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AGENDA ITEM 07 – FINANCE REPORT

BOARD OF DIRECTORS 21 FEBRUARY 2018

Report title Monthly financial performance for month 10 – January 2018

Report from Steven Davies, Chief Financial Officer

Prepared by Jenny Greenshields, Deputy Chief Financial Officer

Damien O’Brien, Head of Financial Management

Assad Choudry, Financial Controller

Previously discussed at None

Attachments None

Brief summary of report

• The Trust reported a £1.60m surplus in January, £0.14m above the budgeted plan. The YTD position now stands at a surplus of £3.83m, £2.56m ahead of plan.

• The Forecast position for 2017/18 before any additional STF incentive income is a £3.02m surplus. The

Trust has been notified by NHS Improvement that there will be a STF incentive scheme of £1 for every £1 that a Trust exceeds its control total. Including this income, an additional £3.28m, the current final forecast for 2017/18 is a surplus of £6.30m.

• In month the R&D department released £0.58m non-recurrent income in order to meet their annual

contribution target. The Trust financial position YTD excluding non-recurrent Right to Light, STF income and the aforementioned R&D income is a surplus of £0.49m. The underlying full year forecast excluding these items is a surplus of £0.05m.

• The favourable variance to plan in month is largely due to planned high levels of NHS activity, a YTD catch-up relating to Education income and continued underspends within Pay costs.

• Commercial Trading Units reported a surplus of £0.43m in month, which was above planned levels by £0.01m. YTD Commercial Trading Units are now above plan by £0.48m. The full year forecast position is for a surplus of £3.58m.

• YTD efficiency scheme achievement now stands at £5.48m against a YTD target of £6.50m, a shortfall YTD

of £1.02m/ 15.7%. • Cash balance was £45.50m at the end of January, £3.80m above plan.

YTD Budget £'000 YTD Actual £'000 Forecast £'000

Reported position 1,274 3,833 6,299

Right to light income 0 (1,665) (1,665)

STF income 0 (1,094) (4,582)

R&D non-recurrent contribution (584) (584) 0

Position excluding STF and Right to Light 690 490 52

2

• Use of Resources Risk rating for the trust at January YTD is 1.

Action Required/Recommendation. The board is asked to consider and discuss the attached report.

For Assurance For decision For discussion To note

3

Monthly Finance Report For January 2018

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

Board of Directors Meeting 21 February 2018

Date produced

12 February 2018

Action for Board:

For information

For consideration

For decision

4

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 14

Better Payment Practice Code and Capital Expenditure 15

Debtors Management & Credit Control 16

5

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

1.46 1.60 0.14 1.27 3.83 2.56 0.50 6.30 5.80


15.85 15.64 (0.21) 143.87 148.09 4.22 172.21 173.23 1.02

15.06 15.14 (0.08) 146.24 148.57 (2.33) 176.28 176.88 (0.60)

0.79 0.50 (0.29) (2.37) (0.48) 1.89 (4.07) (3.65) 0.42

84%

67% Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M)

84% 6.50 5.48 (1.02) 8.20 6.92 (1.28)


0.26 0.68 0.42 0.91 1.09 0.18 0.99 0.99 0.00


0.41 0.43 0.02 2.74 3.22 0.48 3.58 3.58 0.00

M10 YTD YE Forecast1 1

Liquidity 1 1

I&E Margin 1 1

1 1

Agency Spend 1 1

1 1

2016/17

Year End

December

Actual

January

Actual

January

Variance

39.00 45.10 45.50 3.80

Annual PlanExpenditure

Year to Date

Annual

Forecast

Var to Plan

Forecast

30.87 6.22 11.22 19.65

3-5 Mths 2 Mths Total Last Month

(£M) (£M) (£M) (£M)

1.78 0.74 4.16 3.52

0.46 0.21 2.18 2.48

0.37 0.27 3.57 3.23

2.61 1.22 9.91 9.23

Cash Balance (£M)

Full Year Forecast

Debtors

Overdue Debts

NHS Contract Debts 0.13 1.51

Commercial Debts 1.26 0.25

Other

TOTAL

(£M) (£M)

6 Mths + 1 Mth

3.73

41.70

Expenditure

Committed

42.20

Capital Expenditure (£M)

2.34

Full Year Forecast

0.59

2.35

Use of Resources

Rating

Cash FlowJanuary

Plan

Capital

Expenditure

Commercial

Trading Unit

Position

In Month Year to Date

I&E Margin Variance

7.25

IndicatorCapital Service Cover

Year End

Plan

Full Year ForecastNHS In Month Year to Date

Full Year Forecast

Research &

Development

Position

(exc. R&D)

YTD % achieved Year to Date


IncomeExpenditure

Overall Position

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

Income and Expenditure • The full year forecast is to achieve a surplus of

£6.30m which includes an additional £3.28m Sustainability and Transformation Incentive Funding. Total STF monies in 2017/18 are forecast to be £4.58m.

