Item 6. Monthly Finance Report For November Prepared by: Stephen Dunham Financial Controller

Transcription

1 1 Item 6 Monthly Finance Report For November 2015 Prepared by: Stephen Dunham Financial Controller Helen De Spretter Head of Financial Performance and Decision Making David Bebb Deputy Finance Director Steven Davies NHS Finance Director & Deputy Chief Financial Officer Presented By: Action for Board: For information For consideration For decision Charles Nall Chief Financial Officer Board of Directors Meeting 17 th December 2015 Date produced 11 th December 2015

2 2 Contents of Main Report Page Number Executive Financial Summary 3 Detailed Income and Expenditure Position 4 Underlying Position 5 NHS Income 6 NHS Operating Expenditure 8 Efficiency Scheme Performance 11 Research & Development and Commercial Trading Position 12 Cashflow 13 Debtors Management and Credit Control 14

3 3 Overall Position - Surplus / (Deficit) Research & Development Position Commercial Trading Unit Position Financial Sustainability Risk Rating Cash Flow Debtors Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) (1.3) (2.6) Full Year Forecast Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) (1.0) (3.0) (3.5) (0.3) (0.5) (1.3) 1.0 (1.3) (2.3) (3.3) (2.3) (1.0) % Full Year achieved Full Year % forecast In Month 65% 40% Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) 67% (1.4) (1.9) Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) In Month Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) Plan ( M) Actual ( M) Var ( M) (0.1) (0.6) (1.0) Indicator Debt Service Cover YTD Liquidity 4 I&E Margin 3 I&E Margin Variance Financial Sustainability Risk Rating Year to Date Year to Date Executive Financial Summary In Month Year to Date Full Year Forecast Key Risks and Actions Required NHS In Month Year to Date (exc. R&D) Income Expenditure Overall Position Efficiency Scheme Performance YTD % achieved Year to Date Comment Full Year Forecast Full Year Forecast Full Year Forecast Rating of 3 (out of 4) for November YTD, the main pressure coming from I&E margins, both absolute and in relation to plan, in the remainder of the year. FSRR comprises Continuity of Service Risk Rating (Debt Service Cover & Liquidity) and two added measures based on profitability and achievement of plan. Cash Cash Balance ( M) ( M) Year End Actual Actual Actual Actual end end Actual Actual end end of of Forecast Forecast End End Forecast Forecast end end Monitor Monitor Plan Plan 2014/15 End of of Q1 Q1 End End of of Q2 Q2 of of P7 P7 P8 P8 of Q3 of Q3 of Q4 of Q4 Year Year End End Last Month Overdue Debts 6 Mths Mths 2 Mths 1 Mth Total Total ( M) ( M) ( M) ( M) ( M) ( M) NHS Contract Debts Commercial Debts Other TOTAL Key Income and Expenditure Risks: The net surplus in month of 0.2M is 1.3M less than planned surplus of 1.5M due to underperformance in NHS clinical income and high NHS non-pay expenditure. Commercial Trading units achieved a surplus of 0.5M in month, 0.1M below plan making YTD surplus of 1.4M, 0.6M behind plan. NHS pay costs are within plan in month with overspends on medical and admin staff being offset by underspends on nursing staff. NHS non-pay costs are over budget by 0.3M this month due to overspends on genetic tests and MRI scans within ODS; site costs for properties within Estates; and underachievement on the efficiency target. Delivery of efficiencies YTD is at 65% but 0.8M, 31% of the total delivered is non-recurrent. Forecast is to deliver 4.6M, a shortfall of 1.9M. Actions: Activity recovery plan produced by operational managers needs to be actively implemented. Focus on improving commercial divisional performance. Prioritise achievement of recurrent savings schemes to deliver the forecast position. Ensure the controls on bank/agency nursing and admin shifts continue to be maintained. Financial sustainability risk rating FSRR rated 3 year to date, noting worsening forecast performance in December creates risk of further deterioration to a 2 for end of quarter and year to date. Actions: Sensitivity and forecast position being reviewed and remedial actions developed to maintain FSRR of 3. Cashflow and Balance Sheet Risks: Overdue debts total 10.3M ( 4.3M NHS contract debts, down 1.8m in-month). Cash decrease in month of 0.4M (up 7.3M since year end) to 27.1M with strong settlement of NHS debts offset by decreases in s/term creditors. Actions: Review spending priorities for capital, particularly around larger projects requiring loan or other funding support. Increase formality of debtor process with commissioners, working directly to understand underlying issues with payment delays.

