Capital Brokerage Invoice - Excel by vyc14313

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									Forecast performance against financial duties, 2004/5

The Trust's performance against its financial duties is summarised in the following table;

                                                                                         Forecast end
 Financial Duty                  Purpose                            Target               of year 2004/5
                                                                                    £000           £000

 To breakeven on its income      To maintain the financial
 and expenditure budgets         viability of the Trust                                0        £6,800
                               To highlight the recurrent
                               position of the trust after
 To match its underlying costs removing "one off" income
 and income                    and expendture                                          0        £8,500

                                 To ensure that the NHS uses
                                 its assets as intensively as
                                 possible and prices its
 To absorb the cost of capital   services to recover the pubilc
 at 3.5%                         sector's cost of capital.                      3.50%            3.50%

                                 To maintain the medium term
                                 viability of the Trust by
 Associated target; for its      ensuring that past
 cumulative deficit not to       overspends are corrected by Cumulative deficit
 exceed 0.5% of its turnover.    equivalent underspending    of £1.5m                           £9,731
                                                                    % of turnover                3.24%

                                                                    Excess
                                                                    cumulative deficit.         £8,231

                                 Part of the Government's
 To not exceed its external      control on its cash payments
 financing limit                 compared to its cash receipts                -£45,323         -£45,323

                                 Government policy and to           To pay 95%of its
 Associated target; to pay       ensure that the trust is not       valid trade
 95%of its valid trade creditors financing its activities through   creditors within 30
 within 30 days of receipt       late payment                       days of receipt                63%

                                 To protect capital allocated to
 To not exceed its capital       the Trust from being diverted
 resource limit                  into revenue budgets                           £3,867          £3,867
Risk Assessment, 2004/5

                                                                    Impact on forecast outturn
Description of risk                                            Optimistic Mid range Pessimistic
                                                                 £000        £000          £000

Forecast deficit                                                       6800         6800          6800

Divisional budget deficit                                                 0            0             0

Additional £4m savings plans do not materialise                           0         2000          3000

College Crescent sale does not generate a surplus                         0         1500          3000

NCLHA PCT income baseline disputes                                        0            0             0

Additional PCT support income not received                                0         1000          3000

Disputes in respect of 2003/4 over performance income                     0          600           600
Cost of implementing Agenda for change vs budget of
£150,000                                                                 50          100           150
The trust is constrained in ability to raise invoices due to
clinical coding                                                           0            0           500

Teaching income reduction                                              257+placements?

Consultant contract

Renal service; transfer of sufficient resources

Pancreatic cancer transfer?

Funding revenue cost of the fire scheme?
Withdrawal of CIMHT funding (eg occ'n health?)


Clinical coding 2004/5

The prompt and complete coding of clinical activity is key to the trust being able to issue
invoices and chase payment. The longer the delay in issuing bills the more likely it is that PCTs
will resist payment on the grounds of inadequate warning. Completeness of coding is also key
to the credibility of the trust's reference costs.

                                                                            Average of
                                                                 Royal       teaching
                                                                 Free        hospitals
                                                                         %            %
Activity coded 2002/3                                                  89.8        97.7
Activity coded 2003/4                                                  87.4        97.2

                                                               April          May          June          July        August        September October November December January February March
                                                                         %            %             %           %             %           %         %      %        %         %       %       %
% activity coding required to issue invoice                              94           94            94          94            94         94         94     94       94        94      94      94
% activity coded to end May                                              15
Difference                                                               79
                                                   THE ROYAL FREE HAMPSTEAD NHS TRUST                      FAVOURABLE VARIANCE            -
                                                                                                                                          +
                                                                                                           ADVERSE VARIANCE               -
                                                                                                                                          +
                                                 FINANCIAL MONITORING REPORT - 2004/05
                                                SUMMARY INCOME & EXPENDITURE STATEMENT

                                                                           MONTH 2
YEAR TO          YEAR TO           VARIANCE                                                    YEAR TO               YEAR TO             VARIANCE
 DATE                DATE           MONTH                                                       DATE                  DATE                MONTH
ACTUAL               PLAN             12        INCOME/EXPENDITURE                             ACTUAL                 PLAN                    2
 £'000               £'000          £'000                                                       £'000                 £'000               £'000

