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Slide 1 - The Shrewsbury and Telford Hospital NHS Trust by zhangyun

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									                                                                                                                                                                                       Enclosure 4
                                                       Trust Board Meeting
                                                                       – 3 December 2010
                                     FINANCE REPORT for the period ending 31st October 2010 (Month 7)
EXECUTIVE        David Gilburt                                                   KEY FACTS
RESPONSIBILE     Interim Finance Director                                        The table below summarises the Income and Expenditure position for October.
                                                                                 Plan       Actual     Variance     L Year                      Plan       Actual     Variance      L Year     Annual
AUTHOR (if       Tony Brown                                                      £'000      £'000       £'000       £'000                       £'000      £'000       £'000        £'000      Budget
different from   Assistant Director Financial Performance
above)           Jill Price                                                        21,849     22,960        1,111     21,406     Income          154,135 157,167            3,032 149,394 261,883
                 Assistant Director Financial Management                         (14,421)   (15,138)        (717)   (14,928)       Pay         (102,226) (106,569)        (4,343) (101,657) (174,222)
                 Chris Benham                                                     (5,930)    (6,413)        (483)    (6,326)     Non Pay        (42,123) (43,557)         (1,434) (41,145) (71,488)
                 Assistant Director Financial Accounting
                                                                                    1,498      1,409         (89)        152      EBITDA           9,786      7,041       (2,745)      6,592     16,173
CORPORATE        Ensuring a clinically viable and financially sustainable         (1,128)    (1,134)          (6)      (993)   Finance Costs     (7,918)    (7,861)            57    (8,623)   (13,606)
OBJECTIVE        organisation
                                                                                     370        275          (95)      (841)       Total          1,868      (820)        (2,688)    (2,031)      2,567
EXECUTIVE        October 2010 (Month 7) financial performance shows :
SUMMARY          Actual deficit of £275k; plan surplus £370k.                    ● The Better Payments Practice Code (BPPC) target is to pay 95% of creditors within
                                                                                   30 days. In October the Trust showed reduced performance:
                 ●Year to date income includes £1.465m reduction for
                                                                                            61% for Non-NHS invoices (YTD 57%)
                  Emergency threshold adjustment (£262k in October).
                                                                                            46% for NHS invoices (YTD 43%)
                 ●Pay costs; overspend £0.717m, of which 23% in Junior
                                                                                 ● Marginal improvement in liquidity, however pressures in cash position continue as
                  Medical staff and 49% in nursing.                                a consequence of current performance.
                 ●Pay run rate £15.1m.
                 ●Medical staff agency spend reduced by £21k in month.
                 ●e-Rostering lost opportunities being reviewed by
                  Divisional Managers to ensure Ward Managers aware of
                  cost of inappropriate rostering and how to avoid such
                  losses.
                 ●Forecast Outturn £225k surplus including assumption of         RECOMMENDATIONS                         The Board is asked to NOTE at month 7:
                  £3.5m strategic change reserve support.
                 ●Interim Finance Director reviewing forecast assumptions.                                               1. An Income and Expenditure deficit of £0.820m
                                                                                                                            against planned surplus of £1. 868m.
                                                                                                                         2. Forecast Outturn £0.2 million surplus.
                                                                                                                         3. Deterioration in performance against the Better
                                                                                                                            Payments Practice Code (BPCC) target of 95%
                                                                                                                            for Non NHS creditors.



                            Finance Report                             Sheet 1   The Shrewsbury and Telford Hospital NHS Trust
                  Section One- EXECUTIVE SUMMARY


                                                                                                       Monthly   Direction      2010/11                                                                      Sheet
                                                                       Position                      Performance of Travel       Actual                                 Comment                               Ref
                                               In month                           £0.275m surplus       Green        =            Red     £0.095m deficit to plan                                              1
               I & E Position




                                               2010/11 Actual ytd                  £0.820m deficit       Red         =            Red     £2.688m deficit to plan                                              1
                                               Pay Costs                             £15.138m            Red         =            Red     5.0% above plan for the month                                       3-4
                                               WTE Worked                               4521            Green        =           Amber    Below plan                                                          3-4
                                               Agency WTE                                62             Amber        =            Red     Reduced medical staffing reliance                                   3-4
                                               Agency Costs                           £0.552m           Amber        =            Red     See above                                                           3-4
                                               Non Pay Costs                          £6.413m            Red         =            Red     £0.483m over plan                                                   10
                         Balance Improvement
                                  Programme




                                               CIP's delivered                        £1.497m           Amber        =            Red     Shortfall against Plan £0.965m, against revised forecast £0.827m     7



                                               Debtors                                                   Red         =            Red     £1.033m increase; significant prior year NHS amounts outstanding    11
                          Sheet




