2012/13 Finance Report Month 9

1

2

2012/13 DWMH Finance Report Month 9 Page

• Key Messages 3

• Overall Summary and RAG Assessment 4-5

• Trust Income Statement including Functional Analysis 6

• Capital Programme 7

• Activity and Income 8

• Financial Performance Metrics 9-10

• Cash Flow Statement 11

• Debtor and Creditor Performance 12

• Workforce 13-15

• Cost Improvement Target Achievement 16

• Budget Reconciliation 17

• Statement of Financial Position (Balance Sheet) 18

Key Messages

Continued strong financial

performance

• Due to continued strong financial performance the Trust Board decided to revise the forecast

surplus outturn from £1,081k to £1,800k at Month 7. This report reflects this decision.

• The Trust is reporting a year to date surplus of £1,241k, £175k ahead of the revised Month 9 plan of

£1,066k

• This revenue position delivers a Monitor Metric score of 4.05 for Month 9, ahead of the overall

original 2012/13 plan of 3.65

• The surplus is driven in the main by a large number of substantive vacancies, lower than normal

non-pay spend, continued control over temporary staffing expenditure and recovery of income

budgets though block contracts and cost and volume arrangements

• The Trust also continues to fund non-recurrent expenditure solely through non-recurrent means

CIP identified and transacted in full –

time to continue to monitor the impact

and plan for future years

• The Trust transacted the remaining 2012/13 CIP target during Month 6

• Financial achievement of the CIP is contingent on delivering the expected financial position for the

Trust

• The Trust is now focusing on the detailed planning of the 2013/14 schemes and future years under

the management of the CIP PMO

Income – Cost and Volume

performance remains strong, block

contract impact

• Income is ahead of plan to date – mainly due to negotiated block contracts for 2012/13

• Two contracts remain on cost and volume and are performing well, Birmingham and Worcestershire

Bank, Agency and locum spend is

within manageable levels, but has

increased

• The £300k contingency fund agreed at budget setting is now reduced to £2k; the balance being

committed. The forecast of break even for medical budgets remains for Month 9, although some

additional non-recurrent funding has been required to manage operational demands

• Bank and Agency spend on the wards has increased in recent months and significantly during

Month 9, particularly on Holyrood ward. Although wards remain within budget overall due to the

level of funded vacancies, this requires close monitoring to ensure this remains under control

3

Overall Summary and RAG Assessment

Commentary

Revenue Position

• Another good month for the Trust with an in month

surplus of £160k (Month 8, £163k)

• The Trust is ahead of the revised budgeted plan by

£175k at Month 9.

• As a result of the sustained strong performance seen

this financial year the forecast was revised from

£1,081k to £1,800k at Month 7 and the Trust remains

on track to achieve this

CIP 2012/13 Delivery

• The Trust transacted the full balance of CIP during

Month 6, resulting in full delivery for 2012/13 and is now

concentrating on detailed planning for future years

Cash

• The cash balance reflects the strong revenue

performance, and remains significantly ahead of plan.

This reflects the principal fact that there remains

expenditure to be incurred on agreed Strategic Change

Reserve schemes

Capital

• Both of the major capital schemes for 2012/13, the

Canalside project, and the DPH Block 7 project, were

nearing completion as at 31st December 2012.

Budgetary Reserves

• The majority of the Strategic Change Reserve monies

have been devolved to Corporate and Operational

Services. The Trust’s recurrent reserve is now

committed.

4

Statement of Comprehensive Income - Financial Position to 31st December 2012

Annual In Month Year To Date

Plan Plan Actual Variance Plan Actual Variance

Income £000 £000 £000 £000 £000 £000 £000

Revenue From Activities

Revenue-NHS Clinical 63,812 5,318 5,312 (6) 47,858 47,882 24

Revenue-Non NHS Clinical 174 15 17 2 134 147 13

Total Revenue From Activities 63,986 5,333 5,329 (4) 47,992 48,029 37

Other Operating Revenue

Revenue-Education & Training 1,473 120 131 11 1,106 1,177 71

Revenue NHS Non-Clinical 857 67 84 17 655 633 (22)

Other Revenue 613 51 50 (1) 460 560 100

Revenue-Employee Benefits 694 58 60 2 520 563 43

Total Other Operating Revenue 3,637 296 325 29 2,741 2,933 192

Total Revenue 67,623 5,629 5,654 25 50,733 50,962 229

Expenditure

Pay (49,545) (4,154) (4,041) 113 (37,020) (35,983) 1,037

Clinical Supplies and Services (1,917) (160) (156) 4 (1,438) (1,364) 74

Other Costs (11,081) (982) (1,032) (50) (7,895) (8,511) (616)

Expenditure Reserves (498) 147 (26) (173) (1,226) (1,776) (550)

