executive summary - northern devon healthcare nhs trust · 6/5/2018 · cost improvement plan...

Trust Board 5 June 2018 Budget 2018/19

Trust Secretariat of 19 G:\Board Secretariat\Meetings\Board\Meetings\2018-19\05.06.18

EXECUTIVE SUMMARY REPORT TO: Trust Board DATE: Tuesday 5 June 2018 AGENDA NO: 3.2 AGENDA ITEM: Budget 2018/19 SPONSOR: Angela Hibbard, Director of Finance and Performance PREPARED BY: Colin Dart, Deputy Director of Finance PRESENTED BY: Angela Hibbard, Director of Finance and Performance

Purpose

To present to the Committee with a complete view of the final 2018/19 financial plan as approved by the Board at a briefing on 17 April 2018 and reflected in the finance general ledger that has been submitted to NHS Improvement.

Decision

Approval

Receive

Ratify

Link to Strategic Objective(s)

This paper supports delivery of the following strategic objectives, by demonstrating a financial plan that demonstrates no worsening of the performance within the NHS constitutional targets within a highly constrained financial environment. The plan is set at a level that is both challenging yet deliverable. 1. High quality 2. Sustainable local services 3. Integrated health and social care 4. Flexible, fulfilled and multi-skilled workforce 5. Efficient and effective 6. Promote independence and well-being. 7. Support individuals and communities to have more influence

Key Issues

The financial plan approved by the Trust Board for 2018/19 is a £11.9m in year deficit

The Plan requires an £8m savings programme to be delivered

The plans behind the £8m opportunity continue to be developed and monitored as a comprehensive CIP programme of work.

The CIP governance has been reviewed and a proposal was approved by the board to strengthen current arrangements. Project Management Office roles are being recruited.

A CIP Steering Group has been constituted and held its first meeting on 14 May 2018.

A CIP Programme Board has been constituted and held its first meeting on 21 May 2018.

Key risks are identified focusing on ability to manage demand in the system, impact on ability to deliver CIP, regulator response to non-acceptance of control total.

The plan is risk assessed at level 3 (of 4) being moderately high and reflects the ‘Challenged Trust’ status by NHS Improvement.

Equality-Related Impact The Trust is committed to an inclusive NHS that is fair and accessible to all; to upholding the principles of human rights and equality of people who use our services and of those who work in them. This paper has been assessed to have the following equality-related impact:

Positive Impact

Negative Impact

No Impact

Risk



Board/Committee Prompts

Does this paper affect confidence regarding achievement of the identified strategic objective(s)?

What assurance can the Board take from this paper regarding the identified strategic objective(s)?

References

None



1. Purpose

1.1. The purpose of this paper is to present to the committee the supporting

information to the approved financial plan for 2018/19. The paper sets out:

The overall financial position and assumptions used

Key performance trajectories

Statement of Comprehensive Income (Appendix 1)

Statement of Financial Position (Appendix 2)

Statement of Cash Flows (Appendix 3)

Savings plan

Risks (Appendix 4)

Capital Programme (Appendix 5)

2. Background and overview

2.1. Plan Overview

The Board approved a realistic, challenging yet deliverable financial plan on 17 April 2018 that was submitted to NHS Improvement (NHSI) on 30 April 2018. The key highlights being:

Not accepting the notified control total surplus of £5.4m;

Accepting that Provider Sustainability Funding (PSF) of £5.4m would not be earned;

Deliver a £11.9m deficit; after

Achieving £8.0m of savings.

2.2. Operational Performance

The approved financial plan delivers the following performance against the key NHS constitution targets:

RTT 18W% will be maintained at 78% through to Mar 19 (early view reporting for best-estimate of performance as at Mar 18);

Cancer 62D performance will be improved by reducing backlog through the year, from 81% to 86%;



4h flow performance will be increasing through the year from 72% to 83% at M6 to 92% at M12.

This performance for our activity level would have been in line with the national requirement of 90% at M6 and 95% at M12 if NDHT still had the Walk in Centre services that transferred to Royal Devon and Exeter FT at 1 Apr 18;

6WW diagnostics will see a reduction of overall WL and a major reduction in 6W+ waiters

2.3. Rollover Financial Position

The financial plan recognised that a number of transactions to achieve the 2017/18 yearend position were non-recurrent in nature and unwinding these into the 2018/19 opening plan position results in an underlying opening deficit of £8.9m.