• The current CIP forecast is to deliver £6.92m efficiency savings in year, £1.28m below the target of £8.20m. Central non-recurrent benefits will mitigate the shortfall in year but delivery remains a key risk moving forward.

• Further risk persists regarding the Pay run-rate, particularly within Admin and Clerical staff, which has been steadily increasing in recent months. The Access directorate and Moorfields South continue to materially overspend within Admin and Clerical staff.

Use of Resources Rating • Use of resources rating for the Trust at January

YTD is 1. Cash flow and Balance Sheet • Cash balance was £45.5m at the end of January,

£3.8m above plan. • The non-recurrent I&E release of income to meet

contribution targets (eg. R&D in month) is a risk to the cash forecast, in particular given the value of our total creditors.

• Capital expenditure YTD is £6.22m with an annual forecast of £11.22m.

• Overdue debt has increased by £0.6m in January to £9.23m.

6

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

Income

NHS Clinical Income 14,970 14,431 (539) 135,730 136,856 1,126 162,545 162,799 254 134,337 2,519

Commercial Trading Units 2,448 2,558 110 22,330 22,456 126 27,211 27,211 0 24,212 (1,756)

Other Income 2,030 2,752 722 18,551 21,087 2,536 21,937 25,049 3,112 19,972 1,115

Total Income 19,448 19,741 293 176,611 180,399 3,788 211,693 215,059 3,366 178,521 1,878

NHS Expenditure

Pay Expenditure

Medical 2,653 2,564 89 26,466 26,423 43 31,763 31,708 55 26,546 123

Nursing 2,071 2,041 30 20,457 20,463 (6) 24,555 24,555 0 19,953 (510)

Scientific, Professional & Technical 1,283 1,108 175 12,063 10,800 1,263 14,436 12,960 1,476 10,064 (736)

Admin and Clerical 2,704 2,894 (190) 23,762 24,800 (1,038) 28,463 29,760 (1,297) 22,382 (2,418)

Ancillary Services 177 162 15 1,775 1,731 44 2,130 2,077 53 1,845 114

Research & Development Pay 642 593 49 6,367 5,906 461 7,663 7,087 576 5,816 (90)

Total Pay Expenditure 9,530 9,362 168 90,890 90,123 767 109,010 108,147 863 86,605 (3,517)

Non-Pay Expenditure

Drugs 2,351 2,499 (148) 21,314 23,437 (2,123) 25,474 26,624 (1,150) 21,425 (2,012)

Clinical Supplies and Services 1,445 1,305 140 13,257 13,617 (360) 15,850 16,341 (491) 13,969 352

Premises 856 772 84 8,607 8,293 314 10,382 9,952 430 8,233 (60)

Other Expenditure 549 907 (358) 9,558 11,268 (1,710) 12,841 13,521 (680) 11,485 217

Research & Development Non-Pay 237 265 (28) 3,034 2,741 293 3,468 3,290 178 2,522 (219)

Total Non-Pay Expenditure 5,438 5,748 (310) 55,770 59,356 (3,586) 68,015 69,728 (1,713) 57,633 (1,722)

Total NHS Expenditure 14,968 15,110 (142) 146,660 149,479 (2,819) 177,025 177,875 (850) 144,238 (5,239)

Commercial Trading Unit Costs 1,937 2,039 (102) 18,473 18,190 283 22,327 22,327 0 19,750 1,560

Total Expenditure 16,905 17,149 (244) 165,133 167,669 (2,536) 199,352 200,202 (850) 163,988 (3,679)

EBITDA 2,543 2,592 49 11,478 12,730 1,252 12,341 14,857 2,516 14,533 (1,801)

EBITDA Margin % 13.1% 13.1% 6.5% 7.1% 5.8% 6.9% 8.1%NHS Interest, Dividends, Depreciation &

Profit/Loss on Disposals983 900 83 9,088 7,850 1,238 10,534 10,534 0 7,432 (418)

Trading Unit Interest, Depreciation, Dividends &

Profit/Loss on Joint Ventures95 91 4 1,117 1,047 70 1,307 1,307 0 1,504 457

Surplus / (Deficit) 1,465 1,601 136 1,273 3,833 2,560 500 3,016 2,516 5,597 (1,764)