                                               Creditors                                                 Red         =            Red     57% Non-NHS invoices and 43% NHS invoices paid within 30 days      12-13
                    Cash




                                               In Month Movement                  £0.261m decrease       Red         =            Red     £0.055m balance at Month 7 against plan of £0.268m                   5
 Ratios Expenditure
          Capital




                                               In month                               £0.218m           Green        =           Green    The Capital Programme for 2010/11 has been revised to £8.505m.      14
Metrics &




                                               Liquidity                                 7.8             Red         =            Red     Impact of I & E position on working capital                          8
  Key




                                               EBITDA Margin %                         4.5%              Red         =            Red     Below plan level of 6.2%                                             8
                                               Financial Risk Rating                     2               Red         =            Red                                                                          8




                                                                        Finance Report                     Sheet 2           The Shrewsbury and Telford Hospital NHS Trust
        Section Two – Expenditure - Pay

                                                                                        PAY
                                            Pay
                                                                                        ●   Month 7 Pay overspend £717k, across all staff groups except non-
                                                                                            clinical. Efficiencies required to cover the pay award continue to be the
        16,000
                                                                                            main cost pressure.
        15,500
        15,000
                                                                                        ●   Pay cost in Month 7 was £15.1m, the average for months 1 to 6 was
£'000




                                                                                            £15.2m
        14,500
        14,000                                                                          ●   Pay control totals were allocated to divisions during August . The June
        13,500                                                                              pay spend of £15.4m was taken as a base against which to allocate run
        13,000
                                                                                            rate reductions of £350k per month.
                 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar                            In month 7 the pay cost exceeded the control total by £79k. The month 7
                                                                                            run rate is a reduction in pay cost of £277k against the June level.
                           2010/11 Actual         2010/11 Plan       2009/10 Actual     ●   Key initiatives to reduce the level of nursing spend are being
                                                                                            implemented, these include reducing bank shift duration, changing
                                       Control                    Var to    Var to          working patterns and contracting for hours to be worked over a given
                                                     Actual
                                         Total                   Control   Control
                                                                                            period rather than fixed weekly hours. Divisional lead nurses have led
                                         £000          £000        £000         %
                                                                                            these reviews to ensure quality and service levels are maintained.
        Consultants                     (2,447)      (2,512)        (65)     (2.6%)     ●   Review of the progress in implementation of initiatives and the
        Medical Staffing                (2,098)      (2,066)          32       1.5%
                                                                                            effectiveness of those already in place along with an assessment of
        Nursing                         (5,417)      (5,441)        (24)     (0.5%)
        Other Clinical                  (2,224)      (2,239)        (15)     (0.7%)         further initiatives to control the pay run rate will take place in December.
        Non Clinical                    (2,873)      (2,880)         (7)     (0.2%)     ●   The tables opposite show the performance against control total by
                                                                                            staff group and division.
        Total                          (15,059)     (15,138)        (79)     (0.5%)

                                       Control                    Var to    Var to
                                                     Actual
                                         Total                   Control   Control
                                         £000          £000        £000         %

        Division 1                      (5,099)      (5,144)        (45)     (0.9%)
        Division 2                      (4,622)      (4,614)           8       0.2%
        Division 3                      (3,501)      (3,545)        (44)     (1.3%)
        Estates                           (189)        (183)           6       3.2%
        Facilities                        (649)        (601)          48       7.4%
        Corporate                         (999)      (1,051)        (52)     (5.2%)

        Total                          (15,059)     (15,138)        (79)     (0.5%)

                                       Finance Report                         Sheet 3         The Shrewsbury and Telford Hospital NHS Trust
        Section Two – Expenditure – Pay - Agency

                                                                                   AGENCY
                                         Agency Costs                              ●  Month 7 agency costs reduced to £552k (September £576k). This is
                                                                                      equivalent to 62 wte.
   1400
                                                                                   ●  The in month agency spend per wte is £8.9k. The month 6 average was
   1200                                                                               £10.4k.
£'000




   1000                                                                            ●  Consultant agency utilisation shows an increase in the month. This is
        800                                                                           largely due to Locums in Radiology (linked to reducing external reporting
                                                                                      costs), Oncology, Ophthalmology and Haematology covering sickness
        600
                                                                                      and vacancies.
        400                                                                        ●  Medical staffing agency spend shows a further reduction in October.
              Apr   May Jun   Jul   Aug Sep Oct         Nov Dec Jan Feb Mar        ●  Use of nursing agencies has risen again in the month. The key driver for
                                                                                      this has been the need to open escalation beds.
                                    2010/11 Actual      2009/10 Actual             ●  Further reductions in agency utilisation are reported in Non-clinical
                                                                                      groups, where the controls implemented by Facilities, particularly
                                                                                      Housekeeping, continue. This has been possible due to some
                                                                                      improvement in sickness levels. However sickness in this area remains
                                                                                      an issue. Discussions have taken place with HR and it is expected that
                                                                                      implementation of the new sickness policy early in the new year will help
                                                                                      address sickness management issues in a more expedient manner.




