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Appendices - The Shrewsbury and Telford Hospital

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					                                                                    The Shrewsbury & Telford Hospital NHS Trust
                                                                                Income & Expenditure 2004/5
                                                                  Current Plan and Performance to Date as at Month 2 2004/5

                     Changes                                                                                                                                                              Variance
    Original        Previously       Revised       Changes        Current         Forecast                                                             Budget to    Actual to    Variance Previous
     Plan            reported         Plan        in Month         Plan           Outturn       Variance                                                 Date        Date        to Date   Month
     £'000             £'000          £'000          £'000         £'000           £'000          £'000                                                 £'000        £'000        £'000    £'000
                                                                                       -                   Income
     148,508              300        148,808      -   3,500        145,308         145,308                 Service Agreements                            23,320      23,320          -
       5,325              -            5,325            694          6,019           6,019                 Specialised Services Income                    1,002       1,002          -
      17,733              -           17,733      -   1,715         16,018          16,018                 Other Income                                   2,979       2,927 -            52

     171,566              300        171,866      -   4,520        167,346        167,346             -    Total Operating Income                        27,301      27,249 -            52

                                                                                                           Expenditure
     113,888    -         500      113,388            3,061     116,449   116,449                          Pay                                           19,562      19,907 -        345
      52,419    -         300       52,119        -   7,581      44,538    44,538                          Non Pay                                        7,260       7,136          124
                -         807    -     807              -     -     807 -     807                          Outstanding Savings Required
        7,179             -          7,179              -         7,179     7,179                          Depreciation

     173,486    -        1,607       171,879      -   4,520        167,359        167,359             -    Total Operating Expenditure                   26,822      27,043 -        221

-       1,920            1,907   -           13         -     -            13 -            13         -    Total Operating Surplus /(Deficit)               479         206 -        273

         130               -             130            -              130             130                 Interest Receivable                     -         17 -         13 -            4
                         9,000         9,000            -            9,000           9,000                 StHa Brokerage

-       1,790          10,907          9,117            -            9,117           9,117            -    Surplus / (Deficit )for the period               462         193 -        277

        4,210              -           4,210            -            4,210           4,210                 PDC Dividends Payable
                                                                                                           BBC Loan
                                                                                                           StHA 2003/4 Brokerage

-       6,000          10,907          4,907            -            4,907           4,907            -    Retain Surplus / (Deficit) for Period            462         193 -        277

                         4,907         4,907            -            4,907           4,907                 Deficit brought forward

-       6,000            6,000           -              -              -               -              -    Total Cumulative Position                        462         193 -        277
The Shrewsbury & Telford Hospital NHS Trust                                                            APPENDIX B
Financial Position to month 2 2004/5
Income

Variance
    to
previous                                          Annual         Budget        Actual       Variance        Variance
 month                                            Budget        To Date       to Date       to Date         to Date
  £'000                                            £'000         £'000         £'000         £'000             %

           Shropshire County                  -    80,546   - 12,838      - 12,838              -               -
           Telford & Wrekin                   -    53,069   -  8,540      - 8,540               -               -
           South Staffordshire                -       563   -     91      -     91              -               -
           North Staffordshire                -        84   -     14      -     14              -               -
           South Cheshire                     -       127   -     21      -     21              -               -
           Herefordshire                      -       160   -     26      -     26              -               -
           Birmingham                         -        69   -     11      -     11              -               -
           Wolverhampton                      -       167   -     27      -     27              -               -
           Worcestershire                     -       151   -     25      -     25              -               -
           Powys                              -     9,727   -  1,620      - 1,620               -               -
           Powys Provider                     -       189   -     31      -     31              -               -
           North Wales                        -       388   -     65      -     65              -               -
           Velindre                           -        68   -     11      -     11              -               -

           Sub Total - Service Agreements     -   145,308   - 23,320      - 23,320              -               -

           Wales Health Commission            -       458   -        76   -       76            -               -
           Renal Consortium inc. EPO          -     3,355   -       559   -      559            -               -
           Neonatal Consortium                -     2,206   -       368   -      368            -               -

           Sub Total - Specialised Services   -     6,019   -     1,002   - 1,002               -               -

