For Assurance x For decision For discussion To note

Transcription

1 Item 8 Report to Board 7September 2017 Report title Monthly financial performance for month 4 July 2017 Report from Prepared by Previously discussed at Attachments Steven Davies, Chief Financial Officer/Deputy chief executive Jenny Greenshields, Deputy Chief Financial Officer Damien O Brien, Head of Financial Management Assad Choudry, Financial Controller None Brief summary of report The trust reported a 0.28m surplus in July, 0.27m ahead of the budgeted plan. The YTD position now stands at a surplus of 0.74m, 0.77m ahead of plan. The forecast position for 2017/18 is a 0.92m surplus. This has been adjusted from the previously reported, and planned, full-year surplus of 0.5m to take account of an additional 0.42m Sustainability and Transformation Funding (STF) received from NHS Improvement (NHSI). The surplus position in July is driven by the receipt of the aforementioned STF monies of 0.42m. Commercial trading units reported a surplus of 0.34m in month, which was higher than planned levels by 0.17m. YTD Commercial Trading Units are now above plan by 0.26m. The full year forecast position is for a surplus of 3.77m. Efficiency schemes delivered 0.48m of savings in July, 0.11m behind plan as a result of slippage on a number of schemes. Fortnightly meetings are scheduled with divisions to assure progress of efficiency schemes. The forecast is maintained at 8.20m. 65% of total efficiency savings are currently planned for the second half of 2017/18, however it is anticipated that savings will be brought forward as schemes are developed and implemented. Cash balance was 44.32m at the end of July, 3.85m above plan, primarily due to the receipt of STF funding. Use of Resources risk rating for the trust at July is 1. Action Required/Recommendation. The board is asked to consider and discuss the attached report. For Assurance x For decision For discussion To note

2 2 Monthly Finance Report For July 2017 Prepared by: Damien O Brien Head of Financial Management Assad Choudry Financial Controller Jenny Greenshields Deputy Chief Financial Officer Presented By: Action for Board: For information For consideration For decision Steven Davies Chief Financial Officer/Deputy Chief Executive Board of Directors Meeting 7 th September 2017 Date produced 25 August 2017

3 3 Contents of Main Report Page Number Executive Financial Summary 4 Detailed Income and Expenditure Position 5 analysis 6 Divisional Financial Performance 7 NHS Income 8 NHS Operating Expenditure 10 Efficiency Scheme Performance 12 Research & Development and Commercial Trading Position 13 Cash flow & Capital 14 Debtors Management and Credit Control 15

4 Executive Financial Summary 4 Trust Underlying Overall Position - Surplus / (Deficit) Efficiency Scheme Performance Research & Development Position Full Year Forecast Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) (0.03) YTD % achieved % Full Year achieved Full Year % forecast In Month Year to Date Key Risks and Actions Required NHS In Month Year to Date Full Year Forecast (exc. R&D) Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) Income (0.03) Expenditure (0.24) Overall Position (0.22) (0.10) 0.12 (1.06) (0.61) 0.45 (4.20) (3.79) 0.41 Commercial Trading Unit Position Use of Resources Rating Cash Flow Capital Expenditure 80% Year to Date Full Year Forecast 18% Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) 100% (0.35) In Month Year to Date Full Year Forecast Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) (0.01) In Month Year to Date Full Year Forecast Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) Indicator M4 YTD YE Forecast Capital Service Cover 1 1 Liquidity 1 1 I&E Margin 2 2 I&E Margin 1 1 Agency Spend 1 1 Use of Resources Rating 1 1 Cash Balance ( M) 2016/17 Year End June Actual July Plan July Actual July Capital Expenditure ( M) Expenditure Expenditure Annual Var to Plan Annual Plan Year to Date Committed Forecast Forecast Year End Plan Income and Expenditure The Trust reported a 0.28m surplus in July, 0.27m above the budgeted plan. The full year forecast is to achieve a surplus of 0.92m which includes 1.30m Sustainability and Transformation Funding, and assumes full achievement of the Trusts CIP program of 8.20m. NHS income is above plan in month by 0.36m due to the receipt of an additional 0.42m STF income related to 2016/17. Commercial Trading Units reported a surplus of 0.34m in month, which was above planned levels by 0.17m. Efficiency schemes delivered 0.48m savings in July, 0.11m behind plan, and are now 0.35m behind plan YTD. The full year forecast continues at 8.20m. Use of Resources Rating Use of resources rating for the Trust at July is 1. Cash flow and Balance Sheet Cash balance was 44.32m at the end of July, 3.85m above plan. Capital plan for the year is 30.87m with expenditure YTD at 0.57m. Overdue debt has decreased by 3.3m in July to 9.25m. Debtors Overdue Debts 6 Mths Mths 2 Mths 1 Mth Total Last Month ( M) ( M) ( M) ( M) ( M) ( M) NHS Contract Debts Commercial Debts Other TOTAL