Total Operating Expenditure (63,041) (5,149) (5,255) (106) (47,579) (47,634) (55)

EBITDA 4,582 480 399 (81) 3,154 3,328 174

Depreciation (1,238) (116) (113) 3 (929) (929) 0

Amortisation (219) (18) (18) 0 (164) (164) 0

Net Operating Surplus 3,125 346 268 (78) 2,061 2,235 174

PDC (1,350) (113) (113) 0 (1,013) (1,013) 0

Interest Receivable 25 2 2 0 19 19 0

Net Surplus /(Deficit) 1,800 237 160 (77) 1,066 1,241 175

Technical Adjustment 0 0

Technical Surplus 1,800 237 160 (77) 1,066 1,241 175

Overall Summary and RAG Assessment Continued

5

0200400600800

1,0001,2001,4001,6001,8002,000

£'0

00

Run Rate 2012/13Cumulative Budgeted Planned Run RateRevised Cumulative Budget

Actual Run Rate

Expected Run Rate

0

500

1,000

1,500

2,000

2,500

£'0

00

Capital Programme 2012/13

Cumulative Planned Spend

Cumulative Actual Spend

Revised Expenditure Profile

£2,781k

£2,804k

0 1,000 2,000 3,000

CIP Target

Transacted

£'000

CIP 2012/13

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Actual vs Forecast Cash 12/13 and Beyond

Actual Cash Forecast Cash 12/13 Cash Benchmark

Trust Income Statement Including Functional Analysis

Commentary

• Healthcare income continues to perform well,

despite a small under-performance in NCAs

against budget this month

• The IT network infrastructure costs are

reflected in the IT overspend to date. To be

reviewed through budget setting process. An

extension of IT Contract staff has been agreed

until March 2013, increasing the cost pressure

to the IT function

• Corporate Operations under spend includes

vacancies held within the Psychology

management structure

• Estates budgets are over spent due to

recurrent cost pressures in the Facilities

contract and Walsall Locality recharges from

NHS Dudley

• Estates costs are increasing due to the Estates

service SLA remaining constant despite taking

on posts internally in preparation for a full in-

house Estates service

• Within Acute & Older Adult services, a year to

date under spend has been generated from

vacancies in CRHT and in Older Adult CMHTs,

and lower than average ward costs in the early

part of the year

• Early Intervention services include high number

of vacancies in the Primary Care and CAMHS

teams

• Recovery under spend is due to vacant posts

within Day Services, pre-ST

• The YTD medical under spend is a timing issue

only, in particular training budgets are under

spent year to date. Medical services hold an

uncommitted contingency budget at Month 9 of

£2,000

• HR department is forecast to under spend due

to slippage on a non-recurrent Workforce

vacancy with a delay to recruitment

6

Annual Plan In Month Year to Date

Variance

Forecast I&E

2012/13 Plan Actual Variance Plan Actual Variance Outturn Outturn

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

Revenue From Activities

NHS Dudley 28,550 2,379 2,379 0 21,412 21,412 0 0 28,550

NHS Walsall 30,400 2,534 2,534 0 22,799 22,786 (13) (13) 30,387

Birmingham contracts 483 40 41 1 362 429 67 75 558

Sandwell PCT 1,926 160 161 1 1,444 1,444 0 0 1,926

South Staffs PCT 391 33 33 0 293 293 0 0 391

Wolverhampton PCT 491 41 41 0 368 368 0 0 491

Worcestershire PCT 32 3 5 2 24 36 12 15 47

NCG 1,389 116 116 0 1,042 1,042 0 0 1,389

NCAs 150 13 3 (10) 113 72 (41) (50) 100

Total Revenue From Activities 63,812 5,319 5,313 (6) 47,857 47,882 25 27 63,839

Corporate Functions

Chief Executive (739) (64) (53) 11 (547) (527) 20 2 (737)

Corporate Affairs (1,152) (104) (84) 20 (842) (818) 24 14 (1,138)

Corporate Medical (909) (84) (84) 0 (656) (666) (10) 4 (905)

Corporate Operations (2,020) (188) (173) 15 (1,456) (1,262) 194 124 (1,896)

Corporate Estates (2,757) (237) (251) (14) (2,045) (2,340) (295) (349) (3,106)

Corporate Finance (1,196) (101) (100) 1 (894) (900) (6) 6 (1,190)

Corporate Performance & IT (2,433) (223) (216) 7 (1,766) (2,014) (248) (228) (2,661)

Corporate Human Resources (1,342) (117) (104) 13 (964) (801) 163 17 (1,325)

Central Reserves (498) 147 (26) (173) (1,226) (1,776) (550) (366) (864)

Total Corporate Functions (13,046) (971) (1,091) (120) (10,396) (11,104) (708) (776) (13,822)