2.4. 2018/19 overall planning assumptions

The financial plan is based on an agreed set of STP financial principles for 2018/19 of Flat Cash + across all CCG commissioned spend. The +’s in the agreement relate to:

RTT backlog funding in line with planning guidance

Mental health parity of esteem

Primary care non recurrent transformational funding

This means that the level of income received from STP NHS Commissioners (NEW Devon CCG and South Devon & Torbay CCG) will not be increased above 2017/18 levels with regards to price inflation and activity growth. By the same argument this secures any additional payments above tariff such as subsidies into the rolled over contract value. The expectation to the flat cash arrangement is the agreed cost of funding RTT required to hold the 2017/18 exit position. This has been agreed to be funded at PBR tariff and discussion are ongoing to confirm the arrangements to transfer this into the block arrangements. The Trust plan assumes £3.2m of income matched with £3.2m of expenditure.

2.5. 2018/19 income assumptions The key assumptions driving income in the plan can be summarised as:

activity growth

tariff income

flat cash reduction

RTT income

Transfer of Walk in Centre services to RDE NHSFT



Contractual resolutions

STP support repaid 2.6. 2018/19 expenditure assumptions

The key assumptions driving expenditure in the plan can be summarised as:

Cost of delivering activity growth

Pay and non-pay inflation

Cost of delivering RTT activity

Transfer of Walk in Centre services to RDE NHSFT (reduced expenditure)

Electronic Healthcare Record

Unwind salaries recharged to capital programme

CQC action plan and governance 2.7. Reserves

The following material reserves have been incorporated into the financial plan and are held pending allocation to specific budgets:

Activity growth

RTT activity

CQC action plan

A transparent process for utilisation of these reserves will be implemented throughout the financial year to address the capacity within the organisation and the agreed RTT position at the end of the financial year as well as addressing the recommendations raised by the CQC.

The activity related reserves also provide a means to deliver the cost improvement plan productivity focused schemes. The productivity benefits targeted will deliver the increased level of capacity needed allowing for the release of funds. However, productivity KPI’s must be evidenced before release of funding to CIP schemes.



2.8. Key Data

The following table sets out the quarterly and cumulative key performance indicators of the 2018/19 financial plan:

2.9. Risk Rating

The following table sets of the quarterly and cumulative NHSI risk rating of the 2018/19 financial plan:

Plan Risk Ratings Q1 Q2 Q3 Q4

Year Ending

Rating Rating Rating Rating Rating

Capital Service Cover rating 4 4 4 4 4

Liquidity rating 2 3 3 3 3

I&E Margin rating 4 4 4 4 4

Variance From Control Total rating

4 4 4 4 4

Agency rating 1 1 1 1 1

Plan Risk Rating after overrides 3 3 3 3 3

Key Data Q1 Q2 Q3 Q4 Cumulative

£'000 £'000 £'000 £'000 £'000

Turnover

Total operating income 48,664 48,761 49,049 49,175 195,649

Less capital donations/grants income impact (61) (63) (263) (363) (750)

Total Turnover 48,603 48,698 48,786 48,812 194,899

Performance against control total including STF

Surplus/(deficit) before impairments and transfers (3,497) (3,674) (2,255) (1,953) (11,379)

Adjusted financial performance surplus/(deficit) including STF (3,495) (3,674) (2,455) (2,253) (11,877)

Control total including STF 816 637 1,856 2,063 5,372

Performance against control total including STF (4,311) (4,311) (4,311) (4,316) (17,249)

Performance against control total excluding STF

Adjusted financial performance surplus/(deficit) including STF (3,495) (3,674) (2,455) (2,253) (11,877)

Less sustainability & transformation fund (STF) 0 0 0 0 0

Adjusted financial performance surplus/(deficit) excluding STF (3,495) (3,674) (2,455) (2,253) (11,877)

Control total excluding STF (16) (473) 192 121 (176)

Performance against control total excluding STF (3,479) (3,201) (2,647) (2,374) (11,701)

Efficiencies

Total Identified Efficiencies 1,116 2,007 2,412 2,511 8,046

Total Efficiencies 1,116 2,007 2,412 2,511 8,046

Total Efficiencies as a percentage of expenditure (before efficiencies) 2.1% 3.7% 4.5% 4.7% 3.7%