4 4 Overall Trust I&E Summary Income Detailed Income and Expenditure Position - Surplus / (Deficit) In Month Year To Date Full Year Forecast Budget Actual Variance Budget Actual Variance Budget Actual Prior Year YTD Variance Actual Variance 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s NHS Clinical Income 13,490 12,487 (1,004) 103,117 99,412 (3,705) 155, ,126 (4,417) 93,723 5,690 Commercial Trading Units 2,653 2,538 (115) 18,774 17,779 (994) 29,398 27,845 (1,554) 17, Other Income 1,710 1, ,758 14, ,593 21,748 1,155 17,521 (2,833) Total Income 17,853 16,785 (1,068) 135, ,879 (3,770) 205, ,718 (4,816) 128,653 3,226 NHS Expenditure Pay Exenditure Medical 2,568 2,614 (46) 20,646 20, ,906 30, ,732 (555) Nursing 1,941 1, ,519 15, ,303 22, ,380 (673) Scientific, Professional & Technical ,780 7, ,702 11, ,018 (603) Admin and Clerical 2,062 2,101 (39) 16,657 16,978 (321) 24,905 25,463 (558) 15,849 (1,129) Ancillary Services (1) 1,339 1, ,024 1, , Research & Development Pay ,166 4, ,759 7, ,506 (182) Total Pay Expenditure 8,357 8, ,107 65,883 1, ,599 99, ,791 (3,092) Non-Pay Exenditure Drugs 1,851 1, ,782 14, ,021 22, ,029 (1,708) Clinical Supplies and Services 1,048 1,160 (112) 9,488 9,524 (36) 14,493 14,974 (481) 9,433 (90) Premises (99) 6,391 6,404 (14) 9,409 9,561 (152) 5,556 (849) Other Expenditure 1,310 1,445 (136) 8,803 9,086 (283) 18,056 13,694 4,361 9,045 (41) Research & Development Non-Pay ,471 1,842 (371) 2,207 2,843 (636) 1,171 (671) Total Non-Pay Expenditure 5,101 5,400 (299) 40,935 41,593 (658) 67,185 63,904 3,281 38,234 (3,359) Total NHS Expenditure 13,458 13,678 (221) 108, , , ,827 3, ,025 (6,450) Commercial Trading Unit Costs 1,992 1, ,368 16, ,594 24, ,181 2,166 Total Expenditure 15,450 15,642 (192) 124, , , ,842 4, ,206 (4,284) EBITDA 2,403 1,143 (1,260) 11,240 8,389 (2,850) 13,155 12,877 (279) 9,447 (1,058) EBITDA Margin % 13.5% 6.8% 8.3% 6.4% 6.4% 6.4% 7% NHS Interest, Dividends, Depreciation ,151 6, ,615 10, ,186 (1,776) Trading Unit Interest, Depreciation, Dividends Surplus / (Deficit) 1, (1,238) 3,729 1,088 (2,641) 2,000 2, ,354 (2,266) NHS EBITDA 1, (1,174) 8,834 6,624 (2,210) 8,351 9, ,219 (3,594) NHS EBITDA Margin % 11.5% 4.0% 7.6% 5.8% 4.7% 5.2% 9% NHS Surplus / (Deficit) 841 (312) (1,154) 1,683 (338) (2,021) (2,264) (1,299) 965 5,032 (5,370) Commercial Trading Unit EBITDA (86) 2,406 1,765 (641) 4,804 3,830 (975) (771) 2,536 Commercial Trading Unit EBITDA Margin % 24.9% 22.6% 12.8% 9.9% 16.3% 13.8% -4% Commercial Trading Unit Surplus / (Deficit) (85) 2,046 1,426 (620) 4,264 3,299 (965) (1,678) 3,104

