1

Monthly Finance Report For July 2016

Prepared by:

Helen De Spretter

Head of Financial Performance and Decision Making

Assad Choudry Financial Controller

David Bebb

Deputy Chief Financial Officer

Presented By: Steven Davies

Chief Financial Officer

Board of Directors meeting 1

st September 2016

Date produced 23rd August 2016

Action for Board:

For information

For consideration

For decision

Item 13

2

Contents of Main Report

Page Number

Executive Financial Summary 3 Detailed Income and Expenditure Position 4 Underlying Position 5 NHS Income 6

NHS Operating Expenditure 8

Efficiency Scheme Performance 11 Research & Development and Commercial Trading Position 12 Cash flow & Capital 13 Debtors Management and Credit Control 14

3

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

0.59 0.16 (0.43) 2.15 1.87 (0.28) 2.00 2.00 0.00

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

14.36 14.16 (0.20) 55.27 55.89 0.62 167.06 170.02 2.96

14.27 14.39 (0.12) 55.03 56.18 (1.15) 170.46 173.56 (3.10)

0.09 (0.23) (0.32) 0.24 (0.29) (0.53) (3.40) (3.54) 0.14

87%

20% Plan (£M) Actual (£M) Var (£M) Plan (£M) Actual (£M) Var (£M)

78% 1.94 1.69 (0.25) 8.50 6.63 (1.87)

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

0.11 0.17 0.06 0.41 0.84 0.43 1.29 1.37 0.08

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

0.39 0.22 (0.17) 1.49 1.33 (0.16) 4.10 4.16 0.06

YTD

Actual

Q3

Forecast

Q4

Forecast4 4 4

Liquidity 4 4 4

I&E Margin 4 3 3

3 4 4

4 4 4

2015/16

Year End

Q1

Act

July

Act

July

Var

Q3

Plan

Q4

Plan

29.30 27.70 27.90 (4.20) 29.50 28.90

Annual PlanExpenditure

YTD

Expenditure

Total

% Budget

Used

Var to Plan

Forecast

35.57 3.60 6.40 18% 19.87

3-6 Mths 2 Mths Total Last Month

(£M) (£M) (£M) (£M)

2.03 0.06 5.49 4.55

0.62 0.29 2.69 2.52

0.66 0.94 3.47 3.40

3.31 1.29 11.65 10.47

Capital Expenditure (£M)

2.70

2.80

IncomeExpenditure

Overall Position

Debtors

Overdue Debts

NHS Contract Debts 2.37 1.03

Commercial Debts 1.30 0.48

Other

% Full Year achieved

(exc. R&D)

Efficiency Scheme

Performance

0.68 1.19

TOTAL

Q2

Plan

32.10 31.00

(£M) (£M)

Expenditure

Committed

6 Mths + 1 Mth

Annual

Forecast

15.70

4.35

Full Year % forecast

YTD % achieved Year to Date

In Month Year to Date

4

Cash Balance (£M)

Capital

Expenditure

Commercial

Trading Unit

Position

In Month Year to Date

I&E Margin Variance

Financial Sustainability Risk Rating

Q2

Forecast4

4

4

4

Financial

Sustainability Risk

Rating

Cash FlowJuly

Plan

Full Year Forecast

Full Year Forecast

Indicator

Debt Service Cover

Executive Financial Summary

Trust Underlying

Overall Position -

Surplus / (Deficit)

In Month Year to Date Key Risks and Actions RequiredFull Year Forecast

Full Year ForecastNHS In Month Year to Date

Full Year ForecastResearch &

Development

Position

Income and Expenditure:

• The Trust reported a £0.16m surplus in July. This

performance is £0.43m below planned levels. Year to

date performance is £1.87m surplus, £0.28m behind plan.

• This performance has been driven by lower than planned

levels of activity, due to annual leave being taken slightly

earlier than predicted in planning. Early Indications are

that August activity levels will exceed plan.

• In addition temporary pay costs were higher than

planned to support annual leave and additional activity

together with some costs relating to a previous periods.

