Trust Board 26 August 2010 Agenda Item 7 Title of Report Financial ...

Trust Board 26 August 2010Agenda Item 7Title of ReportFinancial ReportAbstract i. Finance Committee Minutes of Meeting held 23 July 2010ii. Finance Directors Reportiii. Contract Income & Activity Reportiv. Divisional Expenditure (incl CRES)v. Capital Programme & Financial Statementsvi. Statement of Financial Position & Treasury Managementvii. Working Capital Facility – Legal Agreement Sign OffLead BodyTrust BoardRecommendations:To inform the Trust Board of the Trust’s financial position andreport on related financial matters that require the Board’sattention.Prepared by: Name &TitlePaul Mapson, Finance DirectorPresented by: Name& TitlePaul Mapson, Finance DirectorAppendices

Trust Board26 th August 2010Agenda 7 (i)FINANCE COMMITTEEMinutes of the meeting held on 23 July 2010Present: Ms L Gardner – Chair Dr J Savage Mr K BlakeMr P Mapson Mr R Woolley Mr T RanzettaIn attendance: Mr D Bodill Mr R Smith Mr E JacksonMrs D LeeMrs D Peacock (minutes)* Mrs J Burrows ** Mrs H Julian* For item 86/10** For Item84/10 Welcome/ApologiesLisa Gardner welcomed Tony Ranzetta to the Finance Committee.Apologies were received from Paul Tanner and Irene Gray.85/10 MinutesThe minutes of the meeting held on the 22 June were agreed as a correct record.86/10 Service Level Agreement PerformanceThe Service Level Agreement Performance report was received. Deborah Lee advised thatactivity is considerably higher than plan for April and May leading to an over performanceof £2.11m. The position includes the impact of the emergency marginal tariff reduction.This is of significant concern to both Commissioners and the Trust given the impact ofunplanned activity on both financial and operational performance. The Trust is workingwith Commissioners and Divisions to return activity levels to plan.The worse case scenario is the Trust’s exposure to performance fines and other contractsanctions with a maximum exposure of £21m for the year. Particular attention was drawn tothe risks associated with Clostridium Difficile which alone could be £5m. There is alsoexposure relating to the under-recovery of Commission for Quality and Innovation(CQUIN) income which Divisions have budgeted for.Paul Mapson updated the meeting on Quality, Innovation and Productivity and Prevention(QIPP). PCTs have yet to deliver detailed plans on where they expect schemes to impact.Richard Smith added that Commissioners have a different view that savings will bedelivered later in the year. This is of concern as there is no evidence yet that schemes willdeliver.Kelvin Blake asked what top level mechanisms are in place to have discussions to changethe flow of patients into the Trust. Deborah Lee stated that both tactical and strategic for aexist to discuss this issue which include both providers, commissioners and importantlyclinicians. Specifically, there is a Network Board looking into the issue of rising emergencyadmissions which is the aspect of care which is most challenging the Trust with respect toPage 1 of 6

the adverse impact on delivery of quality and performance. Paul Mapson stated that areconciled position including all factors will be completed which will show a differentfigure than the £2.11m reported.Paul Mapson stated that a reconciled position including all factors will be completed whichwill show a different figure than the £2.11m reported.Robert Woolley said that he welcomed the report which highlighted the risks andconsequences of a high risk contract. The level of activity undertaken is unsustainable. Ithas been made clear to Divisions that the Trust has to actively reduce levels and the need toencourage Primary Care Trusts (PCTs) on QIPP plans.Kelvin Blake asked are medics referring people more quickly or is there a greater demand?Robert Woolley said that all PCTs argue that acute intervention is higher than otherlocalities. Deborah Lee stated that we are 20% higher demographically. Lisa Gardnerremarked on the In-Treatment Centres where take up has not been good and asked if we aredoing all we can to help? Deborah Lee said there is a need to engage North Bristol Trust(NBT) in particular regarding Orthopaedics.Deborah Lee advised there is 4% growth in the system on emergencies, with UH Bristol upby 11%. Work has focussed on the key drivers and we now have a clearer understanding.Robert Woolley stated that he is meeting with the Chief Executive Officer of the AmbulanceTrust to discuss referrals and the Capacity Management System. He added that theAmbulance Trust has confirmed that providers do not update the system and there is theneed to persuade NBT to follow suite.Lisa Gardner asked are we being penalised and/or getting worse with regards to ClostridiumDifficile? Deborah Lee advised that the National Tolerance is 180, there is a clause in thecontract that should the Trust fall below 200 then it should not deteriorate from the 2009/10out-turn. With no profiled targets Tony Ranzetta stated that the Trust cannot assume levelsof actuals. Kelvin Blake stated that focus is needed at board level.87/10 Matters Arising3.6 Divisional Expenditure – Medicine Action Plan – The Division of Medicine NursingExpenditure Report was received and presented by Helen Julian. She reported that nursingstaff budgets show an adverse variance of £262k. The key issues being, costs of a MaleMedical Assessment Unit in Ward 18; split site working due to refurbishment and additionalstaffing for A&E for England world cup matches. The Division is forecasting an overspendof £452k at year end.The level of lost time funds within the Division is 23%. There are high levels of sickness at6-7% which is a big cause of concern. Controls regarding recruitment are in place with theintroduction of the Pay Control Panel which challenges budget managers re the appointmentof posts.As yet bank usage has not improved, the Temporary Staffing Bureau have reported areduction in the level of bank shifts for June and it is expected that a fall in bank costs willbe seen in later months when time sheets are submitted. A spike in the costs in May wasdue to Registered Mental Nursing (RMN) supervision being required for a patient that wassubmitted under the Section 3 Mental Health Act. An agency person was found as 24 hourcover was required for this and this was at the approximate cost of £32k. A dual qualifiedPage 2 of 6

RMN/Nurse is now to be recruited. Ideally this patient should have been admitted to afeeding bed at NBT, but this was not available.Some discussion was had regarding the trajectory, in particular Ward 11 staff due to returnfrom maternity leave, position not predicted to improve until September. Agency/bank maystill need to be used; closure of beds - excess activity may not allow this to happen.Lisa Gardner asked about annual leave and sickness controls. Helen Julian stated thatmeasures are in place, matrons now sign off bank staff usage and the revised sickness policyis being adhered to. Lisa Gardner asked if substantive nurses work on the bank? It wasadvised that there are nurses on the bank; if any member of the nursing staff has been offsick they are unable to do bank work for two weeks. Tony Ranzetta asked for stagedmonthly monitoring of agency spend as the indicators should be showing costs reducingPaul Mapson asked that the projections for Ward 7 be relooked at.Lisa Gardner thanked Helen Julian for attending.3.1 Divisional Financial Management Issues – The Update on Divisional FinancialControls was received. Dean Bodill stated that at the request of the Finance Committee keycontrols have been reviewed which included authorisation of pay and non-pay items,recruitment, stock controls, awareness of Standing Financial Instructions (SFIs), budgetholders, reporting structures and accountability processes. In general key controls are inplace, the review has identified some areas where Divisions have advised that controls areeither in the process of being improved or are not evident.Paul Mapson stated that this was a useful exercise. He and Lisa Gardner found it worryingthat the Surgery, Head and Neck Head of Division did not regularly attend the DivisionalFinancial Committee.Kelvin Blake asked if the Trust has the right balance/accounts controls in place – shouldthere not be a standardisation of controls across the Trust? Dean Bodill advised that this isbeing worked on. Progress has been made and with the sharing of best practice identifiedwill help to raise standards across the Divisions.3.2 Medical Staffing Variances – The Update on Medical Staff Budget, Spend andVariances was received. Overall medical staff budget were overspent by £2.833m at the endof 2009/10. Dean Bodill advised that it is anticipated that there will be no overspends thisyear. Key changes have been made as highlighted in the tables of the report.Paul Mapson advised that the Divisions are still recruiting to new consultant posts inparticular specialties. Lisa Gardner asked that this continue to be monitored.3.3 Healthcare at Home – The Healthcare at Home Programme was received and noted.Tony Ranzetta advised that a further meeting had been held. The first phase will begin inOctober and it is projected that financial benefit will not be achieved until early 2011.Regular updates will be provided at the Finance Committee.3.4 Specialised Services Financial Trajectory – The ‘Proposal to achieve break even forthe Division of Specialised Services by March 2012’ was received. Dean Bodill advisedthat the paper had been written by Robert Chatfield the new Divisional Manager and showsa real sense of ownership. The Division is now predicting a projected year end deficit of£1m.Page 3 of 6

Deborah Lee advised that the Intensive Care Unit Expansion Business Case will becommunicated - this will address the issue of lack of capacity in ITU which has led to theuse of Cardiac Intensive Care Unit for general surgery patients. She added that repatriationwork is being done on the surgery being carried out in London and Oxford, however due tothe difficulties that the Division face now is not a good time to re-launch. Lisa Gardnerasked are other Divisions charged for the use of these beds. Paul Mapson stated that as yetno adjustments are currently being made.The trajectory is acceptable in terms of processes but more work is to be done. It wassuggested that a financial control target of £1m be in place for this financial year.3.5 CQUINs – Financial Risk Assessment – referred to in item 88/10.3.7 Cash Releasing Efficiency Savings – referred to in item 90/10.3.8 Subjective Analysis – Pay Expenditure – referred to in item 90/10.88/10 Finance Director’s ReportThe Finance Director’s Report was received. The income and expenditure statement showsa surplus of £1.295m to 30 June 2010. The Earnings before Interest, Tax, Depreciation andAmortisation (EBITDA) surplus is £8.02m which is slightly lower than plan, therefore theEBITDA is 96% of plan. The risk rating remains at 3. Paul Mapson stated that this is inline with the annual plan, the risk rating needs to be move to 4 from Quarters 2 onwards.There are concerns in the slight volume deterioration in respect of Clostridium Difficile.Actuals to the end of June being 4 cases ahead of the Service Level Agreement limit – thisrepresenting a fine of £325,000 per case above target.Income is healthy and now stands at £2.11m over target for the year. Clinical Divisions areoverspending by £1.148m to 30 June. Paul Mapson highlighted the risk on CRESachievement as plans are phased through the financial year. The Trust is forecasting aplanned surplus of £6.3m, this has been adjusted by £1.2m in respect of impairments nolonger expected with the best estimate for year end being a £7.5m surplus.Due to cancer targets failing this year, it is fairly likely that the Trust will be unable to getthrough the gateway and will not be able to earn CQUIN income. This is disappointing asup to £5.3m would have been available to be earned by Divisions.The capital expenditure at the 30 June is £5.148m. Cash balance at month 3 stands£41.405m, this being slightly lower than the forecast plan of £42.791m. Debtors haveimproved and stand at £15.34m.89/10 Contract Income and Activity ReportThe Contract Income and Activity Report was received. This was covered in the ServiceLevel Performance report. Richard Smith added that the activity for June has increased forday cases/out patients and that emergency cases had fallen.90/10 Divisional Expenditure Report (incl CRES)The Income and Expenditure Report to 30 June 2010 was received. The summary incomeand expenditure position shows a surplus of £1.295m for the first three months of thefinancial year.Page 4 of 6

