DRAFT NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST FINANCE AND INVESTMENT COMMITTEE

Transcription

1 DRAFT NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST FINANCE AND INVESTMENT COMMITTEE MINUTES OF THE MEETING HELD ON 23 NOVEMBER 2017, IN THE BOARD ROOM, TRUST HEADQUARTERS, NOTTINGHAM CITY HOSPITAL CAMPUS Present: Mr S. Thomas Dr K. Girling Mrs E. Grant Mrs J. Pomeroy Ms C. Shaw Mr R. Egginton Mrs T. Taylor Non Executive Director / Committee Chair Medical Director Non Executive Director Non Executive Director Chief Operating Officer Director of Finance and Procurement Chief Executive In Attendance: Mr N. Callow* Dr A. Carney* Mr T. Guyler* Mr R. Goold* Mr D. Hanslow* Ms N. Hill Ms A. Kemp* Mr S. Linthwaite* Dr A. McGregor* Mr M. O Daly Mr K. Oliver* Mr D. Orme Ms M. Place* Ms L. Reilly* Dr J. Skoyles* Mr D. Stutchbury* Mr J. Whitehall* Mr G. Wilkes* Empath Finance Director Consultant Anaesthetist Director of Improvement and Integration Head of PMO Divisional General Manager Director of Human Resources Divisional Manager Designate Associate Director of Finance Empath Medical Director Trust Secretary Divisional Manager Deputy Director of Finance Apprentice Lead Divisional Nurse Divisional Director Associate Director, Commercial Finance Officer Managing Director, Pharmacy Company * present as indicated 1

2 Cumulative Record of Committee Attendance in 2017/18 Name Possible Actual Mr R. Egginton 8 7 Dr S. Fowlie 2 0 Dr K. Girling 6 6 Ms E. Grant 8 8 Dr P. Homa 7 6 Mr E. Morton 4 1 Mrs J Pomeroy 8 7 Ms L Scull 1 0 Ms C Shaw 8 6 Ms M Sunderland 5 5 Mrs T. Taylor 1 1 Mr S Thomas /235 Introduction / Welcome 13:00 The Chair welcomed all members present. 2017/236 Apologies for Absence There were no apologies for absence. 2017/237 Declarations of Interest on Agenda Items It was noted that Mr Egginton and Ms Shaw were directors of the Pharmacy Company. It was agreed that they need not leave the meeting for the relevant agenda item. 2017/238 Committee Terms of Reference Noted. 2017/239 Draft Minutes of the Meeting Held on 19 October 2017 The minutes of the previous meeting were agreed as a true record. 2017/240 Matters Arising and Action Log from 19 October 2017 The committee noted that the actions in the log were either completed or in hand. 2

3 2017/241 Update on Divisional Financial Position Cancer and Associated Specialties 13:04 The committee held a preparatory discussion. Dr Skoyles, Mr Oliver, Ms Reilly and Mr Whitehall then joined the meeting for this item. Ms Kemp also joined in an observer capacity. The division gave a presentation highlighting that during month eight, the forecast year end position was a 2.4 million surplus, inclusive of services recently transferred to the division. The committee discussed the presentation. In response to a question from Mrs Pomeroy, Mr Whitehall reported that although most specialities were behind plan in the year to date, this reflected a phasing of income which would result in a catch up before year end. In response to a question from the Chair, Mr Oliver reported that the potential for improving the year end projection for Pathology (a recently received speciality) was being actively reviewed. Mr Egginton added that, more generally, all the divisions would be presenting their 2018/19 draft plans in the near future. In response to a question from Mrs Pomeroy, it was agreed that the next CAS presentation to FIC would include extended time provision dedicated to Pathology. She also urged a continuing focus on reducing non pay costs. In response to a question from the Chair, Mr Oliver commented that, although the division was on target to achieve its FEP target, with a forecast saving of 6.1 million, there was probably very limited scope for improving on this further in the present year. In response to a question from Ms Shaw, Mr Oliver reported on improving performance within Urology. The Chair thanked the presenters, who left the meeting at this point. 2017/ /17 Financial Position (Month Seven) 13:48 Mr Egginton presented the monthly financial performance report which, after his following summary, the committee discussed in detail: The trust s performance for October was a 1.9 million deficit before Sustainability and Transformation Fund (STF), which was 1.6 million worse than plan. The year to date position was a 21.2 million deficit (before STF) which was 1.6 million worse than plan. The trust continued to forecast achievement of the full year financial control total of 34 million deficit (before STF). The foregone STF to quarter two could not be recovered, so the trust was forecasting a 12.6 million deficit after STF, compared to the control total of 10.7 million deficit after STF 3

