Budget Report 2014/15 and 2015/16. Trust Board. Robert Forster & Claire Liddy. 26th March your hospitals, your health, our priority.

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1 Budget Report 2014/15 and 2015/16 Trust Board Robert Forster & Claire Liddy 26th March 2014 ST05_Mar12 your hospitals, your health, our priority

2 Agenda 1. Executive Summary 2. Approach 3. I&E 4. Income 5. WTE 6. CIP 7. Capital 8. Challenges and Opportunities 9. Summary

3 Executive Summary This year 15/16 14/15 3m Trading 1.9m and 1.0m profit from land sales CSR 4 14/15 & 15/16 Reserves 3.5m last year 3.0m 14/15 & 15/16 7 Day working early implementer 2 x Ward closures 1 st November 2014 & 1 st April m 14/ m 15/16 5% Repatriation Integration max NEL LOS reduction of 0.8 days & 1773 admissions Market share increase to circa 80%

4 Approach designed to be inclusive and meet Monitor deadline of 4 th April 2014 Budget setting principles To deliver Trust strategic plan and meet monitor requirements To be open and transparent To confirm and challenge To be realistic and set a budget that meets financial targets To be ambitious and stretching To ensure budget is safe, effective and caring To have Devolved Financial Management and budget setting 5 budget development and stakeholder working groups held to refine budget and cross check affordability with quality with the involvement of DDOPs and DMDs. Bgt review 1 6 th Jan Bgt review 2 16 th Jan Bgt review 3 27 th Jan Bgt review 4 29t h Jan ECC 10 th Feb F&I 18 th Feb Trust Board 26 th March Monitor Submission 4 th April

5 I&E Summary 2014/15 Headlines Surplus 4.9m 3m trading & 1.9m Profit on sale of Billinge CIP Included 12.5m (5% exp) CIP Includes 1 ward reduction from November 2014 Tariff deflator 1.5% ( 3.4m) Commissioners intentions Reserves 3m CSR 4 Nb. Full details of Assumptions included in Appendix 2015/16 Headlines Surplus 4m 3m trading & 1m Profit on sale of Whelley CIP Included 12.2m (4.8% exp) Tariff deflator 1.1% ( 2.6m) Integration max including 1 ward reduction from April 2015 Wton phase 1 & Commissioners intentions Reserves 3m CSR 4

6 14/15 I&E profile

7 14/15 & 15/16 quarter profile

8 Income & Activity 700, ,000 Activity planned to reduce due to admission deflection schemes (integration max) 264, , /15 Tariff deflator 1.5% ( 3.4m) A&E & NEL reduction as a result of LTC 500, ,000 Activity 400, , , , /14 Fcast 2014/15 Budget 2015/16 Budget A&E 79,472 77,471 74,158 Outpatient 459, , ,429 Non Elective 32,537 32,922 30,891 Day Case 35,973 44,423 46,948 Elective Inpatient 7,549 9,101 9,444 Total Income 253, , , , , , , , , 's 2015/16 Tariff deflator 1.1% ( 2.6m) Additional income relating to income reduction integration max We have assumed 3.75m reduction for CCG commissioning intentions Increase activity driven by theatres 9 & 10 FYE

9 CQUIN 2014/15 2.5% equates to 5.5m National Total 0.5% Friends and Family Test Improvement against the NHS Safety Thermometer Improving dementia and delirium care 1.1m Greater Manchester Total 0.5% Ambulatory reduce emergency admissions through integration Clinical effectiveness improving effectiveness and improving care of deteriorating patients focusing on earlier recognition and treatment. Learning Disabilities traffic light assessment TLA/LD Tool Patient Safety Lessons learnt once serious incidents, claims, complaints or serious case reviews 1.1m Local Total 1.5% 7 Day, HIS 3.3

10 WTE & Headcount 2013/ / /16 Opening WTE 4,256 4,356 4,316 Service Developments CIP (22) (91) (109) 7 day 33 5 Service Reconfiguration (60) Closing WTE 4,356 4,316 4, /14 Main Service Developments: T9&10 70 wte Hannover 12 wte CSR 23 wte 2014/15 Main Service developments: 7 day working 33 wte Theatre 3&4 6 wte 2015/16 Main Service developments: Wrightington Phase 1 neutral pre business case 76 wte 7 day IM&T 5 wte Service reconfiguration Integration max (60) wte

11 CIP 12.5m 14/15 & 12.2m 15/ /15 Frail Elderly includes 1 Ward Closure from 1 st November Workforce includes headcount freeze, PA reductions Good to great includes loss making specialty service reviews 2015/16 Workforce includes headcount freeze, PA reductions, MAS & Nurse ratio, 35hr contracts for new staff Good to great includes Market share repatriation Integration & alliances includes provider of choice for Integration max and vertical integration

12 3m Reserves - 14% reduction 000's 4,000 3,500 3,000 2,500 2,000 1,500 1, Trust Reserves 2012/13 Budget 2013/14 Budget 2014/15 Budget 2015/16 Budget CQUIN Innovation General

13 Capital plans equating to 21.5m in 14/15 & 24m in 15/16

14 Challenges and Opportunities Challenges Opportunities Commissioners deflections / Integration Max effect and risk shares Recurrent CIP achievement and transformation of service lines Reduction in contingency reserves, Contract conditions, MAS Repatriation Local service reconfiguration (Vascular Transfer, Stroke, Acute Surgery) Growth and commercial development Benefits of strategic initiatives eg. LTC, HIS 7 day working Access to 1% WCCG transformation fund Collaborations, integrations, alliances vertical integrations

15 Summary Key points Investment into quality Repatriation Commence Wigan economy integration Bed reductions Recurrent CIP delivery with WTE reduction More Risk Less Contingency Capacity and waiting list reduction to allow repatriation

To: Trust Board From: Abi Tierney Director of Strategy Andrew Seddon Director of Finance & Procurement Date: 4 th February 2010 Healthcare standard:

Paper C To: Trust Board From: Abi Tierney Director of Strategy Andrew Seddon Director of Finance & Procurement Date: 4 th February 2010 Healthcare standard: C7 a&c Title: Better For Less: Financial Planning