Finance & Performance Committee

Size: px

Start display at page:

Download "Finance & Performance Committee"

June Lindsey
5 years ago
Views:

Finance & Performance Committee MINUTES of a Meeting held on 23 rd June 2014 at 10.

1 Finance & Performance Committee MINUTES of a Meeting held on 23 rd June 2014 at in the Norwich Room, Elliot House PRESENT: Derek Allwood (Chair) Non-Executive Director DA Roy Clarke Director of Finance RC Alex Robinson (Vice-Chair) Non-Executive Director AR Paul Cracknell Director of Strategy and Transformation PC Matt Colmer Director of Performance and Information MC APOLOGIES: Anna Morgan Director of Nursing, Quality and Operations AM IN ATTENDANCE Tony Ing Associate Director of Finance TI Mark Easton Interim Chief Executive Officer ME Marcia Perry Deputy Director for Nursing, Quality & Ops MP Fotoula Blias Smoking Cessation Team FB Minutes Sharon Buxton EA to Director of Finance SB 1 Chairman s Welcome Action Date 14/513 The Chair opened the meeting, welcoming all attendees. 2 Apologies for Absence 14/514 As above. 3 Declarations of Interest 14/515 No new declarations were given. 4 Minutes from the Previous Meeting: 27 th May /516 Minute reference 14/396 the bullet point beginning c2000 staff is to be re-worded 14/517 Minute reference 14/415 reference to in-city is incorrect amend to in-county. 14/518 Subject to the above amendments, the Committee AGREED the minutes to be a true and accurate record of the meeting. RC SB Matters Arising and Action Log 14/519 The Committee reviewed the matters arising from the minutes and the relevant comments against the agreed actions and CONFIRMED that the necessary assurance has been obtained concerning the actions already taken. 14/520 The following actions were deemed closed: 285, 288 and 289. Further Page 1 of 7

2 updates to actions were: 14/521 Actions 290 LAC city/county information: MC informed the Committee that NCH&C are not responsible for reporting on out of city/county children; that the other provider organisation is deemed responsible. MC continued that the Trust does have the figures for all 3 variations and will bring a report to the next meeting for information purposes. ACTION CLOSED. 14/522 Action 291: LAC Epilepsy service: MC noted that the breach was due to 1 child (out of 4) being seen later than 25 weeks. There were good and valid reasons for this and it was therefore not reported as a breach. ACTION CLOSED. 14/523 Action 292: CIP PMO individual schemes: PC and AR held a meeting to discuss the concerns noted at the previous meeting. The ACTION IS CLOSED, but it was noted that the Committee should continue to review the issue. 14/524 Action 293: Reference to QRAC in Estates Strategy: PC noted that the sustainable steering group do not report to QRAC. The Group s annual report is due to be reviewed at the Trust Board meeting in July and it is anticipated that a decision will be made where the Group is to report to. ACTION CLOSED. MC /525 Smoke free Norfolk Consultation 2014: FB informed the Committee that a copy of the consultation will be presented to Local Liaison Group (LLG) today. She noted that there had been some delays around job matching and a cancelled LLG meeting. 14/526 FB noted that the service redesign included the appropriate job descriptions that will ensure the post holders will drive referrals. GP practices are to be targeted to promote costs savings e.g. on individual prescription charges. 14/527 FB informed the Committee of concerns about the number of referrals and that the Commissioners have been advised. It was noted that the West CCG will set targets to GP practices to ensure more referrals. 14/528 Further general discussion ensued around work being undertaken nationally; no actions were noted. 6 Annual Work Plan 14/529 The Committee discussed whether 2.3 Smoking Cessation should be reviewed in July and decided that a written update should be presented. SB to inform FB. The Committee also agreed that item 2.3 should be added to the December meeting. SB Financial Position of Month 2 14/530 RC presented the financial position of the Trust as at Month 2, stating that the Trust generated an in-month surplus of 207k in May, which is 86k ahead of plan. This was driven by: 14/531 Favourable variances in reserves of 150k, income of 138k, pay of 133k (including an underlying 41k adverse relating to CIP underachievement), and depreciation of 31k. 14/532 These were offset by adverse variances in non-pay of 366k, of which 200k related to CIP underachievement. 14/533 Cumulatively, the Trust has generated a surplus of 359k, which is 101k ahead of plan. Driven by favourable variances of: Page 2 of 7

