Report to Board - Moorfields Eye Hospital 08... · 2019-03-28 · Report to Board – 7September 2017 Report title Monthly financial performance for month 4 –July 2017 Report from

Report to Board – 7September 2017

Report title Monthly financial performance for month 4 – July 2017

Report from Steven Davies, Chief Financial Officer/Deputy chief executive

Prepared by Jenny Greenshields, Deputy Chief Financial Officer

Damien O’Brien, Head of Financial Management

Assad Choudry, Financial Controller

Previously discussed at

Attachments 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

Item 8

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:

Steven Davies Chief Financial Officer/Deputy Chief Executive

Board of Directors Meeting 7

th September 2017

Date produced 25 August 2017

Action for Board:

For information

For consideration

For decision

3

Contents of Main Report

Page Number

Executive Financial Summary 4 Detailed Income and Expenditure Position 5 Variance 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

Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M)

0.01 0.28 0.27 (0.03) 0.74 0.77 0.50 0.92 0.42


14.36 14.72 0.36 57.02 56.99 (0.03) 171.56 171.98 0.42

14.58 14.82 (0.24) 58.08 57.60 0.48 175.77 175.77 0.00

(0.22) (0.10) 0.12 (1.06) (0.61) 0.45 (4.20) (3.79) 0.41

80%

18% Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M)

100% 1.80 1.45 (0.35) 8.20 8.20 0.00


0.06 0.05 (0.01) 0.12 0.18 0.06 0.93 0.93 0.00


0.17 0.34 0.17 0.91 1.16 0.25 3.77 3.77 0.00

M4 YTD YE Forecast1 1

Liquidity 1 1

I&E Margin 2 2

1 1

Agency Spend 1 1

1 1

2016/17

Year End

June

Actual

July

Actual

July

Variance

39.00 38.51 44.32 3.85

Annual PlanExpenditure

Year to Date

Annual

Forecast

Var to Plan

Forecast

30.87 0.57 28.01 2.86

3-5 Mths 2 Mths Total Last Month

(£M) (£M) (£M) (£M)

1.94 0.27 3.43 6.89

0.49 0.24 3.09 3.05

0.97 0.08 2.73 2.65

3.40 0.59 9.25 12.59

Use of Resources Rating

Efficiency Scheme

PerformanceFull Year % forecast

% Full Year achieved

Executive Financial Summary

Trust Underlying

Overall Position -

Surplus / (Deficit)

In Month Year to Date Key Risks and Actions RequiredFull Year Forecast

Research &

Development

Position

(exc. R&D)

YTD % achieved Year to Date

In Month Year to Date

IncomeExpenditure

Overall Position

Full Year ForecastNHS In Month Year to Date

Full Year Forecast

Full Year Forecast

0.42

-0.13

Use of Resources

Rating

Cash FlowJuly

Plan

Capital

Expenditure

Commercial

Trading Unit

Position

In Month Year to Date

I&E Margin Variance

3.91

IndicatorCapital Service Cover

Year End

Plan

5.39

40.47

Expenditure

Committed

42.20

Capital Expenditure (£M)

1.26

Cash Balance (£M)

Full Year Forecast

Debtors

Overdue Debts

NHS Contract Debts 2.23 -1.01

Commercial Debts 1.90 0.46

Other

TOTAL

(£M) (£M)

6 Mths + 1 Mth

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.

5

£000s £000s £000s £000s £000s £000s £000s £000s £000s £000s £000s

Income

NHS Clinical Income 12,418 12,277 (141) 49,012 49,013 1 148,378 148,378 0 51,858 (2,845)

Commercial Trading Units 2,231 2,316 85 9,435 8,828 (607) 29,438 29,438 0 9,311 (483)

Other Income 2,985 3,321 336 12,201 11,883 (318) 35,579 35,998 419 8,379 3,504

Total Income 17,634 17,914 280 70,648 69,724 (924) 213,395 213,814 419 69,549 176

NHS Expenditure

Pay Expenditure

Medical 2,653 2,618 35 10,441 10,441 0 31,260 31,260 0 10,403 (38)

Nursing 2,009 2,018 (9) 8,197 8,029 168 24,660 24,660 0 8,017 (12)Scientific, Professional & Technical 1,194 1,063 131 4,758 4,205 553 14,170 14,170 0 3,934 (271)Admin and Clerical 2,248 2,399 (151) 9,038 9,419 (381) 27,031 27,031 0 8,877 (542)