                                    Finance Report                       Sheet 4       The Shrewsbury and Telford Hospital NHS Trust
Section Two – Expenditure – Pay – Medical Staffing

                                                                                                                         ●   Medical Staff overspend £164k (September £141k). Agency overspend
                                                                                                                             within this is £129k which as reported previously is due to the premium cost
                                                                                                                             of providing cover to ensure continuity and safety of service and compliance
                                                                Medical Staffing                                             with EWTD requirements. Where safe and possible, Divisions only provide
                                                                                                                             agency cover for out of hours and weekend periods.
        2,500                                                                                                            ●   Temporary staffing department reports that in October 422 shifts were filled.
                                                                                                                             Of these 70 (16.6%) were internally covered, the balance of 352 (83.4%)
        2,000
                                                                                                                             were filled by agency. For 2009/10 the average was 652 shifts with the
        1,500                                                                                                                agency cover averaging 511.
£'000




        1,000                                                                                                            ●   Medical staff agency cover costs have decreased in October to £356k (£377k
                                                                                                                             in September).
                           500
                                                                                                                         ●   The graphs opposite show the trend in medical staffing expenditure over the
                                 0                                                                                           past 12 months. In October 2009 agency was 29.5% of the total medical
                                      Oct Nov Dec Jan Feb Mar Apr May June Jul Aug Sept Oct                                  staffing spend, in October 2010 this has reduced to 17.2%
                                                                                                                         ●   The impact of the improved fill rate in the August rotation is now fully reflected
                                                       Pay                     Agency                      Locum             in the run rate.




                 100%
                           90%
                           80%
        % of total spend




                           70%
                           60%
                           50%
                           40%
                           30%
                           20%
                           10%
                           0%
                                     Nov   Dec   Jan     Feb      Mar    Apr       May   Jun   Jul   Aug     Sep   Oct
                                                 Pay                    Agency                   Locum




                                                               Finance Report                                Sheet 5     The Shrewsbury and Telford Hospital NHS Trust
Section Three - Cash

                                                     Plan     Actual      Plan     Actual
                                                       M7         M7      YTD        YTD       Closing cash balance of £55k is a decrease of
                                                                                                £261k on the prior month.
Opening cash balance                                    80       316        441       441
                                                                                               EBITDA shortfalls (YTD £2,707k) and the
EBITDA                                               1,450     1,332      8,925     6,218       requirement to make capital expenditure
                                                                                                payments have been managed through
Impairments                                              0          0       500       351       creditor payments within working capital. This
                                                                                                management of working capital is reflected
Working capital movement                             (200)      (896)    (3,855)    3,566       within the poor compliance status of the Better
                                                                                                Payment Practice Code (BPPC).
Operating cash flow                                  1,250       436      5,570    10,135
                                                                                               The Trust follows the national timetable of
Capital expenditure                                 (1,063)     (693)    (8,348)   (7,916)      activity reconciliation and as a result is
                                                                                                carrying significant levels of accrued revenue.
Proceeds from sale of assets                             0          0         0         0       Until agreement has been reached the Trust
                                                                                                cannot invoice this significant amount of
Operating cash flow after net capital expenditure      187      (257)    (2,778)    2,219       accrued revenue.
                                                                                               The Trust has concluded it’s review of the
Net interest paid                                        1          1       (15)        9
                                                                                                historical working capital loan drawdown.
                                                                                                Papers have been submitted to Finance and
Provisions movement                                      0         (5)      (20)      (86)
                                                                                                Performance Committee Meeting and Trust
Loan received                                            0          0     5,400         0
                                                                                                Board. Further to recent SHA and Chief
                                                                                                Executive meetings the Trust will be pursuing
Loan repayment                                           0          0     (240)         0       an application for a working capital loan and is
                                                                                                investigating the possibilities of drawing PDC
Lease payment                                            0          0         0         0       to cover short term cash requirements.
                                                                                               Revised forecasting procedures are in place
PDC received                                             0          0         0         0       with significant cash outflows in the first
                                                                                                quarter 2010/11 due to the completion and
PDC dividend paid                                        0          0    (2,520)   (2,528)
                                                                                                timing of large capital projects (including
                                                                                                decontamination offsite solution).
Cash flow for period                                   188      (261)     (173)     (386)
Closing cash balance                                   268         55       268        55

