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KPMG Full Page Talkbook Template

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KPMG Full Page Talkbook Template

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    1.

    3. 2 Contents

    4. 3 1. Key performance indicators

    5. 4 2.i. Income & Expenditure Summary In- month In March the Trust reported a surplus of 187k against a planned deficit of 1.3m i.e. an in-month 1.5m variance against the plan. Note: this is an artificial variance driven by the fact that corporate reserves were held in month 12 expenditure budgets. A favourable variance of 927k of the variance was income. This reflects the late payment with the PCT and one-off payments for projects in March; e.g. Productive Ward. The expenditure variance continues to reflect the operational challenges e.g. achievement of A&E targets. March continues the month-on-month improvement in our I&E position.

    6. 5 2.ii. Income & Expenditure Summary Year-to-Date Year-to-date, the Trust is reporting a surplus of 258k against a planned 655k surplus. This reflects a year-to-date 0.4m adverse variance against plan. Year-to-date income over-performance of 4.6m relates to patient activity above plan. This is predominantly due to the Hampshire PCT contract, including payment for Rehabilitation. Of the 7.1m year-to-date adverse variance on expenditure, 1.9m (35%) relates to CIPs originally budgeted as cost reduction. The balance relates to in-year cost pressures e.g. utilities and the costs related to increased activity levels.

    7. 6 Monitor Financial Risk Ratings (FRR) Monitor adopts a risk based approach to regulating NHS Foundation Trusts. To support our development towards FT a shadow FRR for the Trust has been calculated. The assessment of risk for each FT signals the degree of concern and guides the intensity of in-year monitoring. Monitor assesses each individual Trust on three main areas and assigns a risk rating, these areas are finance, governance and mandatory services the figures below relate to the FRR.

    8. 7 4. Income & SLA Performance

    9. 8 5. Cost Improvement Plan (CIP) See Annex A (page 17) for further detail re CIP monthly profile (as requested by Board in August 2008). In practice the CIP shortfall (original plans all related to reduced expenditure i.e. the same for less) is mitigated by increased income/activity levels (i.e. more for the same). Forecast activity levels, after allowing for some risk that the PCTs challenges are successful, are expected to deliver the current financial forecast. See slides 10-14 for Divisional Reports.

    10. 9 6.i. Surgery & Anaesthetics Divisional Report Year End Deficit; The Division closed the year at 2.3m adrift from their target position. Main drivers missing CIP target; 0.4m reduction in bank/agency costs; Nursing cost pressures 0.3m . MSSE and Drug cost pressures 0.7m. Hearing Aids 0.1m Financial Performance Summary Surgery & Anaesthetics is 106k adverse to target in month, after taking account of 121k of income above plan. The Division also has high levels of medical locum spend in A&E, which contribute to the in month pay variance 94k.

    11. 10 6.ii. Medicine & Elderly Care Divisional Report Year End Deficit; The Division had a year-end position of 2.2m adrift from its target position. 1.5m was the result of failure to achieve CIPs. Drug cost pressure 0.6m Financial Performance Summary Medicine and Elderly Care is 188k adverse to target in month, after taking account of 348k of income above plan. The Division has high levels of medical locum spend in A&E, which contribute to the in month pay variance 180k.

    12. 11 6.iii. Family Services Divisional Report Year End Deficit 0.9m The Division had cost pressures in year including. Drugs 0.3m; MSSE 0.1m Failed to achieve CIP pay targets in year 0.5m Financial Performance Summary Family Services is showing an adverse variance in the month of 20k adverse variances on non pay YTD reflect non achievement of CIP targets. Pay has been under pressure to cover maternity leave during the year and meet waiting list initiatives.

    13. 12 6.iv. Clinical & Diagnostics Divisional Report Divisional Action Plan to Address Year-end Trajectory The Division achieved a surplus of 1.2m favourable to its target position. Income was 0.7m over budget. SLA income over performed 0.3m; ISTC 0.2m; 0.3m misc income generation Within the overall performance non pay was overspent. Drugs 0.2m and services received (to support activity) 0.2m Financial Performance Summary Clinical & Diagnostics is favourable to target by 196k in-month. This is delivered by favourable performance against income targets (direct access pathology and radiology by GPs and other service users) plus internal recharges for activity above plan (note: internal recharges result in an equal and opposite cost to other Divisions).

    14. 13 6.v. Corporate Services Financial Performance Summary Corporate Services is 0.9m adverse in-month, and overall was overspent against budget of 627k at year end. The main reasons for the over spend were as follows: Utilities continued to overspend all year 460k, reflecting the increase in utilities costs and rates costs. Legal fees of 80k Increase in consultancy costs for project support to the Service Improvement Team.

    15. 14 7.i. Working Capital & Treasury - Balance Sheet

    16. 15 7.ii. Working Capital & Treasury - Cash Flow The Cash Flow Statement sets out the cash plan for 2008/09, along with year-to-date performance. From this, a monthly cash flow forecast has been produced, as per the 2008/09 Cash Flow Forecast chart above. Year-to-date cash spending is net 0.7m adrift of plan, this is primarily due to Higher than planned debtor levels due to the receipt of the final quarter payment of Hampshire PCT contract being receipted after the 31st March, being offset by capital under spends in cash terms, as well as by the 1.25m proceeds from the sale of Marfield House. As anticipated we have met our EFL target, subject to audit, as part of our statutory duties. See section 7.1 for explanation of debtor and creditor movements.

    17. 16 8. Capital 2008/09 Capital Programme The capital programme is funded by a combination of depreciation (c.6.7m annually), cash available from prior year slippage (c.3.6m), loan and/or the raising of additional Public Dividend Capital (PDC). The Trust is not anticipating any PDC for 2008/09. The analysis shows that the Trust has spent 5.6m 2008/09. The Capital Prioritisation Group has recognised the risk of slippage in this years programme. All capital slippage will be carried forward into the 2009/10 capital programme.

    18. 17 Annex A Profiled CIP Actual/Forecast 2008/09

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