Capital

Gross Capital Expenditure 1,482 1,319 1,154 1,665 5,620

Disposals / other deductions 0 0 0 0 0

Charge after additions/deductions 1,482 1,319 1,154 1,665 5,620

Less Donations and Grants Received (187) (189) (188) (186) (750)

Total CDEL 1,295 1,130 966 1,479 4,870

Cash

Cash and cash equivalents at period end 2,145 1,753 2,209 1,209 1,209

DHSC Interim Revenue Financing 2,274 (839) 3,000 3,000 7,435

Agency

Total agency costs excluding outsourced bank 1,158 853 732 465 3,208

Agency ceiling 1,350 1,050 850 740 3,990

Agency costs as a percentage of gross payroll costs 3.6% 2.7% 2.3% 1.5% 2.5%



3. Cost improvement plan (CIP)

3.1. Overview

The trust has undertaken a comprehensive review of the level of CIP achievable based on a number of benchmarking opportunities available. This has identified a target level of opportunity of £8m. This equates to 3.7% of trust baseline expenditure.

£,m

Gross Savings 8.50

Identified investment 0.45

Net Saving 8.05

The CIP opportunity identified is being translated into deliverable plans at specialty level with set financial targets and KPIs based on a number of markers such as:

Target reductions in agency spend through strengthening recruitment and retention

Reduction in number of non-elective admissions and A&E attendances through ensuring patients receive the right level of care and support before needing acute services

Increased utilisation of theatre sessions to deliver productivity gains required to address RTT and growth pressures

CIP governance has increased to provide assurance around CIP delivery from project to Board as set out below:



3.2. 2018/19 Programme

An initial high level programme was constructed utilising the national benchmarking information available.

Informal conversations with regulators indicate that this level of CIP is in line with expectation.

This was further informed by reviewing the output from a CIP workshop.

Further review by the Director of Finance and Interim Director of Operations and Strategy assessed the plan below as reasonable:



Area

Gross

saving

£'000

Identified

Investment

£'000

Net

Saving

£'000 Basis of Allocation

Agency spend

reductions 746 0 746 Division

Theatres

productivity 700 200 500

Reserve

(subject to demonstrable KPI’s)

Pharmacy -

Biosimilars 300 0 300 Division

Pathology 100 0 100 Division

Procurement 600 0 600

Division based on work

programme

Private Patients 600 0 600 Division

Corporate Services 400 0 400 Division

Patient Flow 400 0 400 Division

1% Efficiency 1,600 0 1,600 Division

Demand

Management 800 0 800

Reserve


Elective Care 200 0 200

Reserve


Non Block Contracts 200 0 200 Contract Income

Job Planning 500 0 500 Reserve

RTT delivered at

Marginal rate 800 0 800


Contribution to

overheads 550 250 300 Division

8496 450 8046

3.3. Further Opportunities

Further opportunities will be built into the plan to ensure that the full £8m target can be delivered on a recurrent basis by year end. This will be informed by the governance arrangements for assurance and escalation that are encapsulated in separate committee papers for the Terms of Reference for:

CIP Steering Group

CIP Programme Board

3.4. Plan Phasing The revised quarterly profiles currently reflected in the plan are:

£’000 %

Q1 1,116 14

Q2 2,007 25

Q3 2,412 30



3.5. Internal Processes and CIP Governance The following have been considered for implementation:

Reviewed of CIP Governance arrangements from Project to Board

Received Board approval for a formal Programme Management Office (PMO) function. Roles have been banded and will be advertised imminently.

SmartSheets (Project to Board reporting tool) being populated with PID’s, KPI’s, milestones and trajectories.

Reviewed Terms of Reference and assurance arrangements required for the CIP Steering Group.

CIP Steering Group established to challenge on delivery against key milestones, risks and escalation. First meeting 14 May 2018.

Reviewed Terms of Reference and assurance arrangements required for the CIP Programme Board.

Revised CIP Programme Board established. First meeting 21 May 2018.

Finance Committee – report from CIP Programme Board 22 May 2018

3.6. SmartSheets project to board reporting tool Master Template The master template will be a complete log of all of the CIP schemes being worked up for 2018/19. The Project Initiation Document (PID) is the key supporting document.

The master template will record the operational lead and SRO, a RAG rating for project progress and savings progress as well as forecast and actual savings achieved.

The PMO will own the master template and maintain the details using information from CIP mandates, action plans and CIP steering group.