STF Incentive Income 0 0 0 0 0 0 0 3,283 3,283 0 0Surplus / (Deficit) 0 0 0 0 0 0 500 6,299 5,799 0 0

NHS EBITDA 2,032 2,073 41 7,621 8,464 843 7,457 13,256 5,799 10,069 (1,605)

NHS EBITDA Margin % 12.0% 12.1% 4.9% 5.4% 4.0% 7.1% 6.5%NHS Surplus / (Deficit) 1,049 1,173 124 (1,467) 614 2,081 (3,077) 2,722 5,799 2,637 (2,023)

Commercial Trading Unit EBITDA 511 519 8 3,857 4,266 409 4,884 4,884 0 4,462 (196)

Commercial Trading Unit EBITDA Margin % 20.9% 20.3% 17.3% 19.0% 17.9% 17.9% 18.4%Commercial Trading Unit Surplus / (Deficit) 416 428 12 2,740 3,219 479 3,577 3,577 0 2,958 261

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

In Month Year To Date Full Year Forecast Prior Year YTD

Variance ActualVariance

YTD Actual

Detailed Income and Expenditure Position - Surplus / (Deficit)

7

Variance Analysis

Commentary

• NHS Clinical Income and Commercial Trading income

variances are explained in more detail elsewhere within this report.

• Other income is £2,536k (13.7%) ahead of plan YTD. The

favourable position is due to the receipt of £1,650k rights to light settlement, and a £584k YTD adjustment relating to

R&D income. There has also been a number of minor non-

recurrent benefits in year, largely relating to Education

income.

• Nursing Pay costs are £30k underspent in January and are

now on plan YTD. There are significant vacancy levels at City

Road, within both Theatres and A&E. This has largely been offset through the year by an overspent position at

Moorfields South which is staffing to levels above the agreed

establishment. A revised Urgent Care establishment has been agreed and further work is being undertaken to

redesign the Nursing provision across Moorfields South.

• Admin and Clerical Pay costs are £190k/ 7.0% overspent in

January and now stand £1,038k/ 4.4% overspent YTD. The

Access directorate and Moorfields South are both staffing to above established levels and using significant levels of

temporary staff to cover vacancies. The average monthly

spend on Admin and Clerical staff has increased by £150k per

month in the second half of the year compared to the first half of the year. A business case is being prepared that

redesigns the provision and delivery of administrative

services across the Trust.

• STT Pay costs are £175k (13.6%) underspent in January and

£1,263k (10.5%) YTD. The vacancy rate stands at 8.1% in

January, with a significant level of vacancies within

Ophthalmic services at City Road. Work is underway to re -work all STT establishments, based on current rotas to

ensure the correct establishments are in place. Any excess

budgets will be given up to contribute to divisional CIP targets (having already been released non-recurrently).

8 Variance Anal

DescriptionBudget MTH

(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 8,791 8,658 -133 80,510 81,054 544

Pay Costs 4,403 4,114 289 43,271 41,791 1,481

Non Pay Costs 2,240 2,354 -113 19,171 21,286 -2,115

Below the line 135 135 0 1,370 1,370 0

Contribution/ Deficit 2,013 2,055 43 16,697 16,607 -90


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 1 1 0 9 11 2

Pay Costs 396 431 -35 3,804 3,983 -179

Non Pay Costs -39 28 -67 -37 230 -267

Below the line 1 1 0 16 16 0

Contribution/ Deficit -357 -459 -102 -3,774 -4,218 -444


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 3,732 3,769 37 33,752 34,460 709

Pay Costs 1,206 1,224 -18 11,981 12,083 -102

Non Pay Costs 1,190 1,307 -117 11,625 13,260 -1,635

Below the line 114 114 0 1,139 1,139 0

Contribution/ Deficit 1,223 1,124 -98 9,007 7,978 -1,028


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 2,506 2,099 -407 22,437 22,774 337

Pay Costs 975 1,006 -32 9,681 10,484 -803

Non Pay Costs 734 694 40 7,384 7,841 -457

Below the line 38 38 0 380 380 0

Contribution/ Deficit 759 361 -398 4,992 4,069 -923


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 251 236 -15 2,529 2,570 42

Pay Costs 281 272 9 2,755 2,758 -2

Non Pay Costs 902 913 -11 9,022 8,822 199

Below the line 37 37 0 337 337 0

Contribution/ Deficit -969 -987 -17 -9,585 -9,347 239


(£k)

Actuals MTH

(£k)

Variance

MTH (£k)

Budget YTD

(£k)

Actuals YTD

(£k)

Variance

YTD (£k)