• Commercial Trading Units delivered a surplus of £0.22m

in month, which was lower than planned levels by

£0.17m. Year to date performance is now behind plan by

£0.16m which is forecast to recover by the year end.

• Efficiency schemes have delivered £1.69m of savings year

to date, which is behind planned levels by £0.25m. The

forecast £6.63m noting that some schemes are subject to

slippage which are being replaced by replacement

schemes currently being validated.

Financial Sustainability Risk Rating (FSRR)

• The Trust has achieved a FSRR score of 4 year to date

which is forecast to continue for the remainder of the

year.

Cash flow and Balance Sheet

• Cash balance was £27.90m at the end of July. This has

improved by £0.2m from June. Further back dated

receipts in August have improved this further.

• Cash balances are still behind plan as draw down of the

£4.2m loan funded has now been deferred.

• Forecast capital expenditure has been updated in month

to reflect latest ORIEL project assumptions.

• These changes are now being reflected in a revised

internal cash plan. This will exclude the loan drawn down

and include planned revisions to capital expenditure.

These changes will be reported at the next Trust Board.

4

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

Income

NHS Clinical Income 13,558 13,132 (426) 51,801 51,858 57 155,594 157,855 2,261 49,785 2,073

Commercial Trading Units 2,524 2,294 (230) 9,840 9,311 (529) 29,742 30,075 333 8,855 456

Other Income 1,917 2,018 101 7,878 8,379 501 24,828 25,333 505 7,552 827

Total Income 17,999 17,444 (555) 69,519 69,548 29 210,164 213,263 3,099 66,192 3,356

NHS Expenditure

Pay Exenditure

Medical 2,530 2,702 (172) 9,980 10,403 (423) 30,284 31,107 (823) 9,995 (408)

Nursing 2,007 1,966 41 7,997 8,017 (20) 24,292 24,640 (348) 7,455 (562)

Scientific, Professional & Technical 1,039 1,007 32 4,020 3,934 86 12,322 11,849 473 3,776 (158)Admin and Clerical 2,172 2,170 2 8,705 8,877 (172) 26,069 26,071 (2) 8,515 (362)

Ancillary Services 173 176 (3) 690 694 (4) 2,073 2,125 (52) 642 (52)Research & Development Pay 682 600 82 2,716 2,414 302 8,191 8,087 104 2,335 (79)

Total Pay Expenditure 8,603 8,621 (18) 34,108 34,339 (231) 103,231 103,879 (648) 32,718 (1,621)

Non-Pay Exenditure

Drugs 2,034 2,030 4 7,626 8,063 (437) 22,686 24,399 (1,713) 7,359 (704)

Clinical Supplies and Services 1,373 1,484 (111) 5,192 5,310 (118) 15,534 15,431 103 5,147 (163)

Premises 1,028 1,025 3 3,212 3,389 (177) 9,147 9,542 (395) 3,193 (196)

Other Expenditure 1,257 1,098 159 4,209 4,264 (55) 17,584 18,257 (673) 3,924 (340)

Research & Development Non-Pay 305 196 109 1,200 1,021 179 3,626 3,458 168 974 (47)

Total Non-Pay Expenditure 5,997 5,833 164 21,439 22,047 (608) 68,577 71,087 (2,510) 20,597 (1,450)

Total NHS Expenditure 14,600 14,454 146 55,547 56,386 (839) 171,808 174,966 (3,158) 53,315 (3,071)

Commercial Trading Unit Costs 2,091 2,038 53 8,181 7,891 290 25,072 25,395 (323) 8,276 385

Total Expenditure 16,691 16,492 199 63,728 64,277 (549) 196,880 200,361 (3,481) 61,591 (2,686)

EBITDA 1,308 952 (356) 5,791 5,271 (520) 13,284 12,902 (382) 4,601 670

EBITDA Margin % 7.3% 5.5% 8.3% 7.6% 6.3% 6.0% 7.0%

NHS Interest, Dividends, Depreciation 654 735 (81) 3,377 3,214 163 10,435 10,096 339 3,495 281

Trading Unit Interest, Depreciation, Dividends 66 56 10 265 192 73 851 809 42 172 (20)

