Integrated Performance Report: Strategic Overview. Month /12

Transcription

1 Integrated Performance Report: Strategic Overview Month /12

2 Table of Contents Introduction... 3 KPI Dashboard... 4 Integrated Performance Report : Strategic Overview... 7 Glossary... 10

3 Dear Board Member/Reader Introduction Welcome to the Trust s Integrated Performance Report: Strategic Overview for month /2012 (January 2012 information). The integrated performance strategic overview report is a key tool to provide assurance to the Board that the strategic objectives are being delivered and to direct the Board s attention to significant risks, issues and exceptions. The Trust continues to improve its performance framework to deliver the Trust IM&T strategy of right information in the right format at the right time. Performance reports are now available as electronic documents that allow the reader to look at performance from different perspectives and at different levels within the organisation. Work is ongoing to agree and incorporate the mental health and community Key Performance Indicators for 2012/13. Reports include a performance dashboard, built around a balanced score card set of KPIs, together with a high level dashboard overview. All performance dashboards use the Trust s balanced score card that enables performance to be discussed and assessed with respect to: Business Strategic Performance Impact & Delivery Customer Focus Operational Effectiveness Process Effectiveness Fit for the Future - Workforce KPIs provide a high level view of actual performance against target and assurance to the Board about the delivery of the strategic objectives. All KPIs adhere to the following principles: Makes a difference to measure each month Focus on change areas Focus on risk Key to organisational reputation Variation matters Produced by Performance & Information Page 3 of 10

4 Trust Board Performance Dashboard Vital Signs (Month /12) Business Strategic Performance: Impact & Delivery Month /12 Section KPI Target Current Position Status Trend Assurance Level Comments Monitor Compliance Monitor Governance Risk Rating (FT) Green Amber/R Monitor Finance Risk Rating (FT) CQC CQC Quality Regulations (compliance breach) CQUIN IAPT CQUIN Barnsley Green Amber/Gr CQUIN Calderdale Green Amber/Gr CQUIN Kirklees Green Amber/Gr CQUIN Wakefield Green Amber/Gr Forensic CQUIN Green Green % SU Assessed Within 4 Hours of Referral (Urgent) 85% 84.3% % SU Assessed Within 14 Days (Routine) 65% 68.7% % New Referrals to PTS Assessed Within 14 days 90% 67.4% % New Referrals to PTS Treated Within 18 weeks 90% 89.5% 2 Total Number of People Entering Treatment Total Number of People Supported Back into Employment The number of people who 'moved to recovery' Inf' Prevent' Infection Prevention - currently excludes Barnsley PSA Outcomes % SU on CPA in Employment 10% 7.6% 2 % SU on CPA in Settled Accommodation 60% 70.1% Produced by Performance & Information Page 4 of 10

5 Customer Focus Month /12 Section KPI Target Current Position Status Trend Assurance Level Comments Complaints % Complaints with Staff Attitude as an Issue < 30% 19% 4 9/47 issues exc. compliments MAV Physical Violence - Against Patient by Patient Green Green Physical Violence - Against Staff by Patient Green Green Equality % of Policies, Strategies, Services and Functions Subject to EIA 100% 100% 4 FOI % of Requests for Information Under the Act Processed in 20 Working Days 100% 100% 4 18 Requests received Media % of Positive Media Coverage Relating to the Trust and its Services > 60% 74% 4 Member's Council Membership Befriending services % of Publicly Elected Council Members Actively Engaged in Trust Activity > 50% 63% % of Quorate Council Meetings 100% 100% % of Vacancies Carried by Members Council < 10% 18% 3 % of Population Served Recruited as Members of the Trust 1% 1.3% % of Active Members Engaged in Trust Initiatives > 50% 40% % of Service Users Allocated a Befriender Within 16 Weeks > 70% 67% % of Service Users Requesting a Befriender Assessed Within 20 Working Days > 80% 100% % of Potential Volunteer Befriender Applications Processed in 20 Working Days > 90% 100% 4 SU experience Service User Experience (% Positive Feedback) > 75% 93.5% 3 Quality/compliance report Community % SU on CPA Offered a Care Plan (AWA & OPS) 80% 83.7% 3 SIs SIs TBD 2 3 Quality/compliance report Produced by Performance & Information Page 5 of 10

6 Operational Effectiveness; Process Effectiveness Month /12 Section KPI Target Current Position Status Trend Assurance Level Comments NICE Guidance Implementation 4 Criteria Green 3 Quality/compliance report Number of all Incidents Involving Restraint N/A 316 Quality/compliance report Quality Number of Unique SU Subject to Seclusion N/A 32 Quality/compliance report Number of Incidents of AWOL (Detained Patients) N/A 44 Quality/compliance report Adult Safeguarding Training 80% 70% 3 Quality/compliance report Inpatients Delayed Transfers Of Care (DTOC) (Monitor) < = 7.5% 3.9% % Admissions Gatekept by CRS Teams (Monitor) >90% 92.5% % SU on CPA Followed up Within 7 Days of Discharge (Monitor) 95% 97.7% Community % SU on CPA Having Formal Review Within 12 Months (Monitor) > 95% 96.8% EIP Service - New Cases (PCT) (Monitor) > 95% 206.3% % Inpatients (All Discharged Clients) with Valid Diagnosis Code 99% 95.5% Data Quality Monitor Data Quality: Identifiers 99% 99.6% Monitor Data Quality: Outcomes 50% 79.8% % CPA clients with HoNOS recorded in the last 12 months (Monitor) 50% 75.7% Delivery of CIPs Finance Cash Position In Month Better Payment Practice Code 95% 90 3 Report Deliver Report Time Delivery 10 WD 10 WD 4 Fit for the Future; Workforce Month /12 Section KPI Target Current Position Status Trend Assurance Level Comments Appraisal % of Staff Who Have Had an Appraisal in the Last 12 Months >=80% Sickness Sickness Absence Rate (YTD) <=4.25% Vacancy Vacancy Rate 10% M T Mandatory Training TBD Produced by Performance & Information Page 6 of 10