Income 373 654 280 3,361 3,871 510

Pay Costs 1,624 1,699 -74 12,976 12,890 86

Non Pay Costs 187 187 1 5,621 5,042 579

Below the line 499 441 58 3,988 3,090 898

Contribution/ Deficit -1,938 -1,673 265 -19,225 -17,152 2,073

Corp. Inc. Contribution/ Deficit 57 77 20 -481 1,585 2,066

R&D Contribution/ Deficit 262 676 414 905 1,091 186

Commercial Contribution/ Deficit 415 427 13 2,740 3,220 480

Trust Contribution/ Deficit 1,464 1,602 137 1,274 3,833 2,559

City Road is £43k ahead of its contribution target in month (£90k behind plan YTD) but this includes a

£75k contribution related to Moorfields South injection activity that has been transferred to City Road

during the St Georges decant, and a non-recurrent benefit of £125k relating to 2016/17. There was a YTD

benefit in month of £45k relating to Education funding for Pre-registration pharmacists. A&E activity

continues to materially under-perform with attendances over 1,000/ 11.7% below plan. Significant

vacancies within STT staff and within Theatres and A&E nursing have driven a pay underspend in month

of £289k. The non-pay overspend of £113k is related to high cost drug injection activity.Access directorate is £102k overspent in month and now stands £444k overspent YTD. The poor

position in month and YTD is related to overspends on junior Admin and Clerical staff in the Booking

centre, which is being staffed above agreed establishment levels, largely with temporary staff, and the

under-achievement of CIP targets. A trustwide Admin and Clerical staffing review is being led by the

Deputy Chief Operating Officer.

Moorfields North is £98k behind its contribution target in month and now stands £1,028k behind plan

YTD. Income is £37k ahead of plan in month due to high activity at Bedford and high levels of injection

activity, both of which are driving the YTD income over-performance. The high activity at Bedford and

within injections has driven the non-pay overspend of £117k in month and £1,635k YTD with a YTD

overspend of £1,047k on high cost drugs and £113k on the Bedford SLA. There is also a YTD under-

achievement of £546k within non-pay relating to CIP performance.

Moorfields South is £398k behind its contribution target in month and now stands £923k behind plan

YTD. There is a slight mitigation of £75k relating to high cost drug injection activity sitting within City

Road division resulting from the St Georges decant. 5 days activity were lost at St Georges due to the

decant which has driven the income performance in month, £407k behind plan. The pay overspend of

£32k represents an improvement in the run-rate, resulting from the lower levels of activity, however

there remains an over-establishment of junior Admin and Clerical staff. Costs of £50k relating to St

Anthonys have been included in the position for which funding has been drawn from reserves.Estates and Facil ities is £17k overspent in month but remains underspent YTD, by £239k. There was an

under-achievement of income in month by £15k which is due to lower rental receipts relating to Kemp

House. High equipment maintenance costs in month have contributed to a non-pay overspend of £11k.

City Road

Access

Moorfields

North

Moorfields

South

Estates &

Facilities

Corporate

Corporate is £265k underspent in month and now stands £2,073k underspent YTD. The positive position

in month is due to the release of an additional £271k Education income above planned levels, for which

corresponding costs have been incurred YTD. The YTD underspend has been driven by the phasing of the

release of Education income, and lower interest costs than planned relating to Project Oriel.

Right to l ight income (£1,650k) and lower dividend than planned.

Discussed elsewhere in this report.

Discussed elsewhere in this report.

Divisional Financial Performance

9

NHS Income

Commentary

• A&E activity has under-performed in month

by 1,019 attendances and is the second lowest month for actual activity at 7,665

attendances so far this year. The reducing

trend in A&E attendances is seasonal with spring, and specifically the hay fever season

tending to drive the highest activity levels.

• Elective activity is 347 spells (10.8%) below plan in month, under performing by £0.33m

(9.3%). In actual terms the Trust recorded

just above an average level of elective

activity for the year, £0.08m above the YTD trend. YTD there remains a significant

under-performance of 952 spells / £0.78m.

This is largely related to City Road, although

there is also a material under-performance across Moorfields North. Sub-specialities at

City Road have been made aware of the

required throughput by week to recover

their activity plans; this will continue to be monitored within divisional performance

reviews to be able to build on the improved

performance in October and November.

• High cost drug injection activity is 169

injections (5%) above plan in month, giving a

favourable income variance of £0.13m. YTD there remains a significant over-

performance of 2,566 injections / £2.0m,

which is evenly spread across the 3 divisions.