5 5 Underlying Position Overall Trust I&E Summary In Month Qtr 2 Qtr 1 Year to Date Budget Actual Budget Actual Budget Actual Budget Actual 000s 000s 000s 000s 000s 000s 000s 000s Total Income 17,853 16,785 50,252 49,663 49,079 48, , ,879 Total NHS Expenditure 13,458 13,678 40,916 41,148 40,027 38, , ,476 Commercial Trading Unit Costs 1,992 1,963 5,686 5,648 6,683 6,357 16,368 16,014 Total Expenditure 15,450 15,642 46,602 46,796 46,710 45, , ,490 EBITDA 2,403 1,143 3,651 2,867 2,368 3,142 11,240 8,389 EBITDA Margin % 13.5% 6.8% 7.3% 5.8% 7.0% 6.7% 7.0% 6.7% NHS Interest, Dividends, Depreciation ,604 2,475 2,716 2,707 7,151 6,962 Trading Unit Interest, Depreciation, Dividends Surplus / (Deficit) 1, (482) 312 3,729 1,088 Adjustment to Reach Underlying Position: Income - Project Oriel (36) (36) - Donated Asset Benefit 0 (28) 0 (33) (94) - Ocular Oncology funding for set up costs (328) (328) -VAT Reclaim 7 (65) 39 (5) -Prior Year Education funding (94) (141) Total Income 0 (21) 0 (228) 0 (289) 0 (604) Expenditure - Non-recurrent benefits Corporate non-pay accrual gain (365) (365) Sale Proceeds (86) (86) - Non-recurrent costs Theatre Refurbishment Project Oriel Ocular Oncology Set Up Change in Provisions Other Trading non-recurrent pay costs Other Trading non-recurrent non-pay costs Impairments Total Expenditure , ,042 1,317 Total , , Revised Underlying Position 1, , ,771 1,801 Notes: Underlying position in month is a 0.3M surplus and a 1.8M surplus year to date. Non-recurrent income is offset by underperformance in NHS clinical income. The YTD surplus of 1.8M is below the planned surplus of 3.7M. The plan includes 2.0M for non-recurrent expenditure when only 1.3M expenditure has been incurred and there are additional non-recurrent benefits of 0.6M. The underlying YTD position is therefore 4.0M worse than plan. Non-recurrent income and a 0.4M non-recurrent gain under expenditure are offset by non-recurrent costs YTD. The non-recurrent costs of renting additional theatre capacity during refurbishment works have been included in this non-recurrent expenditure list.

6 6 NHS Income Commentary: NHS clinical income is 1.0M below plan in month and 3.7M below plan YTD. Other Income is on plan in month. Elective activity is 584 spells (18%) below plan in month, which gives an adverse income variance of 0.6M. YTD activity is 2,636 spells (11%) below plan and income is 2.6M below plan YTD. YTD underperformance can be broken down to 1058 spells (42%) at City Road, 1122 spells (43%) across Moorfields North sites and 387 spells (15%) for Moorfields South sites. High cost drugs activity is 384 injections (13%) below plan in month, giving an adverse income variance of 0.2M. YTD position is an underperformance of 1693 injections and 0.6M. All of the underperformance is across North sites with City Road delivering on plan and South sites over performing on plan. Outpatient income is also below plan in month by 0.2M when the YTD position is 0.7M below plan. Areas with underperformance in month include City Road and Moorfields North sites.