Operational Services

Acute and Older Adults

Management and Administration (937) (71) (49) 22 (639) (480) 159 195 (742)

Acute Services (8,837) (736) (676) 60 (6,626) (6,314) 312 371 (8,466)

Acute Estates (3,998) (332) (351) (19) (3,023) (3,071) (48) (55) (4,053)

Older Adults (6,319) (528) (588) (60) (4,736) (4,863) (127) (241) (6,560)

Total Acute & Older Adults (20,091) (1,667) (1,664) 3 (15,024) (14,728) 296 270 (19,821)

Community Services

Management and Administration (552) (65) (84) (19) (356) (386) (30) (91) (643)

Community Services (4,231) (358) (361) (3) (3,168) (3,126) 42 26 (4,205)

Early Intervention (6,873) (573) (523) 50 (5,155) (4,714) 441 477 (6,396)

Recovery Services (3,848) (320) (294) 26 (2,886) (2,769) 117 177 (3,671)

Community Estates (1,165) (109) (136) (27) (853) (897) (44) (110) (1,275)

Total Community Services (16,669) (1,425) (1,398) 27 (12,418) (11,892) 526 479 (16,190)

Medical Services (12,231) (1,021) (1,003) 18 (8,972) (8,937) 35 0 (12,231)

Psychology Services 0 0 0 0 0 0 0 0 0

Total Operating Services (62,037) (5,084) (5,156) (72) (46,810) (46,661) 149 (27) (62,064)

Sub Total 1,775 235 157 (78) 1,047 1,221 174 0 1,775

Interest Receivable 25 2 3 0 19 20 1 0 25

Net Surplus/(deficit) 1,800 237 160 (78) 1,066 1,241 175 0 1,800

Technical Adjustment 0 0 0 0 0

Technical Surplus 1,800 237 160 (78) 1,066 1,241 175 0 1,800

Capital Programme

7

Commentary

• Dorothy Pattison Block 7 –

VAT ruling received - 54% of VAT

to be recovered on Openspace

invoices (£40k to be recovered on

December VAT return)

All 3 valuations included in

expenditure to date – project to be

finished and account to be finalised

11/01/2013

• New Hill House –

Fences only to be funded from

2012/13 Capital Expenditure –

detail awaited

• Canal Side Capital Works –

Requested forecast final spend on

this project as substantially

complete as of 31st December 2012

Proposed Capital Funding April 12 – March 15 2012/13 2013/14 2014/15

£'000 £'000 £’000

MHPT depreciation 1,365 1,435 1,505

Proceeds from Sale of Non Current Assets 0 100 0

Proposed Cash to capital conversion 460 390 0

Total Funding Available 1,825 1,925 1,505

Expenditure YTD

Proposed Capital Schemes 2012/13 2012/13 Actual Accrued Total Variance

Priority £'000 £'000 £'000 £'000 £'000

Schemes not completed Prior Years

DPH Bathrooms Complete 34 34 0 34 0

BFH Aid Call Complete 11 12 0 12 -1

Kings Hill Refurbishment Complete 24 24 0 24 0

Schemes proposed for 2012/13

Dorothy Pattison Block 7 (Ambleside to Grasmere) Started 760 597 0 597 163

Canal Side Capital Works Started 600 415 2 417 183

BFH Entrance to Wards Complete 10 6 0 6 4

BFH Window Replacement (Kinver & Wrekin) Complete 108 108 0 108 0

Relocation of Modular Building to BFH Started 30 20 0 20 10

Blakenall Village Centre Added Space Started 60 46 0 46 14

BFH Sky Lights A/B

BFH Street Lights B 40 0 0 0 40

DPH Switchboard C 15 0 0 0 15

BFH Ventilation & Heating 30 0 0 0 30

BFH Sandringham Refurbishment Complete 5 5 0 5 0

New Hill House 0 0

Digital Dictation - Big Hand Started 67 0 0 0 67

Utensil Washer Complete 14 15 0 15 -1

Contingency 17 0 0 0 17

Total Cost of Proposed Schemes 1,825 1,282 2 1,284 541

Activity and Income

Commentary

• Activity recording continues to

rise, With quarter 3 being

marginally up on quarters 1 and

2. This is particularly

encouraging given that quarter 3

included the Christmas period.

• This suggests an underlying

increase in the levels of activity

recorded and reflects work

underway to improve this.

• Financial performance is also

strong as a result. Although the

majority of the Trust's income is

now on shadow cost and

volume (block), strong activity

recording will help safeguard

baseline income levels going

forward and will help during

contract negotiations

• Commissioners have indicated

that some services may be on

cost and volume contracts for

2013/14, specifically those

currently outside of care cluster

development.