• Outpatients under performed by 302 (0.6%)

attendances in January leading to an income

under-performance of £0.14m. Actual

activity levels were the second highest seen this year which was due to having 22

working days in the month.

10

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

2016/17 Actual

2017/18 Budget

2017/18 Actual

2017/18 Forecast

18 20 22 20 21 19 22 20 17 22 20 20

165 165 165 165 165 165 165 165 165 165 0 0

141 154 155 157 156 170 156 163 164 153 0 0

(23) (11) (10) (8) (9) 6 (9) (2) (1) (11) 0 0

Workings Days Inc. adjustments

Target per working day (£'000)

Actual per working day (£'000)

Variance (£'000)

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

18 20 22 20 21 19 22 20 17 22 20 20

258 251 254 254 254 254 261 261 261 261 0 0

237 252 245 251 241 272 249 299 265 259 0 0

(21) 1 (9) (4) (13) 18 (13) 37 4 (2) 0 0

Workings Days

Target per working day (£'000)

Actual per working day (£'000)

Variance (£'000)

Elective Activity Analysis (Inpatients and Outpatients)

• January elective income was below planned levels by

£329k.

• Average elective income was £153k per working day,

below the plan of £165k. The actual income

generated per working day is lower than most of the

year. In actual activity terms January had 2,879

spells in month.

• Overall elective activity was significantly below plan

in January, with under-performances in Adnexal,

cataracts and Glaucoma.

• January outpatient income was just below planned

levels across most sites and specialities. Activity

levels across out-patient specialties were higher than

normal. This was expected as January had 22

working days.

• Average outpatient income was £259k per working

day, below the plan of £261k. Outpatient first

appointments were above plan in month by £70k and

follow-ups were below plan by £204k in month.

• The over-performance against plan was in City Road

with the South and North divisions having an

underperformance. The January outpatient total

activity undertaken was the second highest so far

YTD.

11

NB. Research and Development Pay is excluded from the tables above and shown as part of the Research and Development position on page 13.

Staff Group & Directorate Staff Group & Directorate

MedicalYear to Date Current Month

Increase /

(Decrease)Nursing

Year to Date Current Month

Increase /

(Decrease)

Moorfields North 392 398 (6) Moorfields North 520 521 (1)

Moorfields South 414 341 73 Moorfields South 359 352 7

City Road 1,759 1,751 8 City Road 1,109 1,087 22

Access 0 0 0 Access 0 0 0

Corporate Departments 78 74 4 Corporate Departments 58 81 (23)

Total 2,643 2,564 79 Total 2,046 2,041 5

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 67 71 (4) Moorfields North 229 233 (4)

Moorfields South 44 49 (5) Moorfields South 231 264 (33)

City Road 956 924 32 City Road 355 353 2

Access 0 0 0 Access 398 431 (33)

Corporate Departments 13 64 (51) Corporate Departments 1,439 1,774 (335)

Total 1,080 1,108 (28) Total 2,652 3,055 (403)

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 £1,108k, which is above by £28k, the

2017/18 year to date averaged expenditure of £1,080k.

• The vacancy rate stands at 8.1% in January, with significant vacancies in Ophthalmic

Services. Non-recurrent benefits relating to prior year temporary staffing accruals have led

to the improved position at City Road in month. The adverse movement in Corporate is a

YTD cross-charge from City Road.

• Average non clinical pay expenditure in month is £3,055k, which is £403k above the 2017/18

year to date averaged expenditure of £2,652k.

• The large movement is driven by a re-coding from non-pay to pay of apprenticeship costs

within Corporate.

• Moorfields South and Access continue to staff materially above agreed establishment levels

and are driving the continued increase in the Admin and Clerical run-rate.

• Average nursing pay expenditure in month is £2,041k, which is £5k below the 2017/18 year

to date averaged expenditure of £2,046k.

• The vacancy rate stands at 14.2% in January with significant vacancies remaining in

Theatres and A&E at City Road.

• Overall Nursing expenditure has been relatively stable over the past 4 months .

• Average medical pay expenditure this month is £2,564k, which is £79k below the 2017/18

year to date averaged expenditure of £2,643k.

• The reduction in expenditure is due to activity at Moorfields South. Due to the St Georges

decant to St Anthony’s in January 5 days of clinical activity were lost, resu lting in reduced

levels of additional Medical sessions being paid.