                                                INCOME

 (205,323)           (198,657)        (6,666) Service Agreements                                  (37,755)              (37,755)                     0
  (12,269)            (12,672)              403 Private Patients                                   (1,321)               (2,141)                   820
  (62,720)            (61,405)        (1,315) All Other Income                                    (12,719)              (12,893)                   174

 (280,312)           (272,734)        (7,579) TOTAL INCOME                                        (51,795)              (52,789)                   994


                                                EXPENDITURE

   171,682            169,593         (2,089) Pay                                                  31,037                31,366                    329
    92,438              85,766        (6,672) Non-Pay                                              18,460                18,352                    (108)
     8,739               8,739                0 Depreciation                                        1,570                 1,570                      0
             0                0               0 Inflation/Flexed Budget Provision                         0                        0                 0

   272,859            264,098         (8,761) TOTAL EXPENDITURE                                    51,068                51,288                    221


   (7,454)             (8,636)             1,182 (SURPLUS) / DEFICIT BEFORE INTEREST                    (727)            (1,500)                   773


     (452)               (250)             (202) Interest Receivable                                     (63)                  (42)                 (21)
     8,886               8,886                0 Interest Payable                                    1,539                 1,539                      0


         961                 (0)            961 (SURPLUS) / DEFICIT FOR PERIOD                           749                       (3)             752




                                              0 Revenue to capital transfer                                                                          0



         961                 (0)            961 ADJUSTED (SURPLUS) / DEFICIT                             749                       (3)             752




                                    CUMULATIVE MONTHLY VARIANCE 2002/03 & 2003/04
                                                                   2003/04 2004/05
                                    CUMULATIVE MONTHLY VARIANCE --2003/04 & 20004/05

   7000
   6000
   7000
   6000
   5000
   6000
   5000
   4000
   5000
   4000
   4000                                                                                                                                  2003/04
                                                                                                                                         2002/03
   3000                                                                                                                                  2002/03
                                                                                                                                         2003/04
                                                                                                                                         2004/05
   3000                                                                                                                                  2003/04
   3000
   2000
   2000
   2000
   1000
   1000
   1000

         0
                 1            2        3           4           5       6       7       8   9        10          11            12
                                                                                                          INCOME AND EXPENDITURE MONITORING REPORT                                                                                                 FAVOURABLE VARIANCE      -
                                                                                                                                                                                                                                                   ADVERSE VARIANCE
                                                                                                                     DIVISIONAL SUMMARY
                                                                                                                 PERIOD ENDING : 31st MAY 2004

                                                                                                                              RFH TRUST

             Cumulative variance                                                             STAFF                           NON-STAFF                EXPENDITURE                      INCOME                               TOTAL                                  END OF YEAR
2003/04         Jan        Feb       Mar     DIVISION
OUT TURN        M10        M11      M12                                 Annual    Actual     Budget     Variance    Actual   Budget      Variance       Variance        Actual           Budget    Variance        Variance             %              Staff    Non-staff       Income          Total
               £000        £000     £000                                Budget    £000       £000        £000       £000     £000         £000           £000           £000             £000       £000             £000                              £000       £000           £000           £000



   3,333        1,975      2,340    2,598    GRAYS INN                  87,465    10,021     10,023          -2     7,487     7,508           -21               -23         -394           -446         52                  29              0.2%
   3,861        1,811      2,201    2,201    LAWN ROAD: ACUTE           74,256     9,340      9,312          27     3,193     3,161            32                59          -31            -31          1                  60              0.5%
       0            0          0        0    LAWN ROAD : HIV            10,230       388        405         -17     1,964     1,948            16                -1            0             -1          1                   0              0.0%
     735          196        292      388    R.N.T.N.E.                 21,791     2,640      2,766        -125     1,191     1,213           -22             -147          -278           -348         69                 -78          -2.1%
   1,447          606        693      693    SUPPORT SERVICES           15,530     1,443      1,512         -69     1,477     1,417              61                -8       -332           -345         13                    5             0.2%
     473          149        185      129    LIVERPOOL ROAD             19,586     2,905      2,993         -89       368       375              -7             -96              -60       -126         65                 -31          -0.9%
     148          472        505      691    PRIVATE PATIENTS           -5,457       525        528          -3       514       571           -56               -59        -1,222         -2,052       830                771           80.9%
        43         90          99      88    WORKS / I.S.                9,036       805        788          17     1,117     1,118              -1                16       -136           -150         15                  31              1.8%
     485          245        221      402    CORPORATE SERVICES         19,924     2,970      3,040         -70     1,133     1,025           108                  38      -1,319         -1,266       -53                 -15          -0.5%
  -9,564         -192       -190    -6,228   INCOME / OTHER                              0          0           0   3,061     3,082           -21               -21      -47,998         -47,998           0               -21              0.0%
                                             Revenue/Capital Transfer