5 Overall Trust I&E Summary Income Detailed Income and Expenditure Position - Surplus / (Deficit) In Month Year To Date Full Year Forecast Prior Year YTD Budget Actual Budget Actual Budget Actual Actual YTD Actual 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s NHS Clinical Income 12,418 12,277 (141) 49,012 49, , , ,858 (2,845) Commercial Trading Units 2,231 2, ,435 8,828 (607) 29,438 29, ,311 (483) Other Income 2,985 3, ,201 11,883 (318) 35,579 35, ,379 3,504 Total Income 17,634 17, ,648 69,724 (924) 213, , , NHS Expenditure Pay Expenditure Medical 2,653 2, ,441 10, ,260 31, ,403 (38) Nursing 2,009 2,018 (9) 8,197 8, ,660 24, ,017 (12) Scientific, Professional & Technical 1,194 1, ,758 4, ,170 14, ,934 (271) Admin and Clerical 2,248 2,399 (151) 9,038 9,419 (381) 27,031 27, ,877 (542) Ancillary Services (10) 2,208 2, (52) Research & Development Pay ,650 2, ,795 7, , Total Pay Expenditure 8,963 8, ,820 35, , , ,338 (862) Non-Pay Expenditure Drugs 2,135 2,478 (343) 8,502 9,150 (648) 25,500 25, ,063 (1,087) Clinical Supplies and Services 1,351 1,369 (18) 5,447 5,488 (41) 16,366 16, ,310 (178) Premises ,343 3, ,122 10, , Other Expenditure 917 1,080 (163) 3,919 3, ,298 14, , Research & Development Non-Pay ,374 1, ,461 3, ,021 (295) Total Non-Pay Expenditure 5,669 6,018 (349) 22,585 22,995 (410) 69,747 69, ,047 (948) Total NHS Expenditure 14,632 14,886 (254) 58,405 58, , , ,385 (1,810) Commercial Trading Unit Costs 1,927 1, ,949 7, ,153 24, , Total Expenditure 16,559 16,758 (199) 66,354 65, , , ,276 (1,142) EBITDA 1,075 1, ,294 4, ,371 12, ,272 (966) EBITDA Margin % 6.1% 6.5% 6.1% 6.2% 5.8% 6.0% 7.6% NHS Interest, Dividends, Depreciation & Profit/Loss on Disposals ,742 3, ,355 10, , Trading Unit Interest, Depreciation, Dividends & Profit/Loss on Joint Ventures ,516 1, (249) Surplus / (Deficit) (25) ,866 (1,126) NHS EBITDA (59) 2,808 2,700 (108) 7,086 7, ,851 (1,151) NHS EBITDA Margin % 5.0% 4.6% 4.6% 4.4% 3.9% 4.1% 6.4% NHS Surplus / (Deficit) (155) (50) 105 (934) (424) 510 (3,269) (2,850) (1,061) Commercial Trading Unit EBITDA ,486 1, ,285 5, , Commercial Trading Unit EBITDA Margin % 13.6% 19.2% 15.7% 18.2% 18.0% 18.0% 15.3% Commercial Trading Unit Surplus / (Deficit) , ,769 3, ,228 (64) 5