Surplus / (Deficit) 588 161 (427) 2,149 1,865 (284) 1,998 1,997 (1) 934 931

NHS EBITDA 875 696 (179) 4,132 3,851 (281) 8,614 8,222 (392) 4,022 (171)

NHS EBITDA Margin % 5.7% 4.6% 6.9% 6.4% 4.8% 4.5% 7.0%

NHS Surplus / (Deficit) 221 (39) (260) 755 637 (118) (1,821) (1,874) (53) 527 110

Commercial Trading Unit EBITDA 433 256 (177) 1,659 1,420 (239) 4,670 4,680 10 579 841

Commercial Trading Unit EBITDA Margin % 17.2% 11.2% 16.9% 15.3% 15.7% 15.6% 6.5%

Commercial Trading Unit Surplus / (Deficit) 367 200 (167) 1,394 1,228 (166) 3,819 3,871 52 407 821

Overall Trust I&E Summary

In Month Year To Date Full Year Forecast Prior Year YTD

Variance ActualVariance

YTD ActualBudget Actual Variance Budget Actual Variance Budget Actual

Detailed Income and Expenditure Position - Surplus / (Deficit)

5

£000s £000s £000s £000s

Total Income 17,999 17,444 69,519 69,548

Total NHS Expenditure 14,600 14,454 55,547 56,386

Commercial Trading Unit Costs 2,091 2,038 8,181 7,891

Total Expenditure 16,691 16,492 63,728 64,277

EBITDA 1,308 952 5,791 5,271

EBITDA Margin % 7.3% 5.5% 8.3% 7.6%

NHS Interest, Dividends, Depreciation 654 735 3,377 3,214

Trading Unit Interest, Depreciation, Dividends 66 56 265 192Surplus / (Deficit) 588 161 2,149 1,865

Adjustment to Reach Underlying Position:

Income

- Donated Asset Benefit 0 (74) 0 (74)

- VAT Reclaim (9) (64) (37) (68)

- Bedford prior year income 0 0 0 (127)

- Vanguard income 0 0 0 (125)

- Sustainability and Transformation Funding Q1 0 0 (275) (275)

- Income data issue - loss of income due to failure of OCT logging 0 120 0 120

- Novartis 0 (50) 0 (50)

- Project Oriel 0 (22) 0 (22)

- Income from Croydon dilapidations 0 0 0 (60)

Total Income (9) (90) (312) (681)

Expenditure

- Project Oriel 111 16 443 75

- Estates costs - Gas 0 200 0 231

- CQC readiness 0 12 0 77

- Change in Provisions 7 6 29 28

- Vanguard costs 0 0 0 125

- Glaucoma Strategic review 0 0 0 25

- Prior year costs 0 0 0 263

Total Expenditure 118 234 472 823

Total 108 143 160 142

Revised Underlying Position 697 304 2,309 2,007

Budget Actual Budget ActualOverall Trust I&E Summary

In Month Year to Date

Underlying surplus year to date is £2.0m. This includes adjustments for prior year expenditure settled in 2016/17, quarter 1 sustainability and transformation income,

donated asset and vanguard income, and project ORIEL expenditure.

Underlying Position

6

NHS Income

Commentary:

A&E activity has under-performed in month by £68k (577 attendances), year to date £226k (1,878 attendances).

Elective activity is 122 spells (4%) below plan in month, which gives an adverse income variance of £147k. Year to date activity is 386 spells (3%) above plan and income is £298k above plan. This includes 466 spells (9% ahead of plan) at City Road, 102 spells (5% ahead of plan) for Moorfields South and Croydon, offset by underperformance of 182 spells (5% behind plan) across Moorfields North sites.

High cost drug injection activity is 70 injections (3%) above plan in month, giving a favourable income variance of £12k. Year to date position is an over-performance of 1,017 injections and £662k.

Outpatient income is under-performing by £431k in month and underperforming by £616k year to date. In addition there was a data systems error affecting ODS data that led to £120k of activity income being lost. Only Moorfields Croydon and surgical services directorates are over-performing in month

Other NHS activity was above plan by £88k in month and below plan year to date by £61k.