• Walsall's contract is showing an

underperformance of £12k

which represents

underperformance on 2011/12

CQUIN schemes.

8

Service name Currency Q1 Q2 Q3

Total Of

Recorded Value

Over/(Under) Performance

(£)

Consultant Services : Outpatient Setting : Adult Other : First Attend Appointment 244 254 320 818 (211)

Consultant Services : Outpatient Setting : Adult Other : Follow Up Attend Appointment 3,306 3,301 3,165 9,772 (27,579)

Consultant Services : Community Setting : Adult Other : First Appointment 1 2 6 9 (8,429)

Consultant Services : Community Setting : Adult Other : Follow Up Attend Appointment 22 21 18 61 (18,044)

Consultant Services : Outpatient Setting : Elderly : First Attend Appointment 64 53 50 167 (23,817)

Consultant Services : Outpatient Setting : Elderly : Follow Up Attend Appointment 306 263 309 878 9,679

Consultant Services : Community Setting : Elderley : First Attend Appointment 156 181 166 503 (4,445)

Consultant Services : Community Setting : Elderley : Follow Up Attend Appointment 458 543 495 1,496 17,237

Inpatients : Adult : Intensive Care ECA Bed Day 53 69 59 181 4,288

Inpatients : Adult : Acute Care Bed Day 7,685 7,466 8,338 23,489 (135,671)

Inpatients : Elderly Bed Day 4,898 4,937 4,976 14,811 (33,642)

Inpatients : Rehab Bed Day 724 717 709 2,150 (3,039)

Day Care Facilities : Regular Attendances : Adult Day Rate 1,254 1,264 1,070 3,588 (44,286)

Day Care Facilities : Regular Attendances : Elderly Day Rate 1,856 2,064 1,739 5,659 106,871

Memory Clinic Day Rate 657 726 737 2,120 108,197

Community Mental Health Team : Adult Face To Face Contact 11,010 11,862 12,037 34,909 188,695

Community Mental Health Team : Adult Non Face To Face Contact 1,068 1,202 1,390 3,660 19,940

Elderly Services Community Team Face To Face Contact 3,654 3,776 3,493 10,923 (138,341)

Elderly Services Community Team Non Face To Face Contact 679 992 950 2,621 29,142

Primary Care Team Face To Face Contact 10,566 10,461 11,418 32,445 416,874

Primary Care Team Non Face To Face Contact 169 202 331 702 1,829

Therapeutic Recovery Service Face To Face Contact 1,373 1,131 1,138 3,642 (89,778)

Therapeutic Recovery Service Non Face To Face Contact 25 23 21 69 (2,889)

AMH Employment Services Face To Face Contact 575 565 460 1,600 (5,075)

AMH Employment Services Non Face To Face Contact 313 315 338 966 1,871

Adult Eating Disorder Community Team Face To Face Contact 272 290 229 791 6,094

Adult Eating Disorder Community Team Non Face To Face Contact 6 3 11 20 (1,300)

Crisis Resolution Home Treatment Team: Adult Face To Face Contact 5,939 6,460 6,888 19,287 134,210

Crisis Resolution Home Treatment Team: Adult Non Face To Face Contact 1,485 1,445 1,688 4,618 69,286

Assertive Outreach Team : Adult Face To Face Contact 2,001 1,622 1,500 5,123 (442,478)

Assertive Outreach Team : Adult Non Face To Face Contact 111 141 149 401 (5,391)

Early Intervention in Psychosis Service: Adult Face To Face Contact 1,985 2,007 1,808 5,800 8,002

Early Intervention in Psychosis Service: Adult Non Face To Face Contact 109 83 163 355 2,129

Other Mental Health Specialist Teams: Child Face To Face Contact 4,320 4,353 4,530 13,203 76,802

Other Mental Health Specialist Teams: Child Non Face To Face Contact 167 307 246 720 12,589

Drug & Alcohol Teams: Adult Face To Face Contact 6,559 6,878 6,499 19,936 1,586

Drug & Alcohol Teams: Adult Non Face To Face Contact 2,321 2,691 2,341 7,353 12,537

Criminal Justice Liaison Team Face To Face Contact 506 353 244 1,103 45,674

Criminal Justice Liaison Team Non Face To Face Contact 70 116 70 256 10,386

Psychiatric Liaison Team Face To Face Contact 390 426 508 1,324 30,276

Psychiatric Liaison Team Non Face To Face Contact 195 195 210 600 9,871

Clinical Psychology Face To Face Contact 3,059 2,749 2,094 7,902 8,678

Clinical Psychology Non Face To Face Contact 135 263 105 503 2,112

Unadjusted Total before CQUIN 80,746 82,772 83,016 246,534 350,440

CQUIN 6,843

Unadjusted Total 357,282

Adjustment for Walsall Shadow as not on cost and volume (199,972)