6 6 Analysis Commentary NHS Clinical Income and Commercial Trading income variances are explained in more detail elsewhere within this report. Other income has overachieved by 336k (11.3%) in July reducing the YTD under-performance to 318k (2.6%). The positive position in month is due to the receipt of an additional 419k STF monies relating to 2016/17. The YTD under-performance is related to the under achievement of income CIPs and a shortfall against plan of Research income, for which there is corresponding under-spends within Pay and Non-pay. Nursing Pay costs are 9k overspent in July and 168k (2.0%) underspent YTD. Significant vacancies in a number of areas, including Theatres and A&E at City Road have contributed to the position. STT Pay costs are 131k (11.0%) underspent in July and 553k (11.6%) YTD. The vacancy rate stands at 9.6% in July, with a significant level of vacancies within Ophthalmic services at City Road. A weekly vacancy panel has commenced at City Road to ensure all recruitment is assessed for service need by the senior divisional management team. Admin and Clerical Pay costs are 151k (6.7%) overspent in July and now stand 381k (4.2%) overspent YTD. This continues a worsening trend month-on-month with Admin and Clerical Pay costs. The over-spend in month is primarily driven by high temporary staff expenditure in the Booking centre at City Road and at St Georges. Drugs have overspent by 343k (16.1%) in July and now stand 648k (7.6%) overspent YTD. Much of the over-spend is related to high cost injection activity for which there is a corresponding over achievement of income.

7 Anal Divisional Financial Performance 7 City Road Access Moorfields North Moorfields South Estates & Facilities Corporate Description Budget MTH Actuals MTH MTH Budget YTD Actuals YTD YTD Income 7,745 8, ,176 31, Pay Costs 4,262 4, ,234 16, Non Pay Costs 1,898 2, ,686 8, Below the line Contribution/ Deficit 1,451 1, ,682 6, Description Budget MTH Actuals MTH MTH Budget YTD Actuals YTD YTD Income Pay Costs ,438 1, Non Pay Costs Below the line Contribution/ Deficit ,537-1, Description Budget MTH Actuals MTH MTH Budget YTD Actuals YTD YTD Income 3,318 3, ,434 13, Pay Costs 1,166 1, ,712 4, Non Pay Costs 1,195 1, ,788 5, Below the line Contribution/ Deficit ,477 3, Description Budget MTH Actuals MTH MTH Budget YTD Actuals YTD YTD Income 2,225 2, ,860 8, Pay Costs 1,006 1, ,848 4, Non Pay Costs ,958 2, Below the line Contribution/ Deficit ,903 1, Description Budget MTH Actuals MTH MTH Budget YTD Actuals YTD YTD Income , Pay Costs ,061 1, Non Pay Costs ,539 3, Below the line Contribution/ Deficit ,762-3, Description Budget MTH Actuals MTH MTH Budget YTD Actuals YTD YTD Income ,293 1, Pay Costs 1,311 1, ,887 4, Non Pay Costs ,180 1, Below the line ,602 1, Contribution/ Deficit -1,906-1, ,376-6, Corp. Inc. Contribution/ Deficit R&D Contribution/ Deficit Commercial Contribution/ Deficit , Trust Contribution/ Deficit City Road reported a contribution of 1,939k in July, 489k ahead of plan, however this was largely due to a YTD adjustment related to Corneal activity. The YTD contribution now stands at 6,429k, 253k behind plan. Income is 319k behind plan YTD due to Cataract and Adnexal elective activity being below plan. Pay costs are 581k underspent YTD which is largely as result of vacancies within STT staff, notably within Ophthalmic Technicians. Non-pay now stands 515k overspent YTD; partly due to high cost drug activity for which there is a corresponding income over-performance and partly due to CIP under-achievement. Access is 17k behind its contribution target in July and now stands 143k behind plan YTD. Pay costs are 73k overspent YTD which relates to agency costs in the validation team and Bank costs in the Booking office and Health Records. Non-pay is now 72k overspent YTD relating to Consultancy costs. Moorfields North is 134k behind its contribution target in July and 176k behind YTD. Income is 131k ahead of plan in July and now slightly ahead of plan YTD. The favourable position in month is due to high injection activity and a YTD correction to Bedford activity. Pay costs are on plan in month and now stand 102k underspent YTD which is due to STT vacancies in Moorfields East and Bedford Optoms; Nursing vacancies in the East and at Bedford and an Associate Specialist vacancy at St Anns. Non-pay costs are 268k overspent in month and are now 287k overspent YTD, which relates to high cost drugs costs and under-achievement of CIPs. Moorfields South is 57k behind its contribution target in July and 215k behind YTD. Income is 106k ahead of plan in month and is now 44k ahead of plan YTD. The favourable month is due to some backdated income corrections for Croydon and high Outpatient activity at both Croydon and St Georges. Pay costs are 56k overspent in month and 233k overspent YTD. The overspend relates to high temporary staff costs at St Georges in both Admin and Clerical and Nursing staff groups. Non-pay costs are 107k overspent in month leading to a 27k overspend YTD; this relates to high Drugs costs and a YTD adjustment to the Croydon SLA. Estates and Facilities is 94k ahead of its conribution target in month and 377k ahead YTD. Income is 73k ahead of plan in July and is now 80k ahead YTD. This relates to a back-dated invoice for Nile Street. Pay costs are 78k overspent in month leading a YTD overspend of 66k, relating to a YTD CIP adjustment on Admin and Clerical staff offset by the CIP target within Non-pay. Non-pay is 98k underspent in month and now stands 363k underspent YTD due to underspends across the division, notably within Premises. Corporate is 224k ahead of its contribution target in month and is now 645k ahead of plan YTD. Pay costs are 44k underspent in month and 28k YTD. The underspend relates to Admin and Clerical vacancies across a number of areas and the monthly position includes a YTD correction to agency costs. Non-pay costs are 96k underspent in month and 238k YTD relating to underspends across a number of departments, including a 63k in year benefit for prior year consultancy costs. The in-month position relates to a YTD adjustment to central reserves reltaing to risk. Discussed elsewhere in this report. Discussed elsewhere in this report.

