2017/18 Month 3 Financial. Performance Report

Transcription

1 2017/18 Month 3 Financial 04a Performance Report Author: Tamira Rolls, Deputy Director of Finance Date: 12 June 2017 Version: 1 Sponsoring Executive Director: Huw George, Deputy Chief Executive/Executive Director of Operations and Finance Who will present: Huw George, Deputy Chief Executive/Executive Director of Operations and Finance Date of Board meeting: 27 July 2017 Committee/Groups that have received or considered this paper: Executive Team The Board are asked to: Approve the recommendation(s) proposed in the paper Discuss and scrutinise the paper and provide feedback and comments Receive the paper for information only Link to Public Health Wales commitment and priorities for action: Priorities for action include relevant priority for action(s) Date: 27 July 2017 Version: 1 Page: 1 of 8

2 1 Introduction and Context 1.1 The purpose of this report is to outline to the Executive Team and the Board the month 3 revenue and capital position for the Trust. It will also report on performance against savings plans and the public sector payment policy performance (PSPP). 1.2 As reported previously, the Trust has set a balanced budget for 2017/18, which includes savings of 2.196m. 1.3 The content of this report is reflected in the Director of Finance commentary that has been submitted to Welsh Government on 13 July 2017 as part of the full financial monitoring return for month 3. 2 Summary of Key Financial Targets 2.1 The following table shows performance against key financial targets, along with a risk rating for each one. Further detail for each target is given in the relevant sections of the report. Key Target Balanced Revenue Outturn Projected Year end 000 Balance to Date 86k surplus Risk Green Achievement of Planned Savings 2.196m 0.480m Amber Expenditure within Capital Expenditure Limit (CEL) Public Sector Payment Policy (PSPP) 95% Target 1.820m 0.136m Green 96% 96% Green 3 Financial Position 3.1 The reported position is a net surplus of 86k; summarised in the table below. Annual Budget Budget Actual Variance Type Income -127,271-31,602-31, Pay 77,788 19,429 19, Non Pay 49,483 12,155 12, Grand Total Date: 27 July 2017 Version: 1 Page: 2 of 8

3 3.2 Details of variances by directorate is given in section 4, with further analysis on pay given in section Where there are significant variances within a directorate or division, recovery plans have been requested to be produced within the next 2 weeks. 4 Financial Performance by Directorate Directorate Annual Budget Budget Actual Variance Public Health Services 44,939 11,233 11, Health and Wellbeing 23,899 5,974 5, Policy, Research & International Devt 2, Quality Improvement and Patient Safety 3, Quality Nursing and Other Allied Profs 2, Operations and Finance 7,121 1,780 1, Workforce and OD 1, Board and Corporate 1, Central Budgets -87,266-21,816-21,808 9 ACE's Hub Directorate NHS Wales Health Collaborative (hosted) Grand Total Note: -ve figures indicate underspend (of expenditure) / over-recovery (of income) +ve indicate overspend (of expenditure) / under-recovery (of income) 4.1 Public Health Services ( 45k overspent) Microbiology is 178k overspent to date, which is largely due to higher than anticipated expenditure on laboratory consumables and underperformance against the savings target. This is a combination of additional expenditure as a result of over-activity, and unmet savings on consumables of approximately 50k. As reported in month 2, alternative savings plans are being drawn up. The overspend on non pay is partially offset by an underspend on pay of 99k which is a primarily a result of vacant medical and Specialist registrars (SpRs) posts. This underspend will be reduce significantly in future months as additional locum staff are recruited. Screening is 271k underspent to date, split across pay ( 157k) and non pay ( 109k). As reported in month 2, pay is underspent as a result of vacancies within BTW, CSW and DESW. Non pay is underspent as a result of a lower expenditure level at the beginning Date: 27 July 2017 Version: 1 Page: 3 of 8

4 of the year in line with the operational plan, and expenditure for the year is anticipated to be in line with the total budget. 4.2 Health and Wellbeing ( 159k underspent) The Health Improvement Division is underspent by 213k across both pay ( 65k) and non pay ( 148k). This is a result of slippage against plans within the Early Years, Education Settings and Obesity Prevention (EYESOP) team and vacant posts within the Divisional management team. There is a small net underspend of 17k across the Primary and Community Care and Health Intelligence divisions as a result of expenditure phasing. These underspends are offset by a variance of 71k relating to the vacancy turnover target for the directorate. 4.3 Quality Nursing and Other Allied Professions ( 24k underspent) The Safeguarding service is 22k underspent as a result of vacant consultant sessions and nursing posts. 4.4 Operations and Finance ( 75k overspent) This is primarily as a result of additional non recurring expenditure within Estates as a result of dual running costs within both Mamhilad and Swansea offices, in addition to the non recurring cost of maintaining the Temple of Peace. This non recurring overspend of 77k will be offset by credits released from creditor write backs. 4.6 People and Organisational Development ( 42k underspent) Pay is underspent by 9k as a result of higher than anticipated turnover. This, along with an over-recovery of income ( 14k) for training courses and slippage against the non pay training budget of 18k has resulted in an overall position of 42k underspent. 5. Budget Phasing 5.1 As reported in month 2, the majority of budgets are phased in twelfths to reflect the pattern of income and expenditure across most of the Trust. However, there are several discreet budgets which are phased differently to reflect the timing of this expenditure. These are shown overleaf. Date: 27 July 2017 Version: 1 Page: 4 of 8

