Capital Requirement - inflow/(outflow) (10,260)

Loan 0 0 0 0 0 6 0 0 0 0 0 0 Capital repayment on loans/leases/PFIs (1,633)

TOTAL RECEIPTS 15,489 16,834 13,913 18,905 16,839 15,046 15,637 15,767 15,073 14,925 15,979 18,365 Working Capital 16Financing Requirement (1,617)

Pay (9,872) (9,849) (9,811) (9,887) (10,396) (10,385) (10,049) (10,075) (10,028) (10,116) (10,224) (10,094) Cash Requirement (7,780)

Non-Pay (5,224) (5,443) (4,411) (4,024) (5,378) (4,254) (5,388) (5,020) (5,506) (3,515) (3,932) (7,203) Disposals

Capital (397) (755) (272) (690) (1,556) (607) (248) (336) (547) (884) (451) (1,920) St Martins 4,986

Loan repayment 0 (409) 0 0 0 0 0 (407) 0 0 0 0 PDC Mother and Baby Unit 1,350

Dividend payment 0 0 0 0 0 (1,534) 0 0 0 0 0 (1,950) Cash Inflows 6,336

TOTAL PAYMENTS (15,493) (16,455) (14,494) (14,600) (17,330) (16,780) (15,684) (15,839) (16,081) (14,516) (14,607) (21,167) Net Cash Movement - inflow/(outflow) (1,444)Closing Cash Position 3,639

Net Cash Inflow/Outflow (4) 379 (581) 4,304 (490) (1,734) (47) (72) (1,008) 410 1,372 (2,802) Achievement of Plan

Capital Sale Proceeds 0 0 0 0 0 0 0 0 6,320 0 0 0

PDC Financing Transactions 0 0 0 0 1,350 0 0 0 0 0 0 0

TOTAL CASH & CASH EQUIVALENT 5,079 5,458 4,876 9,181 10,040 8,306 8,259 8,187 13,499 13,908 15,280 12,478 £000

Opening cash 2018/19 5,083

NHSI Annual Plan 4,562 2,524 2,624 2,464 3,632 1,289 1,189 1,159 1,100 1,110 1,146 3,639 Closing cash 2018/19 (12,478)

Cash (increase) / reduction (7,395)

Items not included in EFL (284)

External Financing Requirement (7,679)

External Finance Limit 1,162

Cash Flow Financing 1,162

Other Capital Receipts 0

External Financing Requirement (7,679)Under/(Over) spend against EFL 8,841

Comments:

2018 - 19 Cash Plan

The closing cash book position at the end of February is £15.3m (this is £0.9m higher that the balance sheet position due to the timing of the last payment run) which is £14.1m higher than plan and the main transactions to highlight

remain as:

Annual Cash Flow

The Trust is managing its Cash resources within the set

External Financing Limit (EFL).

• Collection of debtors mainly relating to payment by the East Kent CCGs of withheld monies.

• Pay costs are lower than the original plan due to substantive vacancies.

• Cash payments for capital schemes are lower year to date, due to slippages on the capital programme.

• The receipt of £6.32m for the sale of a building which was originally planned for March 2019.

The forecast to year end cash position has been increased to £12.5m which is £8.8m higher than planned.

The previous report to the commitee highlighted a year end cash forecast of £7.3m. This has been increased by £5.2m to £12.5m as a result of the invoices relating to the remainder of the capital programme and for the outstanding

amount owed to NHS Property Services which are now assumed to be paid in cash terms after the year end.

02,0004,0006,0008,000

10,00012,00014,00016,00018,000

Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

£0

00

's

Progress against the Cash Plan 2018-19

Plan

Actual

Forecast

Min Cash Bal

14

Page 17: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Capital Programme

Capital Resource Limit£000 £000

Funded by:

Plan CRL Limit 3,924 Own resources 6,062Adjustments: - MBU 1,350 Adjustments: - MBU 1,350Adjustment for PFI Lifecycle Costs 77 Adjustments: - Pharmacy System 12Adjustments: - Pharmacy System 12

Loan payment (800)

PFI unitary charge - capital repayment (681)

Finance lease capital repayment (151)