8 8 NHS Income Commentary A&E activity has over-performed in month by 138 (1.6%) attendances leading to an income over-performance of 16k. Elective activity is 117 spells (4.0%) below plan in month, underperforming by 0.07m. Moorfields North underperformed by 131 spells (15.3%) and by 0.11m (13.5%). City Road was very slightly behind plan and the overall elective position was partially mitigated by a favourable performance at Moorfields South. High cost drug injection activity is 237 injections (8.0%) above plan in month, giving a favourable income variance of 0.19m. The over-performance is largely at City Road although most sites recorded a slight overperformance. Outpatients under performed by 674 (1.5%) attendances leading to an income underperformance of 0.16m. YTD there is now an under-performance in Outpatients of 0.54m, of which 0.31m/ 57% is related to Outpatient Follow-ups at City Road. Sustainability and Transformation funding (STF) of 0.06m has been included within the position, in line with our allocation as advised by NHSI, in addition to 0.42m relating to 2016/17. In 2017/18 NHSI have weighted STF monies more heavily towards the end of the year.

9 Income ( '000) Income ( '000) 9 Elective Activity Analysis (Inpatients and Outpatients) 3,800 3,600 3,400 3,200 3,000 2,800 2,600 2,400 2,200 NHS Elective/Daycase Income 2016/17 Actual 2017/18 Budget 2017/18 Actual 2017/18 Forecast July elective income was below planned levels by 0.07m. Average elective income was 149k per working day, below the plan of 157k. Moorfields North was below plan at all sites in month and accounts for the overall elective underperformance; City Road was very slightly behind plan and both St Georges and Croydon helped to slightly mitigate the position. 2, Workings Days Inc. adjustments Target per w orking day ( '000) Actual per w orking day ( '000) (22) (13) (10) (7) ( '000) Other than Paediatrics which was 88k above plan in month most specialities were behind plan, most notably Cataract which was 102k behind plan. 6,100 5,900 5,700 5,500 5,300 5,100 4,900 4,700 4,500 4,300 4,100 3,900 NHS Outpatient Income 2016/17 Actual 2017/18 Budget 2017/18 Actual 2017/18 Forecast July outpatient income was below planned levels across all directorates, most notably at City Road, Ealing and Northwick Park. Average July outpatient income was 238k per working day, 4k below the plan of 242k. Most sub-specialities under-performed in month but in particular Medical Retina which was 0.11m behind plan in July Workings Days Inc. adjustments Target per w orking day ( '000) Actual per w orking day ( '000) (19) 2 (10) (3) ( '000)