Dean Bodill stated that the report had changed slightly with an additional line being insertedto indicate how CRES shortfalls contribute to the Division position. To date there is aCRES shortfall of £1.041m with the forecast year end shortfall being reported as £3.154mwhich is an improvement on the forecast outturn at month 3 of £3.705m.Tony Ranzetta reported that there were now eleven CRES work streams in operation. Afterthe regular monthly reviews with Divisions and further risk assessment it is anticipated thatthe likely outturn CRES delivery will be between £3.154m and £4.331m. The Trust isworking hard to reduce this shortfall. It was reported that the number of CRES schemes areplanned to deliver in the later part of the year and that the risk associated with this is beingfully assessed.In response to Lisa Gardner’s question regarding the reported overspend at month 3 onsenior managers. Dean Bodill reported that this was due to costs within Skills for Healthincluding redundancy payments. He advised that Skills for Health will be shown separatelyin future reports.91/10 Capital Programme and Financial StatementThe 2010/11 Capital Programme Report and Financial Statements were received. Theexpenditure as at 30 June 2010 was £5.148m against a profiled budget of £5.218m. Theforecast expenditure for the end of the financial year is £32.568m.The Finance Committee ratified the movement in the capital programme and noted thereport.92/10 Capital Prioritisation Group Minutes – 9 June 2010The minutes of the Capital Prioritisation Group were received and noted.93/10 Statement of Financial Position and Treasury ManagementThe Statement of Financial Position (SoFP) and Treasury Management report was received.The SoFP has a working capital balance of £13.819m.The cash balance at 30 June 2010 was £41.405m (including £2.765m for Skills for Health),this is £1.286m below plan. The main variances include increased receipts of £1.456m forother NHS Income and various grants. NHS payments have also increased by £2.712mrelating to £2.2m for Western Comprehensive Local Research Network and settlement ofNHS Litigation fees.Debtors have decreased by £2.623m, this is mainly due to the cancellation of theDepartment of Health Service invoice of £11.254m for Skills for Health core funding for theyear for which the Trust will now invoice quarterly. The focus is now on the greater thanninety days balances.Under the Better Payments Practice Code the Trust achieved 91% and 88% compliance forpayment of NHS and Non NHS creditors respectively94/10 Monitor Assessment and Regulatory SystemThe Quarter 1 Performance Commentary for Monitor Return was received. Paul Mapsonstated that goods news had been received from Monitor informing UH Bristol that theAnnual Plan is not subject to a Stage 2 further review by Monitor.Page 5 of 6

Monitor has identified 10 potential Financial Risk Indicators which are included with theTrust’s position against them in the Monitor Assessment and Regulatory System FinancialPerformance Report Quarter 1. Of note 17% of the Trust’s debtor balances exceed 90 days.The Trust will be participating in the agreement of balances exercise to ensure disputedinvoices are identified as soon as possible. Higher priority will be given to clearing highvalue invoices with other PCTs and Trusts95/10 Quarterly Treasury Management ReportThe Quarterly Treasury Management Report was received and noted. Edley Jacksonadvised that he was in the process of setting investment rates for short term investments.96/10 National Research Ethics Service Hosting ArrangementThe National Research Ethics Service (NRES) Hosting Arrangement report was received.Paul Mapson advised that the paper will be presented at the July Trust Board for approval ofthe hosting arrangement, this being subject to finalising the legal agreement between theTrust and the Strategic Health Authority. The Finance Committee recommended that thehosting arrangement is agreed in principle subject to residual liabilities being coveredadequately by the Strategic Health Authority.97/10 Any other urgent businessThere was no other business.98/10 Date of next meetingDue to annual leave commitments the 23 rd August Finance Committee has been cancelled.The date of the next meeting will be Friday 24 th September at 10am, Boardroom, TrustHQ.Page 6 of 6

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Summary Income & Expenditure StatementAppendix 1ApprovedBudget / Plan2010/11HeadingVarianceFav / (Adv)£'000 £'000 £'000 £'000 £'000 £'000Income (as per Table I and E 2)PlanPosition as at 31st JulyForecastOutturn391,026 From Activities 128,051 131,295 3,244 96,820 396,510114,395 Other Operating Income 39,257 39,688 431 29,938 113,730505,421 Sub totals income167,308 170,983 3,675 126,758 510,240ActualActual to 30thJuneExpenditure(296,879) Staffing (99,834) (100,295) (461) (75,483) (302,898)(150,989) Supplies and services (52,721) (59,840) (7,119) (43,253) (174,204)(447,868) Sub totals expenditure(152,555) (160,135) (7,580) (118,736) (477,102)(23,142) Reserves Reserves (2,656) - 2,656 - -(23,142) Sub Total Reserves (2,656) - 2,656 - -34,411 EBITDA12,097 10,848 (1,249) 8,022 33,1386.81 EBITDA Margin - %6.34 6.33 6.49- Profit / loss on asset disposals - - - - -(1,220) Fixed asset impairments - - - - 1,220(17,955) Depreciation & Amortisation (5,547) (5,549) (2) (4,492) (17,947)149 Interest Receivable 50 59 9 40 200(443) Interest payable on loans & leases (148) (140) 8 (109) (443)(8,662) PDC Dividend (2,887) (2,887) - (2,166) (8,668)6,280 NET SURPLUS / (DEFICIT)3,565 2,331 (1,234) 1,295 7,5001.24 Net margin - %1.36 1.02 1.5Agenda Item 7 (ii) Page : 1 of 5

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Divisional Income & Expenditure StatementAppendix 2ApprovedBudget / Plan2010/11DivisionTotal NetExpenditure /Income to DatePayPosition as at 31st July [Favourable / (Adverse)]Non PayOperatingIncomeIncome fromActivitiesTotal Varianceto dateMemorandumCRES Varianceto DateCumulativeVariance to30th June£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000Service Agreements385,009 Service Agreements 125,584 - - - - - - 2 -(700) SLA Performance (3,427) - (3,415) - 2,032 (1,383) - (932) -40,358 NHSE Income 13,477 - - - - - - - -424,667 Sub Total Service Agreements 135,634 - (3,415) - 2,032 (1,383) - (930) -Clinical Divisions(41,747) Diagnostic & Therapies (13,836) 54 (157) 64 49 10 (176) 7 24(51,926) Medicine (18,143) (324) (732) (10) 471 (595) (212) (325) (1,260)(62,881) Specialised Services (20,571) 17 (989) 73 440 (459) (631) (360) (1,000)(81,868) Surgery Head & Neck (28,130) 116 (1,479) 75 (56) (1,344) (929) (513) (2,706)(81,187) Women's & Children's (27,470) (11) (336) 5 164 (178) (429) 43 -(319,609) Sub Totals (1) (108,150) (148) (3,693) 207 1,068 (2,566) (2,377) (1,148) (4,942)Corporate Services(1,758) Central Services (642) (67) 16 - - (51) (8) (31) (60)(56) Community (8) - 10 - - 10 (1) 8 20(6,762) Trust HQ (2,362) (6) (84) 42 - (48) (24) (43) (120)(4,665) Human Resources (1,495) 95 (21) (30) - 44 6 8 110(4,877) Information Technology (1,670) 28 (40) 15 - 3 - 3 -(5,452) Finance (1,828) (51) 50 (7) - (8) (26) (20) -(24,880) Facilities & Estates (8,160) 76 (177) 37 - (64) (152) (48) (100)(9,088) Misc Support Services (3,599) (59) (28) 79 144 136 (4) 172 78,464 Research and Development 2,633 (82) 32 86 - 36 - 141 125(1,220) Impairment - - - - - - - - 1,220(25,381) Capital Charges (8,023) - (2) 2 - - - (1) -(75,675) Sub Totals (2) (25,154) (66) (244) 224 144 58 (208) 189 1,202(395,284) Sub Totals (1) and (2) (133,304) (214) (3,937) 431 1,212 (2,508) (2,585) (959) (3,740)- Skills for Health 1 (247) 248 - - 1 - (1) -(395,284) Totals I & E (133,303) (461) (3,689) 431 1,212 (2,507) (2,585) (960) (3,740)Reserves(23,103) General - - 2,656 - - 2,656 - 1,553 4,960- NICE - - - - - - - - -- CQUINS - - - - - - - - -(23,103) Sub Total Reserves - - 2,656 - - 2,656 - 1,553 4,960ForecastOutturnVariance6,280 TRUST TOTALS 2,331 (461) (4,448) 431 3,244 (1,234) (2,585) (337) 1,220Agenda Item 7 (ii) Page : 2 of 5

Analysis of pay spend month on month - last 6 months of 2009/10 and 2010/11Agenda Item 7 (ii) - Appendix 3Division October November December January February March April May June July Total (2010/11)£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000Women's and Children's Pay budget 5,154 5,218 5,262 5,266 5,334 5,580 5,286 5,541 5,451 5,362 21,640Bank 159 141 175 105 147 198 122 150 194 160 626Agency 15 20 51 47 37 57 30 34 48 92 204Waiting List initiative 32 31 31 21 29 77 30 31 42 25 128Overtime 5 5 4 12 8 15 9 5 5 5 24Other pay 4,938 5,106 5,052 5,027 5,193 5,151 5,130 5,183 5,270 5,087 20,670Total Pay expenditure 5,149 5,303 5,313 5,212 5,414 5,498 5,321 5,403 5,559 5,369 21,652Variance Fav / (Adverse) 5 (85) (51) 54 (80) 82 (35) 138 (108) (7) (12)Medicine Pay budget 3,351 3,302 3,341 3,500 3,376 3,848 3,365 3,505 3,659 3,460 13,989Bank 257 266 389 262 308 396 274 274 338 231 1,117Agency 48 31 53 69 30 31 44 53 59 61 217Waiting List initiative 37 29 42 28 25 48 28 28 9 65 130Overtime 4 5 5 4 4 4 10 5 6 3 24Other pay 3,019 3,151 3,133 3,198 3,278 3,554 3,189 3,210 3,256 3,168 12,823Total Pay expenditure 3,365 3,482 3,622 3,561 3,645 4,033 3,545 3,570 3,668 3,528 14,311Variance Fav / (Adverse) (14) (180) (281) (61) (269) (185) (180) (65) (9) (68) (322)Surgery Head and Neck Pay budget 5,200 5,310 5,049 5,178 5,153 5,589 5,230 5,335 5,753 5,456 21,774Bank 203 201 242 136 170 241 161 171 200 194 726Agency 177 135 172 170 150 119 78 83 89 92 342Waiting List initiative 161 215 115 98 174 276 66 84 100 157 407Overtime 26 29 15 19 13 16 16 14 13 13 56Other pay 4,838 4,929 4,853 4,886 4,993 4,941 5,026 5,009 5,102 4,991 20,128Total Pay expenditure 5,405 5,509 5,397 5,309 5,500 5,593 5,347 5,361 5,504 5,447 21,659Variance Fav / (Adverse) (205) (199) (348) (131) (347) (4) (117) (26) 249 9 115Specialised Services Pay budget 2,718 2,732 2,681 2,678 2,999 2,802 2,613 3,186 2,778 2,423 11,000Bank 72 72 87 66 73 106 73 71 107 87 338Agency 80 61 (98) 42 10 85 (29) 29 13 13 26Waiting List initiative 32 59 7 73 53 105 12 104 30 24 170Overtime 9 11 11 15 9 11 2 1 2 0 5Other pay 2,527 2,635 2,581 2,555 2,889 2,543 2,571 2,899 2,664 2,313 10,447Total Pay expenditure 2,720 2,838 2,588 2,751 3,034 2,850 2,629 3,104 2,816 2,437 10,986Variance Fav / (Adverse) (2) (106) 93 (73) (35) (48) (16) 82 (38) (14) 14