7 Integrated Performance Report: Strategic Overview Flawless Execution OVERVIEW Month 10 Performance Dashboard 1.0 CQC 5 reviews ongoing Monitor governance rating = Amber-red o Chantry Action plan being implemented -1 moderate action CQC return visit expected o Horizon Centre no concerns o Fox View Action plan almost completed-2 moderate actions o Perinatal Draft report received w/c 20 February -3 moderate & 1 minor actions further discussion scheduled with CQC at CEO / Director level. o Community Treatment Orders awaiting report 2.0 CQUINs 2.1 Barnsley (13 indicators) Q4 Rating based on current performance o Mental Health 2 rated Amber Patient Experience and IAPT 4 rated Green including access waiting times o Community 1 rated Amber Patient Experience 6 rated Green 2.2 Calderdale, Kirklees & Wakefield (13 indicators) Current performance o 4 rated Red for acute access, non-acute access, access to psychological therapies**; nutritional screening, o 3 Amber, 6 green BDU forecast for Red rated CQUINs: o No BDU will achieve Nutritional screening CQUIN o Access Wakefield - Acute access & non-acute access will be achieved at Quarter 4 - PTS access unlikely to achieve Produced by Performance & Information Page 7 of 10

8 Integrated Performance Report: Strategic Overview Kirklees - Acute access and PTS will be achieved at Quarter 4 - Non-acute access unlikely to achieve Calderdale- All 3 access targets will be achieved at Quarter 4 CQUIN contract terms require ALL BDUs to meet the target to generate CQUIN payment except for PTS access indicator. 2.3 Forensic (6 indicators to be achieved across the 3 service lines) BDU forecast: o Newton Lodge achieved at Quarter 4 o Bretton Centre achieved at Quarter 4 o New Haven - achieved at Quarter IAPT (Kirklees) Contract penalty (250K approx) due to underperformance against o Number of people in treatment o Number of people moving to recovery Capacity & demand modelling shows treatment target is appropriate BDU key actions to: o Significantly increase in the number of referrals to IAPT o Increase staff productivity 4.0 PSA Outcomes; % on CPA in employment (adults of working age) Department of Health performance indicator; target 10% Challenging target in current economic climate Annual planning process to be used to look at recovery pathway Produced by Performance & Information Page 8 of 10

9 Integrated Performance Report: Strategic Overview Current Performance: % on CPA in Unemployment levels employment Barnsley** 5.1% 10.4% Calderdale 8.7% 8.8% Kirklees 9.2% 8.6% Wakefield 7.4% 9.4% Yorkshire & Humber 8.9% Great Britain 7.7% ** data available for all ages only 5.0 Adult safeguarding Performance deteriorating (70% Month 10; 71.5% Month 9) BDUs to o Monitor weekly o Increase targeted action 6.0 Sickness Remains a key target at a Trust level o Targeted work in Forensic BDU, Calderdale BDU and Barnsley BDU. 7.0 Information Governance Training 95% target to meet IG toolkit training requirements Included within the Monitor Compliance framework failure to meet IG toolkit while CQC actions are in place will result in Red Governance Risk Rating 1099 staff untrained as at end of January All directors targeting lists of staff who have not yet completed IG training Produced by Performance & Information Page 9 of 10

10 GLOSSARY AWA Adults of Working Age AWOL Absent Without Leave CIP Cost Improvement Programme CPA Care Programme Approach CQC Care Quality Commission CQUIN Commissioning for Quality and Innovation CRS Crisis Resolution Service DTOC Delayed Transfers of Care EIA Equality Impact Assessment EIP/EIS Early Intervention in Psychosis Service FOI Freedom of Information FT Foundation Trust HONOS Health of the Nation Outcome Scales IAPT Improving Access to Psychological Therapies Inf Prevent Infection Prevention MAV Management of Aggression and Violence MT Mandatory Training NICE National Institute for Clinical Excellence OPS Older People s Services PCT Primary Care Trust PSA Public Service Agreement PTS Post Traumatic Stress Sis Serious Incidents SU Service User TBD To Be Decided/Determined YTD Year to Date Produced by Performance & Information Page 10 of 10

11 South West Yorkshire Partnership NHS Foundation Trust Finance Report Month 10 FY 2011/12 Page 1 of 22

12 Table of Contents Overall Financial Position... 3 Finance Key Performance Indicators... 3 Income & Expenditure... 4 Overall Income & Expenditure Position... 4 Summary Performance of Cost Improvement Programme... 7 Analysis of Expenditure by Type Reconciliation of Actual Cash-flow to Plan Cash Position Resources Available for Capital Expenditure Capital Expenditure Balance Sheet Other Key Indicators Monitor Risk Rating Better Payment Practice Code Transparency Disclosure Glossary of Terms & Definitions Page 2 of 22