7 Elective Activity Analysis (Inpatients and Outpatients) 7 Elective income generated 129k per working day in November against a plan of 153k. The total YTD variance of 2,600k below plan is all due to a lower volume of activity against plan. The graph shows that from July to November, income this financial year is below that achieved in 2014/15 by an average of 404k per month. Elective activity is below plan for all specialities at City Road except Cataract which is above plan. Areas of highest underperformance are Glaucoma, Adnexal, Vitreo Retinal and External Disease Target per working day ( '000) (13) 5 (16) (17) 6 (24) (33) (24) Workings Days Inc. adjustments Actual per working day ( '000) Variance ( '000) Other sites with the highest underperformance against plan are St. Anns, Mile End, Ealing, Potters Bar and Queen Mary s Roehampton mainly in Cataract. Forecast is to remain below plan in December and meet plan for Q4. A recovery plan has been worked up by operational staff which needs to be implemented. Outpatient income generated 255k per working day against a plan of 265k. The year to date trend has seen underperformance on follow-up appointments offset by overperformance on new appointments Workings Days Inc Target per working day Actual per working day (7) 9 (12) (13) 38 (8) (18) (10) Variance ( '000) The forecast expects outpatient activity to be on plan in December and just below plan for Q4.

8 8 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 (5) Moorfields North Moorfields South Moorfields South Outpatient & Diagnostic Servs 1,046 1,042 (4) Outpatient & Diagnostic Servs Surgical Services Surgical Services (46) Corporate Departments Corporate Departments Total 2,536 2, Total 1,946 1,941 (6) - Expenditure this month is 2,614k which is 78k above the YTD average and 155k above the average for last financial year of 2,459k. - It is 46k above budgeted expenditure for the month. Overspend is due to continued agency locum usage within Moorfields South and additional sessions within Surgical Services. - Increases in Surgical Services are due to additional sessions. - Expenditure is 1,941k this month which is 6k below the YTD average of 1,946k. - Costs are below budget by 75k. - Theatres at City Road are forecast to continue to overspend across quarter 3 and then to make savings in quarter 4 when a new staffing model is expected to be fully implemented. Other Clinical Increase / Increase / Non-Clinical Year to Date Current Month (Decrease) Year to Date Current Month (Decrease) Moorfields North (2) Moorfields North (3) Moorfields South (1) Moorfields South (4) Outpatient & Diagnostic Servs Outpatient & Diagnostic Servs Surgical Services (2) Surgical Services (34) Corporate Departments 0 0 (0) Corporate Departments 1,275 1, Total Total 2,276 2,265 (11) - Expenditure in month of 957k is a 4k increase on the YTD average monthly expenditure. - Scientific staff pay costs are 19k below budget in month with overspends within pharmacy being offset by underspends within Orthoptics. - Expenditure has decreased this month to 2,265k which is 11k below the YTD average of 2,276k, but still 110k above average monthly expenditure last financial year of 2,155k. - Admin and clerical pay costs are 39k above budget in month, with overspends in A&E. NB. Research and Development Pay is excluded from the tables above and shown as part of the Research and Development position on page 12. Research and Development have a separate quarterly board report.

