SOUTHPORT & ORMSKIRK HOSPITAL NHS TRUST

Transcription

1 Agenda Item 8a SOUTHPORT & ORMSKIRK HOSPITAL NHS TRUST MINUTES OF THE MEETING OF THE FINANCE & PERFORMANCE COMMITTEE HELD ON 08 JANUARY 2010 PRESENT APOLOGIES Jonathan Parry (Chair) Kevin Walsh Sharon Partington Sheilah Finnegan Sarah Groves (representing Liz Yates) Kate Monaghan (representing Janette Brookes) Keith Bennett James Leighton Geraldine Boocock Victoria Raby Richard McCarthy Colin Throp Helen Thompson Mohsen Iskander Steve Taylor Andrew Green Finance & Performance Committee Attendance /10 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Members: J Parry (C) K Barr K Bennett W Baines (d) G Boocock J Brookes K Monaghan (d) S Finnegan M Frayne M Iskander J Leighton R McCarthy S Partington A Marchment (d) V Raby S Christian (d) S Taylor C Throp K Walsh E Yates A Kelly (d) Meeting rescheduled for January 2010 [SG] Page 1 of 5

2 09/093 MINUTES OF THE MEETING HELD ON 30 NOVEMBER 2009 The Minutes of the meeting held on 30 November 2009 were agreed as a correct record. 09/094 MATTERS ARISING FROM LAST MEETING i) Minute 09/085i Victoria Raby reported that an updated action plan would be complete and available by Thursday ii) Minute 09/085iv It was noted that Steve Taylor would present a revised Capital Programme at this meeting, however, Steve was unable to attend the meeting due to annual leave (his representative, Andrew Green was also unable to attend), therefore this matter will be addressed at February s F&P. Action: ST to provide update at next meeting iii) Minute 09/086 (a) Sefton Contract audit trail this has now been actioned (b) Forecast Outturn - Kevin Walsh advised that he had met with General Managers and that further meetings were arranged with Colin Throp w/c Action: CT to report back at next meeting iv) Minute 09/087 James Leighton reported that a breakdown by speciality / area had been completed and forwarded to Liz Yates. v) Minute 09/089 Referral Analysis referral thresholds are now included in the analysis. 09/095 FINANCIAL REPORTING Revenue position Kevin Walsh reported that Month 8 was an in month deficit of 181K with a 410K under-spend (cumulatively) and predicted that the Trust would break even based on expenditure trends coupled with negotiations with Sefton PCT. Further austerity efforts are requested in the last quarter of the financial year. It was noted that there are some concerns for year end especially from the Sefton contract aspect and that negotiations will be ongoing between now and April. The Trust will not be able to achieve break-even if Sefton PCT only settled the contract based on month 5 performance. Sefton PCT have been informed that their proposal is not acceptable. Sheilah Finnegan highlighted that any posts going forward for approval at Cabinet are required to have full authorisation before getting to that stage and that assurance would need to be provided that the funding had been found elsewhere to fund any vacant post. Activity and Income Kevin Walsh reported that there had been a slight over-performance (increase of 1.4%) in November 09. It is extremely likely that the Trust will have to discount the work done for Sefton PCT due to their affordability. Kevin Walsh informed the Page 2 of 5

3 Committee that the month income 8 position has, therefore, been reduced by 100,000 in respect of Sefton PCT elective. This is the Trust s best estimate of the expected level of that discount at this stage and this would be reviewed each month. The Trust continues to try and slow down activity wherever possible without compromising the 18 week target. Victoria Raby reported that Medicine is managing its 18 week percentages. Jonathan Parry advised not to take any risks with breaches. With reference to Table 2 Income and activity by point of delivery (POD). Kevin Walsh highlighted that elective and inpatient follow-ups continued to be the main reason for over performance. Also, the non-elective shortfall has declined in-month and is now recorded at 2% under budget (previously 3%). PCT CONTRACT POSITION Kevin Walsh advised that there was still no agreement for payment of other non-pbr elements of the contract and that the Task and Finish group has not resolved the outstanding elements of the contract. The Trust will not receive any payment for any additional activity within non-pbr outside those agreed previously. Quarter 2 has been paid for in full by Sefton PCT and any proposed discounts would probably affect Quarter 3 and 4 invoices. Kevin Walsh reported that Central Lancs PCT had a slight increase in activity but there was no representative at the last contract meeting from CL. Sefton PCT variance had marginally decreased from month 8. OPERATIONAL BUDGETS KW reported that budgets over spent by 381,000 in month which is mainly attributed to pay. The cumulative overspend on operational budgets now stands at 830,000 and 362,000 of this relates to slippage on the CIP. It was noted that the Nursing and Midwifery variance for month 8 should have been RAG rated red in Table 4. With reference to the corporate budget it was noted that this was providing a benefit due to the reserves which have been expended in capital. Kevin Walsh reported that 756,000 of reserves had still not been utilised but plans were in place for the remainder of the year to utilise these. Each CBU group performance were reported on including particularized annotations regarding income and expenditure, and activity performance issues during November RISKS The top 2 risks of non-elective income and CIP were discussed but cancelled theatre lists were incorporated in the 3 rd risk due to loss of income Kevin Walsh will change this to low risk based on current expectations. COST IMPROVEMENT PROGRAMME The target for 41M has not yet achieved with 3.4M in the current year being actioned to date. Further schemes are to be actioned this year but there is expected to be a recurrent shortfall less than 0.5M CASH AND BALANCE Cash is being managed in line with plan and there had been a slight improvement in the time it takes for the Trust to its bills. CAPITAL PROGRAMME Kevin Walsh reported that the programme was 19% under plan but this was not a concern at this stage. The main issue relates to the refurbishment of G Ward but this will be back on budget by March end Page 3 of 5