                           Finance Report                Sheet 6          The Shrewsbury and Telford Hospital NHS Trust
   Section Four – Forecast Outturn


                         Q1        Q2       Q3       Q4      FY11      FY11     FY11     ●    During October and November further work has taken
                      Actual    Actual Forecast Forecast     Total     Plan Variance          place with Divisions to build detailed forecasts; in addition a
                                                                                              detailed review and assessment of activity and income has
                         £m        £m       £m       £m        £m        £m       £m
                                                                                              been undertaken.
                                                                                         ●    Following this the forecast outturn remains as a £0.2m
Income :                                                                                      surplus. This has been submitted in the month 7 FIMS
                                                                                              return to NHS West Midlands. The forecast includes the
Patient Care           62.2       61.9     62.7     64.7     251.5     241.6     10.0         following assumptions:
Other                   5.1        5.0      5.3      5.6      21.0      20.3      0.6    ●    PCT QIPP schemes not at planned levels.
                                                                                         ●    Current non-elective activity over performance for
Total Income           67.3       66.9     68.0     70.3     272.5     261.9     10.6         Shropshire County PCT continues.
                                                                                         ●    Emergency Threshold adjustment, forecast at £2.6m is not
Pay                   (46.1)     (45.3)   (46.0)   (46.8)   (184.2)   (174.2)   (10.0)        returned.
Non Pay               (18.5)     (18.7)   (18.8)   (18.6)    (74.6)    (71.5)    (3.1)   ●    Pay run rates continue in line with divisional forecasts.
                                                                                         ●    The process for recruitment to previously approved
Total Expenditure     (64.6)     (64.0)   (64.8)   (65.4)   (258.8)   (245.7)   (13.1)        additional posts, including consultant and medical staff
                                                                                              linked to ensuring patient safety and strengthening clinical
                                                                                              quality levels, is undertaken in a phased and measured
EBITDA                   2.7       2.9      3.2      4.9      13.7      16.2     (2.5)
                                                                                              way.
                                                                                         ●    Future fill rates for junior doctor rotations are similar to the
Finance Costs          (3.3)      (3.4)    (3.4)    (3.4)    (13.5)    (13.6)     0.1         August rotations.
                                                                                         ●    Escalation beds required during the winter pressure period.
Surplus / (Deficit)    (0.6)      (0.5)    (0.2)     1.5       0.2        2.6    (2.4)   ●    Divisional forecasts incorporate pay run rate reductions and
                                                                                              medical agency cost reductions.
                                                                                         ●    CIPs at 66% of target.
                                                                                         ●    Strategic Change Reserve funding receivable £3.5m.




                               Finance Report                   Sheet 7         The Shrewsbury and Telford Hospital NHS Trust
Section Five - Improvement Programme

                                                                   SaTH Im provem ent Program m e Status Report


                          £7,000


                          £6,000


                          £5,000


                          £4,000
         £000




                          £3,000


                          £2,000


                          £1,000


                             £0
                                     M1       M2     M3      M4         M5          M6       M7       M8       M9       M10      M11      M12

  Act ual Savings £'000              £87      £208   £383   £631        £894       £1,258   £1,497

  Planned Saving (FIMS) £'000        £90      £240   £463   £803       £1,197      £1,756   £2,462   £3,248   £4,041   £5,035   £5,876   £6,792

  Forecast Savings £'000             £81      £212   £409   £729       £1,103      £1,653   £2,324   £3,080   £3,880   £4,896   £5,756   £6,696




          The summary position is as follows:
               IP target for 2010/11 is £6.8 million.
               At Month 7 £1.497m has been delivered against a target of £2.462m. This equates to 61%. Against the revised
                forecast of £2.324m delivery equates to 64%.
               The current forecast outturn assumption is that delivery will be at 66% (£4.5m)
               For a detailed analysis of Divisional performance see Appendix A7.
               A more detailed report is presented separately to the Finance & Performance Committee.