13 Overall Financial Position Finance Key Performance Indicators Performance Indicator Trust Targets Month 10 Performance Travel Last 6 Months - Most recent Assur - ance 6.1m Surplus on Income & Expenditure 4 4 to 6 Cash position equal to or ahead of plan 4 Capital Expenditure within 5% of plan 4 17 In month delivery of recurrent CIPs 3 7 to 11 In month delivery of non recurrent cost savings 4 7 to 11 Monitor Risk Rating equal to or ahead of plan 4 19 In month Better Payment Practice Code 3 20 Pg 13 to 15 Summary Financial Performance 1. The year to date outturn position for January is a surplus of 8.9m which is 3.4m ahead of plan. The key contributory factors continue to be small overrecovery on income; and under-spend on pay linked to the implementation of the Bank which has significantly reduced overtime and agency spend in year and under-spend as a result of early achievement of CIP and synergy savings. The forecast surplus is 8.5m which is 2.3m ahead of plan. The financial assumptions within the last 2 month in the year reflect plan for recruitment and additional investment in capacity in posts in BDUs e.g. psychologists and other non-recurrent commitments to facilitate the work on service redesign. 2. At month 10 the Trust has 5.5m more cash than planned. The year end forecast cash position is 21.5m. 3. Capital expenditure to January is 6.9m which is 0.5m behind of plan due to delays in works on small schemes, the forecast is on plan with outstanding works being completed by year end. Newton Lodge development and Ward 18 refurbishment are ahead of plan. 4. Recurrent CIPs are reporting an overachievement of 98k at month 10. The forecast outturn remains an overachievement of 61k mainly due to overachievement of the lease car scheme. 5. The Financial Risk Rating at December is 4.3 against a planned outturn of 3.8; this is as a result of the I&E surplus, EBITDA and cash being ahead of plan. 6. Payment of invoices within the 30 days target is 90% at month 10 this target has been achieved. 72% of local suppliers have been paid within 30 days. Page 3 of 22

14 Income & Expenditure Overall Income & Expenditure Position Budget Staff in Post Actual Staff in Post This Month Budget This Month Actuals This Month Variance Income & Expenditure Account Year to Date Budget Year to Date Actual Variance (Fav'ble)/ Adverse Annual Budget Forecast Variance (Fav'ble)/ Adverse Forecast Outturn WTE WTE m m m m m m m m m Healthcare Income (3.3) (3.3) 0.0 NHS Wakefield District (33.6) (33.6) 0.0 (40.2) 0.0 (40.2) (3.3) (3.3) 0.0 NHS Kirklees (33.3) (33.3) 0.0 (40.0) 0.0 (40.0) (1.7) (1.7) 0.0 NHS Calderdale (16.8) (16.8) 0.0 (20.2) 0.0 (20.2) Secure Services (2.0) (2.0) 0.0 Commissioners (19.9) (19.9) 0.0 (23.9) 0.0 (23.9) (0.3) (0.3) 0.0 Wakefield MDC (3.0) (3.0) 0.0 (3.6) 0.0 (3.6) (7.5) (7.5) (0.0) NHS Barnsley (68.5) (68.4) 0.1 (83.5) 0.1 (83.4) (0.0) (0.1) (0.1) Other Non Contract Healthcare Income (0.2) (0.6) (0.4) (0.2) (0.5) (0.7) Post Graduate Medical & Dental Income (18.1) (18.2) (0.1) Total HC Income (175.3) (175.7) (0.4) (211.6) (0.4) (212.1) Operating Expenses Wakefield (0.5) 37.4 (0.3) Kirklees (0.3) 24.4 (0.2) Calderdale (0.3) 14.1 (0.3) (0.0) Secure Services (0.3) 16.9 (0.4) ,596 1, (0.2) Barnsley (1.6) 63.7 (1.2) (0.0) Support & Central Services (0.7) 42.2 (0.4) (0.0) (0.2) Provisions ,583 4, (0.3) Total Operating Expenses (2.8) (1.7) (0.5) (0.9) (0.4) EBITDA (8.9) (12.0) (3.1) (10.2) (2.2) (12.3) Page 4 of 22

15 Budget Staff in Post WTE Actual Staff in Post WTE Forecast Variance This Month This Month This Month Year to Date Year to Date Variance Forecast (Fav'ble)/ Annual Budget Budget Actuals Variance Income & Expenditure Budget Actual (Fav'ble)/ Outturn Adverse Account Adverse m m m m m m m m m (0.5) (0.9) (0.4) EBITDA (8.9) (12.0) (3.1) (10.2) (2.2) (12.3) Depreciation (0.0) PDC Paid (0.2) 2.0 (0.3) Interest Paid (0.0) (0.0) (0.0) Interest Received (0.1) (0.2) (0.1) (0.2) (0.1) (0.3) Impairment of Assets ,583 4,355 (0.2) (0.6) (0.4) Outturn (5.5) (8.9) (3.4) (6.1) (2.4) (8.5) EBITDA, Net Surplus and FRR last 12 months m Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 Sep 11 Oct 11 Nov 11 Dec 11 Jan 12 Month Planned EBITDA EBITDA Planned Surplus Net Surplus YTD Weighted FRR FRR Plan for Year Rating Page 5 of 22

