report title monthly financial performance for month 3 june 2017 09... · 2019-03-28 · report to...

Report to Public Trust Board – 26 July 2017

Report title Monthly financial performance for month 3 – June 2017

Report from Steven Davies, Chief Financial Officer

Prepared by Jenny Greenshields, Deputy Chief Financial Officer

Damien O’Brien, Head of Financial Management

Assad Choudry, Financial Controller

Previously discussed at Management Executive

Attachments None

Brief summary of report

• The Trust reported a £0.77m surplus in June, £0.17m ahead of the budgeted plan. The YTD position now

stands at a surplus of £0.45m, £0.49m ahead of plan.

• The Forecast position for 2017/18 is a £0.5m surplus. The bottom line is planned to fluctuate as the year

progresses based on seasonal activity variations, CIPs being implemented and service developments

progressing, however across the remaining 9 months of 2017/18 the Trust is broadly planning to

breakeven.

• The surplus position in June is driven by planned high levels of NHS income, whilst costs have largely

been maintained at trend coupled with a strong financial performance from Commercial Trading Units.

• Commercial Trading Units reported a surplus of £0.24m in month, which was higher than planned levels

by £0.07m. YTD Commercial Trading Units are now slightly above plan by £0.09m. The full year forecast

position is for a surplus of £3.77m.

• Efficiency schemes delivered £0.36m of savings in June, £0.14m behind plan as a result of slippage on a

number of schemes. Fortnightly meetings are scheduled with divisions to assure progress of efficiency

schemes. The forecast is maintained at £8.20m. 65% of total efficiency savings are currently planned for

the second half of 2017/18, however it is anticipated that savings will be brought forward as schemes are

developed and implemented.

• We are currently working with NHSI to ascertain the correct accounting treatment of the additional

£0.42m STF monies relating to 2016/17, that we were notified of in June. • Cash balance was £38.51m at the end of June, £2.32m behind plan.

• Use of Resources Risk rating for the trust is 1 for June with all individual metrics also scoring 1.

Action Required/Recommendation.

The board is asked to consider and discuss the attached report.

For Assurance x For decision For discussion To note

Item 9

2

Monthly Finance Report For June 2017

Prepared by:

Damien O’Brien

Head of Financial Management

Assad Choudry Financial Controller

Jenny Greenshields

Deputy Chief Financial Officer

Presented By:

Steven Davies Chief Financial Officer

Board of Directors Meeting 26

th July 2017

Date produced 18 July 2017

Action for Board:

For information

For consideration

For decision

3

Contents of Main Report

Page Number

Executive Financial Summary 4 Detailed Income and Expenditure Position 5 Variance analysis 6 Divisional Financial Performance 7 NHS Income 8

NHS Operating Expenditure 10

Efficiency Scheme Performance 12 Research & Development and Commercial Trading Position 13 Cash flow & Capital 14 Debtors Management and Credit Control 15

4

Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M)

0.60 0.77 0.17 (0.04) 0.46 0.50 0.50 0.50 0.00


15.05 15.37 0.32 42.66 42.28 (0.38) 172.32 172.50 0.18

14.64 14.88 (0.24) 43.50 42.78 0.72 176.52 176.68 (0.16)

0.41 0.48 0.07 (0.84) (0.50) 0.34 (4.19) (4.18) 0.01

72%

12% Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M)

100% 1.34 0.96 (0.38) 8.20 8.20 0.00


0.02 0.05 0.03 0.06 0.13 0.07 0.92 0.92 0.00


0.17 0.24 0.07 0.74 0.83 0.09 3.77 3.77 0.00

M3 YTD YE Forecast1 1

Liquidity 1 1

I&E Margin 1 1

1 1

Agency Spend 1 1

1 1

2016/17

Year End

May

Actual

June

Actual

June

Variance

39.00 35.37 38.51 (2.32)

Annual PlanExpenditure

Year to Date

Annual

Forecast

Var to Plan

Forecast

30.87 0.40 30.87 0.00

3-5 Mths 2 Mths Total Last Month

(£M) (£M) (£M) (£M)

3.57 0.41 6.89 8.35

0.53 0.28 3.05 3.18

0.82 0.31 2.65 2.64

4.92 1.00 12.59 14.17

Use of Resources Rating

Efficiency Scheme

PerformanceFull Year % forecast

% Full Year achieved

Executive Financial Summary

Trust Underlying

Overall Position -

Surplus / (Deficit)

In Month Year to Date Key Risks and Actions RequiredFull Year Forecast

Research &

Development

Position

(exc. R&D)