3 - Reserves of 368k - Income of 297k - Pay of 21k (including an underlying 69k adverse relating to CIP underachievement) - Depreciation of 40k and - PDC dividend expense of 1k. These are offset by adverse non-pay variances of 626k (of which 430k related to CIP underachievement). 14/534 Liquidity has increased to 40.2 days (excluding the working capital facility) from 38.3 days. 14/535 The resulting Financial Risk Rating for the Trust is 3 and Continuity of Service rating is 4, both in line with plan. 14/536 The Trust is forecasting its outturn net surplus for the year in line with the plan at 1.8m. The key risks to the achievement of the financial plan relate to the underachievement of CIP and un-mitigated cost pressures. 14/537 RC informed the Committee that the favourable variance in pay costs is due to a small increase in vacancies alongside a reduction in bank and agency costs. 14/538 The improvement in liquidity wa due to increased levels of income and lower levels of capital expenditure compared with plan. 14/539 The Trust has managed to maintain its run rate. It is in the right place for the wrong reasons. CIP is 459k down because plans are failing and there are still planning gaps. Cost pressures are impacting on the position because no mitigation is in place. 14/540 The 1.8m surplus is still deliverable if the Trust gets the CIP plans back on track and cost pressure mitigation plans in place. This will require 2m of mitigation plans and assumes the Trust does not need to deploy its reserves. 14/541 The Committee then challenged and discussed the report in more detail. Points of note: 14/542 AR noted his concerns that once again, it is a familiar situation in that there is not enough CIP progress. AR stated that it appears that the Trust could save money, but is failing to deliver plans. 14/543 It was agreed that the Committee would deal with this issue further into the agenda when the CIP PMO report was reviewed. 14/544 The Committee then discussed issues around cost pressures, mitigation plans and triangulation with performance to review specific units. 14/545 It was noted that the 3 main cost pressures are admin, specialist and children. Further discussion ensued around the CIP gap and gateway 3 and Trust models used. 14/546 The Committee considered Podiatric Surgery noting the final clinical model was still awaited. The NNUH was not bound to provide a guaranteed level of capacity in terms of theatre space. The consultant does the patient assessment and then does the surgery, if assessed as necessary. 14/547 The Committee then undertook a general discussion around reserves and delivery plans 14/548 Page 15: Waterfall diagram: CQUIN: RC noted that the Commissioners have been advised to be harsh about the release of CQUIN reserves. The Trust has reserves for a 750k failure, but should the Trust reach 90%, the funding could be released. RC continued that in previous years, the Trust did achieve the figure. 14/549 MP informed the Committee that a monthly group has been set up to review and discuss the 92 schemes for this year, which is twice as many Page 3 of 7

4 as last. There is a robust reporting mechanism and all CQUIN leads attend. 14/550 The Committee asked for, and received, further clarification around a few points including reference to: PDC dividends Debtors Specialist Services being split across other ADs 14/551 Page 17 CIP Programme Summary: RC explained that the lines on the graph denote: Blue estimation of plan Red Gateway 3 plans Purple budget statements 14/552 The discussions ended with the Committee noting that the gap between delivery and plans is of concern. 14/553 The Committee NOTED the Financial Position of the Month 02 report. 8 CIP Financial Overview 14/554 RC informed the Committee that the total CIP delivered in May was 340k, all of which were recurrent savings. The in-month performance represents an under-achievement of 241k against the budgeted target of 581k. 14/555 Cumulative CIP delivery as at the end of Month 2 is 685k of which all are recurrent savings. This results in a year to date 499k adverse variance against the target of 1,184k. 14/556 The forecast recurrent CIP out-turn is 3,443k, which is 2,057k below the 5,500k full year target. The recurrent out-turn deficit comprises a planning gap of 1,238k and a delivery gap of 819k. 14/557 RC stated that the CIP position will be classed high and red on any indices and that close scrutiny is required. RC noted that the report includes a new pack that is used at EDT and offers a different view of all figures. RC asked whether this version would be useful to the Committee and which information should be used in future reports. 14/558 RC informed the Committee that an extraordinary TMT meeting took place where information was reviewed line by line and scrutinised in detail. There were also a number of month 2 budget meetings set up in the form of a review and road show. 14/559 ME noted that the top 5 leads from the Transformation Board will be attending the EO TMT meeting to provide assurance and discuss any slippage. 14/560 A presentation was given at the management forum that is being used in the Month 2 budget meetings. A re-design of documents and agenda for the Transformation Board is also under way to assist, moving forwards. 14/561 ME noted that the budget meetings will continue throughout the year and at the end of each meeting, a revised budget is put into action plans for further work. 14/562 AR noted his concerns around inheriting the same problems year on year and questioned when it would be appropriate to discuss a more radical way forward. 14/563 ME stated that the timing is key and that currently the Trust is not at this stage. 14/564 The Committee entered into discussion around failure; points of note: Other organisations do not reach 4% delivery The NHS has flat budgets There is no proof that the gap cannot be closed yet Page 4 of 7