Ancillary Services 194 188 6 736 746 (10) 2,208 2,208 0 694 (52)Research & Development Pay 665 582 83 2,650 2,361 289 7,795 7,795 0 2,414 53

Total Pay Expenditure 8,963 8,868 95 35,820 35,201 619 107,124 107,124 0 34,338 (862)

Non-Pay Expenditure

Drugs 2,135 2,478 (343) 8,502 9,150 (648) 25,500 25,500 0 8,063 (1,087)

Clinical Supplies and Services 1,351 1,369 (18) 5,447 5,488 (41) 16,366 16,366 0 5,310 (178)

Premises 965 851 114 3,343 3,134 209 10,122 10,122 0 3,389 255

Other Expenditure 917 1,080 (163) 3,919 3,907 12 14,298 14,298 0 4,264 357

Research & Development Non-Pay 301 240 61 1,374 1,316 58 3,461 3,461 0 1,021 (295)

Total Non-Pay Expenditure 5,669 6,018 (349) 22,585 22,995 (410) 69,747 69,747 0 22,047 (948)

Total NHS Expenditure 14,632 14,886 (254) 58,405 58,196 209 176,871 176,871 0 56,385 (1,810)

Commercial Trading Unit Costs 1,927 1,872 55 7,949 7,223 726 24,153 24,153 0 7,891 668

Total Expenditure 16,559 16,758 (199) 66,354 65,419 935 201,024 201,024 0 64,276 (1,142)

EBITDA 1,075 1,156 81 4,294 4,305 11 12,371 12,790 419 5,272 (966)

EBITDA Margin % 6.1% 6.5% 6.1% 6.2% 5.8% 6.0% 7.6%NHS Interest, Dividends, Depreciation &

Profit/Loss on Disposals926 762 164 3,742 3,124 618 10,355 10,355 0 3,214 90

Trading Unit Interest, Depreciation, Dividends &

Profit/Loss on Joint Ventures136 106 30 577 441 136 1,516 1,516 0 192 (249)

Surplus / (Deficit) 13 288 275 (25) 740 765 500 919 419 1,866 (1,126)

NHS EBITDA 771 712 (59) 2,808 2,700 (108) 7,086 7,505 419 3,851 (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) 419 637 (1,061)

Commercial Trading Unit EBITDA 304 444 140 1,486 1,605 119 5,285 5,285 0 1,420 185

Commercial Trading Unit EBITDA Margin % 13.6% 19.2% 15.7% 18.2% 18.0% 18.0% 15.3%Commercial Trading Unit Surplus / (Deficit) 168 338 170 909 1,164 255 3,769 3,769 0 1,228 (64)

Prior Year YTD

Variance ActualVariance

YTD ActualBudget Actual Variance Budget Actual Variance Budget ActualOverall Trust I&E Summary

In Month Year To Date Full Year Forecast

Detailed Income and Expenditure Position - Surplus / (Deficit)

6

Variance 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 Variance Anal

DescriptionBudget MTH

(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 7,745 8,337 591 32,176 31,857 -319

Pay Costs 4,262 4,145 117 17,234 16,654 581

Non Pay Costs 1,898 2,118 -219 7,686 8,201 -515

Below the line 134 134 0 573 573 0

Contribution/ Deficit 1,451 1,939 489 6,682 6,429 -253


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 1 1 0 4 5 2

Pay Costs 359 369 -10 1,438 1,511 -73

Non Pay Costs 24 32 -8 96 168 -72

Below the line 2 2 0 7 7 0

Contribution/ Deficit -384 -402 -17 -1,537 -1,681 -143


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 3,318 3,449 131 13,434 13,444 10

Pay Costs 1,166 1,164 3 4,712 4,610 102

Non Pay Costs 1,195 1,462 -268 4,788 5,076 -287

Below the line 113 113 0 458 458 0

Contribution/ Deficit 844 710 -134 3,477 3,301 -176


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 2,225 2,331 106 8,860 8,904 44