                                   Finance Report            Sheet 8            The Shrewsbury and Telford Hospital NHS Trust
   Section Six - Financial Risk Rating

Financial        Weight   Metric         Rating categories (min thresholds)    Current Previous                                          ROA excluding dividend (%)
Criteria                                                                       Month    Month
                                            5       4      3      2       1     Value    Value                                                    10


                           EBITDA                                                                                                                  8
Achievement of
                   10%     Achieved       100%    85%     70%    50%    <50%   71.9%    68.0%
     plan
                          (% of Plan)                                                                                                              6
                                                                                                                                                 5.1

  Underlying               EBITDA                                                                                                                  4
                   25%                    11%      9%     5%     1%     <1%     4.5%     4.2%                                                          2.8
 Performance              Margin (% )                                                                         10.4                                     1.9
                                                                                                      Liquidity                                    2                                            EBITDA Margin (%)
                           Return on                                                                                                                                               6.2
                                                                                                                     8.7                                                    4.2
                             assets                                                                                          7.8                   0
                                                                                                                                                                      4.5
                   20%     excluding       6%      5%     3%     -2%    <-2%    2.8%     1.9%
                            dividend                                                                                                              -2
                              (% )                                                                                                                -0.5
   Financial
                                                                                                                                                         -0.8
   Efficiency
                          I&E Surplus                                                                                                                           1.0
                           Margin net
                   20%                     3%      2%     1%     -2%    <-2%   -0.5%    -0.8%
                          of dividends
                               (% )                                                                                                     72
                                                                                                                                   68
                           Liquidity
   Liquidity       25%                     35      25      15     10     <10     7.8      8.7                            100
                          Ratio (days)
                                                                                                    Achievement of plan (%)                                                        I&E surplus margin (%)
   Weighted Financial Risk Rating                                                1.9      1.8
                                                                                                                     Current Month Value                     Plan                 Previous Month Value
          Overall Rating                                                          2        2

   Risk rating of 2.
                                                                                                   Performance below plan continues to impact on the liquidity
    Improvement in each of the FRR performance metrics other than
                                                                                                    position
     liquidity.
                                                                                                   The diagram above illustrates the Trust position in each metric of
    Liquidity metric shows rating of 1. Net current asset reduction mainly
                                                                                                    the FRR against the full year plan position and illustrates the in-
     linked to lower cash balance, increased NHS and capitral creditors
                                                                                                    month improvement against each of the metrics, other than
     and accrual for PDC dividend
                                                                                                    liquidity.
                                                                                                   The Trust is currently underperforming in each area.
                                        Finance Report                          Sheet 9           The Shrewsbury and Telford Hospital NHS Trust
Section Seven- Activity and Income


                                               Day Cases                                                     The graphs opposite detail the 2010/11 activity and 2009/10 actual levels
         4,750                                                                                               for each activity type. PCT QIPP has been profiled and the reconciled
         4,500                                                                                               plan incorporated into the graphs.
         4,250

         4,000                                                                                               Performance for October shows :
Spells

                                                                                                              Total elective and day case activity was 610 spells above plan in
         3,750

         3,500

         3,250
                                                                                                               October. This has given rise to an income over-recovery of £640k in
         3,000                                                                                                 October;
                  Apr    M ay    Jun     Jul    Aug    Se pt    Oct   Nov   De c    Jan   Fe b    M ar


                         2010/11 Actual               2010/11 Plan            2009/10 Actual
                                                                                                              Overall Day Cases show an over performance of 466 spells in October.
                                                                                                               Over performance in Day Case is reported in most specialties. This is
                                                Elective                                                       offset by underperformance in other specialties notably General
    1000
                                                                                                               medicine and Oral Surgery.
     800                                                                                                      Elective inpatient activity was 144 above plan in October. The most
     600
                                                                                                               notable areas of overperformance being General Surgery, Gynaecology,
Spells                                                                                                         Urology and ENT.
     400


     200                                                                                                      Non elective activity is 9 spells below plan in October, General Medicine
         0
                                                                                                               being the main area of over performance. Reported income has been
             Apr       M ay    Jun     Jul     Aug    Se p     Oct    Nov   De c    Jan   Fe b    M ar
                                                                                                               adjusted to reflect the emergency threshold tariff adjustment, this has
                         2010/11 Actual               2010/11 Plan             2009/10 Actual                  reduced reported income by £262k.
                                 Emergency (Inc Maternity)                                                    Non elective activity in total including maternity is £141k below plan in
                                                                                                               October.
     4,200
                                                                                                              Maternity activity is below plan 59 spells in October.
     4,000


     3,800
Spells
     3,600


     3,400


     3,200
                 Apr    M ay    Jun     Jul     Aug    Se p     Oct   Nov    De c   Jan    Fe b    M ar


                         2010/11 Actual               2010/11 Plan            2009/10 Actual




                                               Finance Report                                     Sheet 10         The Shrewsbury and Telford Hospital NHS Trust
Section Seven - Activity and Income

                                  New Out Patients
                                                                                               In October outpatients were 4,082 attendances above plan, the income
     13,500
     13,000
                                                                                                over recovery for the seven months is £2,464k, (October £517k).
     12,500
     12,000
Attend
                                                                                               In October new outpatients are 2,104 attendances above plan but 1,152
     11,500
     11,000
                                                                                                attendances below the September level. This includes Outpatient
     10,500                                                                                     Procedures overperformance in the month of 1,050. The underlying new
     10,000
      9,500                                                                                     outpatient activity is 1,054 above plan.
      9,000
      8,500
               Apr   M ay   Jun   Jul   Aug    Se p   Oct   Nov   De c   Jan   Fe b   M ar
                                                                                               New outpatient over performance is reported for most specialties. Areas of
                                                                                                underperformance include Orthopaedics, Orthodontics, Dermatology and
                     2010/11 Actual           2010/11 Plan         2009/10 Actual
                                                                                                Geriatric Medicine.