           DOH                                -       172   -        29   -       29            -               -
           Road Traffic Accidents             -       844   -       141   -      141            -               -
           Private Patients                   -     2,801   -       559   -      511    -        48     -      8.59
           Perscription Charges               -        79   -        12   -       10    -         2     -     16.67
           Overseas Visitors                  -         3   -         1                 -         1     -    100.00
           Education & Training               -     5,503   -       920   -      886    -        34     -      3.70
           DOH Discretionary Points           -       110                                       -
           Clinical Trials & Research         -       377   -        61   -       67              6            9.84
           Sale of Services                   -       409   -       104   -      117             13           12.50
           Staff & Patient Services           -     1,988   -       345   -      335    -        10     -      2.90
           Recharges with the NHS             -     2,468   -       420   -      424              4            0.95
           Other                              -     1,264   -       387   -      407             20            5.17

           Sub Total - Other income           -    16,018   -     2,979   - 2,927       -        52 -          1.75

           Sub Total Operational Income       -   167,346   - 27,300      - 27,248      -        52 -          0.19

           StHA Brokerage                     -     9,000                                       -               -

           Total Income                       -   176,346   - 27,300      - 27,248      -        52 -          0.19
The Shrewsbury & Telford Hospital NHS Trust                                                  APPENDIX C
Financial Position to April - May 2004/5

Pay
 Variance
     to
 previous                                        Annual     Budget   Actual to       Variance         Variance
  month                                          Budget    To Date    Date           to Date          to Date
   £'000                                          £'000     £'000     £'000           £'000              %

            Womens                                10,319     1,747      1,803    -        56      -      3.21
            Paediatric                             6,637     1,114      1,102             12             1.08
            Surgical                              36,741     6,135      6,302    -       167      -      2.72
            Medical                               29,809     4,982      5,098    -       116      -      2.33
            Radiology                              5,030       838        847    -         9      -      1.07
            Pathology                              5,752     1,021      1,040    -        19      -      1.86
            Pharmacy                               2,535       431        427              4             0.93

            Chief Operation Officer                5,892       982        996    -           14 -        1.43
            Corporate Services inc. Chief Exc.     3,793       616        635    -           19 -        3.08
            Head of Estates & Facilities           7,192     1,199      1,225    -           26 -        2.17
            Medical Director                       1,326       209        191                18          8.61

            Finance                                1,423       288       241                 47         16.32
            Medical Director                                                             -

            Total                                116,449    19,562    19,907     -       345 -           1.76

Non Pay

            Womens                                 1,604       257        232              25            9.73
            Paediatric                               548        90        107    -         17     -     18.89
            Surgical                               9,620     1,624      1,510            114             7.02
            Medical                               12,220     2,180      2,196    -         16     -      0.73
            Radiology                              2,310       785        773              12            1.53
            Pathology                              3,385       596        572              24            4.03
            Pharmacy                                 242        45         53    -          8     -     17.78
                                                                                         -
            Chief Operation Officer                1,541       353        353            -                -
            Corporate Services inc. Chief Exc.     7,046       154        154            -                -
            Head of Estates & Facilities           6,297     1,087      1,106    -         19     -      1.75
            Medical Director                         786        52         49               3            5.77
                                                                                         -
            Finance                                   80        37         31               6           16.22
            Corporate Finance                     14,218                                 -

            Total                                 59,897     7,260      7,136            124             1.71

Total Pay & Non-Pay

            Womens                                11,923     2,004      2,035    -        31      -      1.55
            Paediatric                             7,185     1,204      1,209    -         5      -      0.42
            Surgical                              46,361     7,759      7,812    -        53      -      0.68
            Medical                               42,029     7,162      7,294    -       132      -      1.84
            Radiology                              7,340     1,623      1,620              3             0.18
            Pathology                              9,137     1,617      1,612              5             0.31
            Pharmacy                               2,777       476        480    -         4      -      0.84

            Chief Operation Officer                7,433     1,335      1,349    -           14 -        1.05
            Corporate Services inc. Chief Exc.    10,839       770        789    -           19 -        2.47
            Head of Estates & Facilities          13,489     2,286      2,331    -           45 -        1.97
            Medical Director                       2,112       261        240                21          8.05

            Finance                                1,503       325       272                 53         16.31
            Corporate Finance                     14,218       -         -               -                -

            Total                                176,346    26,822    27,043     -       221 -           0.82
The Shrewsbury & Telford Hospital NHS Trust                                                                    APPENDIX D
Financial Position to month 2 2004/5
Divisional Analysis

Variance
   to                                                  Pay         Non Pay         Income           Total                   Projected
previous                                            Variance       Variance       Variance       Variance                     EOY
 month                                               to Date        to Date        to Date        to Date                   Variance
 £'000                                                £'000          £'000          £'000          £'000                     £'000