Analysis of pay spend month on month - last 6 months of 2009/10 and 2010/11Division October November December January February March April May June July Total (2010/11)£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000Diagnostic & Therapies Pay budget 3,207 2,959 2,939 3,076 2,848 3,112 3,004 3,010 3,122 3,103 12,239Bank 47 39 70 17 31 49 34 39 50 45 168Agency 82 37 19 47 55 84 1 51 44 38 134Waiting List initiative 9 6 3 15 10 15 8 9 18 25 60Overtime 9 25 18 21 23 20 22 28 19 27 96Other pay 2,978 2,835 2,875 2,923 2,708 2,859 2,906 2,951 2,918 2,958 11,733Total Pay expenditure 3,125 2,942 2,985 3,023 2,827 3,027 2,971 3,078 3,049 3,093 12,191Variance Fav / (Adverse) 82 17 (46) 53 21 85 33 (68) 73 10 48Facilities & Estates Pay budget 1,390 1,378 1,676 1,468 1,443 1,692 1,335 1,529 1,681 1,482 6,027Bank 49 47 69 38 32 48 33 38 45 40 156Agency 81 120 97 112 62 104 100 107 86 95 388Waiting List initiative 1 2 1 2 2 1 1 1 1 0 3Overtime 87 90 89 99 94 108 92 89 110 91 382Other pay 1,172 1,168 1,398 1,169 1,240 1,459 1,168 1,235 1,420 1,198 5,021Total Pay expenditure 1,390 1,427 1,654 1,420 1,430 1,720 1,394 1,470 1,662 1,424 5,950Variance Fav / (Adverse) 0 (49) 22 48 13 (28) (59) 59 19 58 77Trust Services Pay budget 1,648 2,191 2,231 3,104 2,052 1,782 2,370 2,022 2,259 2,420 9,071Bank 36 43 56 37 34 75 37 39 63 65 204Agency 30 6 11 5 11 26 23 19 21 31 94Waiting List initiative 0 0 0 1 0 0 2 1 2 1 6Overtime 4 7 4 6 5 8 9 15 9 11 44Other pay 1,583 2,186 2,093 3,000 1,954 1,637 2,292 2,078 2,141 2,321 8,832Total Pay expenditure 1,653 2,242 2,164 3,049 2,004 1,746 2,363 2,152 2,236 2,429 9,180Variance Fav / (Adverse) (5) (51) 67 55 48 36 7 (130) 23 (9) (109)Trust Total Pay budget 22,668 23,090 23,179 24,270 23,205 24,405 23,203 24,128 24,703 23,706 95,740(excl Skills for Health)Bank 823 809 1,088 661 795 1,113 734 782 997 822 3,335Agency 513 410 305 492 355 506 247 376 360 422 1,405Waiting List initiative 272 342 199 238 293 522 147 258 202 297 904Overtime 144 172 146 176 156 182 160 157 164 150 631Other pay 21,055 22,240 21,756 22,829 22,474 21,853 22,282 22,565 22,771 22,036 94,675Total Pay expenditure 22,807 23,743 23,723 24,325 23,854 24,467 23,570 24,138 24,494 23,727 95,929Variance Fav / (Adverse) (139) (653) (544) (55) (649) (62) (367) (10) 209 (21) (189)NOTE: Other Pay includes all employer's oncosts.

Agenda Item 7 (ii)Appendix 5UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Risk MatrixDescription of RiskRisk if no action takenRisk ScoreFinancialValue£'mAction to be taken to mitigate riskLeadRisk ScoreResidual RiskFinancialValue£'mProgress / CompletionCRES Targets High 6.0CRES Group established. Monthly Divisionalreviews to ensure targets are met.TR High 5.0Monthly reviews. Non recurring action ifnecessary.SLA Performance Fines Medium 9.0Infection Control plan implemented. Regularreview of performance.DL High 7.0C Difficile has not improved therefore riskis still high.Maintain capacity to assist withdelivery of 4 hour A&E maximumwaits and 18 week RTT.Medium 3.0Capacity plans developed by Divisions.Likely to be offset by additional income atmarginal rateIS High 2.0Unfunded capacity in Medicine. Continued/ increased use of waiting list initiativepayments.PCT Income challenges Medium 3.0Maintain reviews of data, minmise risk of baddebtsPM Medium 1.0 Position being managed.

Agenda Item 7 (ii)Appendix 4Key Issue RAG Executive Summary TableServiceLevelAgreementIncome andActivityGActivity was slightly higher than plan in June, leading to an over-performance of £0.10m. For the year to datecontract income is £3.77m higher than plan, of which £1.56m relates to 2009/10. The position includes theimpact of the emergency marginal tariff reduction, which is currently valued at £1.24m.A&E Attendances at 30,258 are 1,598 higher than planned. The average number of daily attendances is 333.Emergency activity at 9,590 is 10.8% or 934 spells higher than planned.Non Elective activity at 5,443 is 9.4% or 468 spells higher than planned.Day case activity at 11,949 is 3% or 351 spells higher than planned.Elective activity at 3,595 is 9.2% or 364 spells lower than planned.New Outpatients activity at 32,645 is 1.1% or 355 attendances lower than planned.Follow up Outpatient activity at 79,985 is 0.6% or 513 attendances lower than planned.INC 1An income analysis by commissioner is shown at Table INC 2.Information on clinical activity by Division, specialty and patient type is provided in table INC 3.Income andExpenditureGThe overall position to the end of July 2010 is a surplus of £2.331m.The EBITDA surplus of £10.848m equates to 90% of the Annual Plan target for the first four months.Total income for the four months is £170.983m. This is £3.675m greater than planned.Expenditure at £160.135m is higher than planned by £7.119m.Financing costs at are in line with plan.I&E 1CashReleasingEfficiencySavingsRThe 2010/11 CRES programme totals £15.483m. Actual savings achieved to date total £2.744m which is ashortfall of £1.501m .The forecast outturn achievement is £10.941m, which is a shortfall of £4.542mSlippage on savings not achieved this year will be carried forward for achievement in 2011/12.The carried forward CRES total from 2009/10 totals £7.339m. The achievement to date is £2.279m whichrepresents a small over-achievement of £69k. It is anticipated that this target will be fully achieved this year.I&E4a – 4b4c - 4d

Statement ofFinancialPosition&TreasuryManagementGThe cash balance on 31 st July was £44.251m, of which £2.008m is attributable to Skills for Health undersegmental reporting. The year-end cash balance is forecast to be £31.148m, which is slightly higher than theAnnual Plan of £30.807m.The balance on Invoiced Debtors has increased by £10.533m in the month to £25.873m. The Invoiced Debtorbalance equates to 27.3 debtor days.Creditors and accrual account balances total £75.236m although £18.508m relates to deferred income(including £9.660m for Skills for Health).Invoiced Creditors - payment performance for the quarter of Non NHS invoices and NHS invoices within 30days was 89% and 96% respectively.BS 1BS 2BS 3BS 4BS 1BS5CapitalGCapital expenditure to 31 st July totals £5.490m. This is £2.271m below the plan to date of £7.761m. Theforecast outturn is £32.621m against a programme of £31.619m. The forecast position will be updatedfollowing the review of the specialist paediatric and BRI redevelopment schemes. The reviewed position islikely to result in further slippage in 2010/11 over and above that currently reported.Capital 1Capital 2Capital 3FinancialRisk RatingGThe Trust's overall financial risk rating using the results to 31 st July has been calculated to be 4 (actual score3.55). The Trust’s ratings under the Prudential Borrowing Code are satisfactory with all ratios well within theMonitor thresholds.PrivatePatient CapGPrivate patient income to the 31 st July was £0.808m or 0.62% of total patient related income. This is well belowthe Trust’s Private Patient Cap of 1.1%.

1. Financial Risk RatingFinancial Risk Ratings – July 2010 PerformanceTrust Board26 th August 2010Agenda Item 7 (ii) – Appendix 6The following graphs will show quarterly performance against the 5 Financial Risk Rating metrics.The 2010/11 Annual Plan is shown as the black line against which actual performance will beplotted quarterly in red. The metric ratings are shown for FRR 5 (blue line); FRR 4 (green line) andFRR 3 (yellow line).Planned performance as per the Trust’s Annual Plan (agreed in May 2010) is shown as the blackline. An update for July’s performance is given beside each graph.105.0100.095.090.0EBITDA of Plan AchievedAn EBITDA of£10,848k wasachieved comparedwith a plan of£12,097k. EBITDAAchievement of89.68% of plan earnsa metric score of 4.85.0Q1 M4 M5 Q2 M7 M8 Q3 M10 M11 Q412EBITDA Margin %The EBITDA Margin of6.34% at Month 4 achieves ametric score of 3 in line withthe Annual Plan.10864Q1 M4 M5 Q2 M7 M8 Q3 M10 M11 Q4File: Item 7 (ii) - Appendix 6 Page 1 of 3

Return on Assets %7654The Return on Assetsfor July is 5.31% andearns a metric scoreof 4 driven by thereported surplus of£2,331k.3Q1 M4 M5 Q2 M7 M8 Q3 M10 M11 Q42010/11 Annual Plan Income& Expenditure surplus marginis 1.5% by Quarter 2.The Income & Expendituresurplus margin for July is1.36%, a metric score of 3.4321I & E Margin %Q1 M4 M5 Q2 M7 M8 Q3 M10 M11 Q4Liquidity (days)655545352010/11 Annual Plan liquidityratio is 35.4 days at Quarter 2.The actual liquidity ratio forJuly is 31.4 days and abovethe band 4 minimum of 25days.2515Q1 M4 M5 Q2 M7 M8 Q3 M10 M11 Q4The table below takes each of the metrics and calculates a weighted average score to determine theoverall Financial Risk Rating. The weighted average score for the period is 3.55. The Trust hastherefore achieved a Financial Risk Rating of 4 for the period to 31 st July 2010.File: Item 7 (ii) - Appendix 6 Page 2 of 3

31st July 2010Metric Metric WeightedMetric Result Score Average Weighting Rating categoriesScore % 5 4 3 2 1EBITDAMargin 6.34% 3 0.75 25 11 9 5 1

Trust Board26 th August 2010Agenda Item 7 (ii)FINANCE DIRECTORS REPORT1. OverviewThe summary income and expenditure statement shows a surplus of £2.3m for the four monthsto 31 st July 2010. The EBITDA surplus of £10.8m is below the Annual Plan of £12.1m forthe same period. Therefore EBITDA is at 90% of plan.The risk rating is 3.55 which is rounded up to 4 in line with the Monitor Plan.The position, whilst being complicated by the Monitor Plan being phased, is a significantdeterioration which if not resolved could escalate to a serious year end problem. The issuesthat have contributed to the position this month include the following:- CRES Plans were previously being reported against phased plans. This has beenchanged to use equal twelfths as the plan for budgetary reporting. This is largelypresentational but prevents the possibility of schemes planned for later in the year, whichmay not happen, creating an acceleration in the rate of overspend which would not bereported until late in the year leaving little time for corrective action to be implemented.Impact – adverse £437kAdditional research income has been issued to the Divisions therefore the R&D line hasdeteriorated but Divisions improved by £122k year to date.Surgery, Head and Neck Divisions has deteriorated by £831k in the month which is ofreal concern in the content of an existing unbalanced plan of £2.55m with the month 4position being £1.3m overspent already. The deterioration can be accounted for asfollows:£’000 Trend/planned deterioration 213 Error in counting income re Ilizarov Frames (back dated) 318 Non-pay spending in excess of Operating Plan (drugs, blood, supplies) 276 Other 24831A review of the position in relation to the Operating Plan will be instigated to addressthis position.Medicine Division, whilst not deteriorating in month much beyond the impact ofphasing CRES in twelfths is however of concern due to the major impact of thefollowing: Continuing to hold open unfunded capacity. In July 19 beds on Wards 22/26/27were due to close but have not. The Division have revised their forecast out-turn to a£1.2m overspend as a consequence of retaining this capacity for the year.1

Bed closures of 27 beds due to length of stay reduction in the CRES Plan were alsodue in October. Given that the length of stay has not reduced this year this is at risk.If these beds do not close the forecast out-turn will be just short of a £2m overspend.The associated issues in play here are the operation of the 30% marginal rate whichmakes capacity above 2008/09 out-turn unaffordable and the significant slippage in PCTschemes to reduce emergencies especially Healthcare at Home which appears to beslipping considerably such that the winter impact may not occur at all.SLA Fines – the CDifficile fine for the period to July is assessed as £1.76m compared to£1.3m for the previous period. The SLA tolerance for the period is 33.3 cases withactuals being 40. There are indications already however that the position has improvedin August.The position re CRES delivery has deteriorated with £4.5m being forecast as the year endunder-performance. It should be noted that of the Clinical Divisions’ overspend of £2.6m todate, the CRES under-achievement is £2.2m.The Level of spend on Waiting List Initiatives has once again increased and is now at asimilar level to 2009/10. This is concerning as the Operating Plans created new substantiveposts to reduce Waiting List Initiatives. The increases are mainly in Medicine and Surgery,Head and Neck Divisions2. The main Budget changes in July include the following:-£’000Transformation 500EWTD 1093. Forecast Out-turnThis remains at a £7.5m surplus.4. IncomeActivity was slightly higher than plan in June, leading to an over-performance of £0.10m. Forthe year to date contract income is £3.77m higher than plan, of which £1.56m relates to2009/10. The majority of the over-performance is within BNSSG and the South WestSpecialised Commissioning Group.The main risk to contract income is that PCTs may refuse to pay for any over-performance,instead stating that the Trust must operate within the agreed contract value.2