16 Income and Expenditure Summary The January year to date position is a net surplus of 8.9m; this is 3.4m ahead of plan. Healthcare income is 0.4m overachieved at month 10; this relates to non contract activity. Operating expenses are underspent by 2.8m at month 10 with underspends across all Districts. Of this 2.0m relates to pay underspends, 1.1m underspending on non pay, 0.6m overachieved operating income and 1.0m over commitment of provisions. The variance continues to be mostly due to savings on pay costs as a result of early delivery of synergy and CIP savings, impact of e-rostering, reduction in agency and overtime spending and the underlying turnover of staff. These underspendings are partially offset by committed non recurrent expenditure reported against provisions. The annual budget figures here reflect the plan approved by the Trust Board and submitted to Monitor at the end of May The plan has been updated to take account of changes since May. The plan figures include 11 months income and expenditure for the Barnsley BDU plus additional non recurrent income to transfer Barnsley s surplus from Month 1 to the Trust, 0.6m. The forecast surplus at January for the financial year is 8.5m which is 2.4m ahead of plan. The healthcare income overall is forecast to overachieve by 0.4m. The forecast overachievement relates to 0.5m on non contract activity offset by 0.1m underachievement in Barnsley income; this relates to shortfall in an income CIP which will be addressed in year. Operational budgets are forecast is underspending by 1.7m; of which the pay underspend is 1.8m which includes 1.2m ring fenced underspend against CIPs in No additional pay underspend is forecast as temporary posts have been recruited to reduce waiting lists and support the transition to the new service offer, these posts are having a positive impact on achieving targets. Non pay, including operational income, is 1.1m underspent. The Trust has provided 0.6m for the expected underachievement of CQUIN income and non recurrent expenditure of 2.1m to include backlog maintenance, community home loans equipment, IT equipment and other miscellaneous items which will result in a forecast overspend on provisions of 1.1m. Depreciation is forecast to overspend 0.2m following a review of asset lives, it is offset by a favourable variance on PDC due to changes in the Trusts surplus, capital and cash positions since the budgets were set. Whole time equivalents in post at January are 4,355 against a planned 4,583, this is the equivalent of 228 vacant posts or 5.0%. The numbers of vacancies remained consistent with previous months. The planned EBITDA has been overachieved at month 10 due to the level non contract activity, pay savings and the timing of expenditure where the Trust has received additional income. This includes the month one underspending on Barnsley services, the holiday pay provision and employment tribunal provision transferred from NHS Barnsley. The bar chart illustrates the EBITDA and net surplus planned and achieved for the last 12 months. Last year EBITDA ran between 25% and 70% ahead of plan with an average of 51% from April to March. The current level of EBITDA is running ahead of plan by 45%. The line graph illustrates the financial risk rating (FRR) for the last 12 months compared with the plan for each year. Last year the average FRR was 4.2 against a planned 3.5 this is 0.7 points ahead of plan and consistent with the year end outturn of 4.1. For 2011/12 the average risk rating for the year is 4.3 against a planned 3.8 which is 0.5 points ahead of plan. The planned Financial Risk Rating target reflects the strategy approved by the Board whereby the level of surplus in the plan is 1.5% of turnover recurrently plus additional non-recurrent surplus to fund capital. Page 6 of 22

17 Summary Performance of Cost Improvement Programme Delivery of Recurrent Savings 2011/12 Recurrent CIPs Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar YTD Forecast FY 2011/12 Base Budget Before CIPs k k k k k k k k k k k k k k k Wakefield BDU Target Actual Variance ,815 Kirklees BDU Target Actual Variance ,628 Calderdale BDU Target Actual Variance (4) ,431 Secure Services Target Actual Variance 8 (2) (23) 9 (36) (39) (21) (44) (5) 15,006 Barnsley BDU Target ,824 2,281 Actual ,824 2,281 Variance ,599 Support Target ,125 4,990 Actual ,194 5,058 Variance (2) (2) (2) (95) (11) (9) (11) (20) (69) (68) 40,400 Total Target ,043 9,826 Actual ,148 9,887 Variance 13 (1) (22) 79 (23) (134) (33) 12 8 (4) 0 0 (98) (61) 187,879 Page 7 of 22

18 Delivery of Staff Vacancy Factor Prior Year Vacancy Factor CIP Delivery Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar YTD Forecas t Percentage of Pay Budget k k k k k k k k k k k k k k % Wakefield BDU Target Actual Variance (28) (44) (52) (32) (3) (4) (62) Kirklees BDU Target Actual Variance (64) (28) (20) 5 (10) (11) (11) (12) (84) Calderdale BDU Target Actual Variance (18) (24) (24) (2) (4) (2) (33) Secure Services Target Actual Variance (56) (14) (0) (22) Barnsley BDU Target ,160 Actual ,160 Variance Support Target Actual Variance Total Target ,417 2,925 Actual ,618 2,925 Variance (166) (109) (96) (26) (14) (8) (201) Page 8 of 22

19 Delivery of Un-planned and Non Recurrent Savings 2011/12 In Year Savings Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar YTD Forecast k k k k k k k k k k k k k k Wakefield BDU Target Actual (5) 26 (25) Variance (94) 16 (29) (117) (75) (42) (69) 5 (26) 25 (407) (319) Kirklees BDU Target Actual (22) (15) 18 (36) Variance (29) (16) (46) (60) 26 (28) (49) 15 (18) 36 (169) (167) Calderdale BDU Target Actual (12) Variance (68) (20) (14) (42) (36) (67) (37) (19) (11) 12 (304) (308) Secure Services Target Actual 36 (38) (27) Variance (35) 39 (15) (63) (5) (3) 28 (66) (79) (69) (268) (395) Barnsley BDU Target Actual ,010 1,449 Variance 0 (291) (184) (196) 6 (206) (320) (175) (34) (216) (1,616) (1,212) Support Target Actual (18) (68) Variance (55) (147) (46) (9) (396) 27 (72) (43) 73 (12) (681) (354) Total Target Actual ,925 3,286 Variance (281) (420) (334) (488) (481) (320) (519) (283) (96) (224) (3,444) (2,755) Page 9 of 22