Adjustment for Dudley Shadow as not on cost and volume 81,080

Adjustment for Sandwell Shadow as not on cost and volume (134,379)

Adjustment for Wolverhampton Shadow as not on cost and volume 34,201

Adjustment for South Staffs Shadow as not on cost and volume 20,415

Sub Total 158,629

NCA Budget (112,500)

Walsall 11/12 Write Back - CQUIN (12,059)

Birmingham 11/12 Write Back (3,432)

NCAs 11/12 Write Back (5,209)

Roundings (13)

As Per Ledger Month 9 25,416

Financial Performance Metrics

9

Commentary – Financial Performance Metrics Slide 10

• These metrics represent Monitor’s Compliance Framework “early warning indicators” – measures that may indicate future financial difficulty, and have been adopted by

the SHA as part of their Provider Management Regime, which the Trust is required to report on monthly

• The analysis provided shows that this month the Trust is rated green against all criteria except for one relating to the Working Capital Facility (WCF). The Trust Board

made a decision to procure a Working Capital Facility at the Trust Board meeting in December. The agreement does contain a default clause, although the Trust has

worked extensively with the chosen provider on wording of this clause to ensure it meets the definition of a committed facili ty

• The Trust had previously reported spending less than 75% of planned capital expenditure year to date. As expected and reported, capital expenditure increased,

meaning that this criteria is also now rated green

• Regarding the <5% of debtors being over 90 days target, and Trust excludes those balances provided for in the I&E position already, and those balances where

payment has been agreed and is expected. The Trust has transparently informed the NTDA of this method of calculation

Commentary

• Strong Monitor metric performance

continues, reflected by the strong

revenue performance year to date

• The top table reflects the Trust’s original

plan, and the revised plan reflecting the

revised planned surplus, against which

Month 9 performance is measured

• All metrics have maintained scores from

last month, delivering an overall metric

of 4.05

• The new LTFM has brought with it a

change to the ROA metric; this is now

called NRAF and adjusts for any debt

used to fund the purchase of assets

Monitor Financial Risk Rating

Metric

Original

Plan

Original

Score -

Plan

PlanScore -

Plan

Weighted

FRR - Plan

Actual -

Month 09

Score - Actual

Month 09

Weighted FRR

- Actual Month

09

EBITDA margin 5.6% 3 6.8% 3 0.75 6.5% 3 0.75

EBITDA, % achieved 100.0% 5 100.0% 5 0.50 105.5% 5 0.50

Net Return after Financing 2.4% 4 3.9% 5 1.00 3.6% 5 1.00

I&E surplus margin 1.6% 3 2.7% 4 0.80 2.4% 4 0.80

Liquidity ratio 50.3 4 50.8 4 1.00 53.4 4 1.00

Weighted Average 3.65 4.05 4.05

Amended FRR Criteria Metric Weight 5 4 3 2 1

EBITDA margin 25% 11% 9% 5% 1% <1%

EBITDA, % achieved 10% 100% 85% 70% 50% <50%

Net Return after Financing 20% 3% 2% -1% -5% < -5%

I&E surplus margin 20% 3% 2% 1% -2% < -2%

Liquid ratio (Days) 25% 60 25 15 10 <10

10

Financial Performance Metrics Continued

Criteria Qtr to Mar-12 Qtr to Jun-12 Qtr to Sep-12 Oct-12 Nov-12 Dec-12Qtr to Dec-

12

1 Unplanned decrease in EBITDA margin in two consecutive quarters No No No No No No No

2Quarterly self-certification by trust that the financial risk rating (FRR) may be less than 3 in

the next 12 monthsNo No No No No No No

3 Working capital facility (WCF) agreement includes default clause Yes Yes

4 Debtors > 90 days past due account for more than 5% of total debtor balances No No No No No No No

5 Creditors > 90 days past due account for more than 5% of total creditor balances No No No No No No No

6 Two or more changes in Finance Director in a twelve month period No No No No No No No

7 Interim Finance Director in place over more than one quarter end No No No No No No No

8 Quarter end cash balance <10 days of operating expenses No No No No No No No

9 Capital expenditure < 75% of plan for the year to date No No Yes No No No No

Cash Flow Statement

11

Commentary

Cash Flow

• The Trust made an operat ing surplus of

£2,236k YTD, and received cash of £1,093k in

respect of depreciat ion and amort isat ion

• Trade and Other Receivables increased over

the period (a negat ive impact on cash)

• Trade and Other Payables increased over

the period (a posit ive impact on cash)

• Dividend w as paid for the first half of the

year in September (a negat ive impact on

cash in the month)