Clinical Income by WorktypePlan£mActual£mVariance£mAccident & Emergency 2.71 2.79 0.08Emergency Inpatients 19.06 19.75 0.69Day Cases 8.84 9.18 0.33Elective Inpatients 11.51 11.06 (0.45)Non-Elective Inpatients 7.47 7.70 0.23Excess Beddays 2.44 2.55 0.11Outpatients 13.89 14.16 0.27Bone Marrow Transplants 2.65 2.95 0.30Critical Care Beddays 8.17 8.28 0.11PbR Exclusions/NICE 7.49 7.55 0.06Other 10.91 11.38 0.48Sub-Total 95.13 97.34 2.212009/10 Estimate v Actual 0.00 1.56 1.56Total 95.13 98.90 3.77The income over-performance position for Bristol, North Somerset and South GloucestershirePCTs as at Month 2 (May) can be presented as follows:SLA Variances(All £m)SouthGlosPCTNorthSomersetPCTBristolPCTTotalBNSSGPCTsOver-performance at Month 3 0.87 1.33 2.84 5.04QIPP (0.62) (0.58) (1.44) (2.64)ISTC slippage (0.02) (0.17) (0.16) (0.35)A&E/Emergencies (0.06) (0.39) (0.71) (1.16)Residual Over(Under) performance 0.19 (0.01) 0.19 0.89This demonstrates that of the £5.04m over-performance to date £4.15m is due toQIPP, emergency activity and ISTC slippage. In total there is, therefore, a residual overperformance of 0.89m.Although the Trust has not received any formal income challenges, we have received, andanswered, a number of queries from BNSSG commissioners.5. ExpenditureDivisional PositionIn total, Clinical Divisional budgets are overspent by £2.566m for the four months to 31 st July.Pay and non pay budgets are overspent by £0.148m and £3.693m respectively. The surplus of£1.275m on income budgets partially offsets the expenditure overspendings.The Surgery, Head and Neck Division reports an adverse variance of £1.344m after fourmonths. This is a deterioration of £0.831m for the month. The cumulative overspending onnon pay budgets is £1.479m this is due to expected worsening on non pay in line with theoperating plan plus other deteriorations on drugs, blood and clinical supplies over and abovethis expected deterioration.3

The Division of Women’s and Children’s Services reports an adverse variance of £0.178mfor the four months to 31 st July. Pay budgets were overspent by £0.011m. Non Pay budgetswere overspent by £0.336m. Income from Activities was overachieved in the month by£0.164m.The Diagnostic and Therapies Division reports a cumulative under spending of £10k afterthree months.The Division of Medicine reports an adverse variance of £0.595m – an increase of £0.270min the month. The overspending relates to pay £0.324m including premium costs for vacancyand sickness absence cover. The non pay over spend to date is £0.732m.The Division of Specialised Services reports an adverse variance on its income andexpenditure position of £0.459m. The overspending to date has arisen on non pay budgets£989k of which £0.513m is offset by overachievement against income targets.6. Cash Releasing Efficiency Savings (CRES)CRES achievement against the 2010/11 programme of £15.483m is £2.743m. This is £1.5mless than the phased plan to the end of July. The forecast out-turn achievement being£10.941m i.e. £4.542m below plan. The CRES position for each Division is shown as amemorandum column in table I&E 3a to demonstrate the relationship between Divisionalpositions and CRES achievement. It should be noted that this is shown in terms ofachievement against CRES plans phased in 12ths as they are reported in the ledger.The carried forward CRES total from 2009/10 totals £7.339m. The achievement to date is£2.279m which represents a small over-achievement of £69k. It is anticipated that this targetwill be fully achieved this year.7. Financial Risk RatingThe Trust’s overall financial risk rating, based on results to 31 st July is 4. The actual value foreach of the 5 metrics is given in the table below together with the bandings for each metric.Appendix 6 will provide further information on performance throughout the year.The Trust is also operating well within the 4 metrics specified in the Prudential BorrowingLimit.31st July 2010Metric Metric WeightedMetric Result Score Average Weighting Rating categoriesScore % 5 4 3 2 1EBITDAMargin 6.34% 3 0.75 25 11 9 5 1

8. Capital ProgrammeThe Trust’s capital programme for 2010/11 is £31.619m. The forecast expenditure for theend of the financial year is £32.621m.Approved Plan Position to 31st July Variancefor Year Plan Actual Fav/ (Adv)£’000 £’000 £’000 £’000Sources of FundingPublic Dividend Capital - - - -Donations 2,396 - - -Asset Disposals - - - -Retained Depreciation 16,905 5,635 5,135 500Revenue / cash balances 12,318 2,126 355 1,771Total Funding 31,619 7,761 5,490 2,271ExpenditureStrategic Schemes (15,725) (3,481) (2,337) 1,144Medical Equipment (7,442) (1,770) (1,218) 552Information Technology (2,816) (635) (630) 5Roll Over Schemes (2,275) (365) (241) 124Refurbishments (3,547) (538) (515) 23Operational / Other (6,520) (972) (549) 423Anticipated Slippage 6,706 - - -Total Expenditure (31,619) (7,761) (5,490) 2,271The expenditure to the end of July was £5.490m against a profiled budget of £7.761m, avariance of £2.271m.9. Statement of Position (Balance Sheet) and CashflowCashThe Trust held cashbalances of £44.251mas at 30 th June. This isslightly higher thanplan forecast of£43.525m.5

DebtorsThe total value of invoiced debtors has increased by £10.533m during July to a closingbalance of £25.873m. The amount owing is equivalent to 27.23 debtor days.Creditor PaymentsThe Trust aims to pay 90% of undisputed invoices within 30 days. In June, the Trustachieved 96% and 89% compliance against the Better Payment Practice Code for NHS andNon NHS creditors. The cumulative position is 81% and 90% respectively.10. Working Capital FacilityThe renewal of the Working Capital Facility is shown in section 7 (vii). The Trust Board isrequested to approve as per the recommendation.AttachmentsAppendix 1 – Summary Income and Expenditure StatementAppendix 2 – Divisional Income and Expenditure StatementAppendix 3 – Monthly analysis of pay expenditure 2010/11Appendix 4 – Executive SummaryAppendix 5 – Financial Risk MatrixAppendix 6 – Financial Risk Ratings6

AttendancesUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report June 2010 - Activity PerformanceTable INC111,00010,500Accident and EmergencyActual A & E Activity 2009/10 ActualsYear on year activity up by 4.1% or1,190 attendances.10,0009,5009,000Total attendances to date (30,258)are 1,598 higher than planned. Theaverage number of daily attendancesis 333.8,5008,000Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb MarAverage dailydaily attendances 333 329 328 341attendances 329 328 341 0 0 0 0 0File: Item 7 (iii) - Contract Income and Activity (INC1 to INC3) : Activity Graphs Page : 1 of 7

SpellsSpellsUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report June 2010 - Activity PerformanceTable INC13,800EmergencyActual Emergency Activity 2009/10 Actuals3,6003,4003,2003,000Year on year activity up by 6.1% or552 spellsData includes short stay activity2,8002,600Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb MarTotal activity to date (9,590) is 10.8%or 934 spells higher than planned.1,9001,800Non-ElectiveActualNon Elective Activity2009/10 ActualsYear on year activity up by 34.0% or1,382 spells1,7001,6001,5001,4001,300Total activity to date (5,443) is 9.4%or 468 spells higher than planned.1,200Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb MarFile: Item 7 (iii) - Contract Income and Activity (INC1 to INC3) : Activity Graphs Page : 2 of 7

SpellsSpellsUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report June 2010 - Activity PerformanceTable INC15,500ActualDay Case Activity2009/10 ActualsDay CaseYear on year activity down by 16.7%or 2,390 spells5,000Total activity to date (11,949) is 3.0%or 351 spells high than planned4,5004,000Excludes regular day and nightattendances3,500Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar1,700ActualElective1,600Elective Activity2009/10 Actuals1,5001,400Year on year activity down by 10.3%or 414 spells1,3001,200Total activity to date (3,595) is 9.2%or 364 spells lower than planned1,1001,000Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb MarFile: Item 7 (iii) - Contract Income and Activity (INC1 to INC3) : Activity Graphs Page : 3 of 7

AttendancesAttendancesUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report June 2010 - Activity PerformanceTable INC116,00015,00014,00013,000New OutpatientsActualOut Patient New Attendances Activity2009/10 ActualsYear on year activity up by 7.2% or2,528 attendancesData excludes radiotherapytreatments12,00011,00010,000Total activity to date (32,645) is 1.1%or 355 attendances lower thanplanned9,000Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar38,00036,00034,00032,000Follow Up OutpatientsActual Out Patient Follow Up Attendances Activity 2009/10 ActualsYear on year activity down by 10.9%or 9,750 attendancesData excludes radiotherapytreatments30,00028,00026,000Total activity to date (79,985) is 0.6%or 513 attendances lower thanplanned24,00022,000Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb MarSepOctNovDecFile: Item 7 (iii) - Contract Income and Activity (INC1 to INC3) : Activity Graphs Page : 4 of 7

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTTABLE INC 2AnnualBudgetCommissionerINCOME REPORT TO:- 31 July 2010Year to DateBudget Actual Variance£000 £000 £000 £000156,918 Bristol PCT 51,020 53,856 2,83639,323 North Somerset PCT 12,711 14,037 1,32629,649 South Gloucestershire PCT 9,510 10,397 887225,890 B.N.S.S.G. Total 73,241 78,290 5,04981,733 SW Specialised Consortium Group 26,956 27,339 38315,011 Somerset PCT 4,917 5,404 48712,389 Bath & North East Somerset PCT 4,059 4,031 -286,743 Gloucestershire PCT 2,209 2,678 4696,742 Wiltshire PCT 2,209 2,384 1751,412 Devon PCT 462 605 1432,347 Swindon PCT 771 663 -108767 Cornwall & IOS PCT 251 332 81229 Plymouth PCT 76 75 -1243 Torbay Care Trust 80 177 97958 Dorset PCT 313 339 2688 Herefordshire PCT 29 29 0513 Hereford & Worcester LCCB 171 149 -2280 West Midlands SCG 26 62 36815 South Central Coast SCG 270 380 110531 London SCG 177 177 06,764 Health Commission Wales 2,256 2,289 33493 Monmouthshire LHB 163 182 1997 Pembrokeshire & Ceredigion LHB's 32 19 -13860 Bone Marrow Transplants 287 201 -862,363 Non Contract Activity-English 788 957 169880 Non Contract Activity-Territorial Bodies 293 189 -104149 Non Contract Activity-Reciprocal Patients 49 44 -515,711 Variable Estimates 5,099 1,638 -3,4610 Partially Completed Spells 0 0 00 Prior Year Income 0 1,559 1,5590 Central Levy Reduction 0 0 00 SHA Emergency Tariff Reduction 0 -1,240 -1,2401,200 SHA Reserve 400 400 0385,008 Sub- Total 125,584 129,352 3,7689,062 Dental SIFT 3,021 3,021 014,437 MADEL 4,827 4,827 013,256 Medical SIFT 4,419 4,419 03,603 Merit Awards 1,211 1,211 0Prod Programme FundsLess Transfer to Divisions -3,768 - 3,76880,055 Income in Divisions 28,246 31,921 3,675505,421 Total Income per Table I&E 2 167,308 170,983 3,675Agenda Item 7 (iii) Page : 5 of 7