20 Delivery of Total Savings 2011/12 FY 2011/12 Base Total Cost Savings Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar YTD Forecast Budget Before CIPs k k k k k k k k k k k k k k k Wakefield BDU Target ,418 1,701 Actual ,874 2,008 Variance (115) (25) (78) (149) (79) (46) (52) (456) (307) 33,815 Kirklees BDU Target ,171 1,405 Actual ,424 1,572 Variance (93) (44) (66) (55) 16 (39) (60) (254) (167) 24,628 Calderdale BDU Target Actual Variance (86) (44) (38) (44) (40) (69) (32) (12) 3 22 (340) (308) 11,431 Secure Services Target Actual ,100 Variance (83) 23 (38) (51) (37) (34) 15 (37) (51) (41) (334) (400) 15,006 Barnsley BDU Target ,967 2,517 Actual ,583 3,729 Variance 0 (291) (184) (196) 6 (206) (320) (175) (34) (216) (1,616) (1,212) 62,599 Support Target ,331 5,233 Actual ,081 5,655 Variance (57) (149) (48) 61 (384) (68) (83) (52) 62 (32) (750) (422) 40,400 Total Target 658 1,098 1,098 1,116 1,145 1,145 1,171 1,170 1,170 1,170 1,170 1,170 10,941 12,122 Actual 1,092 1,628 1,550 1,550 1,663 1,607 1,703 1,413 1,183 1,304 14,691 14,938 Variance (434) (530) (452) (434) (518) (462) (532) (242) (12) (133) (3,750) (2,816) 187,879 Page 10 of 22

21 Delivery of Recurrent Cost Improvement Plans The table on page 7 illustrates the delivery of the recurrent cost improvement plans for FY 2011/12. The recurrent impact for FY 2011/12 is 10.4m made up 4.13m for Barnsley BDU and 6.25m for the remainder of SWYPFT. The CIP tables exclude synergy savings which are reported separately. As some of the savings are implemented part way through the year the in year target for this year is 9.8m; being 5.9m in year for SWYPFT plus 3.9m for the 11 months of the Barnsley services. At month 10 the year to date delivery of recurrent CIPs continues to be on track for the BDUs. There is an overachievement of 98k reported at month 10 across all BDUs. Secure Services are reporting an overachievement on the staff vacancy factor CIP in 2011/12 due to early achievement. Support Services are reporting an overachievement in lease car salary sacrifice scheme and have an earlier than planned retirement, these are offset by a few small schemes underperforming. There is also one scheme in Wakefield BDU that has generated saving later than the original plan; the saving is being achieved in month and there is no risk to the future financial position. The forecast for the year is that there will be a small overachievement of recurrent CIPs of 61k mainly due to the over achievement of the lease car salary sacrifice scheme. Delivery of Staff Vacancy Factor Savings Page 8 has details of the in-year performance against the staff vacancy factor CIPs. The vacancy factor targets form part of the recurrent CIPs in prior years; they reflect the historic savings from turnover and are held at BDU level. They have been reported separately to monitor the risk of non delivery. At month 10 there has been an additional 201k locked in against the year to date target and the forecast is that these will be achieved in total. The percentage the savings represent of the total pay budgets for each delivery unit has been included for information; across the Trust this is 1.81%. The forecast achievement of the vacancy factor for the remainder of the year has been included in the table. Delivery of Un-planned and Non Recurrent In-Year Savings Page 9 has details of the in-year performance against the non recurrent savings targets and reports the balance of all other savings not in the other tables. The non recurrent targets were set to mitigate the impact of the part year delivery of the recurrent CIPs, with an overall target of 531k for the year. All Districts have over achieved their non recurrent savings targets YTD. The overall level of unplanned savings achieved at month 10 is 3.9m excluding vacancy factors against a target of 0.5m giving a 3.4m total underspending. Total Cost Savings 2011/12 The table on page 10 combines the recurrent and non recurrent savings to give the overall performance of Districts and Support Services against the planned savings targets; the variances represent the total under or overspend against the delegated budget. At month 10 the YTD underspend is 3.8m with a forecast year end underspend of 2.8m. This is due to the phasing of expenditure in eg facilities, research and development and training and planned temporary recruitment in the second half of the year to eg reduce waiting lists and support the transition to the new service offer. Page 11 of 22

22 Analysis of Expenditure by Type Type Heading Annual Budget YTD Budget YTD Actual YTD Variance Note Direct Credits & Income (6.4) (5.3) (5.5) (0.2) Recharges (3.6) (3.1) (3.6) (0.5) Non-healthcare Income Total (10.0) (8.5) (9.1) (0.7) Admin & Clerical (1.3) 1 Agency Ancillary Medical (1.2) 1 Nursing (1.5) 1 Other Healthcare Staff (2.5) 1 Senior Management (2.3) (1.8) Social Care Staff (0.1) Other Pay Costs (0.1) 3 Pay- Expenditure Total (2.3) Clinical Supplies (0.5) Drugs Healthcare subcontracting (0.2) Hotel Services Office Supplies Other Costs (0.7) 4 Property Costs Service Level Agreements Training & Education (0.2) Travel & Subsistence (0.1) Utilities Vehicle Costs Non-pay Expenditure Total (0.8) Grand Total (3.7) This table analyses operating expenditure by type of expenditure and reconciles to the operating expenses plus provisions in the I&E summary. 1. Actual expenditure on Administrative & Clerical, Medical, Nursing and Other Healthcare staff is less than originally planned due to the early delivery of future CIPs and the in-year impact of synergy savings, the introduction of e-rostering, the reduction in overtime payments, the holding of posts to facilitate service redesign and the level of turnover. 2. During 2009/10 the Trust introduced measures to reduce the level of expenditure on agency staff and these have been effective. YTD agency costs are 3.5m, of which 2.3m relates to Barnsley services which have historically employed agency staff to manage the clinical risks from vacancies particularly medical vacancies. Medical agency expenditure in Barnsley services is 1.1m YTD in line with month 9 following recruitment to posts. 3. This represents the recurrent staff vacancy factor CIP introduced in 2010/11 and additional pay savings requirements for e-rostering and agency spend. At December the savings requirement is 2.8m across the Trust and is achieved through underspends across the pay headings. 4. This includes savings identified for 2012/13 CIPs. Page 12 of 22