Pay Costs 1,006 1,063 -56 3,848 4,081 -233

Non Pay Costs 644 751 -107 2,958 2,985 -27

Below the line 38 38 0 151 151 0

Contribution/ Deficit 536 479 -57 1,903 1,688 -215


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 244 317 73 975 1,055 80

Pay Costs 202 280 -78 1,061 1,126 -66

Non Pay Costs 979 881 98 3,539 3,176 363

Below the line 34 34 0 137 137 0

Contribution/ Deficit -972 -878 94 -3,762 -3,385 377


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 436 410 -27 1,293 1,228 -65

Pay Costs 1,311 1,267 44 4,887 4,859 28

Non Pay Costs 630 534 96 2,180 1,942 238

Below the line 402 291 111 1,602 1,158 444

Contribution/ Deficit -1,906 -1,682 224 -7,376 -6,731 645

Corp. Inc. Contribution/ Deficit 213 -269 -482 -442 -226 215

R&D Contribution/ Deficit 64 49 -15 120 182 62

Commercial Contribution/ Deficit 167 336 169 910 1,164 254

Trust Contribution/ Deficit 14 284 271 -25 740 765

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 back-

dated 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.

City Road

Access

Moorfields

North

Moorfields

South

Estates &

Facilities

Corporate

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.

Divisional Financial Performance

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 over-performance.

• Outpatients under performed by 674 (1.5%) attendances leading to an income under-performance 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

19 17 21 21 19 21 20 17 15 21 20 19

156 194 169 157 0 0 0 0 0 0 0 0

134 181 159 149 0 0 0 0 0 0 0 0

(22) (13) (10) (7) 0 0 0 0 0 0 0 0

20 17 21 21 16 22 22 21 17 20 20 21

232 295 260 242 0 0 0 0 0 0 0 0

213 297 251 238 0 0 0 0 0 0 0 0

(19) 2 (10) (3) 0 0 0 0 0 0 0 0

Workings Days Inc. adjustments

Target per working day (£'000)

Actual per working day (£'000)

Variance (£'000)

Workings Days Inc. adjustments

Target per working day (£'000)

Actual per working day (£'000)

Variance (£'000)

2,000

2,200

2,400

2,600

2,800

3,000

3,200

3,400

3,600

3,800

Inco

me

(£'0

00)

NHS Elective/Daycase Income

2016/17Actual2017/18Budget2017/18Actual2017/18Forecast

3,900

4,100

4,300

4,500

4,700

4,900

5,100

5,300

5,500

5,700

5,900

6,100

Inco

me

(£'0

00)

NHS Outpatient Income

2016/17 Actual

2017/18 Budget

2017/18 Actual

2017/18 Forecast

Elective Activity Analysis (Inpatients and Outpatients)

• 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.

• Other than Paediatrics which was £88k above plan in

month most specialities were behind plan, most

notably Cataract which was £102k behind plan.

• 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.

10

NB. Research and Development Pay is excluded from the tables above and shown as part of the Research and Development position on page 11.

Staff Group & Directorate Staff Group & Directorate

MedicalYear to Date Current Month

Increase /

(Decrease)Nursing

Year to Date Current Month

Increase /

(Decrease)

Moorfields North 367 370 (3) Moorfields North 512 519 (7)

Moorfields South 417 420 (3) Moorfields South 352 365 (13)

City Road 1,771 1,771 0 City Road 1,089 1,078 11

Access 0 0 0 Access 0 0 0

Corporate Departments 55 56 (1) Corporate Departments 55 57 (2)

Total 2,610 2,617 (7) Total 2,008 2,019 (11)

Average Monthly Expenditure (£'000) Average Monthly Expenditure (£'000)

Staff Group & Directorate Staff Group & Directorate

Other ClinicalYear to Date Current Month

Increase /

(Decrease)Non-Clinical

Year to Date Current Month

Increase /

(Decrease)

Moorfields North 45 42 3 Moorfields North 229 233 (4)

Moorfields South 42 44 (2) Moorfields South 210 234 (24)

City Road 951 964 (13) City Road 352 332 20

Access 0 0 0 Access 378 369 9

Corporate Departments 13 13 0 Corporate Departments 1,373 1,420 (47)

Total 1,051 1,063 (12) Total 2,542 2,588 (46)

Average Monthly Expenditure (£'000) Average Monthly Expenditure (£'000)

NHS Operating Expenditure – Pay Costs by Staff Group and Area

• 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.