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUST Table INC 3SERVICE AGREEMENTS INCOME VARIANCE REPORT BY WORKTYPE AND SPECIALTYDay Cases Elective Emergency Non Elective Critical Care BeddaysDivision Board Report Specialty Plan ActivityActual VarianceActual VarianceActual VarianceActual VarianceActual VarianceVariance £ Plan ActivityVariance £ Plan ActivityVariance £ Plan ActivityVariance £ Plan ActivityActivity ActivityActivity ActivityActivity ActivityActivity ActivityActivity ActivityVariance £Surgery, Head & Neck Accident & Emergency 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0General Surgery 0 0 0 0 0 0 0 0 -0 0 0 0 -0 1 1 8,007 0 0 0 0Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Ophthalmology 1,805 1,965 160 208,585 361 314 -47 -1,221 261 109 -152 -105,354 19 15 -4 -3,772 0 0 0 0Other 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Pain Management 27 28 1 2,108 0 1 1 433 8 9 1 1,884 0 0 0 0 0 0 0 0Thoracic Surgery 1 0 -1 -3,174 150 174 24 117,747 34 26 -8 -69,845 25 25 -0 -21,863 0 0 0 0Trauma & Orthopaedics 124 124 0 32,629 89 113 24 7,399 486 488 2 -116,711 11 8 -3 -9,997 0 0 0 0Urology 692 710 18 19,375 188 139 -49 -108,665 99 96 -3 2,570 0 1 1 -178 0 0 0 0Adult Critical Care 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,157 1,152 -5 -3,031Breast Surgery 35 19 -16 -23,612 82 73 -9 -32,279 2 1 -1 -3,160 0 0 0 0 0 0 0 0Colorectal Surgery 102 91 -11 -1,418 118 101 -17 -50,187 433 435 2 -41,432 4 3 -1 -2,016 0 0 0 0Upper Gastrointestinal Surgery 28 20 -8 3,143 302 217 -85 -60,374 435 490 55 15,968 13 9 -4 -35,305 0 0 0 0Vascular Surgery 123 92 -31 -13,103 119 107 -12 -5,897 55 55 -0 -32,595 6 2 -4 -18,510 0 0 0 0Oral Surgery / Dentistry 523 548 25 35,280 7 7 0 4,277 2 2 0 269 0 0 -0 -214 0 0 0 0Maxillo-Facial Surgery 14 21 7 8,903 69 45 -24 -24,834 46 29 -17 -37,142 3 1 -2 -4,730 0 0 0 0ENT / Audiology 124 142 18 36,571 75 81 6 21,625 129 161 32 48,808 1 1 -0 -64 0 0 0 0Clinical Physiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Hepatobiliary & Pancreatic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Surgery, Head & Neck Total 3,598 3,760 162 305,286 1,561 1,372 -189 -131,974 1,992 1,901 -91 -336,742 83 66 -17 -88,644 1,157 1,152 -5 -3,031Women's & Children's Accident & Emergency 0 0 0 0 0 0 0 0 1 0 -1 -755 0 0 0 0 0 0 0 0Cardiac Surgery 0 0 -0 -953 52 61 9 179,625 9 10 1 -48,303 17 15 -2 -20,572 0 0 0 0Cardiology 29 17 -12 -41,822 85 86 1 46,683 14 21 7 18,358 12 10 -2 -21,087 0 0 0 0Clinical Genetics 0 0 -0 -870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Dermatology 21 3 -18 -11,812 1 0 -1 -662 0 1 1 -915 0 0 0 0 0 0 0 0Gastroenterology 162 102 -60 -65,244 43 35 -8 -15,143 6 11 5 31,461 2 0 -2 -9,348 0 0 0 0General Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Gynaecology 478 445 -33 -26,300 344 383 39 34,848 471 469 -2 -68,195 10 8 -2 -6,462 0 0 0 0Medical Oncology 18 38 20 18,269 99 55 -44 -100,527 52 49 -3 -13,563 644 682 38 -87,329 0 0 0 0Nephrology 5 8 3 1,129 43 36 -7 87,367 26 23 -3 -32,188 6 5 -1 -19,605 0 0 0 0Neurology 27 22 -5 -10,047 17 13 -4 -4,893 14 25 11 11,804 2 3 1 1,280 0 0 0 0Other 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Paediatric Surgery 270 257 -13 19,835 175 152 -23 -10,865 198 232 34 -17,934 40 50 10 88,589 0 0 0 0Pain Management 7 5 -2 -2,083 0 0 -0 -245 0 0 0 0 0 0 -0 -470 0 0 0 0Rheumatology 114 97 -17 -12,415 19 13 -6 -2,545 3 1 -2 -1,681 1 0 -1 -749 0 0 0 0Thoracic Surgery 0 0 0 0 2 5 3 25,360 0 1 1 7,296 0 0 0 0 0 0 0 0Trauma & Orthopaedics 186 155 -31 -106,694 92 90 -2 -41,677 117 148 31 109,496 3 0 -3 -18,042 0 0 0 0Urology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Clinical Haematology / Haemophilia 0 0 -0 -256 0 2 2 1,900 0 0 -0 -849 0 0 0 0 0 0 0 0Blood And Marrow Transplantation 1 7 6 0 37 45 8 0 1 1 0 0 0 1 1 0 0 0 0 0General Paediatrics 351 375 24 9,881 148 92 -56 -51,935 1,104 1,181 77 50,574 8 6 -2 -8,462 0 0 0 0Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Oral Surgery / Dentistry 0 0 0 0 0 0 0 0 0 0 -0 -143 0 0 0 0 0 0 0 0ENT / Audiology 235 295 60 166,273 172 120 -52 25,137 42 62 20 11,262 2 3 1 -3,023 0 0 0 0Obstetrics / Midwifery -15 6 21 15,526 36 16 -20 -44,469 13 11 -2 173 3,803 4,255 452 344,654 0 0 0 0Clinical Physiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Respiratory Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Paediatric Intensive Care 0 0 0 0 3 3 -0 -6,772 39 29 -10 -35,047 28 32 4 85,374 0 0 0 0Plastic Sugery 0 0 0 0 0 0 -0 -1,430 0 0 -0 -1,318 0 0 0 0 0 0 0 0Neonatal Critical Care 0 0 -0 -188 0 0 0 0 0 1 1 592 0 0 0 0 4,271 4,585 314 -8,090Paediatric Critical Care 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,029 1,075 46 87,638Neurosurgery 0 0 0 0 0 1 1 5,614 0 0 0 0 0 0 0 0 0 0 0 0Women's & Children's Total 1,890 1,832 -58 -47,772 1,368 1,208 -160 125,372 2,111 2,276 165 20,125 4,577 5,070 493 324,748 5,299 5,660 360 79,548Specialised Services Cardiac Surgery 0 0 0 0 268 234 -34 -216,150 45 60 15 45,071 121 129 8 79,724 0 0 0 0Cardiology 252 262 10 31,575 295 276 -19 -186,702 394 435 41 322,299 173 152 -21 -108,723 0 0 0 0General Medicine 0 0 0 0 0 0 0 0 0 0 -0 -568 0 0 0 0 0 0 0 0Homeopathy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Medical Oncology 1,205 1,421 216 119,395 111 158 47 4,874 81 109 28 34,736 0 1 1 2,578 0 0 0 0Other 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Clinical Haematology / Haemophilia 897 887 -10 -38,122 37 31 -6 -17,870 63 98 35 12,856 2 1 -1 -5,611 0 0 0 0Clinical Oncology 1,724 1,717 -7 -46,973 202 200 -2 -3,327 101 130 29 27,553 1 1 0 -1,077 0 0 0 0Blood And Marrow Transplantation 36 13 -23 -10,062 7 16 9 -12,429 4 13 9 5,216 0 0 -0 -858 0 0 0 0Cardiac Critical Care 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,784 1,808 24 30,853Breast Surgery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Clinical Physiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Palliative Medicine 0 0 0 0 0 0 0 0 2 0 -2 -7,817 0 0 0 0 0 0 0 0Radiotherapy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Specialised Services Total 4,115 4,300 185 55,814 919 915 -4 -431,604 690 845 155 439,346 298 284 -14 -33,966 1,784 1,808 24 30,853Medicine Accident & Emergency 0 0 0 0 0 4 4 8,488 1,169 1,612 443 279,524 0 0 0 0 0 0 0 0Dermatology 293 324 31 19,031 9 1 -8 -8,947 3 0 -3 -6,726 0 0 -0 -1,777 0 0 0 0Gastroenterology 1,312 1,315 3 -5,882 38 47 9 1,482 21 28 7 22,885 0 1 1 -1,824 0 0 0 0General Medicine 214 266 52 23,198 55 46 -9 -11,071 2,421 2,714 293 296,097 16 16 0 5,406 0 0 0 0Hepatology 0 0 0 0 1 1 0 217 1 1 -0 -3,573 0 0 0 0 0 0 0 0Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Neurology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Other 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Rehabilitation 0 0 0 0 0 0 0 0 240 244 4 36,139 -0 2 2 18,070 0 0 0 0Rheumatology 121 110 -11 -13,641 5 0 -5 -3,423 0 0 -0 -214 0 0 0 0 0 0 0 0Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Clinical Haematology / Haemophilia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Geriatric Medicine 0 0 0 0 1 0 -1 -2,510 244 205 -39 -68,588 1 4 3 8,199 0 0 0 0ENT / Audiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Clinical Physiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Respiratory Medicine 0 0 0 0 1 0 -1 -1,106 3 4 1 4,433 0 0 0 0 0 0 0 0Genitourinary Medicine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Medicine Total 1,939 2,015 76 22,706 111 99 -11 -16,870 4,102 4,808 705 559,978 17 23 6 28,074 0 0 0 0Corporate Services 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Diagnostic & Therapies Other 56 42 -14 -5,516 1 1 -0 -17 0 0 0 0 0 0 0 0 0 0 0 0Neurophysiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0ENT / Audiology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Diagnostic & Therapies Total 56 42 -14 -5,516 1 1 -0 -17 0 0 0 0 0 0 0 0 0 0 0 0Grand Total 11,598 11,949 351 330,518 3,959 3,595 -364 -455,093 8,896 9,830 934 682,706 4,975 5,443 468 230,213 8,241 8,620 379 107,370Agenda Item 7 (iii)