Other Income is £101k above plan in month and £501k year to date. This is due to VAT reclaim from HMRC and Donated Asset Income (£74k)

7

19 17 21 21 18.7 21 20 17 15.3 21 20 19

154 153 158 154 154 157 158 175 167 154 154 166

169 170 153 156

15 17 (5) 2

Workings Days Inc. adjustments

Target per working day (£'000)

Actual per working day (£'000)

Variance (£'000)

21 22 22 21 23 22 21 22 22 22 20 23

230 209 249 256 208 248 248 218 190 244 256 224

238 221 237 248 201

8 12 (12) (8) (7)

Workings Days Inc. adjustments

Target per working day (£'000)

Actual per working day (£'000)

Variance (£'000)

Elective Activity Analysis (Inpatients and Outpatients)

July elective income was £156k per working day, compared to a

plan of £154k. Noted that planned levels of activity in July were

lower than June due to phasing of working days.

Year to date, Glaucoma, Paediatrics & Strabismus and Adnexal

service at City Road continued to over perform, resulting in

£547k favourable variance. However, Cataract and Corneal

services in North, non-elective VR have underperformed

against plan, due to shortage of surgical cover and unallocated

theatre sessions.

Outpatient activity was £248k per working day, £8k lower than

plan of £256k per working day. Note that planned levels of

activity in July were considerably higher than in previous

months.

Slippage from Outpatient activity plan was mainly around

follow up activity. In City Road, MR services and optometry led

follow up plan was behind plan by £496k year to date. Delay in

recruiting MR fellows and slippage in implementation virtual

Optometrist led pathways have resulted in underperformance.

However, additional clinics on Saturday have helped bridge this

gap partially. General Ophthalmology and optometry have

underperformed in all outreach directorates. Year to date,

North directorate is £186k behind plan and ODS is £296k

against plan.

8

NB. Research and Development Pay is excluded from the tables above and shown as part of the Research and Development position on page 12.

Staff Group & Directorate Staff Group & Directorate

MedicalYear to Date Current Month

Increase /

(Decrease)Nursing

Year to Date Current Month

Increase /

(Decrease)

Moorfields North 233 244 11 Moorfields North 524 510 (14)

Moorfields South 230 269 39 Moorfields South 220 202 (18)

Moorfields Croydon 173 171 (2) Moorfields Croydon 99 98 (1)

Outpatient & Diagnostic Servs 1,121 1,161 40 Outpatient & Diagnostic Servs 557 563 6

Surgical Services 799 808 9 Surgical Services 553 535 (18)

Corporate Departments 44 48 4 Corporate Departments 51 58 7

Total 2,600 2,701 101 Total 2,004 1,966 (38)

Average Monthly Expenditure (£'000) Average Monthly Expenditure (£'000)

Staff Group & Directorate Staff Group & Directorate

Other ClinicalYear to Date Current Month

Increase /

(Decrease)Non-Clinical

Year to Date Current Month

Increase /

(Decrease)

Moorfields North 49 39 (10) Moorfields North 202 197 (5)

Moorfields South 12 9 (3) Moorfields South 110 114 4

Moorfields Croydon 19 19 0 Moorfields Croydon 59 55 (4)

Outpatient & Diagnostic Servs 821 818 (3) Outpatient & Diagnostic Servs 361 366 5

Surgical Services 72 75 3 Surgical Services 288 297 9

Corporate Departments 11 0 (11) Corporate Departments 1,370 1,317 (53)

Total 984 960 (24) Total 2,390 2,346 (44)

Average Monthly Expenditure (£'000) Average Monthly Expenditure (£'000)

NHS Operating Expenditure – Pay Costs by Staff Group and Area

Average other clinical pay expenditure in month is £960k, which is a £24k decrease on the year to date averaged expenditure of £984k.

Both in month and year to date show an increase over last year’s average monthly spend £944k.