12

Staff Type

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

Nursing 1,747 304 -10 2,041 0% 1,739 287 20 2,046 3% 1,701 266 29 1,996

Medical 2,315 270 -21 2,564 -3% 2,400 207 36 2,643 0% 2,338 230 86 2,654

Non-clinical 2,438 458 159 3,055 15% 2,124 357 171 2,652 9% 1,917 244 261 2,422

Current Month Year To Date Average Average Prior Year

Staff Type

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

Comments

Nursing

Medical

Non-Clinical

85%

15%

0%

Nursing Expenditure Current Month

Employed Bank Agency

85%

14%

1%

Nursing Expenditure YTD Average


89%

10%

-1%

Medical Expenditure Current Month

Employed Locum Agency

91%

8%1%

Medical Expenditure YTD Average


80%

15%

5%

Non Clinical Expenditure Current Month


80%

14%6%

Non Clinical Expenditure YTD Average


85%

13%

2%

Average Nursing Expenditure Prior Year


88%

9%3%

Average Medical Expenditure Prior Year


79%

10%11%

Average Non Clinical Expenditure Prior Year


NHS Operating Expenditure – Pay Costs Agency and Bank Analysis

• Nursing expenditure in January has

remained broadly equal in terms of

the split between substantive and

temporary compared to the YTD

average.

• The vacancy rate in month is 14.2%, a

small improvement in the levels seen

in recent months.

• The high vacancy rate is driven by

A&E and Theatres at City Road.

• There has been a slight increase in the

level of Bank usage within Medical

staff in January, increasing by 2% to

10% of the total (although this is in

line with last month).

• Vacancies have remained consistent

within certain junior doctor staff

groups, notably Adnexal and

Glaucoma.

• Non-clinical staff groups make use of

the highest proportion of agency at

5%. Bank usage is 15%. • The above figures are consistent with

the YTD average but a slight

improvement from 2016/17,

demonstrating a shift from agency

staff to bank.

• The non-clinical vacancy rate is 17.0%.

13

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 1,241 937 967 617 (350) 740 60% 50%

Moorfields South 922 812 630 244 (386) 293 32% 26%

City Road 3,914 3,768 3,201 3,055 (146) 3,914 100% 78%

Access Division 435 404 295 233 (62) 280 64% 54%

Corporate Departments 1,688 1,704 1,410 1,330 (80) 1,688 100% 79%

Total 8,200 7,625 6,503 5,479 (1,024) 6,915 84% 67%

Achievement YTD is £1,330k against a target of £1,410k. This is due to delays in starting a number of schemes across different

areas; in particular relating to Catering, Hybrid Mail and Interpreting services.

Directorate / Corporate

Department

Actions on Shortfall and Unidentified Amount

Achievement YTD is £244k against a target of £630k; slippage is largely related to a proposed Admin restructure, the St Georges SLA

and reducing the DNA rate. In mitigation the division is undergoing a major refurbishment at St Georges and has decanted to St

Anthonys hospital in January.

Achievement YTD is £3,055k against a target of £3,201k. The division is on plan to meet its CIP target, which accounts for almost half

of the Trust total. A quarter of the schemes are non-recurrent and the division is working to ensure that these schemes are made

recurrent leading into 2018/19. Detailed establishment reviews are being undertaken and some high volume and cost procurement

contracts are currently out to tender.

Achievement YTD is £617k against a target of £967k. A number of non-recurrent schemes have been identified in recent months

relating to Pay vacancies. The division is working to ensure that these savings can be made recurrent moving into 2018/19.

Achievement YTD is £233k against a target of £295k, slippage is related to a DNA reduction scheme and Admin restructure.

-

100

200

300

400

500

600

700

800

900

1,000

Am

ou

nt

(£'0

00

)

Period

Efficiency Schemes Profile and Forecast

Target

Actual

Forecast

Summary of Performance:- YTD CIP achievement at January 2018 is £5,479k vs a plan of £6,503k, 84% of the YTD target. The shortfall against target is £1,024k.

- Full year forecast is to deliver £6,915k, £1,285k below the target of £8,200k.

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

stage of the year most schemes being developed are non-recurrent.

4%6%

48%20%

22%

Breakdown of Forecast Achievement by Savings Type

Carter Hospital Medicine & Pharmacy

Carter Procurement

Carter Workforce

INCOME

NON PAY

14

Budget Actual Variance Budget Actual Variance Budget Forecast Variance

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

Total Income 1,152 1,545 393 10,414 9,847 (567) 12,268 12,268 0

Expenditure

Pay Costs 642 593 49 6,367 5,906 461 7,663 7,663 0

Non-Pay Costs 237 265 (28) 3,034 2,741 293 3,468 3,468 0

Total Expenditure 879 858 21 9,401 8,647 754 11,131 11,131 0

Interest, Dividends, Depreciation 11 11 0 109 109 0 148 148 0

Total Contribution to overhead 262 676 414 904 1,091 187 989 989 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 2,448 2,558 110 22,330 22,456 126 27,211 27,211 0 20,942 1,514