• The Trust received £18k of interest , and

spent £1,246k on capital. Capital

Expenditure w as therefore greater than the

cash received for depreciat ion and

amort isat ion (a negat ive impact on cash)

• The impact of all these movements w as to

increase the Trust ’s cash balance over the

period by £4,542k

Cash Benchmark for March 2013

• This figure assumes zero w orking capital

movements, a 12/ 13 financial surplus of

£1,800k and a cash to capital t ransfer of

£460k. This is a useful figure to compare

actual cash against as the year progresses

£'000

Cash Flows from Operating Activities

Operating Surplus/(Deficit) 2,236

Depreciation and Amortisation 1,093

(Increase)/Decrease in Trade and Other Receivables (368)

Increase/(Decrease) in Trade and Other Payables 3,491

Increase/(Decrease) in Provisions 25

Dividend Paid (707)

Net Cash Inflow/(Outflow) from Operating Activities 5,770

Cash Flows from Investing Activities

Interest received 18

(Payments) for Property, Plant and Equipment (1,246)

Net Cash Inflow/(Outflow)from Investing Activities (1,228)

Net Cash Inflow/(Outflow) before Financing 4,542

Cash Flows from Financing Activities 0

Net Increase/(Decrease) in Cash 4,542

Cash at the Beginning of the Period 6,932

Cash at the End of the Period 11,474

EBITDA at 31 December 2012 as per Summary Schedule 2 3,329

Deduct Depreciation and Amortisation (1,093)

Operating Surplus at 31 December 2012 2,236

Cash Benchmark

Opening cash 6,932

Planned surplus (updated to reflect increase at Month 7) 1,800

Planned cash to capital transfer (460)

Forecast Cash 31 March 2013 8,272

Payables Performance

12

Commentary

Better Payment Practice Code

• The Trust has paid over 95% of non

NHS invoices (by value) within 30

days YTD

• BPP performance improved across

all measures in December

• BPP performance may worsen in

January due to the fact that the last

payrun in December was processed

on the 18th of the month

• Performance has recovered to an

extent following poor performance

in November 2012

Aged Receivables Profile by Value

• Aged receivables have decreased

by £775k (69%) in December to

£344k. £500k relates to SCR

monies received in December

• The value of receivables aged

greater than 90 days has

decreased by 70% in the month,

from £449k to £133k. This is as a

result of the SCR monies being

paid by NHS Dudley.

Better Payment Practice Code

On Time Late Total On Time

(%)

Late

(%)

On Time

£

Late

£

Total

£

On Time

(%)

Late

(%)

Number Of Transactions Non-NHS Value Of Transactions Non-NHS Av days

Qtr 1 3,669 232 3,901 94.05% 5.95% 6,000,347 113,584 6,113,931 98.14% 1.86%

Qtr 2 3,148 397 3,545 88.80% 11.20% 5,829,693 146,861 5,976,554 97.54% 2.46%

Month 7 1,041 88 1,129 92.21% 7.79% 1,857,396 87,961 1,945,357 95.48% 4.52%

Month 8 1,237 231 1,468 84.26% 15.74% 2,099,559 167,229 2,266,787 92.62% 7.38%

Month 9 836 75 911 91.77% 8.23% 1,868,718 48,859 1,917,577 97.45% 2.55%YTD 9,931 1,023 10,954 90.66% 9.34% 17,655,712 564,493 18,220,206 96.90% 3.10% 15.83

Number Of Transactions NHS Value Of Transactions NHS

Qtr 1 85 4 89 95.51% 4.49% 926,129 65,433 991,562 93.40% 6.60%

Qtr 2 95 15 110 86.36% 13.64% 1,231,029 297,277 1,528,306 80.55% 19.45%

Month 7 33 6 39 84.62% 15.38% 386,329 79,434 465,763 82.95% 17.05%

Month 8 26 15 41 63.41% 36.59% 196,854 228,095 424,949 46.32% 53.68%

Month 9 24 7 31 77.42% 22.58% 266,001 40,984 306,986 86.65% 13.35%YTD 263 47 310 84.84% 15.16% 3,006,342 711,223 3,717,565 80.87% 19.13%

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

1,600,000

1,800,000

Jan

-12

Feb

-12

Mar

-12

Ap

r-1

2

May

-12

Jun

-12

Jul-

12

Au

g-1

2

Sep

-12

Oct

-12

No

v-1

2

Dec

-12

£

Month

Aged Receivables Profile by Value

Bal (120+)

Bal (91-120)

Bal (61-90)

Bal (31-60)

Bal (0-30)

13

Workforce

Commentary

• In Acute Services: w ard overt ime, bank and agency staff are less than funded vacancies

• In Older Adult Services: w ard overt ime, bank and agency staff exceed funded vacancies , to a larger extent than during Month 8

