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) Delivering an in-year financial saving of £23.2mAt the end of November savings of £12.8m had been delivered, compared to theTrust Plan of £13.8m.Month YTDVariance due to: Actual Plan Variance Actual Plan Variance£m £m £m £m £m £mTrust profile 2.2 2.3 (0.1) 12.8 13.1 (0.3)Unidentified 0 0.0 (0.0) 0 0.7 (0.7)Total 2.2 2.3 (0.1) 12.8 13.8 (1.0)At 30 th November 55% (£12.8m) of CIP schemes had been delivered. Thiscompares to 54% (£14.9m) at 30 th November 2011. At 30 th November 103% of thefull year plan had been identified, with 98% of identified schemes rated either greenor amber.Key issues to note are:(i) £6.3m of the identified £24.0m schemes are non recurrent, albeit the FYE ofthose schemes identified is £5.4m(ii) £3.9m of the identified schemes are amber and £0.4m red rated.Schedule 7 shows the analysis of plans by Divisions, Headquarters Directorates andcentral schemes and Schedules 8a and 8b show the detail of the overall savingsprogramme.c) Achieving the agreed volumes of activity to deliver the income planCumulative NHS Clinical Income at month 8 is estimated to be £3.4m above plan.A phased budget is used to reflect expected actual activity more accurately thanusing a straight line, unphased approach. The budgets for Southampton City andHampshire were adjusted with budget brought forward to the first quarter of thefinancial year, to reflect the expectation that significant activity management forthese PCTs would not be achieved during the first quarter.Actual income reported at month 8 consists of cumulative activity to month 7 asreported in SLAM plus an estimate for month 8 which extrapolates the first 7 months'income and then applies the appropriate phasing as a proxy for actual activity inmonth. Additional income has been anticipated for clinical activity which started inMonth 7 and would therefore not be recognised in this extrapolation, as well as earlydata indicating that spells are likely to be higher than usual.Provisions have been made for likely impacts from fines for 30 day readmissionsand 18 week breaches, a technical adjustment regarding the method for calculatingMRET, and provision for the risk of partial non-achievement of C Diff and CQUIN.Non - NHS clinical income was £0.1m better than Plan and is cumulatively £0.5mabove Plan. Notably private patient income continues to improve and is £0.2mbehind plan cumulatively.There is an in month positive variance of £0.6m on other operating income andcumulatively this income is £4.9m over plan. Of this, £1.7m relates to R&D (mirroredby increased spend) and £1.2m is additional capital works recharged to theUniversity. The balance relates to Divisional sundry income.d) Creation of a contingency to cover unexpected variations on the aboveThe approach for 2012/13, as in previous years, is based on identifying contingencyreserves to cover the likely risk from variations in costs against Plan, and additionalworkload due to unsuccessful activity management. If risks are successfully5
managed out, these reserves will become available to put into the central “bank” towhich bids for funding to improve services, quality and the hospital environment, canbe made.Cash & LiquidityThe period end cash balance at £16.3m was £6.9m below plan due mainly toincreased working capital balances(£4.1m) higher net capital expenditure (£2.2m)and lower cash generated from earnings (£0.9m) partly offset by lower financingcosts (£0.3m).The year end cash forecast at £15.7m is £4.7m lower than plan due mainly to highernon cash income within the Trust planned surplus and less external income tosupport the capital programme.With a working capital facility in place of £43m, the current financial position resultsin a liquidity rating of 3 and an overall Monitor risk rating of 3 (Schedule 1 and Annex5). This is forecast to remain a 3 at the year end.Schedule 1 also shows some key balance sheet indicators.Annex 4 shows cumulative capital expenditure compared to Plan. £12.7m has beenspent to date, £1.1m less than the updated Plan. £1.9m of new finance leases havebeen taken out in the first eight months of the year, compared to a Plan of £3.9m.ForecastA review of the year end Forecast was carried out in the light of October’s results.Whilst the forecast remains in line with Plan there was a level of control actionrequired to ensure the Trust delivers the planned surplus for the year. There will be afurther review of progress following the production of the November.RisksIdentifiedDescriptionPotentialValue £mLikelihoodWeightedvalue £mMitigationRisksOveralldemandlevelsThe Trust isanticipating incomein excess ofcontracted levels,based on capacityin place to deliveranticipated demandand experience ofdrug growth£15m L -10%£1.5m Ensure that paymentsfor overperformanceare secured. If activitydoes not occur ensurethat capacity andcosts are reducedaccordingly.CIPsNon-delivery ofCIPs£5m M –50%£2.5m Strong performancemanagementActivityManagementCost reductionrequired inresponse tosuccessful ActivityManagement.(NB: This risk andthe risks regarding“overall demandlevels” abovecannot becompounded).£5m L –10%£0.5m Ensure fullengagement in ActivityManagement; ensurecosts which can beremoved are removed.DivisionaloverspendingRisks ofoverspending dueto operationalpressures, capacityissues etc£10m M-50%£5.0m Strong performancemanagement.6
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Page 34 and 35: Annex 4CAPITAL EXPENDITURE 2012/13
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4. Signing & Sealing4.1 The Seal of
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performance target and C-Diff targe
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University Hospital Southampton NHS
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Appendix 2Exception Reports - Novem
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Monthly MeasuresPatient ExperienceH
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IM&T Report - Nov 20121. Purpose1.1
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2.2. Information to support patient
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