9 9 NHS Operating Expenditure Pay Costs Agency and Bank Analysis Staff Type Nursing Current Month Year To Date Average Average Prior Year Nursing Expenditure Current Month 9% 3% 88% Nursing Expenditure YTD Average 11% 2% 87% Average Nursing Expenditure Prior Year 16% 2% 82% Comments Bank expenditure has decreased and agency expenditure has increased in month. Bank is 9% and agency is 2% of total expenditure. The employed staff costs have also increased slightly this month. The vacancy rate in month is 14% with 80 vacancies. This has been filled with 64 WTE of bank staff and 13 WTE of agency staff. Other Clinical Other Clinical Expenditure Current Month 0% 1% 99% Other Clinical Expenditure YTD Average 0% 3% 97% Average Other Clinical Expenditure Prior Year 0% 4% 96% Other Clinical staff are the pharmacists, optometrists, orthoptists, technicians in SSD, EDD, prosthetics, contact lens & spectacle manufacturing, the eye bank, medical photographers and radiographers. We do not run a staff bank but agency is used in pharmacy and SSD. The other departments rely on overtime from substantive staff. Non Clinical Expenditure Current Month Non Clinical Expenditure YTD Average Average Non Clinical Expenditure Prior Year Non-clinical staff use the highest proportion of agency at 12%, higher than the proportion of bank used which is 7%. Non-Clinical 7% 12% 9% 13% 7% 17% Corporate departments have the highest vacancy rate for Admin & Clerical staff at 23% and used 261k of agency in month. Costs are just within budget in month. 81% Current Month ( '000) Year To Date Average ( '000) Average Prior Year ( '000) Staff Type Total % Change Total % Change Total Nursing 1, ,941 0% 1, ,947 1% 1, ,918 Other Clinical % % Non-clinical 1, ,265 0% 1, ,276 6% 1, ,155 78% 76% Clinical areas have a vacancy rate of 13% on Admin & Clerical staff.

10 10 NHS Operating Expenditure Non-Pay Costs Comments: Directorates non-pay expenditure is 0.3M above plan in month and 1.4M above plan YTD due to unidentified efficiency target and overspends on consultancy, primarily for the set up and transfer of the ocular oncology service. Comments: Corporate departments non-pay expenditure is 0.1M above plan in month and 1.1M below plan YTD due to 0.8M of cost pressure reserves profiled evenly through the year and 0.4M non-recurrent benefit from prior year accruals. Costs on external consultants are 0.05M above plan in month and 0.2M above plan YTD. The main corporate non-pay pressures continue to be within Estates & Facilities on interpreter s fees, site and refurbishment costs for new buildings.

11 Amount ( '000) Efficiency Scheme Performance Efficiency Schemes Profile and Forecast Breakdown of Forecast Achievement Clinical Supplies 4% 13% 40% Drugs 22% Non-Clinical Supplies 21% Pay Target Actual Forecast Revenue Summary of Performance: - Year to date achievement is 2,605k, 65% of target and 40% of the full year target. The YTD shortfall against target (including an equally phased share of unidentified target) is 1,390k. - Full year forecast is to deliver 4,553k. This is 94% of the identified schemes value but 70% of the full year target. Period YTD Target (original phased budget)( ) YTD Year to Date % Full Year Variance ( ) Achievement Target ( ) Value of Schemes Identified ( ) Full Year Forecast Amount ( ) YTD Amount Forecast % Achieved as Achieveme % of Full nt of Target Year Target Directorate / Corporate Department YTD Amount Achieved ( ) Actions on Shortfall and Unidentified Amount YTD achievement is only 24% of annual target, 17% is due to unidentified amount of target and the remaining 25% is due to under-delivery of schemes particularly Moorfields North 504, , ,320 39% 817, , ,012 58% 24% revenue generation where only 12k of 151k has been delivered. Moorfields South 281, ,556-58,499 79% 460, , ,900 77% 48% Croydon 220, ,152-68,848 69% 330, , ,917 72% 46% The delay in procurement savings on AMD packs and contact lenses continue to impact in year delivery as well as under-delivery on the drugs schemes and revenue schemes around reducing DNA's make up 245k of underperformance Outpatient & Diagnostic Services 1,165, , ,552 50% 2,074,020 1,675,387 1,329,758 64% 28% against plan. The full year unidentified amount is 437k and 209k YTD. YTD achievement is 95% but this mainly due to non-recurrent additional savings Surgical Services 943, ,949-49,973 95% 1,460, ,558 1,291,933 88% 61% which total 752k (84%) of the total achieved YTD of 894k Clinical Directorates 3,115,494 2,043,302-1,072,192 66% 5,142,411 3,782,755 3,690,520 72% 40% Chief Operating Officer 40,000 14,804-25,196 37% 60,000 22,204 22,204 37% 25% Unidentified target of 38k. Corporate Governance 29,328 24,496-4,832 84% 43,992 36,744 36,744 84% 56% Unidentified target of 7k. Director of Nursing 51,336 51, % 77,004 77,004 77, % 67% Director of Strategy 61,328 61, % 91,992 91,992 91, % 67% Unachieved schemes YTD are postage and interpreting, the achievement of which Estates and Facilities 349, , ,066 69% 524, , ,307 65% 46% relies on Trustwide change. Unidentified target of 110k. Full year forecast achievement has fallen to 151k, 66% as further project Finance 132,838 87,584-45,254 66% 228, , ,768 66% 38% consultancy is forecast to be required. Human Resources 77, ,336 0% 116, % 0% One scheme has been identified that would deliver saving in 16/17. Underperformance YTD is 45k. 144k (76% of target) is still forecast for the end Information Technology 126,000 80,834-45,166 64% 189, , ,834 76% 43% of the year. Quality and Safety 11, ,704 0% 23,004 5, % 0% Corporate Department Initiative 879, , ,554 64% 1,353,990 1,084, ,853 64% 41% TRUST TOTAL 3,995,356 2,604,610-1,390,746 65% 6,496,401 4,867,181 4,553,373 70% 40%