           Womens                               -        56             25    -         5    -        36                         -
           Paediatric                                    12    -        17    -         4    -         9                         -
           Surgical                             -       167            114    -        28    -        81                         -
           Medical                              -       116    -        16    -        11    -       143                         -
           Radiology                            -         9             12    -         1              2                         -
           Pathology                            -        19             24    -         1              4                         -
           Pharmacy                                       4    -         8              9              5                         -

           Chief Operation Officer              -        14                            15                  1                     -
           Corporate Services inc. Chief Exc.   -        19                   -        15    -            34                     -
           Head of Estates & Facilities         -        26    -        19             11    -            34                     -
           Medical Director                              18              3    -        22    -             1                     -

           Finance                                       47              6                                53                     -
           Corporate Income                                                                           -                          -

           Total                                -       345            124    -        52    -       273                         -
The Shrewsbury & Telford Hospital NHS Trust                                                                                                                                                APPENDIX E
Financial Savings 2004/5

                                                                          Original   Revised
                                                                          Savings    Savings
                                                                           Plan       Plan
Division    Scheme                                                         £'000      £'000      Changes of Deliverer                                                                        Progress
                                                                                               High   Medium      Low
Surgical
            Reduce overspend on Medical Staffing                              150       150      150                         Appointments made at risk in 2003/4 will be funded by new EWTD allocation
            Review Casemix                                                    100       150      150                         Review to take place on the number of orthopaedic revisions required in the Contract
            Procurement                                                        50        50        25      25                Procurement to review purchasing patterns etc, review of drapes etc already started
            Slippage in Development                                           200       300       150               150      As a result of the planning required to implement some developments this should occur in the early part of the year
            Waiting List Management                                           200       250       175      50        25      As a consequence of the flexibility created in the merger, a greater percentage of activity should be done in planned sessions
            RJAH SLA                                                          100       100       100                        In the even that the RJAH do not use there allocated sessions, these session may be used for waiting list activity
Womens
            Review bed usage on Ward 19                                        60        40                20           20   The Beds will now be managed Flexible
            Introduce NICE Guidelines                                          60        45                25           20   The impact in 2004/5 will only be 75% of the full year effect
            Reduce overspend on Medical Staffing                               40        40       40                         Appointments made at risk in 2003/4 will be funded by new EWTD allocation
            Reduce Maternity/Sickness leave                                    70        70                45           25   Maternity leave not expected to be as high as in 2003/4 and sickness policy to be reviewed
            Review 12/20 week scanning                                         20                                            In view of the Legal / Clinical issues this will not be changed
            Ring Fence Gynae Beds                                              50                                            To enable this to happen a Strategic Decision would need to be taken re ring fencing beds, No decision taken to date
            Review GP Units                                                   150        65                65                The reduced savings relate to a review in Staffing levels at Night for approx 50% of the year in 2004/5
Radiology
            Fund growth in activity from 2004/5 capacity funding              100       125      125                         This covers growth in 2003/4 and estimated growth in 2004/5
            Maintenance on Gamma Camera                                        20        22       22                         Replacement Camera purchased therefore no maintenance required in 2004/5
            Slippage in Development (Room 4 )                                  20        10                10                As a result of the planning required to implement some developments this should occur in the early part of the year
            Procurement                                                        15         6                 6                Procurement to review purchasing pattern etc i.e. Syringe Contract, Contrast Media, Bone Scans
Childrens
           Reduce overspend on Medical Staffing                                60        60       60                         Appointments made at risk in 2003/4 will be funded by new EWTD allocation
           Funding of Paediatric Oncology                                      30        30       30                         Increase in patient numbers funded in SAFF
           Review bed numbers at RSH/PRH                                       80        80       40       40                No of beds to be reviewed and some closed
Outpatients
           Review of staffing levels and skill mix                            200                                            The staffing levels / skill mix in outpatients is in the process of being reviewed
Head of Nursing
           Increase trading activities in EBME                                 24        24       24                         This will be met via obtaining greater income or being more efficient
           Close Rehabit 2 at RSH                                               5         5        5                         Already actioned
           Increase charges for Hydrotherapy pool                               3         3                 3                Already actioned
           Increase income from PPI, Gym rental                                23        23                15           8    Already actioned
Medical
           Introduce additional controls on NICE drugs                        150       337      337                         Partly funded in 2004/5 saff and also use of 2004/5 drug inflation
           Revise controls on travelling expenses, ward environment etc        20       111       25       50           36
           Reduce overspend on Medical Staffing                               100        31       31                         Appointments made at risk in 2003/4 will be funded by new EWTD allocation
           Review of staffing levels and skill mix                            100       138                80           58   The staffing levels / skill mix is in the process of being reviewed