Expenditure

Pay Costs 761 772 (11) 7,218 6,872 346 8,809 8,809 0 6,716 (156)

Non-Pay Costs 1,178 1,267 (89) 11,255 11,317 (62) 13,518 13,518 0 11,014 (303)

Total Expenditure 1,939 2,039 (100) 18,473 18,189 284 22,327 22,327 0 17,730 (459)

Commercial Trading Unit EBITDA 509 519 10 3,857 4,267 410 4,884 4,884 0 3,212 1,055

Commercial Trading Unit EBITDA Margin % 20.8% 20.3% 17.3% 19.0% 17.9% 17.9% 15.3%Interest, Dividends, Depreciation and interests in

joint ventures95 91 4 1,117 1,047 70 1,307 1,307 0 577 (470)

Commercial Trading Unit Surplus / (Deficit) 414 428 14 2,740 3,220 480 3,577 3,577 0 2,635 585

Less Internal Sales 0 0 0 0 0 0 0 0 0 (157) 157

Commercial Trading Unit Surplus / (Deficit) -

discounting internal sales414 428 14 2,740 3,220 480 3,577 3,577 0 2,478 742

Budget Actual

Full Year Forecast Prior Year YTD

Forecast Variance Actual VarianceBudget Actual Variance Variance BudgetCommercial Trading Units


Research and Development Position

Commercial Trading Unit Position

In month R&D income is £0.39m above plan due to the release of non-recurrent income relating to the Reading Centre.

The release of non-recurrent income in month ensures that R&D will meet its contribution target of £0.99m for 2018/19. The identification, deve lopment and delivery of a sustainable and

recurrent R&D contribution is a key priority for the department moving into 2018/19.

YTD commercial income is slightly above plan at £22.46m. Forecast for the full year is to achieve the planned income level of £2 7.21m.

Expenditure YTD is £0.28m below plan at £18.19m. Full year expenditure is expected to be on plan at £22.33m. In month performance was a £0.43m surplus, £0.01m above plan, YTD the surplus now stands at £3.22m, £0.48m above plan.

Full year forecast is to deliver a surplus of £3.58m.

15

Cash Flow

Cash balance was £45.5m at the end of January, £3.8m above plan.

The table below shows reconciliation between plan and

cash balance highlighting key variances as at end of January and forecast for year end.

Rights to light income of £1.7m and additional STF

payment of £0.4m were not in plan at start of the year.

Reduction in debtors of £1.4m is driven by settlement reached with welsh health bodies for historic debt and insurance firms for private patients debt.

Reduction in creditors of £2.0m is driven by resolution of disputed invoices with other NHS trusts. Forecast

increase in payments to creditors relates to research and development projects with the UCL Institute of Ophthalmology, who have indicated in February their

intention to bill the Trust for completed projects before year end. These payments do not impact the income and expenditure position as they have already been

accounted for.

Year end forecast cash balance is largely on plan after

taking into account remaining capital expenditure, interest, loan and PDC dividend payments.

Cash reconciliation to plan at 31.01.2018 31 Jan 2018 Forecast 31 Mar 18

£M £M

Plan 41.7 42.2

Variances to plan during the year

Rights to light income 1.7 1.7

Additional STF 16-17 0.4 0.4

Reduction in debtors 1.4 1.4

Reduction in creditors -2.0 -3.4

Capital expenditure phasing 2.3 -

Sub-total 3.8 0.1

Cash Balance 45.5 42.3

16

Capital Expenditure

Total capital expenditure year to date is £6.22m. In addition, a further £7.25m has been committed through approved orders. This includes a multiple year order for EMR.

Current forecast is to incur expenditure of £11.22m by

year end, £19.65m below plan due to slippage of

strategic schemes into next year.

Better Payment Practice Code

January has marked an improvement on last month with 89% of invoices by volume and 93% by value paid within 30 days.

Year to date, value wise, most of the late payments relate to disputed invoices from NHS organisations which take longer than 30 days to resolve.