Net Cash Movement (429)

Expected CRL 5,363 Available Resources: 5,363

NBV sale of assets 4,986Planned gross capital spend 10,349

Capital Expenditure 2018/19

Annual

PlanPlan Actual Variance Forecast

£000 £000 £000 £000 £000

Expenditure:

Strategic Schemes 7,435 6,208 3,106 (3,102) 4,012

Operational capital 1,689 1,578 1,220 (357) 3,607

IM&T 1,213 1,213 833 (380) 2,081

Total 10,337 8,999 5,160 (3,839) 9,699

Asset Disposals:

Sale of Assets - St Martins (4,986) 0 (4,986) (4,986) (4,986)

Total (4,986) 0 (4,986) (4,986) (4,986)

CRL 5,351 8,999 174 (8,825) 4,713

Over/(Under) shoot against CRL (650)

Year to Date

The capital expenditure forecast below assumes the sale proceeds for St Martins Hospital. This is a variance to

the NHSI return which requires the Trust to remove the spend to be financed from the proceeds until they are

Comments

The capital programme for 18/19 is £10.3m, which is financed from £1.4m PDC for the

Mother and Baby Unit, £5m from the sale of property (received as a cash receipt in

December 2018) and the remainder from internally generated resources. These are

depreciation less the repayment of principal on the current Loans, Leases and PFI

contracts.

The Trust has spent £5.1m year to date against the plan of £8.9m. The £3.8m underspend

relates to the following:-

IT projects £380k underspend due to a delay in the Video Conferencing and Electronic

Observations and the HSCN projects

Strategic Schemes £3.1m underspend due to the revised timing of the Boughton and

Chartwell project, and the difference in timing of the projects relating to the

reconfiguration of the inpatient facilities due to the delay in the sale of a property.

Operational Capital £357k underspend is due to the reconfiguration of schemes due to

service requirements changing.

The Trust is currently forecasting to underspend against the capital programme by £650k at

year end.

15

Page 18: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Risk Schedule

Risk Description

CIPS (5216)

Managing within available resources and delivery of CIP. All schemes to be

delivered whilst maintaining safety and quality and avoiding unfunded

restructuring costs.

Y 632 604 28Non recurrent benefits from Risk Share and Support Services underspend.

Risk reflects the forecast CIP gap, see CIP page 11

NHS debts

Prior year NHS debts that have yet to be resolved. Settlement may result in

credit notes being raised. All disputes assumed to be paid in full (risk share risk

identified separately)

N 390 404 (14)

Remaining unpaid 16/17 and prior debt excluding risk share. For local CCGs

recovery being escalated via the formal contract performance meetings.

Will refer to arbitration if resolution cannot be obtained (See SOFP page

13).

CQUIN (4863) / KPI

Penalties

Managing delivery of CQUIN goals within available resources + delivery of key

SLA targets and avoiding KPI penaltiesY 617 617 0 Current risk reflects worst case scenario for CQUIN failure (see page 10).

Agency CapThe level of spend YTD is in excess of cap therefore the controls assumed to

deliver the outturn of cap must be delivered.Y 246 145 101 Monthly reports to EMT and scrutiny at QPR meetings

CHC

A plan is currently being developed jointly with the commissioners regarding the

potential step down of this unit in year. This is delaying reducing bed occupancy

to the level of beds funded.

Y 120 120 0Joint work streams being set up between CCGs and KMPT to manage

service change.

Addiction ServicesThe occupancy is not achieving as expected therefore the service is not

delivering a contribution.Y 25 25 0

Focus on promotion of services and the overall reduction in pathways costs

from a bespoke addiction service.

2,030 1,915 115Mitigations Deliver CIP (632) (604) (28)

Obtain payment from the CCGs for prior year disputes (390) (404) 14

Release bad debt provisions (1,008) (907) (101)

0 0 0

Other Risks

Cash (4762) achieve EFL

statutory target

If the over spend and debtor risks are not mitigated there will be insufficient

cash to meet our liabilities.0 0 0

Close monitoring of payment runs. Detailed report to FPC. Monthly senior

team meeting to review debt and monthly reporting to contract meetings.