YTD % achieved Year to Date

In Month Year to Date

IncomeExpenditure

Overall Position

Full Year ForecastNHS In Month Year to Date

Full Year Forecast

Full Year Forecast

0.22

1.27

Use of Resources

Rating

Cash FlowJune

Plan

Capital

Expenditure

Commercial

Trading Unit

Position

In Month Year to Date

I&E Margin Variance

0.46

IndicatorCapital Service Cover

Year End

Plan

5.40

40.83

Expenditure

Committed

42.20

Capital Expenditure (£M)

1.30

Cash Balance (£M)

Full Year Forecast

Debtors

Overdue Debts

NHS Contract Debts 2.15 0.76

Commercial Debts 1.95 0.29

Other

TOTAL

(£M) (£M)

6 Mths + 1 Mth

Income and Expenditure • The Trust reported a £0.77m surplus in June,

£0.17m above the budgeted plan. • The full year forecast is to achieve a surplus of

£0.50m which includes £0.90m Sustainability and Transformation Funding, and assumes full achievement of the Trusts CIP program of £8.20m.

• NHS income is above plan in month by £0.32m in part due to a YTD correction related to Bedford and also due to high activity across Moorfields South.

• Commercial Trading Units reported a surplus of £0.24m in month, which was above planned levels by £0.07m.

• Efficiency schemes delivered £0.36m savings in June, £0.14m behind plan, and are now £0.38m behind plan YTD. The full year forecast continues at £8.20m.

Use of Resources Rating • Use of resources rating for the Trust in June is 1. Cash flow and Balance Sheet • Cash balance was £38.51m at the end of June,

£2.32m behind plan. • Capital plan for the year is £30.87m with

expenditure YTD at £0.40m. • Overdue debt has decreased by £1.58m in June

to £12.59m.

5

£000s £000s £000s £000s £000s £000s £000s £000s £000s £000s £000s

Income

NHS Clinical Income 11,042 11,393 351 36,594 36,736 142 147,954 147,954 0 36,711 25

Commercial Trading Units 2,281 2,157 (124) 7,204 6,512 (692) 29,438 29,438 0 7,018 (506)

Other Income 5,098 4,978 (120) 9,216 8,562 (654) 36,766 36,766 0 8,376 186

Total Income 18,421 18,528 107 53,014 51,810 (1,204) 214,158 214,158 0 52,105 (295)

NHS Expenditure

Pay Expenditure

Medical 2,578 2,703 (125) 7,788 7,823 (35) 31,119 31,119 0 7,701 (122)

Nursing 2,066 1,984 82 6,188 6,011 177 24,767 24,767 0 6,051 40Scientific, Professional & Technical 1,221 1,016 205 3,564 3,142 422 14,141 14,141 0 2,926 (216)Admin and Clerical 2,093 2,321 (228) 6,790 7,020 (230) 27,016 27,016 0 6,707 (313)

Ancillary Services 181 194 (13) 542 558 (16) 2,168 2,168 0 518 (40)Research & Development Pay 664 589 75 1,986 1,779 207 7,795 7,795 0 1,814 35

Total Pay Expenditure 8,803 8,807 (4) 26,858 26,333 525 107,006 107,006 0 25,717 (616)

Non-Pay Expenditure

Drugs 2,260 2,425 (165) 6,367 6,672 (305) 25,500 25,500 0 6,034 (638)

Clinical Supplies and Services 1,453 1,529 (76) 4,097 4,119 (22) 16,408 16,408 0 3,671 (448)

Premises 744 814 (70) 2,378 2,283 95 9,601 9,601 0 2,363 80

Other Expenditure 1,114 1,112 2 3,002 2,827 175 15,449 15,449 0 3,320 493

Research & Development Non-Pay 394 353 41 1,072 1,077 (5) 3,461 3,461 0 825 (252)

Total Non-Pay Expenditure 5,965 6,233 (268) 16,916 16,978 (62) 70,419 70,419 0 16,214 (765)

Total NHS Expenditure 14,768 15,040 (272) 43,774 43,311 463 177,425 177,425 0 41,931 (1,381)

Commercial Trading Unit Costs 1,962 1,803 159 6,021 5,350 671 24,153 24,153 0 5,853 503

Total Expenditure 16,730 16,843 (113) 49,795 48,661 1,134 201,578 201,578 0 47,784 (878)

EBITDA 1,691 1,685 (6) 3,219 3,149 (70) 12,580 12,580 0 4,321 (1,173)

EBITDA Margin % 9.2% 9.1% 6.1% 6.1% 5.9% 5.9% 8.3%NHS Interest, Dividends, Depreciation &