The finance manager will be responsible for maintaining and updating the financial trajectory within the master template on a monthly basis consistent with ledger reporting.

Action Plans

Q4 2,511 31

Total 8,046 100



Each project will have an action plan which will record progress against milestones.

The PMO will be responsible for setting up the template using the milestones identified in the CIP mandate and then the operational lead will be responsible for keeping it up to date with progress at least fortnightly, 3 working days ahead of CIP Steering Board.

Any actions that are RAG rated amber or red must have a risk or issue entered into the risks and issues log by the operational lead.

Risks and Issues Log

The operational lead will be responsible for logging any risks and issues onto the log in Smartsheets using the Trust standard scoring and for keeping their project specific risks and issues up to date.

Risk score will be informed by the Trust risk matrix taking into consideration likelihood and impact.

KPI’s

A template will be created for each project to record the planned trajectory for each of the KPIs specific to that project as well as actual delivery against that KPI.

The PMO will be responsible for setting up the initial template for each project and the operational lead will be responsible for updating and maintaining it.

4. Cash

4.1. Due to the deficit nature of the financial plan an additional working capital loan is assumed in year of £9m. This will need to be applied for with NHS improvement. Given the conversations regarding their understanding of the Trust deficit plan this is expected to be supported.

4.2. This is reflected in the Statement of Cash Flows submitted to NHSI on 30 April 2018 as set out in Appendix 3.

5. Capital

5.1. A balanced capital programme has been developed to utilise the capital resources available through the utilisation of the annual depreciation, donated assets the repayment of the Salix loan. This provides capital available of £5.7m.



5.2. This capital has been utilised against existing committed developments, medical devices equipment, IT trakcare commitments and a provision for backlog maintenance.

5.3. The capital programme is included as Appendix 5.



6. Risk

6.1. Although the financial plan shows significant movement from the planned £4m surplus of 2017/18 to a £12m deficit in 2018/19 there still remains an element of risk to delivery of this position as set out in Appendix 4.

6.2. These risks are known at the planning stage and will be reviewed by the executive committee, Finance Committee and Board in accordance with the reporting cycle to ensure that mitigation actions are put in place.

Trust Secretariat of 19

Appendix 1 – Statement of Comprehensive Income

STATEMENT OF COMPREHENSIVE INCOME April May June July August September October November December January February March Cumulative

£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000

Operating income from patient care activities 15,383 15,383 15,383 15,414 15,415 15,415 15,444 15,444 15,444 15,454 15,454 15,454 185,087

Other operating income 838 838 839 839 839 839 839 939 939 939 939 935 10,562

Employee expenses (10,652) (10,652) (10,652) (10,483) (10,483) (10,483) (10,471) (10,471) (10,471) (10,430) (10,430) (10,428) (126,107)

Operating expenses excluding employee expenses (6,727) (6,727) (6,748) (6,652) (6,653) (6,622) (6,628) (6,628) (6,632) (6,647) (6,054) (7,021) (79,739)

OPERATING SURPLUS / (DEFICIT) (1,158) (1,158) (1,178) (882) (882) (851) (816) (716) (720) (684) (91) (1,060) (10,197)

FINANCE COSTS

Finance income 1 1 1 1 1 1 1 1 1 1 1 1 12

Finance expense (2) (2) (2) (56) (2) (2) (2) (2) (2) (116) (2) (2) (192)

PDC dividends payable/refundable 0 0 0 0 0 (1,001) 0 0 0 0 0 (1,001) (2,002)

NET FINANCE COSTS (1) (1) (1) (55) (1) (1,002) (1) (1) (1) (115) (1) (1,002) (2,182)

Other gains/(losses) including disposal of assets 0 0 0 0 0 0 0 0 0 0 0 0 0

Gains/(losses) from transfers by absorption 0 0 0 0 0 0 0 0 0 0 0 0 0

SURPLUS/(DEFICIT) FOR THE PERIOD/YEAR (1,159) (1,159) (1,179) (937) (883) (1,853) (817) (717) (721) (799) (92) (2,062) (12,379)

ADJUSTED FINANCIAL PERFORMANCE

Surplus/(deficit) for the period/year including STF (1,159) (1,159) (1,179) (937) (883) (1,853) (817) (717) (721) (799) (92) (2,062) (12,379)