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUST Table INC 3SERVICE AGREEMENTS INCOME VARIANCE REPORT BY WORKTYPE AND SPECIALTYOther Outpatient ProceduresOutpatients A & E Variance £DivisionSurgery, Head & NeckSurgery, Head & Neck TotalWomen's & Children'sWomen's & Children's TotalSpecialised ServicesSpecialised Services TotalMedicineMedicine TotalCorporate ServicesDiagnostic & TherapiesDiagnostic & Therapies TotalGrand TotalBoard Report SpecialtyAccident & EmergencyGeneral SurgeryNeurologyOphthalmologyOtherPain ManagementThoracic SurgeryTrauma & OrthopaedicsUrologyAdult Critical CareBreast SurgeryColorectal SurgeryUpper Gastrointestinal SurgeryVascular SurgeryOral Surgery / DentistryMaxillo-Facial SurgeryENT / AudiologyClinical PhysiologyHepatobiliary & Pancreatic SurgeryAccident & EmergencyCardiac SurgeryCardiologyClinical GeneticsDermatologyGastroenterologyGeneral MedicineGynaecologyMedical OncologyNephrologyNeurologyOtherPaediatric SurgeryPain ManagementRheumatologyThoracic SurgeryTrauma & OrthopaedicsUrologyEndocrinologyClinical Haematology / HaemophiliaBlood And Marrow TransplantationGeneral PaediatricsVascular SurgeryOral Surgery / DentistryENT / AudiologyObstetrics / MidwiferyClinical PhysiologyRespiratory MedicinePaediatric Intensive CarePlastic SugeryNeonatal Critical CarePaediatric Critical CareNeurosurgeryCardiac SurgeryCardiologyGeneral MedicineHomeopathyMedical OncologyOtherClinical Haematology / HaemophiliaClinical OncologyBlood And Marrow TransplantationCardiac Critical CareBreast SurgeryClinical PhysiologyPalliative MedicineRadiotherapyAccident & EmergencyDermatologyGastroenterologyGeneral MedicineHepatologyNephrologyNeurologyOtherRehabilitationRheumatologyEndocrinologyClinical Haematology / HaemophiliaGeriatric MedicineENT / AudiologyClinical PhysiologyRespiratory MedicineGenitourinary MedicineOtherNeurophysiologyENT / AudiologyVariance £ Plan ActivityActual VarianceActual VarianceActual VarianceVariance £ Plan ActivityVariance £ Plan ActivityActivity ActivityActivity ActivityActivity ActivityVariance £0 0 0 0 0 0 0 0 0 5,882 6,171 289 11,571 11,57133,626 0 0 0 0 43 473 430 48,664 0 0 0 0 90,2970 0 0 0 0 149 150 1 1,534 0 0 0 0 1,534220,058 379 428 49 9,070 30,751 26,266 -4,485 59,119 0 0 0 0 386,4850 0 0 0 0 1,390 536 -854 1,938 0 0 0 0 1,938742 0 0 0 0 760 851 91 7,875 0 0 0 0 13,042-11,297 0 0 0 0 303 359 56 3,323 0 0 0 0 14,891-193,551 4 0 -4 -766 6,708 6,748 40 2,511 0 0 0 0 -278,487-9,908 24 8 -16 -3,184 2,311 1,794 -517 -52,582 0 0 0 0 -152,5721,471 0 0 0 0 0 0 0 0 0 0 0 0 -1,560-5,343 63 1 -62 -14,387 1,413 1,450 37 15,948 0 0 0 0 -62,83327,087 188 237 49 14,170 1,211 1,050 -161 1,630 0 0 0 0 -52,1667,392 0 0 0 0 897 863 -34 -4,440 0 0 0 0 -73,61617,729 59 54 -5 -501 1,239 1,180 -59 -4,707 0 0 0 0 -57,5832,065 644 605 -39 -6,578 10,312 10,087 -224 -35,513 0 0 0 0 -415-10,095 0 0 0 0 1,058 1,128 70 5,951 0 0 0 0 -61,9485,624 0 1 1 128 3,190 2,904 -286 -10,164 0 0 0 0 102,5280 0 45 45 7,759 93 0 -93 0 0 0 0 0 7,7590 0 0 0 0 0 0 0 0 0 0 0 0 085,600 1,360 1,379 19 5,711 61,829 55,839 -5,990 41,088 5,882 6,171 289 11,571 -111,1343,820 0 0 0 0 0 0 0 0 6,418 7,348 926 82,471 85,53681,615 0 0 0 0 123 72 -51 -958 0 0 0 0 190,454-41,535 20 34 14 3,001 883 908 25 3,596 0 0 0 0 -32,8070 0 0 0 0 195 164 -31 -38,148 0 0 0 0 -39,019-508 0 23 23 2,925 497 510 13 -51 0 0 0 0 -11,02214,173 0 0 0 0 313 375 62 9,924 0 0 0 0 -34,1780 0 0 0 0 171 0 -171 -16,927 0 0 0 0 -16,927-7,226 614 492 -122 -28,382 3,821 4,413 592 66,060 0 0 0 0 -35,658-86,749 0 25 25 4,585 7,553 8,133 580 76,377 0 0 0 0 -188,9363,706 0 6 6 1,992 327 328 1 5,107 0 0 0 0 47,508125,451 0 5 5 630 446 479 33 2,455 0 0 0 0 126,680241 0 0 0 0 201 21 -180 645 0 0 0 0 88635,924 0 0 0 0 740 471 -269 -43,767 0 0 0 0 71,782-3,958 0 0 0 0 0 0 0 0 0 0 0 0 -6,756-5,700 0 0 0 0 224 270 46 7,268 0 0 0 0 -15,8220 0 0 0 0 0 0 0 0 0 0 0 0 32,656164 0 0 0 0 992 885 -107 -15,401 0 0 0 0 -72,1540 0 0 0 0 2 276 274 38,522 0 0 0 0 38,522-1,055 0 0 0 0 207 397 190 14,680 0 0 0 0 13,62617,108 0 0 0 0 113 127 14 5,307 0 0 0 0 23,211209,418 0 0 0 0 0 0 0 0 0 0 0 0 209,418-17,418 5 8 3 738 1,949 2,057 108 32,845 1,145 641 -504 -128,190 -111,967-640 0 0 0 0 0 0 0 0 0 0 0 0 -6400 0 0 0 0 0 0 0 0 0 0 0 0 -143-92,577 0 3 3 466 3,043 3,031 -12 3,155 0 0 0 0 110,69244,913 0 29 29 5,243 2,433 2,059 -374 -44,938 0 0 0 0 321,1020 0 12 12 1,513 0 0 0 0 0 0 0 0 1,513-1,386 0 0 0 0 0 0 0 0 0 0 0 0 -1,38615,932 0 0 0 0 0 0 0 0 0 0 0 0 59,487-12,978 0 0 0 0 3 0 -3 -480 0 0 0 0 -16,206-22,399 0 0 0 0 0 53 53 6,360 0 0 0 0 -23,72513,574 0 0 0 0 0 0 0 0 0 0 0 0 101,2120 0 0 0 0 0 0 0 0 0 0 0 0 5,614271,909 639 637 -2 -7,290 24,232 25,029 797 111,631 7,563 7,989 422 -45,718 832,55244,636 0 2 2 356 689 641 -48 -4,566 0 0 0 0 -50,929-77,751 262 699 437 55,120 3,415 3,226 -189 -26,681 0 0 0 0 9,1370 0 0 0 0 0 0 0 0 0 0 0 0 -5680 0 0 0 0 1,006 1,106 100 11,402 0 0 0 0 11,402116,472 0 0 0 0 2,161 2,132 -29 -2,146 0 0 0 0 275,910-292 0 0 0 0 165 0 -165 0 0 0 0 0 -292136,281 0 7 7 1,475 1,584 1,768 184 32,199 0 0 0 0 121,20822,899 0 1 1 223 2,791 2,979 188 22,122 0 0 0 0 21,42025,611 0 0 0 0 0 0 0 0 0 0 0 0 7,4780 0 0 0 0 0 0 0 0 0 0 0 0 30,8530 0 0 0 0 12 14 2 224 0 0 0 0 2240 0 0 0 0 46 0 -46 0 0 0 0 0 0-474 0 0 0 0 4 14 10 2,289 0 0 0 0 -6,002-42,954 0 0 0 0 0 0 0 0 0 0 0 0 -42,954224,428 262 709 447 57,174 11,873 11,880 7 34,842 0 0 0 0 376,88713,114 0 0 0 0 0 0 0 0 15,215 16,098 883 113,891 415,017-45,329 154 154 0 1 4,858 4,991 133 8,624 0 0 0 0 -35,1221,647 0 0 0 0 0 0 0 0 0 0 0 0 18,308117,880 458 458 0 0 3,886 3,971 85 14,740 0 0 0 0 446,250-2,623 0 0 -0 -46 1,098 1,088 -10 8,798 0 0 0 0 2,7720 0 0 0 0 81 94 13 5,611 0 0 0 0 5,611-172 0 0 0 0 436 397 -39 -20,119 0 0 0 0 -20,291-10,372 0 3 3 653 900 785 -115 23,801 0 0 0 0 14,0820 0 0 0 0 0 0 0 0 0 0 0 0 54,20938,407 0 11 11 2,622 1,509 1,520 11 1,739 0 0 0 0 25,4898,463 0 0 0 0 438 378 -60 -8,217 0 0 0 0 2460 0 0 0 0 144 31 -113 -3,056 0 0 0 0 -3,056-21,077 0 0 0 0 717 744 27 2,935 0 0 0 0 -81,0402,500 0 0 0 0 0 0 0 0 0 0 0 0 2,50045 0 0 0 0 0 0 0 0 0 0 0 0 4550,639 0 0 0 0 1,947 1,857 -90 -4,732 0 0 0 0 49,2340 0 0 0 0 5,239 5,238 -1 -103 0 0 0 0 -103153,121 612 626 14 3,230 21,254 21,094 -160 30,020 15,215 16,098 883 113,891 894,1510 0 0 0 0 0 0 0 0 0 0 0 0 0132,359 0 1 1 158 335 98 -237 -989 0 0 0 0 125,9940 0 0 0 0 458 432 -26 -5,231 0 0 0 0 -5,2310 0 0 0 0 4,335 4,358 23 1,045 0 0 0 0 1,045132,359 0 1 1 158 5,129 4,888 -241 -5,176 0 0 0 0 121,807867,416 2,874 3,352 478 58,983 124,317 118,730 -5,587 212,406 28,660 30,258 1,594 79,744 2,114,263Agenda Item 7 (iii)

Trust Board26th August 2010Agenda Item 7 (iii)Contract Income Report1. Overview Of Key IssuesActivity was slightly higher than plan in June, leading to an over-performance of £0.10m.For the year to date contract income is £3.77m higher than plan, of which £1.56m relatesto 2009/10. The position includes the impact of the emergency marginal tariff reduction,which is currently valued at £1.24m and thus commissioner over-performance issignificantly higher given that PCTs are required to fully fund emergency care overperformancevia additional payments to the Strategic Health Authority.2. SLA Position2.1. By WorktypeThe graph below summarises the contract income variance by work type in June:£0.80m£0.60m£0.40m£0.20m£0.00m-£0.20m-£0.40m-£0.60mYear To DateCurrent MonthActivity graphs and a more detailed activity/finance schedule are included as TableINC1 and Table INC3 respectively.2.1.1. Accident & Emergency AttendancesAccident & emergency attendances were £0.06m higher than plan in June and arecurrently £0.08m higher than plan for the year to date.2.1.2. Emergency InpatientsEmergency inpatient spells were £0.32m higher than plan in June and are currently£0.69m higher than plan for the year to date. This is net of the marginal tariff adjustmentPage 1 of 7

of £1.00m (there is also a £0.24m adjustment for Excess Bed Days). The position by divisionin June is shown in the following table:Division £m Main specialties affectedMedicine 0.21 General Medicine (£0.14m).Specialised Services 0.17 Cardiac Surgery (£0.08m), Cardiology (£0.08m).Surgery, Head & Neck 0.01 Ophthalmology (-£0.07m), Upper Gastrointestinal Surgery (£0.05m).Women's & Children's (0.07) Cardiac Surgery (-£0.04m), Nephrology (-£0.03m).Total 0.32The impact of the marginal tariff adjustment on the year to date divisional performancecan be seen below,DivisionGrossValue£mMarginalTariffAdjustment£mNetValue£mMedicine £0.96m -£0.39m £0.57mSpecialised Services £0.64m -£0.20m £0.44mSurgery, Head & Neck -£0.23m -£0.10m -£0.34mWomen's & Children's £0.32m -£0.30m £0.02mTotal £1.69m -£1.00m £0.69m2.1.3. Day CasesDay cases were £0.05m higher than plan in June and are currently £0.33m higher thanplan for the year to date.This continuing trend is due to a lower than expected transfer of activity to theIndependent Sector Treatment Centre (ISTC) at Emerson’s Green. There is some evidenceto suggest that the ISTC activity was slightly higher in May but the volumes are still 50%lower than plan for the first two months of the year. The planned transfer for NorthSomerset was set at an artificially high level and hence the over performance is largelyexpected.2.1.4. Elective InpatientsElective Inpatient spells were £0.51m lower than plan in June and are currently £0.45mlower than plan for the year to date.The key reasons for the variance in June are as follows,Cardiac Surgery was £0.23m lower than plan. Elective capacity at the BristolHeart Institute is being used to treat both emergency patients and also patientsthat require cancer surgery. There were 25 late hospital cancellations for CardiacSurgery in June. This is 9 higher than the expected number based on last year’sdata.Cardiology was £0.07m lower than plan. In addition to the pressures on electivecapacity described above there were no percutaneous valve replacementsperformed in June.Upper Gastrointestinal Surgery was £0.07m lower than plan.Urology was £0.06m lower than plan.2.1.5. Non-Elective InpatientsPage 2 of 7