Profit/Loss on Disposals940 795 145 2,816 2,361 455 10,564 10,564 0 2,479 118

Trading Unit Interest, Depreciation, Dividends &

Profit/Loss on Joint Ventures147 116 31 441 335 106 1,516 1,516 0 136 (199)

Surplus / (Deficit) 604 774 170 (38) 453 491 500 500 0 1,706 (1,253)

NHS EBITDA 1,372 1,331 (41) 2,036 1,987 (49) 7,295 7,295 0 3,157 (1,170)

NHS EBITDA Margin % 8.5% 8.1% 4.4% 4.4% 3.9% 3.9% 7.0%NHS Surplus / (Deficit) 432 536 104 (780) (374) 406 (3,269) (3,269) 0 678 (1,052)

Commercial Trading Unit EBITDA 319 354 35 1,183 1,162 (21) 5,285 5,285 0 1,165 (3)

Commercial Trading Unit EBITDA Margin % 14.0% 16.4% 16.4% 17.8% 18.0% 18.0% 16.6%Commercial Trading Unit Surplus / (Deficit) 172 238 66 742 827 85 3,769 3,769 0 1,029 (202)

Prior Year YTD

Variance ActualVariance

YTD ActualBudget Actual Variance Budget Actual Variance Budget ActualOverall Trust I&E Summary

In Month Year To Date Full Year Forecast

Detailed Income and Expenditure Position - Surplus / (Deficit)

6

01,0002,0003,0004,0005,0006,0007,0008,0009,000

Medical Nursing STT A&C Ancillary R&D

Exp

en

dit

ure

£'0

00

Category

YTD Pay variance

Budget

Actual

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

Drugs Clinical Supplies Premises Other R&D

Expe

ndit

ure

£'00

0

Category

YTD Non-pay variance

Budget

Actual

Variance Analysis

Commentary

• NHS Clinical Income and Commercial Trading income variances are explained in more detail elsewhere within this report.

• Other income has underachieved by £120k (2%) in June and by £654k (7%) YTD in part (£330k) due to the underachievement of planned CIPs. A further £87k is due to lower R&D income than planned, for which there are offsetting underspends within R&D pay and non-pay costs. Some minor overachievements elsewhere have helped to partially mitigate the position.

• Nursing Pay costs are £82k (4%) underspent in June and

£177k (3%) underspent YTD. Significant vacancies in a number of areas, including Theatres and A&E at City Road have contributed to the position.

• STT Pay costs are £205k (17%) underspent in June and £422k (12%) YTD. The vacancy rate stands at 11% in May, with a significant level of vacancies within Ophthalmic services at City Road.

• Admin and Clerical Pay costs are £228k (11%) overspent in June and now stand £230k (3%) overspent YTD. This continues a worsening trend month-on-month with Admin and Clerical Pay costs. The overspend in month is driven by a number of Corporate areas and high temporary staff expenditure in the Booking centre at City Road and at St Georges.

• Drugs have overspent by £165k (7%) in June and now stand £305k (5%) overspent YTD. Much of the overspend is related to high cost injection activity.

• Other expenditure is £175k (6%) underspent YTD. There are under-spends across a number of areas with no single material issue.

7

Variance Anal

DescriptionBudget MTH

(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 8,643 8,310 -334 24,431 23,520 -911

Pay Costs 4,291 4,160 131 12,973 12,509 464

Non Pay Costs 2,093 2,195 -102 5,788 6,083 -296

Below the line 146 146 0 439 439 0

Contribution/ Deficit 2,113 1,808 -305 5,231 4,489 -742


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 1 1 -0 3 4 1

Pay Costs 401 410 -9 1,078 1,142 -63

Non Pay Costs 24 41 -17 72 136 -64

Below the line 2 2 0 5 5 0

Contribution/ Deficit -426 -452 -27 -1,153 -1,279 -126


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 3,649 3,830 181 10,116 9,995 -121

Pay Costs 1,184 1,146 37 3,545 3,446 99

Non Pay Costs 1,267 1,381 -114 3,593 3,613 -20

Below the line 115 115 0 344 344 0

Contribution/ Deficit 1,084 1,187 104 2,633 2,591 -42


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 2,396 2,470 74 6,635 6,573 -62