            Sub Total for Divisions                                         2,200      2,265   1,489     434       342

            Add Procurement Savings (See Apprndix C)                                    300                                  The potential for deliverer is still to be considered

            Total Savings                                                   2,200      2,565   1,489     434       342
The Shrewsbury & Telford Hospital NHS Trust                             Appendix F
Procurement Savings 2003/4


                                         Procurement                     Division /
Scheme                                      Lead            £           Department

Internal Audit Services                  Susan Hall        13,328   Finance
Baby Photography                         Helen Lewis        5,408   Womens
Agency Staff                             Susan Hall         5,593   Misc
Office Furniture                         Helen Lewis        8,837   Misc
Domestic Waste Services                  Helen Lewis        3,264   Estates & Facilities
Dairy Products                           Helen Lewis        2,002   Estates & Facilities
Paper Hand Towels                        Helen Lewis        5,511   Estates & Facilities
Recruitment Advertising                  Susan Hall        12,958   Human Resources
Domestic Waste                           Helen Lewis        1,914   Estates & Facilities
Dell PC's                                Helen Lewis        3,152   IT
Dry Goods                                Helen Lewis        2,598   Estates & Facilities
Clinical Waste Services                  Susan Hall         6,135   Estates & Facilities
Uniforms Contract                        Helen Lewis          750   Misc
Confectionery                            Helen Lewis        2,425   Estates & Facilities
Ingredients from Café bar                Helen Lewis          516   Estates & Facilities
CSSD Consumables                         Sarah Hope           103   Surgical
Window Cleaning                          Helen Lewis           50   Estates & Facilities
Delivery and collection of cooking oil   Helen Lewis           68   Estates & Facilities
Sanitary Bin Service                     Helen Lewis          511   Estates & Facilities
Funeral Services                         Helen Lewis        1,757   Corporate Services

Staff Uniform                            Helen Lewis          920   Misc
Personal Computers                       Tim Oakley         6,274   IT
Lease Car Insurance                      Susan Hall           820   Finance
Enteral Feeds                            Charlotte Hill    90,190   Head of Nursing
Surgical Staples                         Sarah Hope        70,623   Surgical
Still to be Confirmed                                      54,294

Total                                                     300,000
The Shrewsbury & Telford Hospital NHS Trust                                  APPENDIX G
Potential Saving Schemes 2004/5


                                                                                Potential
                                                              Responsible       Savings
Scheme                                                          Officer          £'000

Decentralise Pathology                                      Chris Crosby
Create One Switchboard                                      Chris Needham
Review all external grounds and gardens contracts           Chris Needham
Review A&E Provision at night                               Eric Roe
Review Provision of Elderly Day Care Service                Eric Roe
Combine Acute Referral Centre into A&E                      Eric Roe
Review Lifestyle Service Level Agreement                    Julia Buckley
Review the need for Nebosh training                         Julia Buckley
Review all overtime payments                                Keith Roberts
Review New to Follow up ratios to contracted levels         Lynda Speake
Review Call Centre provision(2 into 1 or Countywide)        Lynda Speake
Sell and lease back assets to interested parties            Martin Herd
Review Expenditure on Software Licenses                     Nigel Appleton
Review Radiology Waiting Lists / Times                      Pam Brown
Review Non Emergency Patient Transport Service              Paul Hodson
Review provision of HDU facilities                          Peter Skitt
Review Orthopaedic Bed Base                                 Peter Skitt
Review Provision of Medicines Management at RSH             Roger Skews
Review Travelling Expenses Policy to RSH to PRH journeys    William Wraith
Review Advertising Effectiveness                            William Wraith
Review Management and Medical Secretaries Staffing Levels   William Wraith

Review Security across both sites                           Julia Buckley


Draft Total                                                                             0
THE SHREWSBURY & TELFORD HOSPITAL NHS TRUST ANALYSIS OF CAPITAL EXPENDITURE AT 31.05.04

                    Project                      Board      Expenditure Expenditure  Expenditure      Variance
                                                Approved      to date   committed - committed
                                                 Budget                   ordered   -to be ordered
                      PRH

1. Completion of 2003/04 schemes

Endoscopy Equipment                                                            6,110
Turnkey for X-Ray Ultrasound Equipment                                        29,139
Replacement Theatres equipment                                   38,763       26,482
H & S Equipment for Bariatric patients                            1,485
Staff Gym (IWL)                                                               11,296
ITU Side Rooms (Infection control)                                             5,718
Refurbishment of Bed Passenger Lifts                                          31,750
Gamma Camera (Access allocation)                                              17,750
Total PRH Commitments b/fwd                        50,000        40,248      128,245                   (118,493)