Capital Programme

(3164)Managing additional capital commitments within existing resources 0 0 0 Prioritisation of schemes undertaken by the Trust Capital Group.

OUTTURN

2018/19 Risk Schedule

Change in Risk

(-ve = Reduced Risk)Mitigation

INCOME AND EXPENDITURE

Sub Total Income & Expenditure Risks

Current Risk (£000) Previous Risk (£000)Included in

Forecast

16

Page 19: Front Sheet - KMPT...Front Sheet Title of Meeting Trust Board Date 28 March 2019 Title of Paper Financial Performance Report for February 2019 (Month 11) Author Victoria French, Deputy

Underlying Position

Month on month normalisation adjustments

Item M1 M2 M3 M4 M5 M6 M7 M8 M9 M10 M11 M12 YTD

Disposal Costs (2) 2 91 (3) (7) (7) (6) (6) (333) (6) (6) (280)

Prior year costs 18 31 14 16 0 34 (31) 146 463 305 570 1,567

Unplanned Contingency (251) (334) (1,078) 90 (423) (183) 667 536 (28) 451 63 (490)

Planned Contingency (251) (83) 19 180 (24) (397) (109) (109) (114) (92) (93) (1,072)

Redundancy (24) 0 0 0 (42) 0 0 0 0 0 0 (66)

Non recurrent vacancies 340 155 608 (254) 505 613 (207) (284) (266) (541) 261 931

Subtotal (170) (229) (346) 29 9 60 314 284 (277) 117 795 0 589

Provider Sustainability Funding 77 78 77 103 103 103 155 155 155 180 180 1,366

Sustainability and Transformation Costs (26) (25) (26) (6) (18) (18) (18) (17) (17) (18) (18) (207)

TOTAL (118) (176) (295) 126 94 145 451 421 (139) 279 957 0 1,747

Normalised positionReported Position pre technical adjustments (166,753) 126,920 31,162 (8,672) 10,495 1,823 (181,373) 138,609 32,627 (10,137) 11,399 1,262

Item

Income

(£000)

Pay

(£000)

Non Pay

(£000)

EBITDA

(£000)

Post

EBITDA

(£000)

Total

(£000)

Income

(£000)

Pay

(£000)

Non Pay

(£000)

EBITDA

(£000)

Post

EBITDA

(£000)

Total

(£000)

Disposal Costs 0 0 0 0 (280) (280) 0 0 0 0 (292) (292)

Prior year costs 200 0 1,367 1,567 0 1,567 200 0 797 997 0 997

Unplanned Contingency 0 0 (490) (490) 0 (490) 0 0 0 0 0 0

Planned Contingency 0 0 (1,072) (1,072) 0 (1,072) 0 0 0 0 0 0

Redundancy 0 0 (66) (66) 0 (66) 0 0 (66) (66) 0 (66)

Non recurrent vacancies 0 0 931 931 0 931 0 0 1,181 1,181 0 1,181

NORMALISED SUBTOTAL (166,553) 126,920 31,831 (7,803) 10,214 2,412 (181,173) 138,609 34,538 (8,025) 11,106 3,081

Sustainability and Transformation Funding 1,366 0 0 1,366 0 1,366 1,546 0 0 1,546 0 1,546

Sustainability and Transformation Costs 0 0 (207) (207) 0 (207) 0 0 (225) (225) 0 (225)

NORMALISED TOTAL (165,187) 126,920 31,623 (6,644) 10,214 3,570 (179,627) 138,609 34,313 (6,705) 11,106 4,402

Movement 1,566 0 462 2,028 (280) 1,747 1,746 0 1,686 3,432 (292) 3,140

Comments:

The tables above show the underlying position within the Trust by removing one off impacts on the financial position. The underlying position would have deteriorated by £1.7m YTD without

these non recurrent items. This is predominantly due to the non recurrent benefit of staff vacancies and STF. This is offset by the planned and unplanned contingency, which is now being

unwound into the position in the last half of the financial year.

The forecast normalised position for 2018/19 is £4.4m deficit. This is consistent with the start point used by NHSI in setting the Trust's control total for 2019/20.

Year to Date Forecast

17