                              Follow Up Out Patients                                           Outpatient procedure activity shows notable over performance in Breast
                                                                                                Surgery, Colorectal Surgery, Orthodontics, Dermatology, Obstetrics and
     17,000                                                                                     Gynaecology. Some of this offsets new outpatient underperformance.
     16,000

     15,000
                                                                                               Follow up outpatients are 1,978 attendances above plan but 837
Attend
     14,000
                                                                                                attendances below the September level.
     13,000

     12,000

     11,000
               Apr   M ay   Jun   Jul   Aug    Se p   Oct   Nov   De c   Jan   Fe b   M ar


                     2010/11 Actual           2010/11 Plan         2009/10 Actual




                              Accident & Emergency


     10,000
       9,750
       9,500
       9,250
                                                                                               A & E attendances are 523 above plan in October (1,611 YTD).
       9,000
Attend
       8,750
       8,500
                                                                                               In month activity analysis shows RSH 51% and PRH 49%, income shows
       8,250                                                                                    a near 50/50 split.
       8,000
       7,750
       7,500
       7,250
       7,000
               Apr   M ay   Jun   Jul   Aug    Se p   Oct   Nov   De c   Jan   Fe b    M ar


                     2010/11 Actual           2010/11 Plan          2009/10 Actual




                                  Finance Report                                 Sheet 11          The Shrewsbury and Telford Hospital NHS Trust
  Section Eight - Expenditure – Non-Pay and Finance Costs


                                               Non Pay                                     Non pay shows an overspend of £483k in month. All non-clinical non-pay
                                                                                            expenditure requisitions continue to be reviewed and scrutinised for validity
        7,000                                                                               and necessity before being approved.
        6,500                                                                              The Divisional Report highlights specific areas of non pay over spend
        6,000
                                                                                            including:
£'000




        5,500
                                                                                                   Cancer/ Oncology/ Haematology drugs offset, by income recovery
        5,000
                                                                                                   Theatres Orthopaedic products, hip, knee and trauma related.
                                                                                                     Division 3 are undertaking a baseline review to identify expenditure
        4,500
                                                                                                     linked to backlog work.
                    Apr May Jun    Jul     Aug Sep Oct Nov Dec Jan Feb Mar
                                                                                                   Patient Transport Costs, offset by income.
                           2010/11 Actual            2009/10 Actual       2010/11 Plan             Theatres stents under accrual correction.
                                                                                                   Drugs issues correction due to system error in month 6.




                                              Finance Costs
                                                                                           Finance costs are £6k underspent in October. Forecast outturn is in line
            1,400                                                                           with plan.
            1,200
            1,000
    £'000




              800
              600
              400
              200
                0
                     Apr May Jun     Jul    Aug Sep Oct Nov Dec Jan Feb Mar

                             2010/11 Actual              2009/10 Actual    2010/11 Plan




                                           Finance Report                      Sheet 12       The Shrewsbury and Telford Hospital NHS Trust
  Section Nine - Debtors

All                            Current              + 30 days               + 60 days        Total
                                  £ '000                   £ '000               £ '000       £ '000     Trade debtors have increased by £1,033k compared to prior
NHS                               1,707                      525                1,036        3,268       month with an increase in accrued revenue of £274k. Total
Priv ate Patients                   146                       37                   57          240       debtors have therefore increased by £1,307k.
Other *                             221                       46                  106          373
Total                             2,074                      608                1,199        3,881
* Includes prescriptions, catering recharges, accomodation, telephones, ov erseas
v isitors and MES activ ity
                                                                                                        Shropshire County PCT prior year invoices remain unpaid with no
                                                                                                         movement within the month. As part of the recent Month 6 financial
 NHS                          Current       + 30 days         + 60 days          2009/10     Total       returns submission the PCT disputed these invoices via the
                                £'000           £'000               £'000          £'000     £'000       agreement of balance process. Discussions at FD level have
 Shropshire County PCT            353                28               73            533       987        commenced with resolution required by the end of November. There
 Telford & Wrekin PCT              26                22               67             36       151        have been small reductions in the +60 and +30 days categories.
 Pow y s                           16               531                                       547       Telford and Wrekin PCT prior year invoices show a reduction of £11k
 RJAH                             612                98              123                 1    834        with the remaining balance represented by high cost drugs. There
 Others                           700               -154             194                 9    749        have been small increases in the +60 and +30 days categories.
 Total                          1,707               525              457            579      3,268