Add back all I&E impairments/(reversals) 0 0 0 0 0 0 0 0 0 0 0 1,000 1,000

Adjust (gains)/losses on transfers by absorption 0 0 0 0 0 0 0 0 0 0 0 0 0

Surplus/(deficit) before impairments and transfers (1,159) (1,159) (1,179) (937) (883) (1,853) (817) (717) (721) (799) (92) (1,062) (11,379)

Retain impact of DEL I&E (impairments)/reversals 0 0 0 0 0 0 0 0 0 0 0 0 0

Remove capital donations/grants I&E impact 1 1 0 0 0 0 0 (100) (100) (100) (100) (100) (498)

Adjusted financial performance surplus/(deficit) including STF (1,158) (1,158) (1,179) (937) (883) (1,853) (817) (817) (821) (899) (192) (1,162) (11,877)


Appendix 2 – Statement of Financial Position

STATEMENT OF FINANCIAL POSITION £'000

Non-current assets

Intangible assets 9,053

Property, plant and equipment: other 65,386

Trade and other receivables: due from non-NHS/DHSC group bodies 1,036

Total non-current assets 75,475

Current assets

Inventories 3,049

Trade and other receivables: due from NHS and DHSC group bodies 6,357

Trade and other receivables: Due from non-NHS/DHSC group bodies 5,262

Cash and cash equivalents: GBS/NLF 1,200

Cash and cash equivalents: commercial / in hand / other 9

Total current assets 15,877

Current liabilities

Trade and other payables: capital (350)

Trade and other payables: non-capital (15,243)

Borrowings (711)

Other liabilities: deferred income (1,418)

Total current liabilities (17,722)

Total assets less current liabilities 73,630

Non-current liabilities

Borrowings (14,970)

Provisions (29)

Total non-current liabilities (14,999)

Total net assets employed 58,631

Financed by

Public dividend capital 56,304

Revaluation reserve 7,562

Income and expenditure reserve (5,235)

Total taxpayers' and others' equity 58,631


Appendix 3 – Statement of Cash Flows

STATEMENT OF CASH FLOWS April May June July August September October November December January February March

£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000

Cash and cash equivalents at start of period 4,051 2,536 1,377 2,145 1,209 1,209 1,753 1,499 1,209 2,209 1,209 1,209

Cash flows from operating activities

Operating surplus/(deficit) (1,158) (1,158) (1,178) (882) (882) (851) (816) (716) (720) (684) (91) (1,060)

Non-cash income and expense:

Depreciation and amortisation 441 441 462 462 463 465 465 465 469 469 490 490

Impairments and reversals 0 0 0 0 0 0 0 0 0 0 0 1,000

Income recognised in respect of capital donations (cash and non-cash) (20) (20) (21) (21) (21) (21) (21) (121) (121) (121) (121) (121)

(Increase)/decrease in trade and other receivables 0 0 0 0 3,839 0 0 0 0 0 0 (1,658)

Increase/(decrease) in trade and other payables 26 63 726 33 732 (500) 0 353 (1,134) 7 850 0

Increase/(decrease) in other liabilities 0 0 (1,025) (175) 36 (13) 802 (2) (170) (208) (683) (47)

Increase/(decrease) in provisions 0 0 0 0 0 0 0 0 0 0 0 0

Net cash generated from / (used in) operations (711) (674) (1,036) (583) 4,167 (920) 430 (21) (1,676) (537) 445 (1,396)

Cash flows from investing activities

Interest received 1 1 1 1 1 1 1 1 1 1 1 1

Purchase of intangible assets (121) (121) (126) (61) (91) (91) (91) (91) (91) (91) (91) (91)

Purchase of property, plant and equipment and investment property (346) (383) (364) (258) (256) (620) (257) (298) (353) (378) (474) (632)

Receipt of cash donations to purchase capital assets 20 20 21 21 21 21 21 121 121 121 121 121

Net cash generated from/(used in) investing activities (446) (483) (468) (297) (325) (689) (326) (267) (322) (347) (443) (601)

Cash flows from financing activities

Loans from Department of Health and Social Care - received 0 0 2,274 0 0 3,000 0 0 3,000 0 0 3,000

Loans from Department of Health and Social Care - repaid 0 0 0 0 (3,839) 0 0 0 0 0 0 0

Other loans repaid (356) 0 0 0 0 0 (356) 0 0 0 0 0

Interest paid (2) (2) (2) (56) (2) (2) (2) (2) (2) (116) (2) (2)