23 Cash & Working Capital Rolling Cash-flow Forecast 30.0 Cashflow Forecast March 2011 to March 2012 This analysis shows the cash flow for the year as per the LTFM. While the LTFM is quarterly, the months in between are extrapolated from the plan. The actual cash position for the month is 26.1m, which is 5.5m ahead of the LTFM planned figure of 20.6m. Cash m The main reasons for this are Earnings before tax, interest, depreciation and amortisation (EBITDA) being ahead of plan by 3.9m, primarily as a result of the under spending within the BDU s and support services. 1.1m additional cash received from NHS Barnsley for transferred provisions (including 0.7m for holiday pay provision). Creditors and accruals being higher, mostly as the result of timing of invoices for the Barnsley BDU; these increase the cash available The cash position will fall as the year progresses due to planned capital expenditure ( 4m in the final months) and PDC payments ( 0.8m in March). The cash will continue to be above plan due to the additional forecast surplus. A further breakdown is provided on page 14. LTFM Plan End of Month Actual Updated Forecast Prior Month Forecact Page 13 of 22

24 Reconciliation of Actual Cash-flow to Plan LTFM Plan m Actual m Variance m Note Opening Balances EBITDA (Exc non cash items) Movement in working capital: Inventories & Work in Progress Receivables (Debtors) (1.4) (5.1) (3.7) 2 Trade Payables (Creditors) (0.1) Other Payables (Creditors) (1.1) 3 Accruals & Deferred income (0.2) Provisions & Liabilities 0.0 (0.1) (0.1) Movement in LT Receivables Capital expenditure (7.4) (6.2) Cash receipts from asset sales PDC Dividends paid (1.0) (0.8) PDC Received Interest (paid)/ received Closing Balances The LTFM plan reflects the May 2011 submission to Monitor. At the end of the period the Trust has 5.5m more cash than originally planned, though the cash position will fall as capex is incurred. Factors which increase cash position against plan: 1. Year to date surplus is higher than plan. 4. Accruals are higher than planned, primarily as a result of Barnsley invoices not yet being received and so not paid and additional Barnsley BDU provisions e.g. 0.7m holiday pay accrual for which the Trust has received cash from NHS Barnsley. The Trust has also accrued committed non recurrent expenditure. 5. Timing of capital expenditure. 6. Due to changes in the Trust surplus, capital and cash position the PDC payments due are less than originally forecast. Factors which decrease the cash position against the plan: 2. Debtors have increased since the year end, due to timing of Barnsley transactions and additional accrued income. The largest amounts at month end are 1.1m with NHS Barnsley, 1.2m with Barnsley MBC ( 0.9m block income), 0.5m with Phoenix Futures and 1.1m with Wakefield MBC (3m SLA). Aged trade debtors ( 3.7m) remain healthy with 75% not outstanding more than 60 days. 3. Other creditors have not increased as much as planned due to invoices not yet being received, these are recorded as accruals. Page 14 of 22

25 Cash Position Cash Balances LTFM Plan m Actual m The cash position at period end is 26.1m. The lowest balance of 26.1m was on the 31st. The highest balance for the month was on 13th and was 37m. This reflects cash balances built up from historical surpluses that are available to finance capital expenditure in the future. Opening Balance Closing Balance The graph illustrates the high and low cash balances each month this financial year. The peak for the month is due to the NHS SLA income being received between the 13 and 21 of the month. 'ms Monthly Cash Balances FY 2011/12 Apr 11 May 11 High m Low m Jun 11 Jul 11 Aug 11 Month Sep 11 Oct 11 Nov 11 Dec 11 Jan 12 The Trust invests cash balances in excess of its operating cash requirements in line with the Treasury Management policy to maximise interest received and on average 19.2m has been on deposit for the year to date. The Treasury Management policy and Monitor requires investment organisations to have a Standard & Poors risk rating of A-1 or a Fitch rating of F1. In month 8 Standard & Poors changed their risk assessment criteria for UK banks. This lowered the rates to A-2 for the banks the Trust invests with; however both banks still meet the Fitch credit rating requirements (F1). To reduce risks the Trust now only invests with UK Government backed banks (Lloyds TSB and Royal Bank of Scotland). The Trust is currently waiting to see if Monitor amend their Standard & Poors risk rating requirement. Page 15 of 22