Pay Costs 947 1,056 -109 2,842 3,018 -176

Non Pay Costs 798 799 -1 2,314 2,233 80

Below the line 38 38 0 113 113 0

Contribution/ Deficit 613 577 -36 1,366 1,208 -158


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 244 257 14 731 738 6

Pay Costs 287 297 -10 859 847 12

Non Pay Costs 845 876 -31 2,560 2,295 265

Below the line 34 34 0 103 103 0

Contribution/ Deficit -922 -950 -28 -2,790 -2,507 283


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 99 153 54 856 818 -38

Pay Costs 1,029 1,149 -120 3,576 3,592 -16

Non Pay Costs 539 588 -48 1,551 1,408 142

Below the line 401 290 111 1,200 867 333

Contribution/ Deficit -1,871 -1,874 -3 -5,470 -5,050 421

Corp. Inc. Contribution/ Deficit -180 187 367 -654 43 697

R&D Contribution/ Deficit 22 51 29 56 132 77

Commercial Contribution/ Deficit 172 238 66 742 827 85

Trust Contribution/ Deficit 604 772 168 -39 455 494

City Road is behind its contribution target by £305k in June and now stands £742k behind plan YTD. The

poor performance is entirely due to an income under-performance, both in month and YTD. Day cases

now stand £500k behind plan YTD and all Elective and Outpatient activity is materially behind plan.

Delays in implementing the Theatre util isation CIP has exacerbated the income under-performance

further. A Pay underspend (£131k month/ £464k YTD) has helped to partially mitigate the financial

performance. High levels of nursing vacancies (Theatres) and across STT disciplines has led to the Pay

underspend.The Access division is £27k behind its contribution target in June and £126k behind YTD. The adverse

position is equally attributable to YTD overspends in Pay (£63k) and Non-Pay (£64k). The Pay

overspend is due to high temporary staffing costs within the Validation team, Health Records and the

Booking office. The Non-pay overspend is largely due to external consultancy costs.

Moorfields North had a positive month in June delivering a variance of £104k above its contribution

target meaning the YTD under-performance has reduced to £42k behind plan. The positive month was

due to Income over-performing by £181k relating to a YTD correction to the Bedford contract and the

removal of RTT fines that Bedford had cross-charged. Income remains behind plan YTD, by £121k, due

to a shortfall of Elective activity and delays in implementing CIPs. Pay costs are £99k underspent YTD

largely due to Junior Doctor vacancies. The adverse Non-pay position in June is related to the activity

levels delivered.Moorfields South is £36k behind its contribution target in month and now stands £158k behind plan

YTD. The adverse variance from plan is due to Pay costs being overspent by £109k in June and £176k

YTD. The Pay overspend is related to high temporary staffing costs within Admin and Clerical staff, due

to senior management vacancies, and further vacancies and high sickness in the Booking centre at St

Georges. There are further material overspends within Medical and Nursing staff, largely due to

temporary staff covering vacancies. Income is above plan in month due to high elective activity at St

Georges but remains behind plan YTD due to low levels of Outpatient activity across the division.Estates is £28k behind its contribution target in June but remains favourable YTD; £283k ahead of plan.

The in-month overspend was largely due to a Non-pay overspend of £31k due to high Electricity and Gas

charges, which are being investigated. YTD there is a Non-pay underspend of £265k which is expected to

partially equalise as the year progresses.

City Road

Access

Moorfields

North

Moorfields

South

Estates &

Facilities

Corporate

Corporate is on plan in June and £421k ahead of plan YTD. The favourable YTD position is due to Below

the line (BTL) costs being £333k underspent and Non-pay costs being £142k underspent. The BTL

underspend is related to interest costs associated with Project Oriel which have yet to be incurred. The

Non-pay underspend is related to a number of areas with the largest underspends within IT and HR,

although there is no single driver of this favourable position.

The favourable YTD variance is due to central reserves.

Discussed elsewhere in this report

Discussed elsewhere in this report

Divisional Financial Performance

8

0

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

14,000,000

16,000,000

18,000,000

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

Actual Monthly Income against Budget by Point of Delivery

Other Income

Education

Research & Development

Other Main SLA Income

Bedford Activity

High Cost Drugs

Outpatient

Non-Elective Income

Elective Income

A&E

Total Budget

0

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

14,000,000

16,000,000

18,000,000

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

Actual Monthly Income against Budget by Directorate

R&D

Moorfields South

Moorfields North

Corporate Departments

City Road

Access

Total Budget

NHS Income

Commentary

• A&E activity has over-performed in month by 215 (2.6%) attendances leading to an income over-performance of £26k.

• Elective activity is 252 spells (7.3%) below plan in month, underperforming by £0.24m. Although the most material under-performance was at City Road (186 spells/ £0.24m), there was also a significant under-performance against plan at Moorfields North. This was partially mitigated by a favourable performance at Moorfields South

• High cost drug injection activity is 148 injections (4.7%) above plan in month, giving a favourable income variance of £0.12m. The over-performance is spread across all divisions.