Non NHS Debtors > £ 25k                    £ '000      NHS Debtors > £ 100k                   £ '000
                                                                                                        Of the other debtors outstanding £30k has been referred to a
CP Plus                                       62       Shropshire County PCT                    987
                                                                                                         specialist collection agency with appropriate provisions for write off
BUPA                                          60       RJAH                                     834
                                                                                                         made based on expected collection success.
Ov erseas Visitor Z                           56       Pow y s                                  547
                                                       Telford & Wrekin PCT                     151     £56k in respect of an overseas visitor with no means to pay is
                                                       West Mids Specialised Serv ices         -109      shown in line with DH guidance – this debtor has been provided for
                                                                                                         in full.
Total                                        178                                              2,410
                                                                                                        The credit balance of £109k for West Midlands Specialised
                                                                                                         Services is the net result of a September raised credit note for
                                                                                                         £227k.



                               Finance Report                                   Sheet 13        The Shrewsbury and Telford Hospital NHS Trust
   Section Ten – Creditors (Non NHS)

Table 1                                                                                                                       Table 1 summarises the non-NHS creditor payment
NON NHS                     YTD         M1        M2      M3      M4      M5      M6      M7                            YTD    performance for the cumulative prior year, month 7
                         2009/10    2010/11   2010/11 2010/11 2010/11 2010/11 2010/11 2010/11                        2010/11   and year to date position. The graph shows the prior
By Volume                                                                                                                      year by month with current month position.
Total Volume               75587      4240       7670   6614    6654    4503           5514              7188          42383  The Better Payment Practice Code stipulates a
BPPC compliant volume      49629      1813       2135   2062    1318    1962           1921              2374          13585   target of 30 days.
BPPC compliant %            66%       43%        28%    31%     20%     44%            35%               33%            32%
                                                                                                                              Increase in monthly compliance position due to
                                                                                                                               prioritisation of non-NHS payments. The current
By Value                                                                                                                       cumulative compliance is on par with month 6 and
Total value (£000)          72097     5275       7056   11389   9671    8155           9066            10630           61242   is 32% for volume and 57% for value.
BPPC compliant value (£000) 46040     2679       1850    7013   5234    6082           5590             6464           34912
                                                                                                                              Table 2 summarises the actual payment
BPPC compliant %             64%      51%        26%     62%    54%     75%            62%              61%             57%
                                                                                                                               performance in the month.


Table 2                                                                                                 B et t er Payment Pr act i ce C o d e -                  T r ad e C r ed i t o r s

Payment made            QuantityQuantity % Value £000 Value %
0-30 days                 2,374       33%      £6,464     61%
31-35 days                  238        3%        £267      3%                    P e r c e nt a ge

36-40 days                  251        3%        £313      3%                             100
                                                                                           95
41-45 days                  334        5%        £465      4%                              90
                                                                                           85
46-50 days                  301        4%        £447      4%                              80

51-55 days                  344        5%        £303      3%                              75
                                                                                           70

56-60 days                  288        4%        £268      3%                              65
                                                                                           60

over 60 days              3,058       43%      £2,103     20%                              55
                                                                                           50
Total invoices paid       7,188      100%     £10,630    100%                              45
                                                                                           40
                                                                                           35
                                                                                           30
                                                                                           25
                                                                                           20
                                                                                           15
                                                                                                     40118   40148     40179       40210      40238      40269    40299   40330    40360     40391   40422   40452

                                                                                                                                                             M ont h



                                                                               %Invoi ces Pai d In 30 Days           %Val ue of Invoi ces Pai d In 30 Days




                                Finance Report                   Sheet 14                The Shrewsbury and Telford Hospital NHS Trust
     Section Ten – Creditors (NHS)

