Finance Assurance Report. March 2017

Transcription

1 Finance Assurance Report March

2 Executive summary Key Financial Information I&E Year to Date Budget Actual Variance m m m Income Pay Non pay Unallocataed costs / efficiencies EBITDA ITDA Operating surplus Exceptionals Net Deficit Cash flow Year to Date Plan Actual Variance m m m Deficit from operations Depreciation/Impairments Working capital movements Cash from operations Capital expenditure Disposal proceeds Financing Increase/(decrease) in cash The current Trust position, shows a adverse variance of 0.4m in month and 0.8m full year. On a control total basis the trust has over achieved by 2.2m; this is primarily due to the non-recurrent financial benefits received in year. The trust continues to have an underlying deficit that needs to be addressed in the new financial year. KPI s (UOR) YTD actual Ytd Plan Indicator Detail Rating Detail Rating Capital service cover Liquidity (days) I&E margin (%) I&E margin variance (%) Agency Metric % Use of Resources Rating 3 3 2

3 Income and expenditure Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Income 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s Clinical services contracts 14,134 13,654 13,487 13,447 13,368 13,448 13,195 13,119 13,191 13,269 13,275 13,268 14,029 Other Clinical Income Other Non-Clinical Income Pass Through Income Sustainability & Transformation Fund ,041 Total Income 15,744 14,882 14,699 14,649 14,707 14,746 14,738 14,628 14,602 14,809 14,600 14,527 18,649 Pay Administrative & Clerical Staff 1,408 1,427 1,450 1,453 1,475 1,450 1,435 1,478 1,450 1,461 1,425 1,476 1,384 Medical Staff 1,369 1,282 1,296 1,265 1,314 1,358 1,371 1,431 1,311 1,332 1,220 1,220 1,061 Nursing Staff 3,860 3,985 3,920 3,995 3,934 3,927 3,903 3,864 3,914 3,847 3,839 3,813 3,812 Healthcare Assistants 1,395 1,425 1,386 1,401 1,410 1,385 1,397 1,416 1,372 1,359 1,327 1,344 1,325 Other staff pay Professions allied to medicine 1,401 1,385 1,422 1,404 1,417 1,401 1,417 1,431 1,418 1,416 1,399 1,414 1,399 Senior Managers ,050 Scientific, Therapeutic & Tech Total Pay (excl exceptional costs) 11,183 11,503 11,437 11,515 11,532 11,493 11,568 11,595 11,480 11,420 11,156 11,278 11,102 Non Pay Supplies & Servs - Clinical 1, , , Supplies & Servs - General Establishment Expenses Other Expenses Premises 1,573 1,100 1, , ,118 1, ,015 1,033 1,308 Pass Through Costs Total Non Pay 4,581 3,287 3,320 2,433 3,626 3,412 2,769 3,542 3,183 2,339 3,348 3,126 4,394 EBITDA (excl exceptional costs) (20) 92 (58) 701 (451) (159) 401 (509) (61) 1, ,153 EBITDA margin (excl exceptional costs) -0.1% 0.0% -0.4% 4.8% -3.1% -1.1% 2.7% -3.5% -0.4% 7.1% 0.7% 0.8% 16.9% Interest Received (1) PFI Interest Paid Fin Lease Paid Depreciation PDC Dividend (42) Net surplus/(deficit) (excl exceptional costs) (545) (413) (564) 195 (990) (679) (126) (1,014) (577) 529 (423) (373) 2,828 I&E surplus/(deficit) margin 1.2% -0.4% -3.8% 1.9% -3.1% -4.6% 15.2% 18.2% 0.0% -2.2% 15.2% 18.2% 0.0% (Gains)/Loss on disposals (600) (46) Impairments 1, ,383 Reversed Impairments (285) (155) Donations (146) Restructuring costs (19) (47) 19 0 (3) 184 Net surplus/(deficit) (1,948) (413) (139) 195 (1,213) (679) (333) (995) (530) 411 (377) (374) (909) I&E surplus/(deficit) margin -12.4% -2.8% -0.9% 1.3% -8.2% -4.6% -2.3% -6.8% -3.6% 2.8% -2.6% -2.6% -4.9% Commentary Income has increased by 4.1m in month; this is primarily due to 0.5m from Q4 STF plus a 1.5m STF bonus, 0.6m from the CCG for CQUIN, 0.5m for the new MH assessment service funded by PCC Monthly pay costs have decreased by 0.2m this is due to an adjustment to the annual leave accrual. There is a reclassification between Senior Managers and Medical staff that offset each other. Non Pay costs have increased by 1.3m in month the main reasons are: prior year IT SLA with NCUH 0.3m, impairment of receivables 0.3m, various premises costs 0.3m and 0.2m legal provisions At Month 12 agency expenditure is 6.2m, exceeding the Trust s 4.6m annual agency cost ceiling by 1.6m 3