26 Resources Available for Capital Expenditure Source of Funds m Depreciation 2.2 Internally Generated and Brokered Movement in working capital 9.2 Income & Expenditure Surplus 0.0 New Strategic Capital/PBL Other Disposal NBV 0.0 Capital Resources The capital programme for 2011/12 will be funded entirely from cash available from depreciation and previously generated surpluses which are in working capital. Any surpluses generated during the year will not be required to fund this year s capex. The Trust s capital plans reflected here are consistent with the 3 year Annual Plan submitted to Monitor in May Total Resources for Capital Expenditure 11.4 Page 16 of 22

27 Capital Expenditure Capital Expenditure Plans - Application of funds Year to Date Year to Date Year to Date Variance Scheme Total Annual Budget Revised Annual Budget Year End Forecast Forecast Variance Plan Actual m m m m m m m m Maintenance (Minor) Capital 2010/11 Small Schemes c/fwd /12 Small Schemes (1.0) 1 Total Maintenance Capital (1.0) SK Community Team Base Reprovision (0.3) Newton Lodge Refurbishment & 10 Bed Extension IM&T Ward 18 Refurbishment (0.3) Total Other Schemes (0.1) VAT Refunds Revenue Transfers TOTALS (0.5) Note Capex is behind plan primarily due to timing activity as below: 1. The small schemes due to be completed by our P21+ partner were delayed, due to the process taken to select a new partner. Work is underway on the design for these schemes so they will be delivered before the year-end. 2. Newton Lodge expenditure is ahead of plan due to the re-profiling of expenditure, this brought forward a phase of work in order to save costs. 3. Ward 18 Expenditure is ahead of plan, this is due to the project starting earlier than expected and the increases to budget for the Ward 16 decant option. Page 17 of 22

28 Balance Sheet At 31/03/11 At 31/01/12 Note m m Non Current (Fixed) Assets Current Assets Inventories & Work in Progress NHS Trade Receivables (Debtors) Other Receivables (Debtors) Cash and Cash Equivalents Total Current Assets Current Liabilities NHS Trade Payables (Creditors) (1.6) (3.1) 2 Non NHS Trade Payables (Creditors) (1.4) (1.7) 3 Other Payables (Creditors) (2.0) (3.2) 4 Capital Payables (Creditors) (0.8) (1.5) 5 Accruals (5.8) (11.5) 6 Deferred Income (0.8) (0.7) Total Current Liabilities (12.5) (21.8) Net Current Assets/Liabilities Total Assets less Current Liabilities Provisions for Liabilities (1.6) (1.6) Total Net Assets/(Liabilities) Taxpayers' Equity Public Dividend Capital (42.0) (42.0) Revaluation Reserve (7.6) (7.6) Other Reserves (5.3) (5.2) Income & Expenditure Reserve (7.8) (16.7) 7 Total Taxpayers' Equity (62.7) (71.5) The Balance Sheet analysis compares the current month end position to the previous year end position, while the Reconciliation of Actual Cashflow to Plan analysis on page 14 compares the current month end cash to the LTFM forecast for the same period. The most significant increases are as a result of additional income and costs relating to the Barnsley BDU. 1. The largest other debtor increases are 1.2m with Barnsley MBC ( 0.9m block income), 0.5m with Phoenix Futures, 1m with Wakefield MBC for 3 months SLA (most of which was paid in M11), 0.3m for staff lease cars and 1.3m of accrued income with NHS Barnsley. 2. In line with prior months the largest NHS trade creditor increases are 0.8m for Barnsley BDU pension costs and 0.4m for NHS Barnsley. 3. Non NHS trade creditor has increased slightly which is not un expected given the growth of the Trust. 4. The increase in other creditor is due to additional PAYE and NI for Barnsley BDU staff. 5. Capital payables increase due to timing of activity and invoicing. The largest costs are 1.1m with Interserve for Newton Lodge and Ward When invoices are expected but haven t been received the Trust accrues for known a cost (which has a positive impact on cash until these are paid). The largest increases are: 0.7m holiday pay for Barnsley BDU, 2.4m of committed non recurrent expenditure (including 0.4m for community equipment) which is provided for at the start of the year that has yet to be incurred, other smaller increases include 0.6m PDC paid in March and 0.2m Mid Yorks. 7. Year to date surplus plus brought forward reserve. A measure of the Trust s ability to meet its costs is its liquid ratio which looks at debtors and cash vs. creditors. Despite the TCS acquisitions this remains at a healthy 1.5 (1.6 for the year end), above 1 meaning the Trust can cover its debts. Page 18 of 22

29 Other Key Indicators Monitor Risk Rating Financial Risk Rating FY 2011/12 January 2012 Actuals May 2011 Plan Metric Score Rating Score Rating EBITDA margin 6.7% 3 4.5% 2 EBITDA, % achieved 155.1% % 5 ROA 18.3% % 5 I&E surplus margin 5.0% 5 2.8% 4 Liquid ratio Weighted Average At the end of May 2011 the Trust submitted a detailed plan for financial year 2011/12 to Monitor; this includes summarised positions for 2012/13 and 2013/14. The planned Financial Risk Rating target reflects the strategy approved by the Board whereby the level of surplus in the plan is 1.5% of turnover recurrently plus additional non-recurrent surplus to fund capital. For 2011/12 the planned Risk Rating for the year is 3.8. The actual Monitor Financial Risk Rating at January 2011 is 4.3, it has been at this level since May 2011and is ahead of the planned year end position of 3.8. The over performance is as a result of the EBITDA margin achieved of 6.7%, this has rated 3 rather than the planned 2. The EBITDA margin needs to be at least 5% to score 3. Mental health trusts have much lower bed base, low tech environment and do not have 100% ownership of community bases. This means the plan can comfortably cover a lower EBITDA without compromising operations. The increased surplus above plan has improved the I & E margin score but has had no impact on the others. The Trust currently has sufficient cash to fund 37 days expenditure. Page 19 of 22