• Average nursing pay expenditure in month is £2,019k, which is £11k above the 2017/18


• 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.

• Average medical pay expenditure this month is £2,617k, which is £7k above the 2017/18


• The worsening position is largely attributable to additional sessions at City Road.

11

Staff Type

Employed Bank Agency Total % Change Employed Bank Agency Total % Change Employed Bank Agency Total

Nursing 1,701 274 44 2,019 1% 1,718 267 23 2,008 0% 1,706 263 35 2,004

Medical 2,348 269 0 2,617 0% 2,368 180 62 2,610 0% 2,291 241 69 2,601

Non-clinical 2,064 356 168 2,588 2% 2,043 333 166 2,542 6% 1,892 224 277 2,393

Current Month Year To Date Average Average Prior Year

Staff Type

Current Month (£'000) Year To Date Average (£'000) Average Prior Year (£'000)

Nursing

Medical

Non-Clinical

86%

14%

Nursing Expenditure Current Month

Employed Bank

86%

13%

1%

Nursing Expenditure YTD Average

Employed Bank Agency

90%

10%

0%

Medical Expenditure Current Month

Employed Locum Agency

91%

7%2%

Medical Expenditure YTD Average


80%

14%

6%

Non Clinical Expenditure Current Month


80%

13%7%

Non Clinical Expenditure YTD Average


85%

13%

2%

Average Nursing Expenditure Prior Year


88%

9%3%

Average Medical Expenditure Prior Year


79%

9%12%

Average Non Clinical Expenditure Prior Year


NHS Operating Expenditure – Pay Costs Agency and Bank Analysis

• 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.

• 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.

• 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%.

12

Full Year

Target

(£'000)

Value of

Schemes

Identified

(£'000)

YTD Target

(original

phased

budget)

(£'000)

YTD Amount

Achieved

(£'000)

YTD

Variance

(£'000)

Full Year

Forecast

Amount

(£'000)

Forecast %

Achievement

of Target

YTD Amount

Achieved as

% of Full

Year Target

Moorfields North 1,245 487 170 124 (46) 1,245 100% 10%

Moorfields South 923 452 129 97 (32) 923 100% 11%

City Road 3,909 3,270 1,003 797 (207) 3,909 100% 20%

Access Division 435 153 9 9 0 435 100% 2%

Corporate Departments 1,688 1,361 491 420 (71) 1,688 100% 25%

Total 8,200 5,723 1,802 1,447 (355) 8,200 100% 18%

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.

Directorate / Corporate

Department

Actions on Shortfall and Unidentified Amount

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.

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).

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.

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.

-

100

200

300

400

500

600

700

800

900

1,000

1,100

1,200

1,300

1,400

Am

ou

nt

(£'0

00

)

Period

Efficiency Schemes Profile and Forecast

Target

Actual

Forecast

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.

- The Trust is continuing to identify further schemes to bridge the gap that currently exists within the CIP program.

- Fortnightly meetings for each directorate have been initiated to ensure deliverability against identified schemes and to continue to identify new schemes.

1%

8%

27%

24%

40%

Breakdown of Forecast Achievement

Agency & Consultancy

Drugs

Clinical Supplies

INCOME

Pay

13

Budget Actual Variance Budget Actual Variance Budget Forecast Variance

£000s £000s £000s £000s £000s £000s £000s £000s £000s

Total Income 1,041 882 (159) 4,189 3,904 (285) 12,394 12,394 0

Expenditure

Pay Costs 665 582 83 2,650 2,361 289 7,795 7,795 0

Non-Pay Costs 301 240 61 1,374 1,316 58 3,461 3,461 0

Total Expenditure 966 822 144 4,024 3,677 347 11,256 11,256 0

Interest, Dividends, Depreciation 11 11 0 45 45 0 203 203 0

Total Contribution to overhead 64 49 (15) 120 182 62 935 935 0

Research and Development

In Month Year to Date Full Year

£000s £000s £000s £000s £000s £000s £000s £000s £000s £000s £000s

Total Income - including Internal Sales 2,231 2,316 85 9,435 8,828 (607) 29,438 29,438 0 9,409 (581)

