Title of Report Executive Summary Agenda Item: 22 Finance Committee Minutes – 2/8/07 & 6/9/07 The minutes from the monthly Finance Committee held in August and September, detail summaries of the financial performance in each operational division and actions requested from Non-Executive Directors. The Board is asked to note the contents of the minutes. Actions requested Corporate Objectives supported by this paper: 4) We want to maintain the viability of the Trust by improved efficiency and effectiveness (using benchmarking and economies of scale where appropriate) and ensuring that high quality services are provided cost effectively Key issues / Risks: Not relevant for this paper (see Finance Report) Public and/or patient involvement: Not relevant for this paper Resource implications: Not relevant for this paper Communication: Updates on the Trust’s financial performance are included in regular briefings to staff Name Job Title Month and Year Email Mr Barry Livesey Acting Director of Finance November 2007 [email protected] FINANCE COMMITTEE MINUTES OF THE MEETING HELD 2 AUGUST 2007 Present: Part I – Corporate Overview Mr J Jesky, Chairman (in the Chair) Mr J Battye, Non Executive Director Mr H Griffith, Non Executive Director Mrs B Herring, Programme Director - Finance Mr M Holly, Non Executive Director Ms K James, Director of Operations Mr B Livesey, Associate Director of Finance Mr J Saxby, Chief Executive Mrs A Unwin, Non Executive Director Part II – Divisional Review Medicine Mr S Farey, Divisional Director Mrs J Moore, Divisional Accountant Surgery Mrs S Lunt, Divisional Director Women & Children Mrs S Taylor, Divisional Accountant Diagnostic Mrs J Wood, Divisional Director Mr G Boothby, Divisional Accountant Apologies: Mr R Chadwick, Director of Finance and IM&T Mr T Wilders, Director of Strategic Planning Mrs M Carroll, Director of Nursing Mr R Pickering, Director of Human Resources Mr J Wilkes, Director of Facilities Mr J Lindars, Divisional Director Mr G Thompson, Divisional Accountant Part I 49/07 MINUTES OF THE LAST MEETING The minutes of the last meeting held on 12 July 2007 were received and approved as a correct record, with an amendment; Mr Saxby asked that minute 41/07 show the planned surplus for the year. This amendment was agreed. MATTERS ARISING 39/07 Mr Jesky reported that Fin McNicol is preparing a press release on the financial position for 20 June 2007. 43/07 Mr Livesey reported that the analysis of the Financial Recovery Plan (FRP) to show responsibility by Executive Director is being done and will be available in the July FRP summary. 42/07 Mr Saxby reported that he had asked Mr Wilkes, Turnaround Director to reinvigorate the salary sacrifice scheme or look for a substitute scheme to achieve the same level of savings. Page 1 of 5 ACTION ACTION 41/07 Mr Griffith referred to the analysis of income for May 2007. The answer is Yes. 51/07 Finance Report to 30 June 2007 Mr Livesey presented this report and explained the revised format which focuses on key targets and risks. • • • • • • • 52/07 The Trust remains on target to achieve its planned surplus of £4,960,000. Neither the External Finance Limit (EFL) nor the Capital Resource Limit (CRL) have been confirmed by the SHA. Financial plans for the capital programme and cash flows are therefore currently based on anticipated EFL and CRLs. The Trust is not expecting to have to borrow funds this year, based on these estimated figures. Expenditure budgets are overspent by £85,000 at the end of June. This is an encouraging trend given that the overspend in April was £195,000 and in May was £144,000. Income budgets are marginally underachieving although activity is ahead of target. This variance is due to casemix variations. The year end forecast remains an overachievement of £382,000. At this stage in the year it is not expected that the planned profit on sale of assets will be fully achieved. An alternative plan is being developed to take effect this financial year. Cash balances are £24m - ahead of plan by £8m. There are issues to be resolved with the SHA concerning funding for the PACS project and the capital development of the ‘Making it Better’ review. A discussion regarding the quantification of key risks, overall financial exposure and mitigating factors took place and it was agreed that it was key that the Committee received assurance that these items could be managed within the current financial forecast. RC It was agreed that explanatory narrative of significant variations would be included in future reports. RC Facilities and Corporate Finance Report to June 2007 Mrs Herring presented these reports and confirmed that facilities and corporate departments expect to break even at the year end. Mr Saxby asked whether posts (establishment) were removed from budgets as savings schemes become live to ensure adequate control and monitoring of the FRP. Ms James replied that workforce numbers were monitored and Mr Livesey confirmed that ‘Actual’ staff numbers were hours worked converted to WTE. This included bank staff but not agency. Mr Saxby suggested that substitute schemes for sickness reduction savings should be sought where sickness savings are not materialising. Page 2 of 5 General discussion took place on FRP targets and the actions being ACTION taken across all budgets to balance in year by reducing other costs if FRP schemes were not being achieved. Mr Holly asked that this be included in the divisional reports as the recurrent/non recurrent effect of these measures needed to be understood. 