Table 1
NHS Spend                        YTD        M1         M2        M3      M4      M5      M6      M7     YTD  Table 1 summarises the non-NHS
                              2009/10   2010/11    2010/11   2010/11 2010/11 2010/11 2010/11 2010/11 2010/11  creditor payment performance for the
By Volume                                                                                                                                cumulative prior year, month 7 and year
Total Volume                     2189        29         79      154    489      24    272               121            1168              to date position. The graph shows the
BPPC compliant volume            1192        14         35       23     97       7     88                53             317              prior year by month with current month
BPPC compliant %                 54%       48%        44%      15%    20%     29%    32%               44%             27%
                                                                                                                                         position.
By Value                                                                                                                           The                Better               Payment                  Practice        Code
Total value (£000)              20045     1776       1529      1487   3448     415   2371             1246           12272  stipulates a target of 30 days.
BPPC compliant value (£000)      6993      687        892       347   1242      67   1424              573            5232
BPPC compliant %                 35%      39%        58%       23%    36%     16%    60%              46%             43%  The cumulative compliance position at
                                                                                                                                         Month 7 is on par with the prior month at
                                                                                                                                         27% for volume and 43% for value.
                                                                                                                                   Table 2 summarises the actual payment
Table 2                                                                                                                             performance in the month.
Payment made                  QuantityQuantity % Value £000 Value %
0-30 days                          53       44%        £573     46%                                                    Better Payment Practice Code - NHS Creditors

31-35 days                           8       7%          £4      0%
36-40 days                         11        9%         £65      5%
41-45 days                           1       1%          £0      0%                   Percentage
                                                                                           100

46-50 days                           1       1%          £2      0%                        90
                                                                                           80
50-55 days                           8       7%         £43      3%                        70

56-60 days                           1       1%          £8      1%                        60
                                                                                           50
over 60 days                       38       31%        £551     44%                        40
                                                                                           30
Total invoices paid               121      100%      £1,246    100%                        20
                                                                                           10
                                                                                                   Nov-09   Dec-09   Jan-10   Feb-10    Mar-10    Apr-10   May-10     Jun-10     Jul-10   Aug-10   Sep-10   Oct-10
                                                                                                                                                      Month



                                                                                                                     % Invoices Paid In 30 Days     % Value of Invoices Paid In 30 Days




                                  Finance Report                  Sheet 15       The Shrewsbury and Telford Hospital NHS Trust
   Section Eleven - Capital

                                                                          Total
                                                                    Expenditure/         Forecast % of spend
                              Plan CRL Expenditure Committed         Committed            Outturn /committed
                                2010/11   M07 YTD    M07 YTD           M07 YTD            2010/11     against
                                  £'000      £'000      £'000             £'000             £'000    forecast       The Capital Programme for 2010/11 remains at £8,505k.
B/Fwd 2009/10 projects              546        272        135               407               472      86.2%
                                                                                                                    £321k of capital funds remains available.
2010/11 projects                                                                                                    CT Scanner PRH – now completed and fully operational.
CT Scanner PRH                     800         493            179            672              676      99.4%         Scheme ‘signed off’.
Bathroom refurbishment             350           0              0              0                0       0.0%
Decontamination Project          3,734       1,518            911          2,429            3,434      70.7%        Decontamination Project – Building handed over to Trust on 3
Redevelopment of Women and                                                                                           November. Commissioning of the autoclaves and washer –
Children Zone                    3,000           0              0              0                0       0.0%         disinfectors   commenced.       Procurement     of   additional
Electrical infrastructure          600           0              0              0                0       0.0%         instrumentation is ongoing. Unit is on target to open February
Theatres Air Handling              450         290             58            348              360      96.7%         2011 with PRH service moving first.
Breast Screening (Digital)         466         129            399            528              540      97.8%
Others                           1,438         416            183            599            1,622      36.9%        Theatres Air Handling Scheme – Theatre 1 and 2 now fully
                                10,838       2,846          1,730          4,576            6,632      69.0%         operational. Formal hand over and ‘sign off’ completed.
                                                                                                                    Breast Screening Service move to Digital - Ex-demo mobile has
2010/11 contingency funds        1,350        450             107            557            1,080      51.6%
                                                                                                                     been delivered to PRH site - currently undergoing
2010/11 unallocated funds         371           0               0              0             321        0.0%
                                                                                                                     commissioning and radiation safety checks to make ready for
                                                                                                                     clinical use. Old equipment has been removed from static room 1
Total 2010/11                   13,105       3,568          1,972          5,540            8,505      65.1%         at RSH and enabling works are currently under way. Delivery of
                                                                                                                     PACS equipment expected 22nd November.
Planned CRL consists of:                             Forecast CRL consists of:
Depreciation                     7,705               Depreciation                           7,705
DH Loan for Decontamination      2,400               DH Loan for Decontamination                0
DH Loan for W&C Zone             3,000               DH Loan for W&C Zone                       0
                                                     CRL Transfer - PSAG                      500
                                                     CRL Transfer - Maty Refurbishment        300
Total 2010/11                   13,105               Total 2010/11                          8,505



                                  Finance Report                                   Sheet 16               The Shrewsbury and Telford Hospital NHS Trust

								
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