Average non clinical pay expenditure in month is £2,346k, which is £44k below the year to date averaged expenditure of £2,390k. This is due to costs associated with corporate areas to support CQC preparedness and a small number of non recurrent projects.

Both in month and year to date show an increase over last year’s average monthly spend £2,289k.

Average nursing pay expenditure in month is £1,966k, which is £38k below the year to date averaged expenditure of £2,004k.

In month average monthly spend for nursing is above last year‘s monthly average spend of £1,862k.

Average medical pay expenditure this month is £2,701k, which is £101k above the year to date averaged expenditure of £2,600k. This has been largely caused by increased temporary staffing to support activity and cover annual leave and vacancies.

In month and year to date medical pay expenditure are both above last year’s average monthly spend which was £2,499.

9

Staff Type

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

Nursing 1,685 252 30 1,967 -2% 1,706 263 35 2,004 8% 1,613 210 41 1,864

Other Clinical 973 13 21 1,007 2% 962 7 14 983 4% 909 0 35 944

Non-clinical 1,872 235 238 2,345 -2% 1,892 224 277 2,393 5% 1,757 216 316 2,289

Staff Type

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

Comments

Nursing

Other Clinical

Non-Clinical

Current Month Year To Date Average Average Prior Year

86%

13%

1%

Nursing Expenditure Current Month

Employed Bank Agency

85%

13%

2%

Nursing Expenditure YTD Average

Employed Bank Agency

97%

1% 2%

Other Clinical Expenditure Current Month

Employed Bank Agency

98%

1% 1%

Other Clinical Expenditure YTD Average

Employed Bank Agency

80%

10%

10%

Non Clinical Expenditure Current Month

Employed Bank Agency

79%

9%

12%

Non Clinical Expenditure YTD Average

Employed Bank Agency

87%

11%

2%

Average Nursing Expenditure Prior Year

Employed Bank Agency

96%

0%4%

Average Other Clinical Expenditure Prior Year

Employed Bank Agency

77%

9%

14%

Average Non Clinical Expenditure Prior Year

Employed Bank Agency

NHS Operating Expenditure – Pay Costs Agency and Bank Analysis

Nursing bank expenditure has increased

and substantive expenditure has

decreased in month. Bank is 13% and

agency is 1% of total expenditure. The

vacancy rate in month is 16.8%, with the

highest vacancy rate in Croydon at

30.7%. WTE 90 of bank staff and 5.5 WTE

of agency staff were employed this

month to cover 107.3 vacancies and

additional sessions.

Other clinical bank and agency staff

usage is minimal at 3% , agency is used in

Surgical Services and Croydon.

The other departments rely on overtime

from substantive staff to provide cover.

Given no levels of bank and agency this

cohort of staff reporting will be replaced

by medical staff in future reports.

Non-clinical staff groups make use of the

highest proportion of agency at 10%.

Bank usage is 10%.

Admin & Clerical staff has a vacancy rate

of 14.8% and used £235k of agency in

month. All departments are within

establishment except R&D where there is

a small over establishment of 0.5WTE

that has matched funding.

10

NHS Operating Expenditure – Non-Pay Costs

Comments:

Corporate non-pay expenditure is £89k below plan in month and £100k below plan year to date.

This is due to underspends in key corporate areas offset by unplanned expenditure within estate to support the CQC inspection and higher than planned postage and IT printing costs.

Comments:

Directorate non-pay expenditure is £75k below plan in month and £708k above plan year to date.

This is due to continued overspend in high cost drugs and related clinical support costs backed by activity levels being above planned levels.

In addition there is a continued overspend on service level agreements with other NHS organisations.