Expenditure

Pay Costs 783 707 76 3,257 2,675 582 9,964 9,964 0 3,015 340

Non-Pay Costs 1,144 1,165 (21) 4,692 4,548 144 14,189 14,189 0 4,877 329

Total Expenditure 1,927 1,872 55 7,949 7,223 726 24,153 24,153 0 7,891 669

Commercial Trading Unit EBITDA 304 444 140 1,486 1,605 119 5,285 5,285 0 1,518 88

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 ventures136 106 30 577 441 136 1,516 1,516 0 192 (249)

Commercial Trading Unit Surplus / (Deficit) 168 338 170 909 1,164 255 3,769 3,769 0 1,325 (161)

Less Internal Sales 0 0 0 0 0 0 0 0 0 (97) 97

Commercial Trading Unit Surplus / (Deficit) -

discounting internal sales168 338 170 909 1,164 255 3,769 3,769 0 1,228 (64)

Commercial Trading Units

In Month Year to Date Full Year Forecast Prior Year YTD

Forecast Variance Actual VarianceBudget Actual Variance Variance BudgetBudget Actual

Research and Development Position

Commercial Trading Unit Position

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 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

Cash Flow

Cash balance was £44.3m at the end of July, £3.8m above plan.

This is primarily due to receipt of 2016-17 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

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.

Capital Expenditure (£ Millions)Annual

Budget

Expenditure

Year to Date

Expenditure

Committed

Year End

Forecast

Var to Plan

Forecast

Estates 7.68 0.21 0.40 5.65 2.03

Medical Equipment 1.55 0.02 0.03 1.51 0.04

IT 4.42 0.33 3.48 3.70 0.72

Corporate 0.22 0.00 0.00 0.22 0.00

Strategic Schemes 17.23 0.00 0.00 17.23 0.00

Dubai 0.65 0.01 0.00 0.58 0.07

Contingency/Carry Forward (0.87) 0.00 0.00 (0.87) 0.00

Total 30.87 0.57 3.91 28.01 2.87

15

Debtors Management and Credit Control

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.

Comments

Overall debt has decreased by £0.8m in July to £13.2m (£14.0m June) due to settlement of 2016-17 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 2016-17 performance/NCA debt and credit notes issued following 2016-17 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

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 835 8 16 18 12 19 908 67 975

NHS Service Income 1,394 (206) 2,080 27 254 (1,024) 2,525 1,043 3,568

Total Contract Debts 2,229 (198) 2,096 45 266 (1,005) 3,433 1,110 4,543

Private Patients 1,903 73 201 213 238 460 3,088 785 3,873

Sundry Debtors 1,262 58 672 237 81 421 2,731 2,045 4,776

TOTAL 5,394 (67) 2,969 495 585 (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 908 67 975 1,101 19 1,120 (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 3,088 785 3,873 3,030 586 3,616 1.9% 34.0% 7.1%

Sundry Debtors 2,731 2,045 4,776 2,651 2,454 5,105 3.0% (16.7%) (6.4%)

TOTAL 9,252 3,940 13,192 12,586 1,435 14,021 (26.5%) 174.6% (5.9%)

16

Overdue CCG debt

NEL, NWL and SWL CCG groups collectively account for £1.2m (55%)

of overdue English contract debt.

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 1st to 14th August, of which £2.1m was

for SLA invoices, £0.5m for 2016/17 performance/NCA invoices and

£0.1m for 201718 performance/NCA invoices.

Overdue Sundry debt

Overdue sundry debt is £2.7m in July. £0.3m of this is overdue from

Barts Trust and £0.2m from St Georges Trust.

£1.0m cash was received from 1st to 14th August, of which £0.9m was

from Bedford Trust.

Note: Standard NHS payment terms are 30 days from the invoice

date. SLA payments are mostly made on the 15th 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.

£5,394

£67£2,969£495

£585

£124

£3,940

Total Debt by Age £'000

6 Mths +

5 Mths

4 Mths

3 Mths

2 Mths

1 Mth

Current

£13,192Total

£908

£2,525

£3,088£2,731

£3,940

Total Debt by Type £'000

Welsh Debts only

NHS Service Income

Private Patients

Sundry Debtors

Current

Total £13,192

Documents

Report to Board - Moorfields Eye Hospital 08... · 2019-03-28 · Report to Board – 7September 2017 Report title Monthly financial performance for month 4 –July 2017 Report from