5 Area of Spend Directorate Phasing / Allocation Flu Campaign Public Health Services Between Sept and March Public Health Campaigns Central and Health and Wellbeing Between August and March Staff and Public Health Operations and Finance Between November and March Conferences An element of Screening Non Pay Public Health Services Between August and March 5.2 We have been successful in securing additional funding from Welsh Government of 1.5m in 2017/8 for genomics and molecular testing development within Microbiology. Budgets for both income and expenditure will be added from month 4, to reflect the planned spending. 6. Pay Analysis 6.1 The table below summarises all significantly pay underspends by directorate or division, with details of the impact of these underspends given below the table. Directorate Amount Quality, Nursing and Other Allied Health Professionals 34k Public Health Services - Screening 117k Public Health Services Microbiology and Health Protection 113k NHS Quality Improvement 69k 6.2 Quality, Nursing and Other Allied Health Professionals The underspend is primarily within the Safeguarding team and there is no negative impact on the performance to date. As reported previously, plans are in place to increase the number of hours of both consultant and designated nurse to increase capacity for the remainder of the year. 6.3 Screening The Screening division have reported that programme performance is always the top priority, and therefore the pay underspend itself has not had a detrimental effect on performance to date. There is some concern within the division that the effect of having unrecruited posts is having an impact on staff. Date: 27 July 2017 Version: 1 Page: 5 of 8

6 6.4 Microbiology and Health Protection Despite the fact that staffing levels have been adversely affected by recruitment delays and increased turnover, laboratory activity continues to increase and performance indicators met. However, they report that this has had an impact on laboratory staff, and there are therefore plans in place to increase the number of staff, including additional locum medical staff. 6.5 NHS Quality Improvement The underspend is a result of slippage against planned recruitment to senior management posts within the new structure. There is flexibility built into the plans for the directorate to increase the level of non pay expenditure to ensure that the operational plan remains on target. 6.6 Agency and locum costs for the year to date are 382k, equating to 2% of total pay expenditure. This is higher than the levels in 2016/17 (1.5%), primarily due to difficulty in recruiting microbiology consultants and the resulting locum costs. 7. NHS Wales Service Level Agreements (SLAs) and Long Term Agreements (LTAs) 7.1 All SLAs for 2017/18 have been issued, however the following remain unsigned by both parties as at the end of June 2017: Area Microbiology (PHW Income) Screening (PHW Expenditure) Organisation Cardiff & Vale HB Aneurin Bevan UHB Abertawe Bro Morgannwg UHB Hywel Dda UHB Powys Teaching HB Velindre NHS Trust Betsi Cadwaladr Aneurin Bevan 7.2 The delay in agreeing the remaining SLAs is due to queries regarding specific narrative in the documents, which is being addressed as a matter of urgency, and Public Health Services report there are no issues relating the financial element. 7.3 Payment is being received for services provided and we will monitor any issues as part of our normal debtor management processes. Date: 27 July 2017 Version: 1 Page: 6 of 8

7 8. Forecast Position 8.1 The Trust is currently anticipating a breakeven position, in line with the 2017/18 budget, with the following risks and assumptions: Assumption Saving plans will be achieved Microbiology overactivity expenditure will be offset by income Amt Risk Further Details 2.196m Medium Currently reviewing several Microbiology and Health Protection savings plans (approx 500k) as risk of non achievement has been assessed to be high. Alternative plans are currently being drawn up for this element of the savings plan. As all other plans are low risk, the overall rating is set at medium 140k Medium It is anticipated that there will be a similar level of over-activity in 2017/18 as in previous years. The SLAs include a section on over-activity, and so once these are signed, the risk will be lowered to Low. 9. Balance Sheet and Cash Flow 9.1 There are no issues to report on the balance sheet. The cash balance of the Trust is 6.114m, an increase of 1,986k over the opening balance. This increase is a result of a lag in the receipt of invoices from NHS Wales organisation for Screening SLAs in addition to necessary delays in making grant payments to local authorities for various health improvement programmes in line with the required monitoring process. 9.2 The net current assets of the Trust are 3.3m. There are no NHS debtors over 17 weeks. 10. Capital Programme 10.1 The table overleaf summarises the Trust capital funding for 2017/18, along with expenditure to date. Date: 27 July 2017 Version: 1 Page: 7 of 8

8 Total Capital Funding as at Month 3 Plan Exp Strategic Capital: Cervical Screening Wales Informatics System (CSIMS) Strategic Capital Sub Total Discretionary Capital: IM&T Replacement Programme Our Space phase 2 (building works / furniture) Our Space phase 2 (IM&T inc VC and AV) 111 Microbiology Equipment Replacement Programme 150 DESW Van Replacement Programme 150 Total Unallocated 321 Total Discretionary Capital 1, Total Approved Capital Funding Received to Date 1, Conclusion 11.1 The month 3 position for the Trust is a small surplus of 86k on revenue The Trust forecasts a breakeven position in accordance with its financial strategy and the assumptions within the IMTP. Date: 27 July 2017 Version: 1 Page: 8 of 8