  961          5,351      6,346     961      GRAND TOTAL                252,361   31,037      31,366       -329     21,506    21,419             87             -242      -51,770        -52,764       994                 752                                                                  4,511


                                                                                                                                                                                                               TARGET                                                                                   0
                                                                                                                                                                                                                                                                                        Range
                                                                                                                                                                                                               Forecast position on issued budgets                                  4500        4500

                                                                                                                                                                                                                                                                                 Actual to
                                                                                                                                                                                                               Other budgetary pressures                             Target                  Difference
                                                                                                                                                                                                                                                                                     date
                                                                                                                                                                                                                                                                      £000          £000           £000
                                                                                                                                                                                                               Progress on £4m savings plan                           4000          1800           2200
                                                                                                                                                                                                               Progress on £6.8m budget gap                           6800          3000           3800
                                                                                                                                                                                                               Progress on sale of College Crescent                   3000 Under negotiation


                                                                                                                                                                                                               Overall trust deficit risk                                                        10500
                                                                             Divisional Position to end of May, 2004

GRAYS INN DIVISION




                                                                                                GRAYS INN DIVISION
                                                                                                 OVERALL VARIANCE
           3000

           2500

           2000
                                                                                                                                                                              2003/04
   £'000




           1500
                                                                                                                                                                              2004/05

           1000

             500

                   0
                                  APR               MAY          JUN         JUL         AUG           SEP      OCT     NOV         DEC         JAN         FEB         MAR



LAWN ROAD DIVISION



                                                                                                LAWN ROAD DIVISION
                               3000
                                                                                                 OVERALL VARIANCE
                               2500

                               2000
                                                                                                                                                                              2003/04
                       £'000




                               1500
                                                                                                                                                                              2004/05
                               1000

                                  500

                                    0
                                              APR          MAY         JUN         JUL     AUG          SEP     OCT    NOV     DEC        JAN         FEB         MAR



RNTNE DIVISION




                                                                                                  RNTNE DIVISION
                                                                                                 OVERALL VARIANCE
                   500

                   400

                   300

                   200                                                                                                                                                        2003/04
           £'000




                   100                                                                                                                                                        2004/05

                           0

                   -100

                   -200
                                        APR          MAY         JUN         JUL         AUG          SEP     OCT     NOV     DEC         JAN         FEB         MAR




SUPPORT SERVICES




                                                                                                     SUPPORT SERVICES
                                                                                                     OVERALL VARIANCE
                   900
                   800
                   700
                   600
                   500                                                                                                                                                        2003/04
           £'000




                   400                                                                                                                                                        2004/05
                   300
                   200
                   100
                         0
                                    APR             MAY          JUN         JUL         AUG          SEP     OCT     NOV     DEC         JAN         FEB         MAR




LIVERPOOL ROAD DIVISION




                                  200                                                     LIVERPOOL ROAD DIVISION
                                                                                              OVERALL VARIANCE
                                  150


                                  100
                          £'000




                                                                                                                                                                              2003/04
                                   50
                                                                                                                                                                              2004/05

                                    0


                                   -50


                                  -100
                                              APR          MAY         JUN         JUL         AUG      SEP     OCT    NOV     DEC        JAN         FEB         MAR
Savings plan 2004/5
 The trust’s budgetary plan in 2004/5 requires:
    1. All budget holders to not spend more than their issued budgets. Divisional budgets have
        been increased by an average of 13% compared to 2003/4, and this is net of a share of
        £5.6m of assumed savings.
    2. Identification of a further £4m of savings from initiatives coordinated across the trust.
        Once a plan has been identified these target sums have had to be removed from issued
        budgets.
    3. The latest HA communication requires the trust to identify a further £3.8m of savings by
        31st March 2005.
    4. This table provides an update on the position regarding
            a. Nursing bank and agency control
            b. Manpower control across the remainder of the trust.