12 Research and Development Position 12 Research and Development In Month Year to Date Full Year Budget Actual Variance Budget Actual Variance Budget Forecast Variance 000s 000s 000s 000s 000s 000s 000s 000s 000s Total Income (21) 7,490 7, ,230 11, Expenditure Pay Costs ,166 4, ,759 7, Non-Pay Costs ,471 1,842 (371) 2,207 2,843 (636) Total Expenditure ,637 6, ,966 10,209 (243) Interest, Dividends, Depreciation Total Contribution to overhead , (43) Income: Income is on plan in month and 0.2M above plan year to date due to the release of prior year provisions for income from academic partners for set up costs. Expenditure Expenditure is 0.1M below plan in month and year to date with an offset between pay and non-pay due to actual costs not following the mix assumed for planning purposes. Commercial Trading Units Commercial Trading Unit Position In Month Year to Date Full Year Forecast Prior Year YTD Budget Actual Variance Budget Actual Variance Budget Forecast Variance Actual Variance 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s 000s Total Income 2,670 2,565 (105) 18,894 17,951 (943) 29,590 28,085 (1,505) 17, Expenditure Pay Costs ,134 5, ,065 8, ,240 1,482 Non-Pay Costs 1,272 1,296 (24) 10,234 10,257 (22) 15,529 15, , Total Expenditure 1,992 1, ,368 16, ,594 24, ,181 2,166 Commercial Trading Unit EBITDA (76) 2,526 1,937 (589) 4,996 4,070 (926) (538) 2,475 Commercial Trading Unit EBITDA Margin % 25.4% 23.5% 13.4% 10.8% 16.9% 14.5% -3% Interest, Dividends, Depreciation Commercial Trading Unit Surplus / (Deficit) (75) 2,167 1,598 (569) 4,456 3,540 (916) (1,445) 3,043 Internal Sales (17) (27) 10 (120) (172) 52 (192) (241) 49 (233) 61 Commercial Trading Unit Surplus / (Deficit) - discounting internal sales (85) 2,046 1,426 (620) 4,264 3,299 (965) (1,678) 3,104 Income: Income is 0.1M behind plan in month and 0.9M behind plan year to date. Expenditure Expenditure is on plan in month and 0.4M behind plan year to date. Overall Position is a 0.5M surplus in month which is 0.1M below plan. Year to date is a 1.4M surplus which is 0.6M behind plan. Full year forecast is a surplus of 3.3M which is 1.0M below plan.