4 Balance sheet Balance Sheet at: 31/03/ /02/ /03/2016 m m m Fixed assets Assets held for sale Debtors Cash and bank Current assets Creditors (21.8) (20.7) (24.1) Provisions (current) (1.1) (1.0) (1.0) Current liabilities (22.9) (21.7) (25.1) Net current assets (7.9) (8.0) (4.8) Long-term liabilities (8.5) (7.3) (7.6) Net assets Capital expenditure Trade debtors Capital and reserves PDC Income & expenditure Revaluation reserve At the end of March, the invoiced debtor position had decreased by 2,211k to 3,147k. Overdue debts decreased by 2,798k, primarily as a result of NHS England and Cumbria CCG settling several previously queried invoices. The total value of overdue invoices is 1,120k, with the most significant overdue balances being within the NHS (Cumbria CCG 256k; NHS England 147k; UHMB 138k). Following detailed review of our capital program and reflecting the 1m external funding obtained the Trust has confirmed an expected capital spend of 4.8m in 16/17. This reflects the significant planned expenditure in March. The Trust spent 2.4m in month 12 compared with 2.4m in months 1 to 11. Major items of spend in month were 1.2m of software licences, 0.4m on Hadrian developments and 0.3m on Yewdale developments. The Trusts cash balance now stands at 5,650k, an increase of 1,493k from 28 February ( 4,157k). This improvement is as a result of receiving 1,309k distress funding during March, as well as NHS England and Cumbria CCG settling several high value outstanding invoices. The cash flow forecast chart in the Executive Summary details the flow of cash until mid July, and it is forecast that further cash funding will be required in May ( 0.5m) and June ( 0.9m). 4

5 Care Group and Directorate performance Care Group/ Directorate YTD* m Childrens (0.2) Comm Serv 0.7 Mental Health (2.7) Specialist (0.8) Ops Mgt 0.2 DoFSS 1.7 DoQN (0.3) DoWF&OD 0.2 Med Director 0.1 Corp and others 0.9 * Variance in year to date spend against budget; figures in brackets indicate an overspend. 5

6 Efficiency Programme Key points: - Target for 16/17 Efficiency Schemes is 5.8m, - Outturn achievement is 6m, an overachievement of 0.2m m (46%) of the Efficiency Schemes achieved in 16/17 were non-recurrent. - Operations achieved 91% of their target, of which 85% were recurrent schemes. - Support Services achieved 122% of their target, of which 23% were recurrent schemes. 6

7 Control totals against Normalised Spend 7

8 Glossary of terms Term Explanation (italicised words have their own definition) Bank Temporary staff who provide cover for planned and unplanned shortfalls in staffing BCT Better Care Together (system-wide transformation programme in N Lancs and S Cumbria) CCC Cumbria County Council CCG Clinical Commissioning Group (unless otherwise specified, Cumbria CCG) CIP Cost Improvement Programme (savings targets) CMHART Community Mental Health Access and Recovery Team CoIN Community of Interest Networks CQUIN Commissioning for Quality and Innovation (a mechanism for commissioners to link a proportion of income to the achievement of locally agreed quality improvement goals CSRR Continuity of Services Risk Rating (Monitor s rating of the Trust s financial health (liquidity and debt levels), and therefore ability to continue to deliver services) CV Contract Variation DoFSSS Director of Finance, Strategy and Support Services DoO Director of Operations DoQN Director of Quality and Nursing (and department) EBITDA Earnings Before Interest Tax Depreciation & Amortisation (a standard measure of operating surplus / deficit) FP10 Prescriptions issued for patients in community settings FSRR Financial Sustainability Risk Rating (NHS Improvement s rating of the Trust s financial health (liquidity, debt levels, surplus margin, and achievement of plan)). HCA Healthcare Assistant HV Health Visitor / Health Visiting IM&T Information Management and Technology ITDA Interest Tax Depreciation and Amortisation; non-operating costs, in the Trust s case mainly depreciation, PDC dividend and PFI interest LIFT Local Improvement Finance Trust, a public private partnership mechanism for funding estates developments Liquidity The extent to which the Trust has cash to meet immediate and short-term obligations, or assets that can be quickly converted to do this Locum Temporary replacement medical staff MD Medical Director N3 New Networks for the NHS NCUH North Cumbria University Hospitals NHS Trust NHS E NHS England NHS I NHS Improvement Ops Mgt Operations Management directorate PDC Public Dividend Capital (the Department of Health s equity interest in the assets of the Trust); the Trust pays the Dept an annual dividend of 3.5% of net assets (less cash) PFI Private Finance Initiative (private sector funding/managing of public expenditure projects) Reserves Budgets set aside for specific purposes or contingencies, and not yet allocated to a specific code SR Success Regime (system-wide transformation programme in W E and N Cumbria) STF / STP Sustainability and Transformation Fund / Sustainability and Transformation Plan TMG Trust Management Group WF&OD Workforce and Organisational Development (directorate) YTD Year to date Protected characteristics Please assess the relevance of the content of this executive paper against the 9 protected characteristics from the Equality Act 2010 and assess the relevance as: or Relevant Low / Medium / High. If not please provide a statement saying why in the explanatory notes section If low, medium or high please provide a statement in the explanatory notes section setting out what the implication could be and what action will be taken to address the implications Protected Characteristic 1.Race 2.Religion / Spirituality 3.Gender 4.Disability 5.Sexual Orientation 6.Age 7.Pregnancy / maternity 8.Gender Reassignment 9.Marriage and Civil Partnership Relevance Explanatory es The paper neither omits or reinforces any of the protected characteristics so therefore is not. 8