Nursing agency and bank hours control
                                                   Position for June 2004               Cumulative position
                                        Budgeted                                     Cumulative Target
                                        hours to Actual                   Value of savings to annual
                                        be filled hours filled Difference difference date        saving
By division                                                                     £000       £000          £000




Total                                                                                                    700

Other manpower control
                                        Staff in      Target
                                        post 31st     reduction    Target staff Staff in        Value of    Value of
                                        March         by 1st       in post in    post 31st      savings to savings
                                        2004          September September May 2004 Difference date          target
                                                wte            wte          wte         wte wte        £000      £000
A and C                                         965            -53          912
Medical                                         632            -35          597
PAMS/P and Tech                                 857            -48          809
ASC                                             430            -25          405
Estate officers                                  73             -4            69
Staff in post excluding agency                2957            -165        2792                                   2850
Clinician managed budgets (from 1st June 2004)

 Budget position as at end of May, 2004
                                                                                 Overall
                                                                                 service     End of
                                                                                 group       year
                            Drugs                     Medical staffing           variance    estimate
               Budget    Expenditure Variance Budget   Expenditure Variance
 Division        £000       £000       £000     £000      £000         £000        £000        £000
 Lawn Road          832          787        -45   3061         3053         -8         -53
 Grays Inn         1531        1544          13   3237         3282         45          58
 Liverpool Road       93          70        -23    864          858         -6         -29
 RNTNE                46          46          0    881          860        -21         -21
 Total trust       2502        2447         -55   8043         8053         10         -45


 The above budgets will be distributed to clinician budget holders from 1st June
 2004.
            PLEASE NOTE THIS SHEET IS JUST USED FOR CALCULATIONS ELSEWHERE IN THE REPORT, P
                                                      REVENUE EXPENDITURE MONITORING REPO
                                                                DIVISIONAL SUMMARY
                                                               FINANCIAL YEAR 2004/5
                                                                     RFH TRUST

                                                                                 SURPLUS/DEFIC


2004/05                        APR       MAY      JUN       JUL         AUG
GID                                        29.0
LWN                                        60.0
LWN HIV                                     0.0
LIV                                       -31.0
RNT                                       -78.0
SUPP                                        5.0
pp                                       771.0
WRKS                                       31.0
CRP                                       -15.0
INC/OTHER                                 -21.0
2004/05                              0      751         0         0.0      0.0


2003/04                        APR       MAY      JUN       JUL         AUG
GID                                      184.0     346.0     490.0       590.0
LWN                                      177.0     261.0     391.0       450.0
LWN HIV                                     0.0
LIV                                       -11.0   -33.0      -42.0       -49.0
RNT                                        45.0    72.0       85.0       101.0
SUPP                                     133.0    194.0      268.0       300.0
pp                                         32.0    72.0      169.0       231.0
WRKS                                      -21.0   -36.0      -46.0       -17.0
CRP                                       -29.0   -38.0      -58.0        34.0
INC/OTHER                                 -59.0   -20.0      -29.0       -46.0
2003/04                              0      451     818     1228.0      1594.0
 EWHERE IN THE REPORT, PLEASE IGNORE
DITURE MONITORING REPORT
SIONAL SUMMARY
NCIAL YEAR 2004/5
  RFH TRUST