• Outpatients under performed by 1,782 (3.6%) attendances leading to an income under-performance of £0.27m. YTD there is now an under-performance in Outpatients of £0.49m.

• Sustainability and Transformation funding (STF) of £0.04m has been included within the position, in line with our allocation as advised by NHSI. In 2017/18 NHSI have weighted STF monies more heavily towards the end of the year. We will include an additional £0.42m STF monies in our position in M4, relating to 2016/17. NHSI notified us of the additional allocation in June.

9

19 17 21 21 19 21 20 17 15 21 20 19

156 194 169 0 0 0 0 0 0 0 0 0

134 181 159 0 0 0 0 0 0 0 0 0

(22) (13) (10) 0 0 0 0 0 0 0 0 0

20 17 21 21 16 22 22 21 17 20 20 21

232 295 260 0 0 0 0 0 0 0 0 0

213 297 251 0 0 0 0 0 0 0 0 0

(19) 2 (10) 0 0 0 0 0 0 0 0 0

Workings Days

Target per working day (£'000)

Actual per working day (£'000)

Variance (£'000)

Workings Days Inc. adjustments

Target per working day (£'000)

Actual per working day (£'000)

Variance (£'000)

2,000

2,200

2,400

2,600

2,800

3,000

3,200

3,400

3,600

3,800

Inco

me

(£'0

00)

NHS Elective/Daycase Income

2016/17 Actual

2017/18 Budget

2017/18 Actual

2017/18Forecast

3,900

4,100

4,300

4,500

4,700

4,900

5,100

5,300

5,500

5,700

5,900

6,100

Inco

me

(£'0

00)

NHS Outpatient Income

2016/17 Actual

2017/18 Budget

2017/18 Actual

2017/18 Forecast

Elective Activity Analysis (Inpatients and Outpatients)

• June elective income was below planned levels by

£0.24m.

• Average elective income was £159k per working day,

below the plan of £169k. Although City Road

accounted for much of the under-performance, all

sites with the exception of St Georges and Potters

Bar were behind plan in June.

• Cataract (£94k) and External disease (£111k) were

the services with the highest levels of

underperformance, as with both April and May.

• May outpatient income was below planned levels

across all directorates, with the exception of

Moorfields North, specifically the Eastern sites.

• Average May outpatient income was £251k per

working day, £10k below the plan of £260k.

• Key areas driving the in-month under-performance

were most City Road sub-specialities.

10

NB. Research and Development Pay is excluded from the tables above and shown as part of the Research and Development position on page 11.

Staff Group & Directorate Staff Group & Directorate

MedicalYear to Date Current Month

Increase /

(Decrease)Nursing

Year to Date Current Month

Increase /

(Decrease)

Moorfields North 366 378 (12) Moorfields North 510 515 (5)

Moorfields South 416 426 (10) Moorfields South 347 362 (15)

City Road 1,771 1,847 (76) City Road 1,092 1,052 40

Access 0 0 0 Access 0 0 0

Corporate Departments 55 53 2 Corporate Departments 54 55 (1)

Total 2,608 2,704 (96) Total 2,003 1,984 19

Average Monthly Expenditure (£'000) Average Monthly Expenditure (£'000)

Staff Group & Directorate Staff Group & Directorate

Other ClinicalYear to Date Current Month

Increase /

(Decrease)Non-Clinical

Year to Date Current Month

Increase /

(Decrease)

Moorfields North 46 29 17 Moorfields North 227 224 3

Moorfields South 41 40 1 Moorfields South 202 228 (26)

City Road 947 930 17 City Road 359 332 27

Access 0 0 0 Access 381 410 (29)

Corporate Departments 13 17 (4) Corporate Departments 1,357 1,322 35

Total 1,047 1,016 31 Total 2,526 2,516 10

Average Monthly Expenditure (£'000) Average Monthly Expenditure (£'000)

NHS Operating Expenditure – Pay Costs by Staff Group and Area

• Average other clinical pay expenditure in month is £1,016k, which is below by £31k, the

2017/18 year to date averaged expenditure of £1,047k.

• The vacancy rate stands at 11.0% in June, with significant vacancies in Ophthalmic Services.

• Average non clinical pay expenditure in month is £2,516k, which is £10k below the 2017/18

year to date averaged expenditure of £2,526k.

• There have been high levels of expenditure in a number of Corporate areas and high

temporary staff usage in the Booking centre at City Road and at St Georges.