11

10%

2%

40%30%

18%

Breakdown of Forecast Achievement

Clinical Supplies

Drugs

Non-Clinical Supplies

Pay

Revenue

-

100

200

300

400

500

600

700

800

900

1,000

Am

ou

nt (

£'0

00

)

Period

Efficiency Schemes Profile and Forecast

Target

Actual

Forecast

Full Year

Target (£)

Value of

Schemes

Identified (£)

YTD Target

(original

phased

budget)(£)

YTD Amount

Achieved (£)

YTD

Variance (£)

Full Year

Forecast

Amount (£)

Forecast %

Achievement

of Target

YTD Amount

Achieved as

% of Full

Year Target

Moorfields North 1,228,342 1,188,246 311,137 279,958 (31,178) 1,021,323 83% 23%

Moorfields South 719,964 726,841 133,169 113,316 (19,853) 535,944 74% 16%

Croydon 450,947 459,202 93,881 74,595 (19,287) 363,296 81% 17%

Outpatient & Diagnostic Services 2,829,212 2,074,282 184,393 119,626 (64,767) 1,185,706 42% 4%

Surgical Services 1,500,794 2,272,809 679,176 586,473 (92,703) 1,789,496 119% 39%

Corporate Departments 1,770,741 2,167,586 540,563 520,811 (19,752) 1,739,065 98% 29%

Directorate / Corporate

Department

Actions on Shortfall and Unidentified Amount

Year to date achievement is £113k against a plan of £133k . Full year forecast is

underachieving because of slippage in interpreting, Consumables management and

closure of weekend beds.

Year to date underachievement relates to slippage in 3 schemes, Spectacle Tender, Oral

immunosuppressant's and Reduction in hospital supply of ciclosporin eye preparations.

Full year forecast is underachieving because of unidentified CIP target.

Year to date achievement is £280k against a target of £311k, and slippage is primarily

due to underachievement of virtual clinic schemes and a delay to increased Darent Valley

injections. Full year forecast is underachieving because of unidentified CIP target has not

yet been fully identified. Further schemes in pipeline are due to deliver in back end of

2016/17.

Year to date achievement is £75k against a plan of £94k. Full year forecast is

underachieving because of slippage in interpreting and Private patient income

Year to date achievement is mainly due slippage of schemes: Admissions review,

implementation of Bighand software and review of sterilisation service. Full year forecast

is underachieving because of unidentified CIP target.

Year to date underachievement is due to slippage in corporate schemes within estates

and facilities

Target efficiency for the year is £8.5m. Schemes identified to date are £8.8m, ahead of the target by £0.3m. Some of these schemes however are yet to be approved and have started later than expected.

Forecast delivery remains at £6.7m as new schemes are approved and existing ones expedited to close the forecast gap.

Additional funding for expansion of the PMO to support this work will be considered at the September board.

12

Budget Actual Variance Budget Actual Variance Budget Forecast Variance

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

Total Income 1,119 989 (130) 4,408 4,349 (59) 13,357 13,166 (191)

Expenditure

Pay Costs 682 600 82 2,716 2,414 302 8,191 8,087 104

Non-Pay Costs 305 196 109 1,200 1,021 179 3,626 3,458 168

Total Expenditure 987 796 191 3,916 3,435 481 11,817 11,545 272

Interest, Dividends, Depreciation 19 19 0 77 77 0 246 246 0

Total Contribution to overhead 113 174 61 415 837 422 1,294 1,375 81

Research and Development

In Month Year to Date Full Year

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

Total Income 2,548 2,315 (233) 9,936 9,409 (527) 30,027 30,360 333 8,925 484

Expenditure

Pay Costs 780 757 23 3,130 3,015 115 9,443 9,732 (289) 2,978 (37)

Non-Pay Costs 1,311 1,282 29 5,051 4,877 174 15,630 15,663 (33) 5,297 420

Total Expenditure 2,091 2,039 52 8,181 7,892 289 25,073 25,395 (322) 8,275 383

Commercial Trading Unit EBITDA 457 276 (181) 1,755 1,517 (238) 4,954 4,965 11 650 867

Commercial Trading Unit EBITDA Margin % 17.9% 11.9% 17.7% 16.1% 16.5% 16.4% 7.3%Interest, Dividends, Depreciation 66 56 10 265 192 73 851 809 42 172 (20)

Commercial Trading Unit Surplus / (Deficit) 391 220 (171) 1,490 1,325 (165) 4,103 4,156 53 478 847

Less Internal Sales (24) (21) (3) (96) (97) 1 (284) (285) 1 (70) (27)