         SURPLUS/DEFICIT


             SEP         OCT      NOV        DEC         JAN      FEB         MAR




                   0.0      0.0        0.0         0.0      0.0         0.0     0.0


             SEP         OCT      NOV        DEC         JAN      FEB         MAR
              777.0      1018.0   1365.0     1738.0      1975.0   2340.0       2598
              597.0       844.0   1190.0     1510.0      1811.0   2201.0       2698
                            0.0
              -30.0        30.0    125.0      148.0       149.0    185.0        129
              116.0       138.0    196.0      204.0       196.0    292.0        388
              364.0       413.0    479.0      533.0       606.0    693.0        855
              299.0       345.0    391.0      424.0       472.0    505.0        691
               -5.0        -1.0     38.0       56.0        90.0     99.0         88
              125.0       153.0    161.0      187.0       245.0    221.0        402
             -235.0       -91.0   -104.0     -166.0      -192.0   -190.0      -6868
             2008.0      2849.0   3841.0     4634.0      5352.0   6346.0      981.0
Working capital position, May 2004
       The trend in loans and creditors owing at the end of each financial year is as follows

                                                               All cash     All creditors due Total
       Analysis of liabilities due within one year             loans        within one year liabilities
                                                                       £000               £000        £000
       1991/1992                                                          0              9,784       9,784
       1999/2000                                                      6,500             32,912      39,412
       2000/2001                                                     12,200             37,890      50,090
       2001/2002                                                     25,488             46,948      72,436
       2002/2003                                                     39,200              46912      86,112
       2003/2004                                                     48,500             38,315      86,815
                                                                 Mid May     As at mid June
       Value of creditors awaiting payment                             £000               £000
       Trade                                                           3600               7150
       NHS and other                                                   3400               3150

                                                                                            Indicating the first signs of creditors
                                                                      7000            10300 needing to be slowed down
       Outstanding invoices owing to the Royal Free
                                                                   May-03                          May-04
       Owed by:                                                > 180 days Total                > 180 days Total
       Health authorities                                                0               55              0       466
       PCTs                                                           5711            16878           2699    19391
       NHS trusts etc                                                 1802             8312           1210      1956
       Non NHS                                                        2219            10003           2698      9282
       Private patients                                               2268             5293           2106      6226
       Total                                                         12000            40541           8713    37321
       Proportion of debt >180 days                                   30%                             23%       3220 Reduction
       The trend in the trust's 30 day payments' performance is
                                                                    2001/2            2002/3       2003/4      2004/5
       Percentage of non NHS bills paid within 30 days; target
       95%                                                            67%               56%          63%         63% Est

                                                               Annual                       Actual to               Forecast actual
       Cash Budget 2004/5                                      Budget      Budget to May    May          Difference for 2004/5
       Cash receipts                                                  £000            £000         £000        £000             £000
       Cash receipts from commissioning                           303800             52700       48767        -3933           303800
       External financing limit                                     -2732                 0            0          0            -2732
       Brokerage                                                   48500                  0            0          0            48500
       Other (private patients and other receipts)                 43125              7192         7824         632            43125
       Net interest receivable                                         450               75           71         -4              450
       Total net receipts                                         393143             59967       56662        -3305           393143
       Cash payments
       Pay                                                         175517             28603         28646          43            175517
       Non pay                                                     155859             26639         26850         211            155859
       Capital                                                       3867               644           402        -242              3867
       Repayment of brokerage 2003/4                                48500                               0           0             48500
       Public dividend capital                                       9400                               0           0              9400
                                                                   393143             55886         55898          12            393143
       Difference/ Change in working capital                            0             -4081          -764       -3317                 0
Medium term capital position

 Operational and major capital allocations 2003/4 to 2005/6
                                      2002/3      2003/4    2004/5              2005/6
                                        £000        £000     £000                £000
 Operational capital funding            4475       4,921     5,617               6,356
 Annual Increase                                    10%       14%                 13%
 Other medium term capital issues
 HA contribution to the fire scheme                  500     6000                 6000
 Capital brokerage 2003/4 to
 support revenue                                       2050
 Repayment of brokerage                                           -1025          -1025
 Sale of College Crescent originally
 intended to fund 2003/4 brokerage                                     ?
 Use of operational capital to fund
 the fire scheme                                                    -500         -1500
 Net operational capital after
 existing liabilities                                             4,092          3,831
 Capital charge for nurses tower
 finance lease                                                         ?             ?
 Transfer of residences to a
 developer                                                             ?             ?