• In Medical Services there w ere 10.20 high cost agency locums (6.20 in Dudley & 4 in Walsall) plus 2.20 agency medical secretaries

• Corporate movements in agency WTE are due to changes in consultancy & agency t reatment

• Month on month, funded establishment remains stable

Function Funded WTE

Actual Worked

WTE

(substantive staff)

Actual Worked

WTE

(bank staff)

Estimated WTE

(agency staff)

Total Actual

WTE

Variance

WTE

Variance WTE

Month 8

Acute Management 24.34 20.92 0.00 1.73 22.65 1.69 1.54

Acute Services 250.94 203.12 28.35 7.39 238.86 12.08 5.27

Acute Estates 21.13 21.56 0.18 0.00 21.74 (0.61) (1.08)

Older Adult Services 188.75 160.10 25.91 29.20 215.21 (26.46) (14.69)

Medical Services 114.40 100.79 0.00 12.40 113.19 1.21 1.06

Community Services 104.26 99.19 1.05 2.79 103.03 1.23 0.72

Community Management 6.00 5.36 0.00 6.31 11.67 (5.67) (5.96)

Early Intervention Services 174.54 143.03 0.00 13.56 156.59 17.95 17.84

Recovery Services 105.74 94.66 1.76 0.49 96.91 8.83 6.96

CEO 7.87 8.85 0.00 1.00 9.85 (1.98) (2.34)

Corporate Affairs 16.14 14.88 0.00 2.00 16.88 (0.74) 0.20

Corporate Medical 6.20 2.00 0.00 0.00 2.00 4.20 4.20

Corporate Ops (incl Gov) 55.36 48.86 0.00 0.00 48.86 6.50 6.82

Finance 15.32 16.60 0.00 2.00 18.60 (3.28) (3.53)

IT 1.00 0.00 0.00 1.00 1.00 0.00 0.00

Estates 5.72 4.58 0.00 2.00 6.58 (0.86) 0.14

Performance 13.91 14.15 0.00 2.00 16.15 (2.24) (2.00)

HR 39.36 32.83 0.00 2.00 34.83 4.53 4.13

1,150.98 991.48 57.25 85.88 1,134.61 16.37 19.27

14

Workforce Continued (1)

Commentary

Current posit ion

• This month the presentat ion has

changed to reflect changing

operat ional circumstances and the

subsequent impact on the current

forecast versus the original plan

• Dudley had 6.2 agency locums and 1

Trust -paid locum against 6 vacant

posts and 2 staff on maternity leave

• Walsall had 4 agency locums covering

3 vacant posts plus 2 instances of sick

leave

• Year to date costs exceed forecast due

to the t iming of locum leave and

unplanned sick leave

• Temporary staff usage on inpat ient

areas relates to cover of vacancies,

long term sick or maternity leave

cover, high observat ion levels

• Acute w ards under spent by £42k on

staffing overall in-month, including a

£15k under spend on Langdale

result ing from low usage of ECA and

low er than average observat ion levels

£0

£5,000

£10,000

£15,000

£20,000

£25,000

£30,000

£35,000

£40,000Temporary Staffing Analysis - Adult Acute Wards

Clent

Kinver

Wrekin

Ambleside

Langdale

0

50000

100000

150000

200000

250000

300000

Oct

-11

No

v-1

1

Dec

-11

Jan

-12

Feb

-12

Mar

-12

Ap

r-1

2

May

-12

Jun

-12

Jul-

12

Au

g-1

2

Sep

-12

Oct

-12

No

v-1

2

Dec

-12

Jan

-13

Feb

-13

Mar

-13

Medical Locum Spend Analysis and Forecast

Original Forecast at M2

Actual

Current Forecast

15

Workforce Continued (2)

Commentary

• Temporary staff usage on

inpat ient areas relates to cover of

vacancies, long term sick or

maternity leave cover, and special

observat ions (the high costs at

Bloxw ich in recent months result

from a combinat ion of all of these

factors occurring simultaneously)

• Older adult w ards overspent by

£79k in-month, but this w as

part ially mit igated by £18k of

savings against other OA budgets

(e.g. vacancy savings in OA

CMHTs, day centres, psychology)

• The sharp increase in Holyrood

temporary staffing in Mth 8-9

mainly relates to a number of

pat ients present ing w ith

challenging behaviours (result ing

from lack of alternat ive

provision), requiring unusually

high observat ion levels,

combined w ith higher than

average w ard occupancy

£0

£10,000

£20,000

£30,000

£40,000

£50,000

£60,000

£70,000

£80,000

£90,000

Temporary Staffing Analysis - Older Adult Wards

Holyrood

Malvern

Cedars

Linden

16

Cost Improvement Target Achievement

Commentary

• The Trust has transacted all CIP for 2012/13

• Total transacted to date is £2,764k against a revised target (after taking last year’s over-achievement into account) of £2,740k. The extent to which

these identified schemes are considered delivered will be measured through achievement of the Trust’s forecast surplus as the year progresses.