53/07 Financial Turnaround Project Mr Livesey presented the report, explaining that: targets are embedded within budgets; the forecast year end deficit of £704,000 is mainly due to failure of salary sacrifice (£300,000) and asset sales (£492,000); regular meetings are held with divisional directors to discuss individual schemes; a comprehensive review of Commissioning Baseline Schemes and large expenditure saving schemes is being undertaken; a 2.5% savings target can be expected for 2008/09. Ms James confirmed that schemes that were underachieving were discussed and closely reviewed. 54/07 Any Other Business There was no any other business. 55/07 Part II Divisional Financial Review – Medicine Mr Farey presented the report saying that it was encouraging that the division had delivered breakeven on its budgets in the month of June. He outlined a number of financial risks and reported that short term savings were planned to mitigate them. Mr Holly discussed the division’s FRP and asked that details of mitigating actions being taken by the division were included in the report in future. The schemes for sickness, night management savings, inhouse stress echo testing, cardiology and TB clinics were also discussed. Mr Farey confirmed that the division expected to break even at the year end. 56/07 Divisional Financial Review – Surgery Mrs Lunt presented her report showing an overspend of £36,900 at the end of June. The FRP for the division is ahead of target. The main risks around delivering divisional savings are in procurement, non recurrent staff reductions and sickness and these are being mitigated by reviewing the timetable for service rationalisation, potential savings from purchase of procedure packs and potential savings from rolling out of the booking Page 3 of 5 system at Rochdale. ACTION Mr Holly asked that the risks and mitigating factors be outlined in the next report. Mr Saxby asked about FRP schemes for one-stop clinics and sickness and medical staffing costs. Mrs Lunt confirmed that the division was maximising all opportunities for short term savings. Mrs Lunt confirmed that the division expected to break even at the year end. 57/07 Divisional Financial Review – Women and Children Mrs Taylor presented the report in Mr Lindars absence. The division is overspent by £30,500 which is a slight improvement on the position at the end of May. Mrs Taylor reported that the non recurrent underachievement against the target savings from the bed review had now been recovered and that the savings against vacancies were still being pursued. Mr Holly asked that future reports outline the risk around the year end forecast and FRP schemes and the mitigating factors that are available. In response to a number of questions from Mr Saxby, Mrs Taylor said that the directorate for gynaecology was preparing a recovery plan to achieve its elective activity target, confirmed that reductions to establishments were made for FRP schemes, and explained that the sickness target had been achieved by increasing vacancy factors and focussing on certain areas. Overall pay budgets are underspent across the division. 58/07 Divisional Financial Review – Diagnostic Division Mrs Wood outlined the division’s financial position at the end of June. Discussion followed on the divisional FRP schemes and targets. Mrs Wood confirmed that the savings from pharmacy automation would not be achieved but that savings from the use of Tazocin would substitute. Savings of £287,000 expected from discharge drugs were no longer anticipated but Mrs Wood said that plans were being developed around drug savings, stationery costs and re-use of patient drugs. Some of these schemes will need to be trialled. Mr Holly asked that all risks and mitigating factors, recurrent and non recurrent be included in the next report. Mr Saxby asked about the underperformance against activity targets at the end of June and Mrs Wood confirmed that this was under review. Page 4 of 5 ACTION Mrs Wood confirmed that the division expected to break even at the end of the year. 59/07 Date and Time of Next Meeting The next meeting will be held on 6 September 2007 in the Executive Directors Meeting Room, Second Floor, Trust HQ. Please note that the meeting will begin at 12 noon. BH/CF Page 5 of 5 FINANCE COMMITTEE MINUTES OF THE MEETING HELD 6 SEPTEMBER 2007 Present: Part I – Corporate Overview Mr J Jesky, Chairman (in the Chair) Mr J Battye, Non Executive Director Mr R Chadwick, Director of Finance and IM&T Mrs B Herring, Programme Director - Finance Mr M Holly, Non Executive Director Ms K James, Director of Operations Mr B Livesey, Associate Director of Finance Mr J Saxby, Chief Executive Mrs A Unwin, Non Executive Director Mr J Wilkes, Director of Facilities Part II – Divisional Review Medicine Mr S Farey, Divisional Director Mrs J Moore, Divisional Accountant Surgery Mrs S Lunt, Divisional Director Mr G Thompson, Divisional Accountant Women & Children Mr J Lindars, Divisional Director Mrs S Taylor, Divisional Accountant Diagnostic Mr G Boothby, Divisional Accountant Apologies: Mr H Griffith, Non Executive