Commercial Trading Unit Surplus / (Deficit) -

discounting internal sales367 199 (168) 1,394 1,228 (166) 3,819 3,871 52 408 820

VarianceBudget Actual Variance Budget Actual Variance BudgetCommercial Trading UnitsIn Month Year to Date Full Year Forecast Prior Year YTD

Forecast Variance Actual

Research and Development Position

Commercial Trading Unit Position

In month income is below plan by £0.13m and expenditure is below plan by £0.19m. This is as a result of determination of some income streams with research partners which has been re-phased to align with project deliverables. This does not result in an increase to the trusts bottom line as the income must be used for research activity. Year to date performance is below plan by £0.06m for income and £0.48m below plan for expenditure. The expenditure underspend is primarily as a result of extra research capability funding and infrastructure funding that has been phased equally across the year. Costs will be incurred later in the year.

Commercial income in month is below plan by £0.23m. This is due to a lower than planned level of activity in some areas offset by stronger performance in others.

Costs have continued to be below planned levels partly offsetting underperformance in income. Forecast remains to largely deliver the £4.16m surplus target

before adjustment for internal sales.

13

Cash Flow

Cash balances were £27.9m at the end of July. As predicted this has

improved from June levels, as revised CCG payments are received. During

the early part of August the remainder of these payments have also been

received.

Cash balances remain considerably behind planed by £4.2m. This is

primarily due to the drawdown of planned loans being deferred until

necessary. This has avoided the liquidity pressure of repayments and the

associated interest charges.

These changes are now being reflected in a revised internal cash plan to

support reporting. This will exclude the loan drawn down and include

planned revisions to capital expenditure. These will be reported at the

next Trust Board.

Capital Expenditure

Annual budget for capital expenditure is £35.58m. As part of the monthly

capital forecast review all schemes have been reviewed to assess any

planned slippage. Key elements of the programme have now been

reforecast. In particular Oriel land acquisition £2.4m and supporting

design fees £10.0m have been slipped to 2017/18.

Total committed capital expenditure to date is £6.35m with cash

expenditure of £3.55m and a £2.8m committed. Expenditure to date

includes investment in expansion to trust clinical estate, IT and medical

equipment.

Current forecast for capital expenditure for the year is £15.68m which

reflects slippage noted above.

Capital Expenditure (£ Millions)Annual

Budget

Expenditure

YTD

Expenditure

Committed

Expenditure

Total

% Budget

Utilised

Year End

Forecast

Estates Schemes 6.61 2.65 2.34 4.99 75% 6.61

Medical Equipment - replacement 0.48 0.07 0.07 0.14 30% 0.48

Medical Equipment - other replacement 0.50 0.00 0.00 0.00 0% 0.50

Medical Equipment - new 0.20 0.07 0.01 0.08 40% 0.20

Medical Equipment Donated 0.08 0.07 0.00 0.07 97% 0.08

Pharma 0.12 0.00 0.00 0.00 0% 0.12

Private Patients 0.75 0.00 0.00 0.00 0% 0.75

IT 2.71 0.69 0.38 1.07 40% 2.71

Corporate 0.06 0.00 0.00 0.00 0% 0.06

Strategy 24.00 0.00 0.00 0.00 0% 4.10

Contingency 1.07 0.00 0.00 0.00 0% 1.07

Carry Forward (1.00) 0.00 0.00 0.00 0% (1.00)

Total 35.58 3.55 2.80 6.35 18% 15.68

14

Cash balances were £27.9m at the end of July. As predicted this has

improved from June levels, as revised CCG payments are received.

During the early part of August the remainder of these payments

have also been received with the corresponding improvement to

cash reserves to support planned payments for capital schemes.

Cash balances are considerably behind planed by £4.2m. This is

primarily due to the drawdown of planned loans being deferred

until necessary. This has avoided the liquidity pressure of

repayments and the associated interest charges.

These changes are now being reflected in a revised internal cash

plan to support reporting. This will exclude the loan drawn down

and include planned revisions to capital expenditure. These will be

reported at the next Trust Board.