This remains on revised plan

• Schemes planned for 2012/13 that have not delivered to date are still expected to do so and will contribute towards future years targets

• It is vital that the Trust continues to identify and deliver CIP two years in advance, in accordance with requirements relating to performance

management and identifying the impact of service change on quality and safety. A CIP Project Management Office is now in place

Operations Medical Estates Corporate Inflation Productivity Total

2011-12 CIP Carried Forward (389,152) 348,424 (40,728)

2012-13 CIP Target 2,781,000

Revised CIP Target 2,740,272

CIP 12 -13 Transacted Month 1 457,955 687,000 - 420,476 625,000 200,000 2,390,431

CIP 12 -13 Transacted Month 2 - - 23,600 - - - 23,600

CIP 12 -13 Transacted Month 4 57,373 - - - - - 57,373

CIP 12 -13 Transacted Month 6 163,036 - - 60,173 69,000 - 292,209

Total CIP Identified 678,364 687,000 23,600 480,649 694,000 200,000 2,763,613

Planned full year over-achievement (678,364) (687,000) (23,600) (480,649) (694,000) (200,000) (23,341)

17

Budget Reconciliation – Expenditure Budget Movement

Commentary

• Small funding of cost

pressure movements and

budget virements during

Month 9

Contract

Income

Corporate

Costs

Acute & Older

Adult

Community

Services

Medical

Services

Psychology

ServicesReserves Dep'n & PDC

Interest

ReceivableSurplus

Budgets approved by Trust Board (61,689,684) 9,450,835 17,684,952 15,280,224 12,018,167 1,544,270 2,022,619 2,632,000 (25,000) (1,081,617)

Adjustment for Depn.& PDC (210,000) (2,069,000) (349,000) (4,000) 2,632,000 0

Net Budgets (61,689,684) 9,660,835 19,753,952 15,629,224 12,018,167 1,548,270 2,022,619 0 (25,000) (1,081,617)

Total - Month 08 (63,810,871) 12,663,268 20,090,927 16,642,975 12,220,912 0 417,790 0 (25,000) (1,799,999)

SCR Adjustments -30,000 30,000 0

Medical appointment - Dr Das 10,439 (10,439) 0

Walsall CRS South Appointment 5,870 (5,870) 0

Funding of Depreciation (Canalside) 19,118 (19,118) 0

Trf of Estates Budgets -80,000 80,000 0

Miscellaneous movement -453 453 0

Total - Month 09 (63,810,871) 12,583,268 20,140,474 16,668,416 12,231,351 0 412,363 0 (25,000) (1,799,999)

Statement of Financial Position

18

Commentary

Non Current Assets

• Capital expenditure is higher than the depreciat ion

and amort isat ion charges YTD. This has led to an

increase in total non current assets of £192k since 31

March 2012. Progress against capital schemes is

review ed in Slide 7

Current Assets

• Receivables are £369k greater than at 31 March 2012

• Cash is £4,542k higher than the balance at 31 March

2012. An analysis of cash flow s can be seen elsew here

in this report

Current Liabilities

• Payables have increased significant ly YTD by £3,836k.

This is part ly due to accrued commit ted expenditure

against Strategic Change Reserve schemes

Provisions

• This balance is made up of provisions for consultant

contracts and staff on fixed term contracts

Tax Payers’ Equity

• The only change from March 2012 is the addit ion of

the YTD surplus of £1,241k

31 March 2012 31 December

2012

Movement

£000 £000 £000

Non-Current Assets

Property, Plant and Equipment 41,535 41,891 356

Intangible Fixed Assets 929 765 (164)

Total Non-Current Assets 42,464 42,656 192

Current Assets

Receivables less than one year 1,488 1,857 369

Cash (OPG and Other) 6,932 11,474 4,542

Total Current Assets 8,420 13,331 4,911

Current Liabilities

NHS Payables less than one year (393) (1,491) (1,098)

Payables less than one year (4,867) (7,605) (2,738)

Provisions less than one year (33) (58) (25)

Total Current Liabilities (5,293) (9,154) (3,861)

Net Current Assets less Liabilities 3,127 4,177 1,050

Provisions greater than one year (476) (476) 0

Total Assets less Current Liabilities 45,115 46,357 1,241

Financed by Tax Payer Equity:

Public Dividend Capital (48,321) (48,321) 0

Revaluation Reserve (96) (96) 0

I&E Reserve b/f 3,302 3,302 0

Current Year I&E 0 (1,241) (1,241)

Total Taxpayers' Equity (45,115) (46,357) (1,241)