• Average nursing pay expenditure in month is £1,984k, which is £19k below the 2017/18


• The vacancy rate stands at 15.1% in June with significant vacancies in Theatres and A&E at

City Road. High temporary staff costs at St Georges have led to an increase in the run-rate

at Moorfields South.

• Average medical pay expenditure this month is £2,704k, which is £96k above the 2017/18


• The worsening position is largely attributable to additional sessions at City Road.

11

Staff Type

Employed Bank Agency Total % Change Employed Bank Agency Total % Change Employed Bank Agency Total

Nursing 1,721 319 -56 1,984 -1% 1,722 265 16 2,003 -1% 1,713 267 37 2,017

Medical 2,433 224 46 2,703 4% 2,375 150 83 2,608 2% 2,301 203 63 2,567

Non-clinical 1,979 396 140 2,515 0% 2,035 325 166 2,526 5% 1,899 220 290 2,409

Current Month Year To Date Average Average Prior Year

Staff Type

Current Month (£'000) Year To Date Average (£'000) Average Prior Year (£'000)

Nursing

Medical

Non-Clinical

84%

16%

Nursing Expenditure Current Month

Employed Bank

86%

13%

1%

Nursing Expenditure YTD Average

Employed Bank Agency

90%

8%

2%

Medical Expenditure Current Month

Employed Locum Agency

91%

6%3%

Medical Expenditure YTD Average


79%

16%

5%

Non Clinical Expenditure Current Month


80%

13%7%

Non Clinical Expenditure YTD Average


85%

13%

2%

Average Nursing Expenditure Prior Year


90%

8%2%

Average Medical Expenditure Prior Year


79%

9%12%

Average Non Clinical Expenditure Prior Year


NHS Operating Expenditure – Pay Costs Agency and Bank Analysis

• Nursing substantive expenditure has

decreased slightly in month

compared to April and May. There

has been a shift from what were low

levels of agency to bank staff.

• The vacancy rate in month is 15.1%, a

very small reduction from May.

• Medical locums represent 8% of

expenditure in month, while agency

expenditure is at 2%.

• This is in line with the average split of

staff seen last year, 2016/17 and

positively represents a modest

reduction in the level of agency staff.

• Non-clinical staff groups make use of

the highest proportion of agency at

5%. Bank usage is 16%. • The above figures represent an

improvement on the YTD average and

a significant improvement from

2016/17, demonstrating a shift from

agency staff to bank.

• The non-clinical vacancy rate is

19.0%.

12

Full Year

Target

(£'000)

Value of

Schemes

Identified

(£'000)

YTD Target

(original

phased

budget)

(£'000)

YTD Amount

Achieved

(£'000)

YTD

Variance

(£'000)

Full Year

Forecast

Amount

(£'000)

Forecast %

Achievement

of Target

YTD Amount

Achieved as

% of Full

Year Target

Moorfields North 1,129 629 146 60 (86) 1,129 100% 5%

Moorfields South 915 487 95 73 (22) 915 100% 8%

City Road 4,033 3,602 779 575 (204) 4,033 100% 14%

Access Division 435 153 7 7 0 435 100% 2%

Corporate Departments 1,688 1,271 310 241 (68) 1,688 100% 14%

Total 8,200 6,142 1,336 956 (380) 8,200 100% 12%

Achievement YTD is £241k against a target of £310k, slippage is due to delays in starting a number of schemes across different

areas; especially Catering, Hybrid Mail and Interpreting services. CIP schemes have been identified YTD that total £1,271k, albeit

those schemes identified are at various stages of development and implementation.

Directorate / Corporate

Department

Actions on Shortfall and Unidentified Amount

Achievement YTD is £73k against a target of £95k, slippage is largely related to 2 schemes; capturing diagnostic imaging income and

reducing the DNA rate at the St Georges sites. CIP schemes have been identified YTD that total £487k. . Other schemes identified

are at various stages of development and implementation.

Achievement YTD is £575k against a target of £779k, slippage is largely due to delays in progressing a scheme to improve Theatre

utilisation . CIP schemes have been identified YTD that total £3,602k, which has slipped due to delays in schemes such as Theatre

utilisation as aforementioned, and various Optometry schemes.

Achievement YTD is £60k against a target of £146k, and slippage is due to delays in starting a number of schemes, especially Darrent

Valley and Laser Business Case schemes. CIP schemes identified YTD total £629k. There are a few schemes identified as

opportunities, but are awaiting on business case authorisation in order to confirm the final saving figures.

Achievement YTD is on target at £7k; the other schemes have been phased to start towards the latter part of the year.