10 10 NHS Operating Expenditure Pay Costs by Staff Group and Area Staff Group & Directorate Average Monthly Expenditure ( '000) Staff Group & Directorate Average Monthly Expenditure ( '000) Medical Increase / Nursing Increase / Year to Date Current Month (Decrease) Year to Date Current Month (Decrease) Moorfields North (3) Moorfields North (7) Moorfields South (3) Moorfields South (13) City Road 1,771 1,771 0 City Road 1,089 1, Access Access Corporate Departments (1) Corporate Departments (2) Total 2,610 2,617 (7) Total 2,008 2,019 (11) Average medical pay expenditure this month is 2,617k, which is 7k above the 2017/18 year to date averaged expenditure of 2,610k. The worsening position is largely attributable to additional sessions at City Road. Average nursing pay expenditure in month is 2,019k, which is 11k above the 2017/18 year to date averaged expenditure of 2,008k. The vacancy rate stands at 16.0% in July with significant vacancies in Theatres and A&E at City Road. High temporary staff costs at St Georges have led to an increase in the run-rate at Moorfields South. Staff Group & Directorate Average Monthly Expenditure ( '000) Staff Group & Directorate Average Monthly Expenditure ( '000) Other Clinical Increase / Increase / Non-Clinical Year to Date Current Month (Decrease) Year to Date Current Month (Decrease) Moorfields North Moorfields North (4) Moorfields South (2) Moorfields South (24) City Road (13) City Road Access Access Corporate Departments Corporate Departments 1,373 1,420 (47) Total 1,051 1,063 (12) Total 2,542 2,588 (46) Average other clinical pay expenditure in month is 1,063k, which is above plan by 12k, the 2017/18 year to date averaged expenditure of 1,051k. The vacancy rate stands at 9.6% in July, with significant vacancies in Ophthalmic Services. Average non clinical pay expenditure in month is 2,588k, which is 46k above the 2017/18 year to date averaged expenditure of 2,542k. There have been high levels of expenditure in a number of Corporate areas and high temporary staff usage in the Booking centre at City Road and at St Georges. NB. Research and Development Pay is excluded from the tables above and shown as part of the Research and Development position on page 11.

11 NHS Operating Expenditure Pay Costs Agency and Bank Analysis 11 Staff Type Nursing Current Month Year To Date Average Average Prior Year Nursing Expenditure Current Month Employed 14% Bank Nursing Expenditure YTD Average Employed Bank Agency 13% 1% Average Nursing Expenditure Prior Year Employed Bank Agency 13% 2% Nursing substantive expenditure in July has stayed in line with June. There has been a shift from what were low levels of agency to bank staff. The vacancy rate in month is 16.0%, an increase from 15.1% in June. 86% 86% 85% Medical Medical Expenditure Current Month Employed Locum Agency 10% 0% Medical Expenditure YTD Average Employed Locum Agency 7% 2% Average Medical Expenditure Prior Year Employed Locum Agency 9% 3% Medical locums represent 10% of expenditure in month, while agency expenditure has reduced from 2% to 0%. This is an improvement from the YTD average and 2016/17 where 2/3% agency was consistently used. 90% 91% 88% Non-Clinical Non Clinical Expenditure Current Month Employed Bank Agency 14% 6% 80% Non Clinical Expenditure YTD Average Employed Bank Agency 13% 7% 80% Average Non Clinical Expenditure Prior Year Employed Bank Agency 9% 12% 79% Non-clinical staff groups make use of the highest proportion of agency at 6%. Bank usage is 14%. The above figures represent a slight improvement on the YTD average and a significant improvement from 2016/17, demonstrating a shift from agency staff to bank. The non-clinical vacancy rate is 17.0%. Current Month ( '000) Year To Date Average ( '000) Average Prior Year ( '000) Staff Type Employed Bank Agency Total % Change Employed Bank Agency Total % Change Employed Bank Agency Total Nursing 1, ,019 1% 1, ,008 0% 1, ,004 Medical 2, ,617 0% 2, ,610 0% 2, ,601 Non-clinical 2, ,588 2% 2, ,542 6% 1, ,393

