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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
Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M)
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
Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M)
0.02 0.05 0.03 0.06 0.13 0.07 0.92 0.92 0.00
Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M)
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
DescriptionBudget MTH
(£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
DescriptionBudget MTH
(£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
DescriptionBudget MTH
(£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
DescriptionBudget MTH
(£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
DescriptionBudget MTH
(£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
year to date averaged expenditure of £2,003k.
• 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
year to date averaged expenditure of £2,608k.
• 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
Employed Locum Agency
79%
16%
5%
Non Clinical Expenditure Current Month
Employed Bank Agency
80%
13%7%
Non Clinical Expenditure YTD Average
Employed Bank Agency
85%
13%
2%
Average Nursing Expenditure Prior Year
Employed Bank Agency
90%
8%2%
Average Medical Expenditure Prior Year
Employed Locum Agency
79%
9%12%
Average Non Clinical Expenditure Prior Year
Employed Bank Agency
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