-

100

200

300

400

500

600

700

800

900

1,000

1,100

1,200

1,300

Am

ou

nt

(£'0

00

)

Period

Efficiency Schemes Profile and Forecast

Target

Actual

Forecast

Summary of Performance:

- CIP achievement in June was £0.36m vs a plan of £0.50m. The shortfall against target is £0.14m.

- Full year forecast is to deliver the target of £8.2m.

- The Trust is continuing to identify further schemes to bridge the gap that currently exists within the CIP program.

- Fortnightly meetings for each directorate have been initiated to ensure deliverability against identified schemes and to continue to identify new schemes.

1%

9%

25%

30%

35%

Breakdown of Forecast Achievement

Agency & Consultancy

Drugs

Clinical Supplies

INCOME

Pay

13

Budget Actual Variance Budget Actual Variance Budget Forecast Variance

£000s £000s £000s £000s £000s £000s £000s £000s £000s

Total Income 1,091 1,004 (87) 3,148 3,022 (126) 12,394 12,065 (329)

Expenditure

Pay Costs 664 589 75 1,986 1,779 207 7,795 7,795 0

Non-Pay Costs 394 353 41 1,072 1,077 (5) 3,461 3,132 329

Total Expenditure 1,058 942 116 3,058 2,856 202 11,256 10,927 329

Interest, Dividends, Depreciation 11 11 0 34 34 0 212 220 (8)

Total Contribution to overhead 22 51 29 56 132 76 926 918 (8)

Research and Development

In Month Year to Date Full Year

£000s £000s £000s £000s £000s £000s £000s £000s £000s £000s £000s

Total Income - including Internal Sales 2,281 2,157 (124) 7,204 6,512 (692) 29,438 29,438 0 7,094 (582)

Expenditure

Pay Costs 803 613 190 2,474 1,967 507 9,964 9,964 0 2,258 291

Non-Pay Costs 1,160 1,190 (30) 3,547 3,383 164 14,189 14,189 0 3,595 212

Total Expenditure 1,963 1,803 160 6,021 5,350 671 24,153 24,153 0 5,853 503

Commercial Trading Unit EBITDA 318 354 36 1,183 1,162 (21) 5,285 5,285 0 1,241 (79)

Commercial Trading Unit EBITDA Margin % 13.9% 16.4% 16.4% 17.8% 18.0% 18.0% 17.5%Interest, Dividends, Depreciation and interests in

joint ventures147 116 31 441 335 106 1,516 1,516 0 136 (199)

Commercial Trading Unit Surplus / (Deficit) 171 238 67 742 827 85 3,769 3,769 0 1,105 (278)

Less Internal Sales 0 0 0 0 0 0 0 0 0 (76) 76

Commercial Trading Unit Surplus / (Deficit) -

discounting internal sales171 238 67 742 827 85 3,769 3,769 0 1,029 (202)

Commercial Trading Units

In Month Year to Date Full Year Forecast Prior Year YTD

Forecast Variance Actual VarianceBudget Actual Variance Variance BudgetBudget Actual

Research and Development Position

Commercial Trading Unit Position

In month R&D income is £0.1m below plan. Expenditure was also below plan in month.

Overall financial performance in month is £0.03m above plan, and YTD contribution now stands at £0.13m, £0.08m above plan.

The forecast for the full year is on plan at £0.92m contribution.

Commercial income in month is behind plan by £0.12m. Forecast for the full year is to achieve the planned income level of £29.44m. Expenditure in month is below planned levels by £0.16m. Full year expenditure is expected to be on plan at £24.15m. In month performance was a £0.24m surplus, £0.07m above plan, YTD the surplus now stands at £0.83m, £0.09m above plan. Full year forecast is to deliver a surplus of £3.77m.

14

Cash Flow

Cash balance was £38.5m at the end of June, £2.3m below plan. This is primarily due to delay in receipt of STF incentive funding which is expected to be received in July.

Forecast cash balance at year end is largely on plan after taking into account capital expenditure, PDC dividend and interest payments.

Capital Expenditure

Total capital expenditure year to date is £0.40m. In addition a further £0.46m has been committed through approved orders.

Capital plan for the year is £30.87m and incorporates investment in Trust clinical estate, medical equipment, IT and strategic schemes.

Planning for strategic schemes will be reviewed over the coming months and forecast will be updated accordingly.