4 PERFORMANCE RATINGS The table identifying performance against the 5 ratios utilised by Monitor to assess an organisation s risk rating was reviewed and the overall rating for this Trust were noted as not having changed in the last month. Although the EBITDA achieved is currently 7.68% it was noted that a year end break-even position would deliver 7%. FORECAST OUTTURN The forecast outturn by CBU was reviewed and noted. The CBU General Managers then presented their reports setting out areas of current pressure and proposals/plans to reduce over-spends by year end clear actions were provided by the General Managers indicating predicted overspend and estimated recovery against those. INCOME AFFORDABILITY KW reported that although a break-even position was being forecast for year end a technical deficit would be declared. The benefit of 7.17M has not been agreed and it looks likely that this could be nearer the 8M mark. The December report will provide an update. 09/095 CORPORATE PERFORMANCE REPORT i) Number of out-patients waiting >11 weeks no patients breached 13 weeks. ii) Performance has improved regarding non breach 18 weeks. 18 week completeness continues to fluctuate. Performance trend indicators are incorrect. 09/096 TRUST ACTIVITY ANALYSIS Action: James to ensure corrections are made. The report reflecting actual activity against plan as at month 8 was reviewed briefly and noted that there was nothing to report outside of the discussions held under agenda item 4. 09/097 REFERRAL ANALYSIS Upper / lower thresholds it was reported that none of these indicators were available but the Trust will be looking at this as part of its 2010/2011 planning. Completion on the referral model due shortly which will be based on referral trends, however, it was stated that difficult discussions had taken place with Community in terms of what is out there. 09/098 IMPACT ASSESSMENTS Action: Richard McCarthy to provide update at February meeting. i) Interviews for IBD Nurse Specialist were held in December, but no appointments to post made. Advert not out for circulation at present. Post to be filled possibly internally. Action: Victoria Raby to update at February meeting. ii) Haemotology Medical Staff Support appointed to and commenced Action: an assessment to be provided in 6 months. Page 4 of 5

5 iii) The Galaxy System will go live with pilot commencing Marcus Cope to lead. Action: Keith Bennett to provide update at February F&P meeting. iv) Due to a change in PbR rules relating to the re-building of Diagnostics this business case decision was to be reviewed. It was agreed that this review would be incorporated into the proposed OBC for private EVLT. 09/099 REFERENCE COSTS The Trust received its draft Reference Cost Index for 2008/09 and it has reduced by 8 percentage points from 104 to 96. The paper highlighted the main reasons for this improved performance. Also, noted was further improvements to the score once the revised MFF of all Trusts is taken into consideration. 09/100 LIQUIDITY PLAN As part of the ALE process the Trust needs a liquidity plan in place in order to achieve a level 3. Due to the Trust s inability to deliver a material surplus it is vital that the liquidity position is improved by reviewing its working capital. A review of stocks and assets would facilitate this. Action: Action plan update to be provided at Committee meeting. 09/101 FINANCIAL RISK RATING This paper was presented to show the required level of financial performance in order to achieve level 4. The following criteria for this is as follows: EBITDA margin of 9% or more A return of assets of 5% or more A liquidity ratio of 25 days or more A surplus of 2.3M would be required in order to satisfy the three elements above. The Committee were appraised of the difficulty of achieving the above criterion and in a level 4 performance. 09/102 INFORMATION STRATEGY BOARD MINUTES The minutes were noted. 09/103 ANY OTHER BUSINESS i) Review of reduction of EVLT s and transfer to private sector. Action: Keith Bennett to provide update at February meeting. iii) Cytology meeting update this is still an issue re: L Iskander who is involving her BMA rep. 098/103 DATE / TIME OF NEXT MEETING Action: Ken Barr will update further at February meeting. The next meeting will take place on Monday 25 th January 2010 at 9.30am in the Boardroom, Corporate Management Office, Southport & Formby DGH. Page 5 of 5