4 In response to a question from the Chair, Mr Egginton reported that the month seven performance reflected a combination of factors, including a trend of overspend on plan and, in month, the need to write down some income. Ms Shaw reiterated that the present position had been discussed in considerable detail with the clinical divisions. Mrs Grant stressed the need to focus on the pivotal opportunities for improved financial performance. Ms Shaw concurred and provided further detail on a number of initiatives. In response to a question from the Chair, Mr Egginton confirmed that further clarity on some key schemes would be available at the next meeting. Ms Shaw reported that the trust would be very challenged to meet the performance standard required for future receipt of STF. 2017/243 Financial Efficiency Plan (FEP) 2017/18 14:16 Mr Goold attended for this item. Mr Egginton presented the FEP update report. In month seven, the FEP delivered 3.6 million of efficiencies against a plan of 3.9 million. The year to date delivery was 20.6 million, against a plan of 21.0 million. In the forecast to year end, there was an assessed risk of 3.0 million remaining to the FEP plan. This was a reduction in risk of 0.3 million to the previous month. The current year end forecast was a minimum of 38.0 million, and currently increasing, once all risks were taken into account. The committee discussed the report in detail. In response to a question from the Chair, it was agreed that the report to the next meeting would include consideration of additional controls and opportunities which might be deployed in the current year. In response to his further question, Mr Goold described some of the drivers to the underperformance on the theatres schemes and the remedial actions being taken. 2017/244 The Apprenticeship Levy, Financial Implications and Future Plans 14:35 Ms Place attended for this item and presented a report on the apprenticeship levy which commenced nationally in May 2017, necessitating an investment of 0.5% of the pay bills of larger employers, supported by a Government top up. The funds would be submitted to HMRC and, to the extent unutilised, would not be returned to the employer. In response to a question from Mrs 4

5 Pomeroy, Ms Place explained that the definition of apprentice could include existing members of staff. NUH would contribute about 2.8 million (an estimated figure, because the pay bill would fluctuate month on month) per year, every year. She also gave an update on current levels of investment, return on investment and possible financial risks to the organisation relating from challenges in recruiting. In response to a question from Mrs Taylor, Ms Place reported that the trust was exploring how to achieve the accreditation of a training organisation in this context. In response to a question from Dr Girling, Ms Place confirmed that the plans included apprenticeship in trades utilised by Estates and Facilities Management. In response to a question from Ms Shaw, Ms Place confirmed that there was scope for partnership working with other NHS providers. 2017/245 Half Yearly Report from the Pharmacy Company 14:53 Mr Wilkes attended for this item and presented the report, including an update on plans to implement robotics and realise the benefits in March 2018 and to evaluate and share the findings of the pharmacist prescribing pilot by February The company s financial performance continued to be positive. In response to a question from Mrs Grant, Mr Wilkes described arrangements for dispensing urgent medicines outside of regular hours. In response to a question from Mrs Pomeroy, Mr Egginton confirmed that the forthcoming experience of robotics would provide an opportune moment to consider the future potential scope of the company. 2017/246 Financial Planning 2018/19 15:02 Mr Orme presented an update briefing report on work to develop the 2018/19 financial plans and detailed budgets, first formal drafts of which would be presented to the committee in February. (brief comfort break at this point) 2017/247 Back Office Finance, Payroll and Procurement Services 15:10 Mr Linthwaite attended for this item. 5