PDC dividend (paid)/refunded (845) (1,001)

Net cash generated from/(used in) financing activities (358) (2) 2,272 (56) (3,841) 2,153 (358) (2) 2,998 (116) (2) 1,997

Increase/(decrease) in cash and cash equivalents (1,515) (1,159) 768 (936) 1 544 (254) (290) 1,000 (1,000) 0 0

Cash and cash equivalents at end of period 2,536 1,377 2,145 1,209 1,209 1,753 1,499 1,209 2,209 1,209 1,209 1,209


Appendix 4 – Material financial risks scoring above 12

No. Financial Risk Description Impact x likelihood

Mitigating action

1

Baseline activity levels exceed volumes set within block contract

The interplay with the contract subsidy ensures that an overall quantum of contractual income is achieved in the rollover block but the ability of the organisation to deliver against the block contract is compromised if activity levels continue to exceed planned volumes. This will otherwise manifest in further waiting list deterioration and over the level of acute bed stock required

4x3 =12

1. Demand management programme of work to be built into CIP to include parties from CCG, Community and Local Authority

2. Productivity generated through theatre utilisation programme to address RTT in the short term

2 Ability to further contain in year growth

The contract contains further activity assumptions for growth containment which is driving the in-year deficit position as costs are still assumed. CIP delivery is predicated on reducing activity levels so capacity can be reduced to remove cost

4x3=12

Mitigations as above plus

3. Strengthen CIP governance to increase assurance around CIP delivery to ensure early warning system when actions of track and clear escalation route to resolution of issues

3.

None agreement of control total will place the trust in SOF 4 with mandated regulator intervention

The scale of the regulator intervention is not known but is likely to be proportionate to the scale of the deficit compared to other deficit organisations and arrangements already being put in place to address viability issues.

3x4=12

7. Successful implementation of management contract with RDE to provide assurance to NHSI that action is being taken to address clinical and financial issues

4 Risk of overall STP position

The STP may require organisations to achieve better than current plan to remain in line with the original STP trajectory which was £61m deficit in 2018/19. The STP is currently £7m away from this trajectory in the collective plans

3x4=12 8. Should this risk arise it will need to be debated in the STP forum and brought back for board sign off.


and therefore downside organisations may be asked to do better

A number of options are available:

(1) refusal to change plan

(2) agreement on assurance of additional system support

(3) agreement with unidentified CIP increase

5 Ability to deliver breakeven duty over three years

Delivering a deficit position to the magnitude of £12m may risk the ability of the trust to recover within a three year period – required to achieve the statutory duty

3x4=12

9. A 3 year recovery plan to be formulated in line with the development of a financial strategy

10. Consideration given to applying to extend the breakeven duty over 5 years.


Appendix 5 – Capital Programme

2018/19

Description Trust Charitable Total

£000s £000s £000s

SOURCE OF FUNDS

Depreciation 5,700 5,700

Donations

- Equipment 250 250

- Cancer Information Centre 500 500

Less:

SALIX loan repayment (712) (712)

Depreciation, donations and loans 4,988 750 5,738

TOTAL SOURCE OF FUNDS 4,988 750 5,738

APPLICATIONS

Applications - Developments

Theatre Upgrade 100 100

Elliot Hire of Portacabins 45 45

A&E Primary Care Streaming 395 395

Cancer Information Centre 500 500

Sub-total 540 500 1,040

Application - Backlog Maintentance

Maintenance 500 500

Sub-total 500 0 500

Application - Equipment

Replacement Equipment Programme 850 850

New Equipment - donated 250 250

Sub-total 850 250 1,100

Application - Other Equipment

Hotel Services (incl Sodexo contractual) 60 60

Sub-total 60 0 60

Applications - IM&T BAU Capital

Server 100 100

Non-core systems 125 125

Sub-total 225 0 225

Applications - IM&T Smartcare

Hardware 500 500

Digital Observations 124 124

Business Intelligence 100 100

RiO 95 95

Trak 1,627 1,627

Smartcare Project Team 367 367

Sub-total 2,813 0 2,813

TOTAL APPLICATIONS 4,988 750 5,738

(Over)/Under Commitment 0 0 0

executive summary - northern devon healthcare nhs trust · 6/5/2018 · cost improvement plan...

Documents