12 Amount ( '000) 12 Efficiency Schemes Profile and Forecast Breakdown of Forecast Achievement 1,400 1% 1,300 1,200 1,100 1, Target Actual Forecast 40% Summary of Performance: - CIP achievement in July 17 was 0.48m vs a plan of 0.59m, 81.2% of the monthly target. The shortfall against target is 0.11m. - Full year forecast is to deliver the target of 8.2m. 8% 24% - The Trust is continuing to identify further schemes to bridge the gap that currently exists within the CIP program. 27% Agency & Consultancy Drugs Clinical Supplies INCOME Pay Period - Fortnightly meetings for each directorate have been initiated to ensure deliverability against identified schemes and to continue to identify new schemes. Directorate / Corporate Department Full Year Target ( '000) Value of Schemes Identified ( '000) YTD Target (original phased budget) ( '000) YTD Amount Achieved ( '000) YTD ( '000) Full Year Forecast Amount ( '000) YTD Amount Forecast % Achieved as Achievement % of Full of Target Year Target Actions on Shortfall and Unidentified Amount Moorfields North 1, (46) 1, % 10% Achievement YTD is 124k against a target of 170k, and slippage is due to a number of schemes, especially Darrent Valley and Laser Business Case schemes. CIP schemes identified YTD total 487k. There are some schemes identified as opportunities, but are waiting on business cases to go through to confirm the savings. Moorfields South (32) % 11% Achievement YTD is 97k against a target of 129k, slippage is largely related to 2 schemes; Nursing skill mix schemes and reducing the DNA rate at the St Georges sites. CIP schemes have been identified YTD totalling 452k.. The other schemes identified are at various stages of development and implementation. City Road 3,909 3,270 1, (207) 3, % 20% Achievement YTD is 797k against a target of 1003k, slippage is due to delays in progressing a scheme to improve Theatre Utilisation and a Pharmacy procurement scheme. CIP schemes have been identified YTD that total ( 3,270k). Access Division % 2% Achievement YTD is 9k against a target of 9k, most schemes are phased towards the latter part of the year, as this is a new division that was formed from the restructure. Corporate Departments 1,688 1, (71) 1, % 25% Achievement YTD is 420k against a target of 491k, slippage is due to delays in starting a number of schemes across different areas; including relating to Catering, Hybrid Mail and Interpreting services. CIP schemes have been identified YTD that total ( 1,361k), albeit those schemes identified are at various stages of development and implementation. Total 8,200 5,723 1,802 1,447 (355) 8, % 18%

13 Research and Development Position 13 Research and Development In Month Year to Date Full Year Budget Actual Budget Actual Budget Forecast 000s 000s 000s 000s 000s 000s 000s 000s 000s Total Income 1, (159) 4,189 3,904 (285) 12,394 12,394 0 Expenditure Pay Costs ,650 2, ,795 7,795 0 Non-Pay Costs ,374 1, ,461 3,461 0 Total Expenditure ,024 3, ,256 11,256 0 Interest, Dividends, Depreciation Total Contribution to overhead (15) In month R&D income is 0.16m below plan. Expenditure was also below plan in month by 0.14m. Overall financial performance in month is 0.02m below plan, and YTD contribution now stands at 0.18m, 0.06m above plan. The forecast for the full year is on plan at 0.94m contribution. Commercial Trading Units Commercial Trading Unit Position In Month Year to Date Full Year Forecast Prior Year YTD Budget Actual Budget Actual Budget Forecast Actual 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s Total Income - including Internal Sales 2,231 2, ,435 8,828 (607) 29,438 29, ,409 (581) Expenditure Pay Costs ,257 2, ,964 9, , Non-Pay Costs 1,144 1,165 (21) 4,692 4, ,189 14, , Total Expenditure 1,927 1, ,949 7, ,153 24, , Commercial Trading Unit EBITDA ,486 1, ,285 5, , Commercial Trading Unit EBITDA Margin % 13.6% 19.2% 15.7% 18.2% 18.0% 18.0% 16.1% Interest, Dividends, Depreciation and interests in joint ventures ,516 1, (249) Commercial Trading Unit Surplus / (Deficit) , ,769 3, ,325 (161) Less Internal Sales (97) 97 Commercial Trading Unit Surplus / (Deficit) - discounting internal sales , ,769 3, ,228 (64) Commercial income in month is above plan by 0.09m. Forecast for the full year is to achieve the planned income level of 29.44m. Expenditure in month is below planned levels by 0.06m. Full year expenditure is expected to be on plan at 24.15m. In month performance was a 0.34m surplus, 0.17m above plan, YTD the surplus now stands at 1.16m, 0.26m above plan. Full year forecast is to deliver a surplus of 3.77m.