Director Mrs J Wood, Divisional Director, Diagnostics Part I – Corporate Overview 60/07 MINUTES OF THE LAST MEETING The minutes of the last meeting held on 2 August 2007 were received and approved as a correct record. MATTERS ARISING 61/07 49/07 43/07 Mr Livesey reported that this had now been done. 62/07 FINANCE REPORT TO 31 JULY 2007 Mr Chadwick presented this report. He reported that at the end of July the Trust had a surplus of £2,676k compared to the target of £2,682k and that the Trust was on target to achieve its statutory financial duties at the end of the year. EMM\FC\Mins\Sept2007 Page 1 of 4 ACTION Two further papers were tabled showing the detailed Balance Sheet and Cash Flow position as at the end of July. A discussion followed based on a number of questions raised by members of the Committee. It was agreed that the cash flow graph previously produced be reinstated into future reports to the Committee. 63/07 Mrs Herring FACILITIES AND CORPORATE FINANCE REPORT TO 31 JULY Mr Wilkes presented the Facilities report which showed a forecast underspend of £120,000 at year end, with the main risk factor being the expenditure on Portering. Mr Wilkes presented the Corporate Finance report which showed a forecast year end break even position. Mr Saxby asked that the Salary Sacrifice be reviewed. 64/07 REPORT OF THE TURNAROUND DIRECTOR Mr Wilkes presented this report. The Collaborative Procurement Hub was again discussed and Mr Wilkes reported that there should be a small improvement by the year end. Mr Wilkes reported that the progress report narrative reconciles back to £187,000. Mr Chadwick agreed to provide a summary report for next month’s meeting of the Finance Committee. Various schemes were to be discussed with the Divisional Directors and Divisional Accountants in Part II. 65/07 WAIVING OF TENDER PROCEDURES Mr Chadwick presented this report which was approved. 66/07 Part II – Divisional Financial Review Medicine Mr Farey presented this report saying that although the divisional overspend had worsened slightly during July, this was expected and the division remained slightly ahead of the run rate target. A number of budgetary pressure areas were discussed along with the risks against the financial recovery plan associated with the sickness/absence scheme. Ms James asked for the inpatient and day case elective activity figures to be separated in future reports. EMM\FC\Mins\Sept2007 Page 2 of 4 Mr Chadwick Mr Farey confirmed that the division expected to break even at the end of the year. Surgery Sue Lunt reported that the in month & cumulative overspends were both ahead of the run rate & the division was still confident in delivering break even by year end. There remained some risk areas relating to the division's Financial Recovery Plan schemes as at July, but Gary Thompson reported that the division had made significant progress in reviewing these schemes & identifying replacement schemes where necessary & the target is now expected to be delivered in full this year. There remains a recurrent element of c. £245,000 relating to sickness which will need to be addressed in 2008/9. Bob Chadwick commented on the fact that the income associated with elective in patient underperformance would not be offset by the daycase overperformance. Sue Lunt explained medical staff absence in general surgery was impacting on this but that the division had plans with particular reference to Orthopaedics, general surgery & urology to address this. In addition, Sue referred to the fact that the division was significantly overperforming against both non elective inpatients and new outpatients; the latter suggesting a healthy order book for future elective care. Women and Children Mr Lindars presented the division’s financial position to the end of July. This showed an overspending of £27,000 which was a slight improvement on the previous month and was in line with the FRP. Mr Lindars described the risks associated with the non achievement of the recovery plan targets in respect of vacancies, both recurrently and non recurrently. Mr Holly requested that plans for addressing these risks be included in the next report. Mr Lindars additionally presented the report on gynaecology activity and confirmed the plans that were in place to recover the under performance against target by the end of the financial year. Diagnostics Mr Boothby presented this report in Mrs Wood’s absence. The division is overspent by £8,200 which is an improvement on the previous period and ahead of the division’s planned variance. The division is forecasting to achieve expenditure targets and deliver its contribution to the financial recovery plan. EMM\FC\Mins\Sept2007 Page 3 of 4 Activity targets continue to not to be met. Haematology day case activity is significantly below target and is the result of a coding change. A serious data quality incident has been reported to establish how the change has arisen. Risks identified in earlier months relating to the financial recovery plan have now been removed and reduced. 67/07 Date and Time of Next Meeting The next meeting will be held on 4 October 2007 in the Executive Directors Meeting Room, Second Floor, Trust HQ. Please note that the meeting will begin at 1.00 pm EMM\FC\Mins\Sept2007 Page 4 of 4
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