Non-elective inpatients spells were £0.07m higher than plan in June and are currently£0.23m higher than plan for the year to date. This continuing trend is due to a higher thanexpected number of births.2.1.6. Excess Bed DaysExcess bed days were £0.13m lower than plan in June and are currently £0.11m higherthan plan for the year to date. This is net of the marginal tariff adjustment of £0.24m forEmergency Excess Bed Days.2.1.7. OutpatientsOutpatients were £0.01m higher than plan in June and are currently £0.27m higher thanplan for the year to date.2.1.8. Bone Marrow TransplantsBone marrow transplants are currently £0.30m higher than plan for the year to date. This isbased on activity during the first 4 months of the year. Activity in July was £0.12m higherthan plan. This predominantly relates to activity from outside of the South West.2.1.9. Critical Care Bed DaysCritical care bed days were £0.03m higher than plan in June and are currently £0.11mhigher than plan for the year to date.2.1.10. PbR Excluded Drugs & Devices / NICEPbR excluded drugs & devices / NICE were £0.13m lower than plan in June and arecurrently £0.04m higher than plan for the year to date.2.1.11. OtherOther activity was £0.14m higher than plan in June and is currently £0.42m higher thanplan for the year to date. Other activity includes radiotherapy courses, regular day/nightattendances, direct access services, critical care retrievals, exceptional funding, at costcontracts, diagnostic imaging, top-ups and fines.Direct access services and at cost contracts were both higher than plan in June by£0.06m and £0.05m, respectively. The year to date position is largely due to exceptionalfunding and chemotherapy drugs which are higher than plan by £0.21m and £0.15mrespectively.Page 3 of 7

Grand TotalOtherSouth West StrategicHealth AuthorityWelsh CommissionersOther South WestCommissionersVariable EstimatesSouth West SpecialistCommissioning GroupNHS SouthGloucestershireNHS North SomersetNHS Bristol2.2. By CommissionerThe table below summarises the contract income variance by work type & commissioner:Worktype £m £m £m £m £m £m £m £m £m £mAccident & Emergency 0.07 0.01 -0.01 0.00 0.00 0.00 0.00 0.00 0.01 0.08Bone Marrow Transplants 0.00 0.00 0.00 0.14 -0.24 0.00 0.08 0.00 0.32 0.30Critical Care Beddays -0.18 0.07 0.15 0.03 -0.05 0.19 -0.06 0.00 -0.03 0.11Day Cases 0.15 0.19 0.03 -0.06 -0.05 0.09 -0.02 0.00 0.01 0.33Elective Inpatients -0.15 -0.07 0.08 -0.28 -0.20 0.08 0.15 0.00 -0.05 -0.45Emergency Inpatients 0.54 0.40 0.03 0.39 -0.03 0.28 0.02 -1.00 0.04 0.69Excess Beddays 0.14 0.00 0.01 0.21 -0.01 0.00 0.00 -0.24 -0.01 0.11Non-Elective Inpatients 0.23 -0.04 0.02 0.02 -0.02 0.15 -0.15 0.00 0.01 0.23Outpatients 0.34 0.12 0.04 -0.02 -0.33 0.12 0.00 0.00 0.00 0.27PbR Exclusions/NICE 0.01 -0.04 -0.12 0.06 -0.03 0.15 0.03 0.00 -0.01 0.06Other 1.68 0.67 0.66 -0.12 -2.77 0.28 -0.02 0.00 0.10 0.48Total 2.84 1.33 0.89 0.37 -3.74 1.34 0.03 -1.24 0.39 2.212009/10 Estimate v Actual 0.52 0.36 0.03 0.19 0.00 0.43 -0.01 0.00 0.05 1.56Total 3.35 1.69 0.92 0.56 -3.74 1.77 0.02 -1.24 0.44 3.77Notes to tableDuring the Operational Planning process the Trust agreed to reduce Service Level Agreement values forsaving schemes put forward by Primary Care Trusts, referred to as Quality, Innovation, Productivity andPrevention (QIPP) schemes. As the PCTs have yet to supply detailed plans of where they expect theseschemes to impact on activity, the Trust has created a dummy commissioner – Variable Estimates – to offsetthe over-performance against these lines.Under 2010/11 Payment by Results rules the Trust will only be paid 30% for any over-performance onEmergency activity above a baseline of 2008/09 outturn for activity within Payment by Results. The PCTswill still pay the remaining 70%, however this will be paid to the Strategic Health Authority, rather than theTrust. The total year to date Emergency activity adjustment is shown in the table above.2.2.1. NHS Bristol (over-performance £2.84m)Of the over performance for NHS Bristol, £1.44m relates to commissioner saving schemes(QIPP), which we have profiled in twelfths and are showing under ‘Other’. Additionally,they have seen a high level of Emergency activity, particularly in General Medicine andAccident and Emergency, which increased by £0.14m and £0.11m respectively in month.Non-Elective Obstetric activity has been higher than planned, however bookings forbirths are high over the coming months, which will impact on non-birth activity in thepreceding months. This level was not reflected in the contract; therefore the overperformanceis likely to continue.2.2.2. North Somerset (over-performance £1.33m)The main drivers behind the North Somerset over performance are non-delivery of QIPP,which accounts for £0.58m of this, Emergencies in General Medicine, andOphthalmology day cases. The Ophthalmology day cases over-performance arises fromthe planning assumption that very large volumes of cataract work would transfer to theISTC, however this has not materialised. North Somerset PCT has instigated a ReferralManagement Service to try and remedy this but for a predominantly elderly population,Emersons Green is not a location of choice for many patients.2.2.3. South Gloucestershire (over-performance £0.89m)Page 4 of 7

In addition to QIPP of £0.62m, the over-performance for South Gloucestershire issignificantly high in Critical Care, with four patients in the first three months with notablylong lengths of stay. Of these, two are Thoracic Surgery cases, one Colorectal and oneMedical Oncology.2.2.4. South West Specialist Commissioning (over-performance £0.30m)The over-performance for South West Specialist Commissioning is driven by a number offactors, across specialties and work types.The over-performance in the first three months in Bone Marrow Transplants is discussedabove. Excess Bed days are over plan, mainly due to three patients with a significantlength of stay. Emergency activity within Trauma and Orthopaedics has been higher thanplan. This activity may have some seasonality to it, as it was high at the same time lastyear. Specialist Commissioning is significantly under for Elective activity, particularlyCardiac Surgery and Cardiology.3. Key Contractual Issues3.1. QIPP (Quality, Innovation, Productivity and Prevention)Risk assessment: HighThere is still little evidence of PCT QIPP delivery plans starting to impact on activityalthough, as previously reported, many schemes were not due to start until July 2010.North Somerset and South Gloucestershire PCT are still to share the detail of their QIPPplans with the Trust, for validation by operational leads. This is essential prior to theQuarter 1 formal review with BNSSG PCTs. This lack of information means that PCTdelivery of QIPP plans remains assessed as high risk. As highlighted in last month’s report,many of the QIPP schemes relate to emergencies (which are subject to 30% marginaltariff for over-performance against 2008/09 baseline) and therefore the Trust carries asignificant risk in this respect also.3.2. CQUINs (Commissioning for Quality and Innovation)Risk assessment: HighThe Month 3 CQUINs monitoring report is attached at Table INC4. Of the gatewaytargets, the breast symptom referrals within 2 weeks target remains high risk, althoughsignificant effort is being made to achieve the percentage performance required in thelast three quarters to enable the target to be met for the year as a whole. As previouslyadvised, if this or any of the other mandatory gateway targets (Cancer/A&E/18 Weeks)are missed, the Trust forfeits the right to earn any of the potential £5.3m CQUIN rewards.The cancelled operations gateway target is also high risk – non-achievement of thistarget for the year will reduce potential rewards by 10% or £0.53m.NHS Bristol (as co-ordinating commissioner) is yet to agree to a contract variation to thegateway to remove the 18-week Referral to Treatment target and reduce the A&E 4-hourwait threshold from 98% to 95%, in line with the NHS Operating Framework revisions. Wecontinue to press for this, in collaboration with North Bristol Trust.More extensive reporting on the individual CQUIN indicators will be available for nextmonth. At the present time, the QIPP CQUINs (internal Trust productivity) remain highestrisk of non-achievement.Based on Quarter 1 performance, the Trust would not achieve the CQUIN gateway andwould not therefore qualify for any of the £5.3m rewards. Year-to-date (Quarter 1), weare meeting the MRSA Bloodstream CQUIN indicators. If this performance continues, andPage 5 of 7

assuming achievement of the gateway, the Trust would earn a reward of £0.21m forachievement of this target.3.3. Contract limitersContract limiters are detailed at Table INC5.Limiters carrying a high risk of non-achievement and high financial impact are as follows:A&E conversion ratio – Quarter 1 performance is on target (45.96% against a target of49.97%). Emergency readmissions within 14 days – Quarter 1 performance is on target (5.23%against a target of 5.69%), based on 28-day specialty exceptions rules. However, itshould be noted that this methodology is still to be finally agreed with NHS Bristol, andtherefore carries some risk.Other referrals – Other referrals in Quarter 1 continue to be higher than the limiterwhich is based on 2009/10 outturn. NHS Bristol has accepted that some of this growthis legitimate. Detailed analysis and understanding of factors generating this increaseis continuing, for discussion with NHS Bristol. The Trust is working closely with NHS NorthSomerset on its other referrals project.New to follow-up ratio – Quarter 1 performance continues to be significantly higherthan the limiter (2.23 against 2.04), although a number of adjustments are still to beagreed.3.4. Quality RequirementsThe quality requirements / penalties schedule is attached at Table INC6.The following targets are high risk:Clostridium difficile – the Month 4 position is 7 cases above the contractual target. Ifthis were to continue for the whole year, the Trust would incur a penalty of £7.09m(the maximum under the contract). However, based on last year’s profile and the lownumber of cases in August, the Trust remains confident that this penalty will not beincurred.Cancelled operations – this target has been failed for Quarter 1. If this performancecontinues, the fine for the year will be £0.05m.Stroke care – percentage spending 90% of time on stroke unit – the Trust has failed thistarget for Quarter 1. If this continues, a penalty of £0.09m would be incurred for theyear.Cancer - Breast symptom referrals within 2 weeks – as reported under CQUINs(above), this target was failed for Quarter 1. If this continues, the penalty payableunder the contract is 2% of service line revenue (agreement is still to be reached withNHS Bristol on the calculation of this). Percentage of women booking by Week 13 – this target was not met in Quarter 1,and would attract a fine of £0.05m if this continued for the whole year.4. Contract Income – Changes In PlanMonitor requires variances to be analysed from the Annual Plan. This table summariseschanges in the budget approved from the Annual Plan and Resources Book.Page 6 of 7

ContractIncome£mLevies£mSkills forHealth£mR&D£mDivisions£mTOTAL£mMonth 3 384.79 40.14 36.60 11.11 31.74 504.37Outpatient procedures rebasing 0.22 0.00 0.00 0.00 0.00 0.22Increase in MADEL funding 0.00 0.15 0.00 0.00 0.00 0.15Increase in Medical SIFT funding 0.00 0.06 0.00 0.00 0.00 0.06Increase In Merit Awards funding 0.00 0.02 0.00 0.00 0.00 0.02Research & Dev elopment - Various Adjustments 0.00 0.00 0.00 0.07 0.00 0.07Skills for Health - Various Adjustments 0.00 0.00 0.28 0.00 0.00 0.28Div isions - Various Adjustments 0.00 0.00 0.00 0.00 0.26 0.26Month 4 385.01 40.36 36.88 11.18 32.00 505.425. Costing and Service Line ReportingThe Department of Health is currently verifying the 2009/10 Reference Cost submissionand a resubmission period is open for Trusts that have material errors in their initialsubmission. It is not expected that the Trust will need to resubmit.During the verification process the Department of Health produce indicative ReferenceCost Indices. Whilst these indices are based on incomplete data and exclude specificelements they do provide organisations with an early indication of their final ReferenceCost Index. The Trust’s indicative Reference Cost Index is 96.Service Line Reports have now been produced for Quarter 4. A full report will beproduced for the September Finance Committee.It is anticipated that the 2010/2011 Quarter 1 Service Line Reports will be made availablein October 2010. This is a slight delay on the the expected timescalse which is in part dueto the work needed to restucture the allocation tables to reflect the new cost centre andaccount code structure.Page 7 of 7