9 Annex 1 This Month Budget This Month Actual This Month Variance fav/(adv) 16/17 YTD Actual 16/17 YTD Variance fav/(adv) Annual Budget 16/17 YTD Budget 15/16 YTD Actual 000s Income 000s 000s 000s 000s 000s 000s 000s 159,477 Clinical services contracts 12,643 14,029 1, , , ,145 5,659 Other Clinical Income ,659 7,101 1,442 6,477 6,320 Other Non-Clinical Income ,320 6, ,286 3,389 Pass Through Income ,389 3, ,960 Sustainability & Transformation Fund 163 2,041 1,878 1,960 3,511 1, ,805 Total Income 14,112 18,649 4, , ,237 3, ,409 Pay 17,310 Administrative & Clerical Staff 1,422 1, ,310 17,359 (49) 16,186 14,610 Medical Staff 1,199 1, ,610 15,460 (850) 14,926 48,943 Nursing Staff 3,862 3, ,943 46,754 2,189 49,096 15,477 Healthcare Assistants 1,268 1,325 (57) 15,477 16,548 (1,071) 16,343 4,159 Other staff pay ,159 3, ,534 17,356 Professions allied to medicine 1,399 1, ,356 16, ,101 9,403 Senior Managers 785 1,050 (265) 9,403 9,815 (412) 8,897 10,343 Scientific, Therapeutic & Tech (138) 10,343 10,566 (223) 6, ,601 Total Pay (excl exceptionals) 11,085 11,102 (17) 137, , ,442 Non Pay 7,620 Supplies & Servs - Clinical (22) 7,620 9,098 (1,478) 11,482 3,733 Supplies & Servs - General (484) 3,733 4,498 (765) 3,942 5,751 Establishment Expenses (19) 5,751 6,236 (485) 6,529 3,136 Other Expenses (612) 3,136 4,294 (1,158) 4,577 12,988 Premises 977 1,308 (331) 12,988 11,264 1,724 14,886 3,389 Pass Through Costs ,389 3, ,617 Total Non Pay 2,926 4,394 (1,468) 36,617 38,779 (2,162) 41,917 1,038 Unallocated costs , ,038 0 (836) Unallocated Efficiency Programme (87) 0 (87) (836) 0 (836) Total Unallocated Costs (1) 0 (1) ,385 EBITDA (excl exceptionals) 102 3,153 3,051 2,385 4,379 1,994 (1,950) 1.3% EBITDA margin (excl exceptionals) 0.7% 16.9% 16.2% 1.3% 2.4% 1.1% -1.1% (20) Interest Received (1) (1) 0 (20) (26) (6) Interest Paid (PFI & finance leases) Fin Lease Paid 0 3 (3) 0 14 (14) 0 4,015 Depreciation ,015 3, ,223 1,700 PDC Dividend 142 (42) 184 1,700 1, ,674 Net surplus/(deficit) (3,875) (excl exceptional costs) (422) 2,828 3,250 (3,875) (1,603) 2,272 (7,391) -2.2% I&E surplus/(deficit) margin -3.0% 15.2% 18.2% -2.2% -0.9% 1.3% -4.3% 0 Impairments 0 3,383 3, ,383 3,383 1,533 0 Reversed Impairments 0 (155) (155) 0 (155) (155) 1,533 0 (Gain)/Loss on disposal (218) (218) 0 0 Donations (146) 650 Restructuring costs (4,525) Net surplus/(deficit) (476) (909) (433) (4,525) (5,353) (828) (8,822) -2.6% I&E surplus/(deficit) margin -3.4% -4.9% -1.5% -2.6% -3.0% -0.4% -5.1% Commentary Income has over achieved plant for the full year by 3.4m. The main causes are: Other clinical income from the Police & Crime Commissioner 0.9m, market rent adjustment 0.3m and a 1.5m STF bonus. Pay costs are 0.5m underspent for the year. A substantial underspend in Nursing ( 2.2m) is offset by overspends elsewhere, especially HCAs ( 1m) and Medical staff ( 0.9m) caused by agency staff. Non pay costs are 2.1m over budget despite 3m of non recurrent benefits. Significant pressures beyond plan include agency manged service fee 0.5m, legal costs of 0.6m mainly relating to Workington PFI (including forward provisions), 0.3m provision for doubtful debts, cost pressures in Supplies & Services Clinical including medical stock, clinical services received and sexual health test costs). To some extent these reflect historic under budgeting which has, where appropriate, been addressed in the 2017/18 budget. The dual running of the N3/CoIN network contract is causing a non recurrent pressure of 0.4m. IM&T slippage and reversal of prior year premises accruals (both non-recurrent) partially offset the pressures noted above. 9