5 PwC will be confirming the timescales for their work around sharing national information NCH&C is a strong organisation compared with others in Norfolk Differences between localities and number of plans. 14/565 MP assured the Committee that a clear process is followed when assessing schemes and clinical risk mitigations are planned, following comments and examples noted from the Cost Pressure Mitigation Report. 14/566 The Committee NOTED the Month 2 CIP performance of the Trust as at 31 st May 2014 report. 9 Performance Report 14/567 MC presented the report stating: Podiatric Surgery: 7 breaches due to staffing issues and the cancelling of sessions by NNUH. A contract query notice has been raised by Commissioners and the Medical Director has been contacted to liaise with NNUH. 14/568 Specialist Epilepsy: the breach has not raised a contract query. 14/569 MSK Physio: A demand and capacity plan has been given to the Commissioners for further discussion. A meeting is to be arranged by Commissioners following their cancellation of the previous one. 14/570 KPI s agreed with Commissioners are c200, which is less than last year. There is a better understanding and a report will be provided at the next meeting for review. MC noted that 20 KPI s have not been met, but the reasons for not achieving are valid. 14/571 The Committee then discussed and challenged the report; points of note: MP will investigate why the SIRI 40 days reports are currently showing red on page 3 14/572 Figures around mandatory training, PDP s and sickness are reported retrospectively due to issues around data input and reporting. PC noted that controls are in place and the Trust are aware of why some targets are being missed 14/573 Children in Care It was noted that the Commissioners are aware of this issue; the red figures (page 3) are around patient choice. 14/574 MC noted that item 2a (page 1) is entering phase 2 and that MONITOR will be expected to request why the Trust has not yet hit the trajectory during the Foundation Trust process. 14/575 The Committee NOTED the Performance Report. MC MP Investment Group Minutes/Chair s Report 14/576 Minute reference 14/313 WAN project RC informed the Committee that there were existing issues with BT, but that Virgin are working to address them. It is anticipated that the project will finish in time and on budget. 14/577 PC noted that extraordinary meetings had been held to discuss the Cambridgeshire project. DA will provide a note to the Trust Board in this regard. 14/578 The Committee NOTED the minutes and Chair s report. DA Page 5 of 7

6 12 CIP PMO Report 14/579 PC presented the report noting that the control process has been enacted and the updated profile is covered in the paper. 14/580 The Committee discussed and challenged the report noting: A good report that illustrates actual organisation change Closure is the end of the mitigation strategy CIP schemes continued to be monitored, even though closed, to track benefits 14/581 AR noted that project delays are due to staff issues (pages 6, 7 and 8) PC informed the Committee that reductions are expected and that more details will be available at the next meeting. 14/582 AR asked if the Continence Service is a priority. PC explained that the profile has risen and there has been a drive to accountability. PC offered to the Committee before the next meeting with an update. 14/583 The Committee discussed the CNT readiness (page 11) noting that a meeting had been arranged tomorrow to address the gaps and to reschedule milestones. Notes resulting from the discussion are: Explicit reporting moving forwards to raise the profile and accountability Cash release and organisation improvement/change Children s schemes are disrupted due to management changes The North hub is not yet business as usual but will be soon Teething issues relating to the North hub are being cascaded to other hubs for information/action. 14/584 The Committee then discussed the benefits realisation (page 10); points of note: Logging in issues are being monitored and work is underway to inform staff of processes around mobile access prior to their rollout Black spots when using sim cards and netbooks are monitored and reported monthly via the IM&T Programme Board 14/585 Issues around (page 7) non-clinical support services were briefly discussed and the Committee were informed that a meeting has been arranged for tomorrow to review and understand the issues further. 14/586 The Committee NOTED the CIP PMO report. PC PC QUIPP 6 monthly report (renamed: System Update/Horizon Scanning) 14/587 PC presented the report and the Committee discussed and challenged; points of note: Examples should be given regarding the better care fund Funding has not yet been released 14/588 Further general discussion took place around: CCGs Planning Funding (King s Fund and Better Care Fund) Urgent Care Network No actions were taken. Page 6 of 7

7 14 Any Other Business 14/589 The Committee then reviewed the additional paper: Cost Pressure Mitigation 14/590 PC presented the paper stating that the mitigation proposals relate mainly to the most significant cost pressures - those that are over 50k. The document confirms the process and financial mitigation to be discussed at the Trust Board. 14/591 Initial comments included reference to the Continence Service and subsequent funding issues. These posed some uncertainty and the Committee asked that RC and MP meet outside of the meeting to discuss further and provide an update next time. 14/592 RC stated that the report is written in this way as it takes into consideration the complex staffing issues. 14/593 Following more discussion, it was agreed that a one page update report is included in the PMO report moving forward. 14/594 ME stated that the TMT meetings around major CIP schemes and the introduction of the monthly budget meetings will ensure the Trust is better equipped to know the issues and what else needs to be completed moving forwards. RC/ MP PC /595 No other business discussed. Date and Time of Next Meeting: Monday 28 th July Norwich Room, Elliot House DEADLINE FOR PAPERS AND ACTION LOG COMMENTS: ON FRIDAY 18 th July 2014 The meeting ended at Minutes signed by:... Print name:... Date:... Page 7 of 7

BOARD OF DIRECTORS COVER SHEET PART 1. DATE: 30 January Subject: CHARITABLE FUNDS EXPENDITURE OVER 25,000

BOARD OF DIRECTORS COVER SHEET PART 1 DATE: 3 January 219 Agenda item: 11 Paper: F Subject: CHARITABLE FUNDS EXPENDITURE OVER 25, Prepared by: Presented by: Purpose of paper Background Key points for Board