% of bills paid within target - Volume Target Act YTD Var YTD Apr May Jun Jul Aug Sep Oct Nov Dec Jan

NHS 95% 66% -29% 72% 46% 73% 55% 61% 88% 81% 72% 56% 86%

Non-NHS 95% 88% -7% 80% 82% 89% 90% 87% 94% 94% 91% 80% 89%

Total 95% 87% -8% 79% 80% 88% 88% 85% 94% 94% 90% 79% 89%

% of bills paid within target - Value Target Act YTD Var YTD Apr May Jun Jul Aug Sep Oct Nov Dec Jan

NHS 95% 54% -41% 74% 35% 65% 39% 43% 81% 80% 67% 41% 94%

Non-NHS 95% 87% -8% 75% 76% 90% 83% 90% 93% 93% 91% 92% 93%

Total 95% 82% -13% 75% 70% 86% 75% 81% 92% 92% 89% 80% 93%

Capital Expenditure

(£ Millions)

Annual

Budget

Expenditure

Year to Date

Expenditure

Committed

Year End

Forecast

Var to Plan

Forecast

Estates 7.74 2.28 2.22 5.05 2.69

Medical Equipment 2.33 1.34 0.48 1.95 0.38

IT 4.71 2.53 4.53 3.61 1.10

Corporate 0.22 0.00 0.02 0.02 0.20

Strategic Schemes 17.24 0.00 0.00 0.42 16.82

Dubai 0.65 0.07 0.00 0.17 0.48

Carry Forward (2.02) 0.00 0.00 0.00 (2.02)

Total 30.87 6.22 7.25 11.22 19.65

17

Debtors Management and Credit Control

Comments

Overall debt has increased by £0.5m in January to £14.1m (£13.6m December) primarily due to NHS performance activity being billed in month.

Total overdue debt has increased by £0.7m in January to £9.9m (£9.2m December). NHS performance and sundry overdue debt has increased and is partially offset by a reduction in private patients overdue debt.

Key debtors over 4 months overdue

NELC Group £0.6m

Welsh Health Bodies £0.3m

SWL Group £0.1M

Key debtors over 1-3 months overdue

NELC Group £1.2m

SWL Group £0.5m

NHSE £0.3m

NWL Group £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.

Type of Debt 6 Mths + 5 Mths 4 Mths 3 Mths 2 Mths 1 Mth Overdue Current Total

Jul 17 Aug 17 Sep 17 Oct 17 Nov 17 Dec 17 Jan 18 Jan 18 Jan 18

Welsh Debts only 276 15 10 12 13 9 335 11 346

NHS Service Income (147) 598 520 626 725 1,505 3,827 2,025 5,852

Total Contract Debts 129 613 530 638 738 1,514 4,162 2,036 6,198

Private Patients 1,263 116 145 197 212 253 2,186 551 2,737

Sundry Debtors 2,340 66 182 126 266 592 3,572 1,615 5,187

TOTAL 3,732 795 857 961 1,216 2,359 9,920 4,202 14,122

Type of Debt Overdue Current Total Overdue Current Total % Var % Var % Var

Jan 18 Jan 18 Jan 18 Dec 17 Dec 17 Dec 17 Overdue Current Total

Welsh Debts only 335 11 346 325 10 335 3% 10% 3%

NHS Service Income 3,827 2,025 5,852 3,195 1,727 4,922 20% 17% 19%

Total Contract Debts 4,162 2,036 6,198 3,520 1,737 5,257 18% 17% 18%

Private Patients 2,186 551 2,737 2,477 355 2,832 (12%) 55% (3%)

Sundry Debtors 3,572 1,615 5,187 3,235 2,279 5,514 10% (29%) (6%)

TOTAL 9,920 4,202 14,122 9,232 4,371 13,603 7% (4%) 4%

18

Overdue CCG debt

NEL, NWL and SWL CCG groups collectively account for £2.5m (77%) of

overdue English contract debt £3.2m.

NCA (Non-Contract Activity) overdue debt includes Kent & Sussex Area

CCGs with 44% of the total overdue balance of £0.5m. As is the case with

all NCA debts, an individual targeted approach is made for each debtor

(113 in total).

Overdue Sundry debt

Overdue sundry debt has decreased by £0.3m in January to £3.6m (£3.2m

December). Key overdue debtors are as follows:

Barts Trust £0.3m

F. Hoffmann-La Roche Ltd (R&D) £0.3m

St Georges Trust £0.3m

Croydon Trust £0.2m

UCLH Trust £0.2m

Lowy Medica Research (R&D) £0.1m

Other Trusts £0.5m

Overseas patients £0.3m

PP consultants service charges £0.6m

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.

£3,732

£795

£857

£961£1,216

£2,359

£4,202

Total Debt by Age £'000

6 Mths +

5 Mths

4 Mths

3 Mths

2 Mths

1 Mth

Current

£14,122Total

£335

£3,827

£2,186£3,572

£4,202

Total Debt by Type £'000

Welsh Debts only

NHS Service Income

Private Patients

Sundry Debtors

Current

Total £14,122

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