13 Cash Flow 13

14 14 Debtors Management and Credit Control Type of Debt 6 Mths + 5 Mths 4 Mths 3 Mths 2 Mths 1 Mth Overdue Current Total May 15 Jun 15 Jul 15 Aug 15 Sep 15 Oct 15 Nov 15 Nov 15 Nov 15 Welsh Debts only 1, , ,392 NHS Service Income 1, ,958 1,465 4,423 Total Contract Debts 2, ,337 1,478 5,815 Private Patients 2, ,699 1,042 4,741 Pharmacy Sales ,334 Sundry Debtors ,776 1,534 3,310 TOTAL 5, ,007 1,272 1,727 10,331 4,869 15,200 Prior month 5, , ,416 2,938 11,720 Change in month k (425) 343 (694) 742 (144) (1,211) (1,389) Change in month % (7.4%) 126.1% (64.9%) 280.0% (10.2%) (41.2%) (11.9%) Type of Debt Overdue Current Total Overdue Current Total % Var % Var % Var Nov 15 Nov 15 Nov 15 Oct 15 Oct 15 Oct 15 Overdue Current Total Welsh Debts only 1, ,392 1, , % (7.7%) 0.7% NHS Service Income 2,958 1,465 4,423 4, ,105 (37.5%) 290.5% (13.4%) Total Contract Debts 4,337 1,478 5,815 6, ,487 (28.9%) 279.7% (10.4%) Private Patients 3,699 1,042 4,741 3, , % 28.3% 8.2% Pharmacy Sales , , % (4.5%) (0.8%) Sundry Debtors 1,776 1,534 3,310 1,560 1,439 2, % 6.6% 10.4% TOTAL 10,331 4,869 15,200 11,720 3,494 15,214 (11.9%) 39.4% (0.1%) 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. Monthly highlights Total overdue debt fell by 1.4M in November to 10.3M ( 11.7M October 2015). Although total NHS overdue debt fell by 1.8M during November as historic performance balances continued to be settled, the aging of NHS debt remains a concern. NELC Group has continued settling historic debts from 2014/15, but significant performance debts from 2015/16 are now overdue by several months. At the end of November NEL have overdue outstanding debts of 2.1M, of which 0.5M relate to 2014/15. Much of Private Patients 6 months plus debt is matched by credit balances and a reconciliation process with debtors continues. December 2015 is likely to see a sharp increase in overdue debts, as November invoices become overdue over the Christmas period and no indication has yet been received that settlement will take place at this time.

15 15 1,727 1,272 1,007 5,334 Overdue by age, k as at November ,869 6 Mths Mths 4 Mths 3 Mths 2 Mths 1 Mth Current Overdue CCG debts NEL, NWL and SWL CCG groups collectively account for 2.2M (50%) of overdue English contract debts, 1.5M of which is 3 months or more overdue (see previous NEL comments). This represents a much lower value than in previous months and reflects the continuing effort to resolve historic debts by the Accounts Receivables and Contracting teams, although the amounts involved remain significant and concerning. NCA (Non-Contract Activity) overdue debt includes Kent & Sussex Area CCGs with 50% of the total overdue balance of 0.4M. As is the case with all NCA debts, an individual targeted approach is made for each debtor (130 in total). 2.8M cash was received from 1 to 7 December, of which 2.4M SLA 0.3M in respect of 2014/15 Performance, and 0.1M in respect of 2015/16 Performance. Overdue Sundry debts 4,869 1,379 2,958 Overdue by debtor, k as at November 2015 Welsh Debts only NHS Service Income Overdue sundry debts decreased by 0.2M in November to 1.8M. 0.25M of this is due from NHS England for Ocular Oncology setup costs awaiting authorisation, 0.14M from Princess Alexandra Hospital which remains under dispute, and 0.16M from Barts regarding CLRN. 408 debtors comprise the remaining 1.2M. Private Patients Pharmacy Sales Sundry Debtors 0.11M cash was received from 1 to 7 December, of which 78K was for overdue debts. 1, ,699 Current A note on collection and overdue contract debts 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.