Capital Expenditure (£ Millions)Annual

Budget

Expenditure

Year to Date

Expenditure

Committed

Year End

Forecast

Var to Plan

Forecast

Estates 6.83 0.17 0.14 6.83 0.00

Medical Equipment 1.58 0.01 0.04 1.58 0.00

IT 4.42 0.21 0.28 4.42 0.00

Corporate 0.22 0.00 0.00 0.22 0.00

Strategic Schemes 17.24 0.00 0.00 17.24 0.00

Dubai 0.65 0.01 0.00 0.65 0.00

Contingency/Carry Forward (0.08) 0.00 0.00 (0.08) 0.00

Total 30.87 0.40 0.46 30.87 0.00

15

Debtors Management and Credit Control

Please note: Values shown in the above tables are for the stated types of debt only, and exclude UAE.

Additional items not included above comprise overall debt for the Trust, including provisions and accruals.

Comments

Total debt has decreased by £1.9m in June to £14.0m (£15.9m May). As a result of expected underperformance in April against SLAs due to bank holidays and 2016-17 year end reconciliations with commissioners, credit notes have been issued in June.

Total overdue debt has decreased by £1.6m in June to £12.6m (£14.2m May) due to commissioners, mainly NHSE and SWL, settling overdue debt as part of 2016-17 year end reconciliations.

Key debtors over 4 months overdue

Welsh Health Bodies £1.1m

NWL Group £0.7m

NELC Group £0.4m

Barts Trust £0.3m

St Georges Trust £0.2m

Key debtors 1-3 months overdue

SWL Group £1.1m

NELC Group £0.7m

NWL Group £0.4m

Type of Debt 6 Mths + 5 Mths 4 Mths 3 Mths 2 Mths 1 Mth Overdue Current Total

Dec 16 Jan 17 Feb 17 Mar 17 Apr 17 May 17 Jun 17 Jun 17 Jun 17

Welsh Debts only 1,033 13 8 16 19 12 1,101 19 1,120

NHS Service Income 1,112 658 (314) 3,205 395 749 5,805 (1,624) 4,181

Total Contract Debts 2,145 671 (306) 3,221 414 761 6,906 (1,605) 5,301

Private Patients 1,945 141 93 291 275 285 3,030 586 3,616

Sundry Debtors 1,298 59 59 704 306 224 2,650 2,454 5,104

TOTAL 5,388 871 (154) 4,216 995 1,270 12,586 1,435 14,021

Type of Debt Overdue Current Total Overdue Current Total % Var % Var % Var

Jun 17 Jun 17 Jun 17 May 17 May 17 May 17 Overdue Current Total

Welsh Debts only 1,101 19 1,120 1,091 12 1,103 0.9% 58.3% 1.5%

NHS Service Income 5,805 (1,624) 4,181 7,265 140 7,405 (20.1%) (1260.0%) (43.5%)

Total Contract Debts 6,906 (1,605) 5,301 8,356 152 8,508 (17.4%) (1155.9%) (37.7%)

Private Patients 3,030 586 3,616 3,182 622 3,804 (4.8%) (5.8%) (4.9%)

Sundry Debtors 2,650 2,454 5,104 2,639 931 3,570 0.4% 163.6% 43.0%

TOTAL 12,586 1,435 14,021 14,177 1,705 15,882 (11.2%) (15.8%) (11.7%)

16

Overdue CCG debt

NEL, NWL and SWL CCG groups collectively account for £3.3m (65%)

of overdue English contract debt, £1.1m of which is over 4 months

overdue.

NCA (Non-Contract Activity) overdue debt includes Kent & Sussex

Area CCGs with 37% of the total overdue balance of £0.8m. As is the

case with all NCA debts, an individual targeted approach is made for

each debtor (125 in total).

£3.3m cash was received from 1st to 12th July, of which £2.2m was for

SLA invoices, £0.5m for 2016/17 performance/NCA invoices and

£0.6m for 201718 performance/NCA invoices.

Overdue Sundry debt

Overdue sundry debt is £2.7m in June. £0.3m of this is overdue from

Barts Trust and £0.3m from St Georges Trust.

£0.1m cash was received from 1st to 12th July.

Note: Standard NHS payment terms are 30 days from the invoice

date. SLA payments are mostly made on the 15th of each month and,

once set up, tend to run smoothly.

Delays in payment occur when data is delayed or disputed, or

queries arise which require investigation.

£5,388

£871£154

£4,216

£995

£1,270

£1,435

Total Debt by Age £'000

6 Mths +

5 Mths

4 Mths

3 Mths

2 Mths

1 Mth

Current

£14,021Total

£1,101

£5,805

£3,030

£2,650

£1,435

Total Debt by Type £'000

Welsh Debts only

NHS Service Income

Private Patients

Sundry Debtors

Current

Total £14,021

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