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

Jan 16 Feb 16 Mar 16 Apr 16 May 16 Jun 16 Jul 16 Jul 16 Jul 16

Welsh Debts only 1,061 11 14 16 22 20 1,144 11 1,155

NHS Service Income 1,313 (34) 1,983 35 36 1,013 4,346 1,281 5,627

Total Contract Debts 2,374 (23) 1,997 51 58 1,033 5,490 1,292 6,782

Private Patients 1,299 139 172 312 284 459 2,665 713 3,378

Pharmacy Sales 0 0 1 0 5 21 27 1,108 1,135

Sundry Debtors 682 312 312 32 940 1,191 3,469 1,542 5,011

TOTAL 4,355 428 2,482 395 1,287 2,704 11,651 4,655 16,306

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

Jul 16 Jul 16 Jul 16 Jun 16 Jun 16 Jun 16 Overdue Current Total

Welsh Debts only 1,144 11 1,155 1,124 22 1,146 1.8% (50.0%) 0.8%

NHS Service Income 4,346 1,281 5,627 3,418 1,295 4,713 27.2% (1.1%) 19.4%

Total Contract Debts 5,490 1,292 6,782 4,542 1,317 5,859 20.9% (1.9%) 15.8%

Private Patients 2,665 713 3,378 2,493 656 3,149 6.9% 8.7% 7.3%

Pharmacy Sales 27 1,108 1,135 31 1,139 1,170 (12.9%) (2.7%) (3.0%)

Sundry Debtors 3,469 1,542 5,011 3,288 1,805 5,093 5.5% (14.6%) (1.6%)

TOTAL 11,651 4,655 16,306 10,354 4,917 15,271 12.5% (5.3%) 6.8%

Debtors Management and Credit Control

Please note: Values shown in the above tables are for the stated types of debt only, and exclude UAE.

Additional items not included above comprise overall debt for the Trust, including provisions and accruals.

Comments

Overall debt has increased by £1.0m in July

to £16.3m (£15.3m June16). Total overdue

debt has increased by £1.2m in July to

£11.6m (£10.4m June 2016).

This includes bulk of £1.6m revised CCG

contracts amount for Q1 billed in June which

has become overdue in July. This amount has

been received in August.

Key debtors over 4 months overdue

NELC Group £1.6m

SWL Group £0.7m

NWL Group £0.4m

NCA CCGs Kent & Sussex Area £0.4m

Key debtors 1-3 months overdue

NELC Group £0.2m

NWL Group £0.1m

SWL Group £0.1m

NCA CCGs Kent & Sussex Area £0.1m

15

Overdue CCG debt

NEL, NWL and SWL CCG groups collectively account for £3.2m (91%) of

overdue English contract debts, £2.7m of which is over 4 months overdue.

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

with 50% of the total overdue balance of £0.7M. As is the case with all NCA

debts, an individual targeted approach is made for each debtor (125 in total).

£2.3m cash was received from 1 to 15 August, of which £2.1m was for SLA

invoices, £0.2m for 2015/16 performance/NCA invoices and £0.4m for

2016/17 performance/NCA invoices.

Overdue Sundry debt

Overdue sundry debt increased by £0.2m in July to £3.5m. £1.3m of this is

overdue from Bedford Hospital and £0.2m from Barts.

£2m cash was received from 1 to 15 August, of which £0.7m was from

Bedford Hospital.

Note: Standard NHS payment terms are 30 days from the invoice date. SLA

payments are mostly made on the 15th of each month and, once set up, tend

to run smoothly.

Delays in payment occur when data is delayed or disputed, or queries arise

which require investigation.

£4,355

£428

£2,482

£395£1,287

£2,704

£4,655

Total Debt by Age £'000

6 Mths +

5 Mths

4 Mths

3 Mths

2 Mths

1 Mth

Current

£16,306Total

£1,144

£4,346

£2,665

£27

£3,469

£4,655

Total Debt by Type £'000

Welsh Debts only

NHS Service Income

Private Patients

Pharmacy Sales

Sundry Debtors

Current

Total £16,306