 Fire Scheme
                                       2003/4     2004/5      2005/6       2006/7        2007/8      2008/9     2009/10     2010/11      2011/12     Total
                                         £000        £000       £000          £000          £000       £000       £000        £000         £000        £000
 Balance brought forward                      0           0
 HA allocation                              500        6000                                                                                            40,593
 Trust contribution                           0         500                       Trust and HA profile currently being agreed                          10,000
 Total funds                                500        6500           0              0           0            0           0          0           0      50593
 Planned expenditure                        500        6517       10368           7416        6753        6753        4505        5040        2741      50593
 Difference                                   0

  The key issues for the board’s attention are;
     1. The phasing of the trust’s capital contribution to the fire scheme. The HA proposal is £1.5m in each of the first four years of the
         scheme commencing in 2004/5. An alternative phasing of £0.5m and £1m for the first two years has been proposed by the trust
         but would leave a £1.5m per annum liability in future years.
     2. The very low level of operational capital following the repayment of brokerage and the contribution to the fire scheme.
     3. The proposed sale of College Crescent is
Medium Term Position

                                 Underlying and in year trend
          6000
                                   In year/accounts position
          4000
          2000
                0
 £000




          -2000        2001/2            2002/3         2003/4       2004/5
          -4000                   Underlying position
          -6000
          -8000
         -10000



                                  Trend in cumulative deficit
            0
    -1000           2001/2      2002/3      2003/4      2004/5

    -2000
    -3000
  £000




    -4000                                                                     Cumulative deficit
                             Assuming £4m
    -5000                    deficit
                                                                              Trust Limit 0.5%
    -6000
                                                                              turnover
    -7000
    -8000


                                                                                  £000
Required underspend to correct cumulative deficit                                 9731

Summary of Medium term liabilities                                     Repayable
                                                  2003/4             2004/5   2005/6        2006/7
Revenue                                             £000               £000     £000          £000
Trust accounts' liabilities                         3000               3000
Camden loan 2002/3                                   700                         700
Camden loan 2002/3                                   500                           ?
Camden loan 2003/4                                  1000               1000
HA loan 2003/4                                      1000                        1000
Consultants contract 2003/4                          700                         700
Deficit 2002/3                                       250                600
Deficit 2003/4                                      1000                500      500
Deficit 2004/5                                                            ?        ?                ?
Commercial R and D investigators'
income.                                 1600                     When expenditure>income
Total revenue liabilities               9750                           5100      2900               0
Capital
Nurses tower                                                                Residential stock transfer?
Fire scheme trust contribution         10000                            500      1000        1500
Brokerage                               2050                           2050 College Crescent?
Total capital liabilities              12050                           2550      1000        1500
Former Special Trustee income not available
                                        £000                           £000       £000           £000
Income to trust                             0                            60         60             60
Clinical/research fellows                   0                             0        850            850
Divisional capital funds                    0                           380        380            380
Total pressure                                                          440       1290           1290
Medium term position

                                                   2002/3     2003/4   2004/5      2005/6     2006/7
                                                                £000      £000       £000       £000
Opening income                                       277400   272000   280000      280000     280000
Deficit liability                                                            0
Deficit support/movement towards tariff                          Counted below       2000       2000
Movement towards tariff funding                                                      3000       4000
Fire scheme                                                                300        851        964
Renal business case                                                                     ?          ?
Additional income                                             272000    280300     285851     286964
Level of income growth excl inflation and over
performance                                                            103.05%    101.98%    100.39%
Opening expenditure                                                     280000     280000     280000
Recurrent position                                                        8200      10200       5900
Balance to full year effect, consultant contract                           7600       3400       3400
Cost savings/commitments removed                                          -5600      -2700      -2700
Revenue implications of fire compliance                                     300        851        964
Renal business case                                                                      ?          ?

Total expenditure                                    278200   280200    290500     291751     287564
Sale of College Crescent                                                  -3000
Closing recurrent position                                     8200      10200       5900        600
In year position (+=deficit)                            800    1000       7200       5900        600

								
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