2. New commitments
Capital Salaries                                  165,000        12,677      152,323                           0
Private Patient development                        48,000                                    48,000            0
League of Friends refurbishment                    40,000         8,605       34,473                     (3,078)
Decontamination Business case fees                 20,000                     15,000                       5,000
Portacabin 1 - Medical Records                                    2,139       10,861                    (13,000)
Portacabin 2 - Medical Records                                    2,677        8,323                    (11,000)
Total of PRH new commitments                      273,000        26,098      220,980         48,000     (22,078)



                      RSH

1. Completion of 2003/04 schemes

Refurbishment of Pathology (mini phase)                           7,980      18,499
Rainbow Ward asbestos removal                                                 8,501
LIS - IT Developments                                            42,555      84,964
MRI Scanner & associated building works                                      97,290
Paediatric Oncology Unit F & E (Rainbow Ward)                                14,804         30,196
Pharmacy Clean Room                                                          18,013
Skills Lab (Dr Maxton-SIFT)                                       7,732       2,146
A & E additional capacity                                        121659      47,724
Audiology Equipment                                              20,610
Rainbow Ward Alterations                                                      6,779         16,260
Troponin analyser                                                             8,695
Theatres North Swiss LithoClast Master System                                18,794
Radiology Transvaginal Ultrasound                                             6,698
Repairs to Boiler House Generator                                            10,000
Dental Compressors                                                            5,307
Residences Block - Outstation Upgrade                                         5,701
Gamma Camera                                                                 17,750
Private Patient Development Business Case                                    48,773
Total RSH Commitments b/fwd                       50,000        200,535     420,438         46,456    (617,429)



2. New Committments
                                                                                                             0
CT Scanner                                       750,000                                   750,000           0
IT/Sema Investment                               367,000                                   367,000           0
X-Ray Room 4 (Access capital)                    330,000                                   330,000           0
Capitalised Salaries                             185,000         31,388     153,612                          0
MRI Scanner caging                               100,000                     97,290                      2,710
DDA                                               100,000                           100,000           0
Mammography cancer equipment                       76,000                            76,000           0
Total RSH New Commitments                       1,908,000    31,388    250,902    1,623,000       2,710



3. South to North Business Case                                                                       0
New Build construction (Costain)                2,640,000   175,278   1,407,005               1,057,717
Clerk of works                                                8,408      28,000      3,593      (40,000)
Container Hire                                                  489                  2,511       (3,000)
Car Park/Road re-instatement                      40,000                            40,000            0
Roundabout                                       350,000                           350,000            0
Fees                                             150,000      5,605                194,395      (50,000)
Enabling works                                                            4,401                  (4,401)
Equipment                                         500,000                28,554     421,446      50,000
Total South to North Business Case              3,680,000   189,779   1,467,960   1,011,945   1,010,316

                                                                                                      0
4. EBME-X-Ray Contingency                                                                             0
Haag Streit Slit Lamp                                                   11,798                  (11,798)
Yag Lasers Photodisruptors & assoc equip                                44,274                  (44,274)
Kanmed Gel Warming Cabinet                                               5,869                   (5,869)
Exercise ECG System                                                     18,305                  (18,305)
Barcode Monitor                                                          6,184                   (6,184)
Balance of £500k uncommitted                                                       413,569     (413,569)
Contingency                                      500,000                                        500,000
Total EBME/X-Ray Contingency                     500,000         0      86,431     413,569            0



5. Estates Compliance                                                                                 0
Wireless Alarm system                                                    4,680                   (4,680)



Total Estates Compliance                                                 4,680                   (4,680)




7. IT (Funding bid for)
Dell PC's/Poweredge Blades                                              45,878                  (45,878)
HP Procurve & Equip                                                     20,128                  (20,128)
                                                                        66,006                  (66,006)

Total                                           6,461,000   488,048   2,645,641   3,142,970    184,341

Current notifed CRL                             3,992,000
allocations awaited:-                           3,258,000

Projected CRL                                   7,250,000

Available capital resource                      (789,000)

8. Potential uses of available resource
Accomodation to enable vacation of South Site   1,500,000                         1,500,000
Day Surgery (PRH)                                 500,000                           500,000
Creche Facilities                                 500,000                           500,000
North Flat Roofs                                  500,000                           500,000
Maternity re-wiring/modernisation                 400,000                           400,000
Fire Alarm System                                 328,000                           328,000
Pathology Modernisation                           200,000                           200,000
                                                3,928,000                         3,928,000

				
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