6 Mr Orme presented a briefing report. The committee discussed the report and approved the proposed next steps for developing a business case. 2017/248 Sustainability and Transformation Partnership Update 15:22 Mr Guyler attended for this item and presented the monthly update report, including the system financial position for month six, which the committee noted and discussed. 2017/249 Treatment Centre Update 15:36 Mr Stutchbury attended for this item. Mr Egginton presented an update report with regard to plans for responding to the forthcoming market testing exercise. Further updates would be provided on a monthly basis. The committee discussed the report. Mrs Taylor and Dr Girling provided further context to the exercise. 2017/250 Full Business Case For The Modular Theatres Element Of The Theatres 1-17 Upgrade Programme 15:50 Mr Hanslow and Dr Carney attended for this item and presented the full business case. In response to a question from Mrs Pomeroy, Mr Hanslow confirmed that the alternative options which had been evaluated had not been deemed as cost effective. Ms Shaw commented on the role of the proposed solution in the context of the future strategy for the estate. In response to a question from Mr Egginton, Mr Hanslow described the ongoing infrastructure flexibilities inherent in the proposed solution. Following discussion the committee supported referral to the Board for approval and the use of enabling design fees. 2017/251 Full Business Case to Establish a Network Pathology Service to Transform Pathology Services Across the East Midlands 2017/252 Risk 16:07 Mr Callow and Dr McGregor attend for this item and presented the case. Following discussion the committee agreed to support a submission to the Board. 16:33 Extent of necessary recovery from month seven financial deficit. 2.7 million identified as at risk to full FEP delivery. 6

7 Risks inherent in a market testing exercise for the treatment centre. Loss of opportunities under the apprentice levy. 2017/253 Procurement Quarterly Report 16:36 The committee noted the report. 2017/254 Briefing from Investment Governance Committee Meeting Held on 7 November :36 The committee received and noted the minutes. 2017/255 Review of Annual Programme of Work 16:37 The annual programme was noted. Mrs Pomeroy, as Audit Committee chair, asked for the appropriate inclusion and timing of BAF items pertinent to the committee. This was agreed. It was also noted that the financial information available in advance to the committee meeting on 14 December 2017 would be dependent on data availability. It was agreed that Mr Egginton and Mr Orme would review this further, accordingly. 2017/256 Any Other Urgent Business Notified in Advance to the Chair There was no other urgent business. 2017/257 Items to Draw to the Attention of The Board 16:42 The CAS division was forecasting a year end position was a 2.4 million surplus, inclusive of services recently transferred to the division. Trust performance for October was a 1.9 million deficit before Sustainability and Transformation Fund (STF), which was 1.6 million worse than plan. The trust was forecasting a 12.6 million year end deficit after STF, compared to the control total of 10.7 million deficit after STF The current year end FEP forecast was a minimum of 38.0 million, and currently increasing, once all risks were taken into account. Various business and other cases supported (see below) 7

8 2017/258 Items to Draw to the Attention of Other Committees 16:44 People Committee Apprentice Levy. 2017/259 Agenda Items for Future Meetings 16:44 Nothing additional. 2017/260 Evaluation of Today s Meeting 16:45 What Went Well? Well chaired. Even Better If? The Apprentice Levy item could have explored more opportunities on this topic Could the meeting be shorter than nearly four hours long? Could some of the papers have been shorter? What decisions have we made? Supported next steps on developing a business case regarding back office functions. Supported referral of the theatres business case to the Board. Supported referral of the Pathology paper to the Board. How will things be different as a result of today s meeting? As per above cases Congruence with NUH s Values? Yes. 2017/261 Date of Next Meeting The next meeting would be held on 14 December 2017 The meeting ended at 16:48 8