14 14 Cash Flow Cash balance was 44.3m at the end of July, 3.8m above plan. This is primarily due to receipt of STF incentive funding in July. Forecast cash balance at year end is expected to be above plan after taking into account capital expenditure, PDC dividend, loan capital repayments and interest payments. Capital Expenditure Capital Expenditure ( Millions) Annual Budget Expenditure Year to Date Expenditure Committed Year End Forecast Var to Plan Forecast Estates Medical Equipment IT Corporate Strategic Schemes Dubai Contingency/Carry Forward (0.87) (0.87) 0.00 Total Total capital expenditure year to date is 0.57m. In addition, a further 3.91m has been committed through approved orders. Capital plan for the year is 30.87m and incorporates investment in Trust clinical estate, medical equipment, IT and strategic schemes. Planning for strategic schemes will be reviewed over the coming months and forecast will be updated accordingly.

15 15 Debtors Management and Credit Control Type of Debt 6 Mths + 5 Mths 4 Mths 3 Mths 2 Mths 1 Mth Overdue Current Total Jan 17 Feb 17 Mar 17 Apr 17 May 17 Jun 17 Jul 17 Jul 17 Jul 17 Welsh Debts only NHS Service Income 1,394 (206) 2, (1,024) 2,525 1,043 3,568 Total Contract Debts 2,229 (198) 2, (1,005) 3,433 1,110 4,543 Private Patients 1, , ,873 Sundry Debtors 1, ,731 2,045 4,776 TOTAL 5,394 (67) 2, (124) 9,252 3,940 13,192 Type of Debt Overdue Current Total Overdue Current Total % Var % Var % Var Jul 17 Jul 17 Jul 17 Jun 17 Jun 17 Jun 17 Overdue Current Total Welsh Debts only , ,120 (17.5%) 252.6% (12.9%) NHS Service Income 2,525 1,043 3,568 5,804 (1,624) 4,180 (56.5%) (164.2%) (14.6%) Total Contract Debts 3,433 1,110 4,543 6,905 (1,605) 5,300 (50.3%) (169.2%) (14.3%) Private Patients 3, ,873 3, , % 34.0% 7.1% Sundry Debtors 2,731 2,045 4,776 2,651 2,454 5, % (16.7%) (6.4%) TOTAL 9,252 3,940 13,192 12,586 1,435 14,021 (26.5%) 174.6% (5.9%) Comments Overall debt has decreased by 0.8m in July to 13.2m ( 14.0m June) due to settlement of performance and NCA debt. Total overdue debt has decreased by 3.3m in July to 9.3m ( 12.6m June). This is due to a combination of settlement of performance/nca debt and credit notes issued following year-end and April 17 reconciliations with commissioners in June. Key debtors over 4 months overdue Welsh Health Bodies 0.9m NWL Group 0.6m SWL Group 0.5m Barts Trust 0.3m St Georges Trust 0.2m Please note: Values shown in the above tables are for the stated types of debt only, and exclude UAE. Additional items not included above comprise overall debt for the Trust, including provisions and accruals.

16 16 Total Debt by Age '000 Overdue CCG debt NEL, NWL and SWL CCG groups collectively account for 1.2m (55%) of overdue English contract debt ,940 2,969 5, Mths + 5 Mths 4 Mths 3 Mths 2 Mths 1 Mth Current 13,192 Total NCA (Non-Contract Activity) overdue debt includes Kent & Sussex Area CCGs with 38% of the total overdue balance of 0.9m. As is the case with all NCA debts, an individual targeted approach is made for each debtor (124 in total). 2.7m cash was received from 1 st to 14 th August, of which 2.1m was for SLA invoices, 0.5m for 2016/17 performance/nca invoices and 0.1m for performance/nca invoices. Overdue Sundry debt Total Debt by Type '000 Overdue sundry debt is 2.7m in July. 0.3m of this is overdue from Barts Trust and 0.2m from St Georges Trust m cash was received from 1 st to 14 th August, of which 0.9m was from Bedford Trust. Welsh Debts only 3,940 2,525 NHS Service Income 2,731 3,088 Private Patients Sundry Debtors Current Total 13,192 Note: Standard NHS payment terms are 30 days from the invoice date. SLA payments are mostly made on the 15 th of each month and, once set up, tend to run smoothly. Delays in payment occur when data is delayed or disputed, or queries arise which require investigation.