30 Better Payment Practice Code Number % Value % NHS Year to Dec Year to Jan Non NHS Year to Dec Year to Jan Payments to Local Suppliers Number % Value % Year to Dec Year to Jan The Better Payment Practice Code requires the Trust to aim to pay 95% of valid invoices by the due date or within 30 days of receipt of goods or a valid invoice, whichever is later. The performance against target for NHS invoices is 90.2% of the total number of invoices that have been paid within 30 days and 91.4% by the value of invoices. This fell earlier in the year due to the manual process being used for Barnsley BDU invoices. The original plan was for e- procurement to be rolled out in summer 2011, this has been delayed until the start of Extra resource has been put in place improve the performance against BPPC targets To date the Trust has paid 95.2% of Non NHS by volume within 30 days and 95.5% of Non NHS invoices by value. With the current economic climate the Government has asked the Public Sector to try and pay Local Suppliers within 10 days, though this is not mandatory for the NHS. Given the Trust s position within the community this was adopted in November To date the Trust has paid 81.2% of Local Suppliers invoices by volume and 72.3% of invoices by value within 10 days. Until e-procurement is rolled out in the Barnsley District the payments to local supplier target will continue to be challenging. Page 20 of 22

31 Transparency Disclosure As part of the Government s commitment to greater transparency, there is a requirement to publish online, central government expenditure over 25,000. This is for non pay expenditure; however, organisations can exclude any information that would not be disclosed under a Freedom of Information request as being Commercial in Confidence. At the current time Monitor has not mandated that Foundation Trusts disclose this information but the Trust has decided to comply with the request. The transparency information for the current month is shown in the table below. Date Expense Type Expense Area Supplier Transaction Number Amount ( ) 18/08/11 Non Healthcare Other NHS Bodies Trust Wide Leeds Partnerships NHS Foundation Trust ,479 19/12/11 Drugs Trust Wide Mid Yorkshire Hospitals NHS Trust ,409 21/12/11 FP10'S Trust Wide NHSBSA Prescription Pricing Division ,157 23/12/11 Calderdale TCS Health Centre Admin SLA Calderdale NHS Calderdale ,791 23/12/11 Calderdale TCS Dean Clough Premises SLA Calderdale NHS Calderdale ,202 28/12/11 Non Healthcare NHS Trusts Calderdale Calderdale and Huddersfield NHS Foundation Trust ,566 29/12/11 Rent Barnsley NHS Barnsley ,501 29/12/11 Rent Barnsley NHS Barnsley ,514 29/12/11 Lease Rents Barnsley NHS Barnsley ,322 03/01/12 Estate Management SLA Wakefield NHS Wakefield ,601 04/01/12 Specialty Registrar (CT1 3) Trust Wide Leeds Partnerships NHS Foundation Trust ,363 09/01/12 Rendered by PCT Barnsley Barnsley Metropolitan Borough Council ,444 09/01/12 Local Authority Social Workers Barnsley Barnsley Metropolitan Borough Council ,031 11/01/12 Non Healthcare NHS Trusts Wakefield Mid Yorkshire Hospitals NHS Trust ,339 12/01/12 Lease Rents Calderdale Department Of Health ,438 13/01/12 Switchboard SLA Barnsley Barnsley Hospital NHS Foundation Trust ,743 23/01/12 Non Healthcare NHS Trusts Calderdale Calderdale and Huddersfield NHS Foundation Trust ,566 27/01/12 LIFT Sites Soft FM Contract Barnsley NHS Barnsley ,514 Page 21 of 22

32 Glossary of Terms & Definitions Recurrent action or decision that has a continuing financial effect Non-recurrent action or decision that has a once-off or time limited effect Full Year Effect quantification of the effect of an action, decision or event for a full financial year. Part Year Effect - quantification of the effect of an action, decision or event for the financial year concerned. So if a CIP were to be implemented half way through a financial year, the Trust would only see six months benefit from that action in that financial year. Recurrent Underlying Surplus We would not expect to actually report this position in our accounts, but it is an important measure of our fundamental financial health. It shows what our surplus would be if we stripped out all the non-recurrent income, costs and savings. Forecast Surplus This is the surplus we expect to make for the financial year Target Surplus This is the surplus the Board said it wanted to achieve for the year (including non-recurrent actions), and which was used to set CIP targets. This is set in advance of the year, and before all variables are known. Recently this has been set as part of the IBP/LTFM process. Previously we had aimed to achieve breakeven. In-Year Cost Savings These are non-recurrent actions which will yield non-recurrent savings in-year. So are part of the Forecast Surplus, but not part of the Recurrent Underlying Surplus. Cost Improvement Programme (CIP) We only agree actions which are a recurring effect, so these savings are part of our Recurrent Underlying Surplus. Non-recurrent CIP A CIP which is identified in advance, but which only has a once-off financial benefit. This Trust has historically only approved recurrent CIPs. These differ from In-Year Cost Savings in that the action is identified in advance of the financial year, whereas In-Year Cost Savings are a target which budget-holders are expected to deliver, but where they may not have identified the actions yielding the savings in advance. EBITDA earnings before interest, tax, depreciation and amortization. This strips out the expenditure items relating to the provision of assets from the Trust s financial position to indicate the financial performance of its services. IFRS International Financial Reporting Standards, these are the guidance and rules by which financial accounts have to be prepared. Page 22 of 22