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTCONTRACT MONITORING PERFORMANCE TARGETSTable INC4CQUINs - CONTRACT SCHEDULE 18Prior to accessing any reward, UHBristol must first achieve Gateways G1, 2 and 3.As at Month 3CQUIN GATEWAY - Schedule 18 Part 1ID Title YTD Value ThresholdMandatoryGatewaysmet for 50%RewardAdditionalGateways metfor further %Reward Data availableG1 Emergency Care 4 Hour Throughput (including WIC) 98.04% 98% Yes Jun-10G2a Cancer 62 Day Referral To Treatment (Urgent GP Referral) 85.2% 85% Yes Jun-10G2b Cancer 62 Day Referral To Treatment (Screenings) 90.6% 90% Yes Jun-10G2c Cancer 62 Day Referral To Treatment (Upgrades) 100.0% 90% Yes Jun-10G2d Cancer - 31 Day Diagnosis To Treatment (First Treatments) 98.0% 96% Yes Jun-10G2e Cancer - 31 Day Diagnosis To Treatment (Subsequent - Drug) 99.3% 98% Yes Jun-10G2f Cancer - 31 Day Diagnosis To Treatment (Subsequent - Surgery) 97.1% 94% Yes Jun-10G2g Cancer - 31 Day Diagnosis To Treatment (Subsequent - Radiotherapy) 99.1% 94% Yes Jun-10G2h Cancer - Urgent Referrals Seen In Under 2 Weeks 95.0% 93% Yes Jun-10G2i Cancer - Breast Symptom Referrals Seen In Under 2 Weeks 84.2% 93% No Jun-10G3a Referral To Treatment Admitted Under 18 Weeks 93.2% 90% Yes Jun-10G3b Referral To Treatment Non Admitted Under 18 Weeks (including Audiology)97.8% 95% Yes Jun-10G4 MRSA Cases Against 2008/09 Baseline -2 0 Yes Jun-10G5 Diagnostics 6 Week Wait (15 Key Tests) 99.60% 99.5% Yes Jun-10G6 Number of Last Minute Cancelled Operations 1.11% 0.8% No Jun-10Year-endForecastGateways G1-3 - Mandatory 2 2 2 or 3Four Gateways - 70% of available reward out of 3 out of 3 out of 3Five Gateways - 90% of available rewardSix Gateways - 100% of available rewardCQUIN REWARDS - Schedule 18 Part 2CQUIN indicators with possible rewards after achievement of GatewaysCurrent suggested reward: 0% 0% or 90%Agenda Item 7 (iii)ID Title YTD Value ThresholdMaximumRewardCurrentSuggestedReward Data availableYear-endForecastQ01 Percentage of Adult Admissions With a VTE Risk Assessment 90% £0.53m Exp July 2010Q02 Annual Survey - Improve responsiveness to personal needs of patients - £0.53m Exp Jan 2011Q03 Average Length Of Stay - Elective 3.81 3.64 £0.35m Jun-10Q04 Average Length Of Stay - Emergency 5.26 5.07 £0.35m Jun-10Q05 New to Follow-Up Ratio 2.24 1.93 £0.35m Jun-10Q06 Rate of Non Face To Face Follow-Up Care - £0.35m Apr-10Q07 Elective SAR100 Ophthalmology - £0.35m Apr-10Q08 Emergency Readmissions (Same Specialty) Within 14 Days - £0.35m Apr-10Q09a Smoking Cessation - Staff Who Have Had Brief Intervention Training - £0.05m Exp July 2010Q09b Smoking Cessation - Referrals to Cessation Service - £0.17m Exp July 2010Q10 Reduction in Medication Errors - £0.21m Exp July 2010Q11a GP Discharge Process - Summaries Issued Within 24 Hours - £0.10m Exp Jan/Mar 2011Q11b GP Discharge Process - Information is Complete - £0.10m Exp Jan/Mar 2011Q12 Hospital Accquired Pressure Ulcers Per 10,000 Beddays - £0.21m Exp Oct 2010Q13 Increased use of WHO Surgical Checklist 89.43% 90% £0.21m Apr-10Q14a Emergency Care 30 Minutes Assessment 72.20% 75% £0.21m Jun-10Q14b Emergency Care 30 Minutes Assessment Data Quality - Jun-10Q15 Infection Control - MRSA Bloodstream Cases Against Trajectory -1 0 £0.21m £0.21m Jun-10 £0 / £0.19mQ16 Improved Outcomes for Adult and Paediatric BMT - £0.21m Exp July 2010Q17 Improved Outcomes in Paediatric Cardiac Surgery - £0.21m Exp July 2010Q18 Improved Outcomes in Neonatal Care - £0.21m Exp July 2010£5.26m £0.21m £0 / £0.19m

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTCONTRACT LIMITERS SCHEDULETable INC5Limiter area Limiter Description Trust position RiskDay cases that could be carried out asoutpatientsFor the 49 listed procedures review clinical practice in all 49 areas includingprocedures undertaken in outpatients but not recorded as procedures. For10/11 there will be a minimum benefit of £500k from the in year review.Carry out all YAG Laser Treatment as Outpatient Proceduresrather than Day Cases (impact of £0.38m). Review otherareas in Quarter 1.Minimum benefit of £0.50maccounted for in contract.Haematology serviceAgree to review adult haematology specialty by end of quarter 1 and agreeplan to address issues identified, both clinical and recording as appropriate.Review to the carried out, in particular reviewing other similartrusts.n/aPlanned procedures not carried outLow priority proceduresCommissioners will only pay for the following codes where cancellation is due This will be calculated monthly and included in the contractto patient choice or clinical reasons Z530, Z531, Z532 in short stay elective / monitoring to PCTs.day cases.Commissioners will not pay for any activity listed as not funded unlessapproval has been granted. For Criteria Based Access the PCT will not payfor any procedure where prior approval is required and has not been soughtor granted. CBA list to be re-issued with clarity re what requires priorapproval.A&E Conversion rateCommissioners will not pay for any activity in excess of that which arises fromapplying the 08/09 conversion rate to 10/11 activity. The conversion rate willbe calculated on the ratio of non-minor attendances to emergencyadmissions from A&E.Long-stay patientsUHB will provide commissioners with a daily list of all in patients who haveexceeded 20 days.Emergency Re-admissions 10% improvement in the rate of emergency 14 day re-admissions from 09/10baseline (applying national 28 day specialty exceptions).Other referralsCap at 09/10 out turn adjusted for agreed changes in recording and excludingscreening programme referrals.Elective marginal rateNew to follow up ratioCommissioners will pay a 65% marginal rate for elective activity above the09/10 out turn (adjusted for ACTUAL ISTC or any other in year servicetransfers in 10/11) with the exception of non-recurrent activity up to the Trustproposed level which will be paid for at national tariff providing the waiting listhas reduced proportionately (adjusted for any referral inflation) thusconfirming the N/R nature (BNSSG only).Global New to Follow Up ratio (adjusted for ISTC, recording changes andophthalmology SAR 100 deficit)Review of the number of these procedures the Trust carriedout last year will be undertaken to understand potentialimpact.This will be calculated monthly at a Trust-wide level.This is available to commissioners.This will be calculated monthly.Once agreement of calculation is established with hostcommissioner this will be calculated monthly.Host commissioner to provide ISTC information. Once thishas been made available the Trust and the hostcommissioner will work towards establishing a monthlycacluation of this.Once agreement of calculation is established with hostcommissioner this will be calculated monthly.Accounted for in the contract.n/a£0.75m based on 100 additionaladmissions per month.None.£0.25m based on noimprovement from 2009/10Impact of £0.26m accounted forin the contract.n/aImpact of £0.34m accounted forin the contract.Agenda Item 7 (iii)

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTCONTRACT MONITORING PERFORMANCE TARGETSTable INC6Data is reported as per the "Period of Reporting" column.Indicators starting with "A" are the Part 4a "Quality Requirements"Indicators starting with "B" are the Part 4B "Nationally Specified Events"Indicators starting with "X" are the Part 4B Serious Untoward Incident (SUI) and Never Events from the "Nationally Specified Events"Forecast financial riskbased on fullachievement goingforward £mForecast financial riskbased on currentperformance £mID Title Month ScoreConsequencePeriod ThresholdMaximum financialrisk £mA01 Infection Control - MRSA Bloodstream Cases Against Trajectory Jun-10 -1 Annual 0 0 0 0.25A02 Number of Last Minute Cancelled Operations* Jun-10 1.11% Quarterly 0.8% 0 0.05 0.05A03 Choose and Book Slot Availability* Jun-10 97.70% Monthly 96% 0 0 0.11A04 Diagnostics 6 Week Wait (15 Key Tests)* Jun-10 99.60% Monthly 99.5% 0 0 0.11A05 Rapid Access Chest Pain 2 Week Wait* Jun-10 100% Monthly 98% 0 0 0.11A06 GUM Offer Of Appointment Within 48 Hours* Jun-10 100% Monthly 98% 0 0 0.11A07 Cancelled Operations To Be Re-Booked Within 5 Days Apr-10 Per Breach - Not available Not available Not availableA08 Delivery of Obligations in each Ambulance Services Handover Plan Apr-10 Monthly - 0 0 Not availableA09 Number of Milestones Missed in the 10/11 DSSA Plan Apr-10 Monthly - 0 0 Not availableA10 Percentage of Women Booking By Week 13 (Quarterly)* Jun-10 81.90% Quarterly 88% 0 0.05 0.05A11 Stroke Care: Percentage Spending 90%+ Time On Stroke Unit* Jun-10 72.10% Quarterly 86.20% 0 0.09 0.09A12 High Risk TIA Patients Starting Treatment Within 24 Hours* Jun-10 62.50% Quarterly 52.9% 0 0 0.09B01a Referral To Treatment Admitted Under 18 Weeks Jun-10 95.00% Monthly 90% 0 0 5.01B01b Referral To Treatment Non Admitted Under 18 Weeks Jun-10 98.60% Monthly 95% 0 0 1.67B02 Infection Control - C.Diff Infections Against Last Year Jul-10 7 Annual 0 2.48 7.09 7.09B03 Emergency Care 4 Hour Throughput (including WIC) Jun-10 98.04% Annual 98% 0 0 0.21B04a Cancer - Urgent Referrals Seen In Under 2 Weeks Jun-10 95.00% Annual 93% Not available Not available Not availableB04b Cancer - Breast Symptom Referrals Seen In Under 2 Weeks Jun-10 84.20% Annual 93% Not available Not available Not availableB04c Cancer - 31 Day Diagnosis To Treatment (First Treatments) Jun-10 98.00% Annual 96% Not available Not available Not availableB04d Cancer - 31 Day Diagnosis To Treatment (Subsequent - Surgery) Jun-10 97.10% Annual 94% Not available Not available Not availableB04e Cancer - 31 Day Diagnosis To Treatment (Subsequent - Drug) Jun-10 99.30% Annual 98% Not available Not available Not availableB04f Cancer - 31 Day Diagnosis To Treatment (Subsequent - Radiotherapy) Jun-10 99.10% Annual 94% Not available Not available Not availableB04g Cancer 62 Day Referral To Treatment (Urgent GP Referral) Jun-10 85.20% Annual 85% Not available Not available Not availableB04h Cancer 62 Day Referral To Treatment (Screenings) Jun-10 90.60% Annual 90% Not available Not available Not availableB04i Cancer 62 Day Referral To Treatment (Upgrades) Jun-10 100% Annual 90% Not available Not available Not availableB05 Breaches of the Same Sex Accommodation Requirements Jun-10 0 Per Breach 0 Not available Not available Not availableX01 Wrong Site Surgery Jun-10 0 Monthly 0 Not available Not available Not availableX02 Retained Instruments Post Operatively Jun-10 0 Monthly 0 Not available Not available Not availableX03 Wrong Route of Administration of Chemotherapy Jun-10 0 Monthly 0 Not available Not available Not availableX04 Misplaced Naso- or Orogastric Tube Jun-10 0 Monthly 0 Not available Not available Not availableX05 Inpatient Suicide by Use of Non Collapsible Rails Jun-10 0 Monthly 0 Not available Not available Not availableX06 In Hospital Maternal Death from Post-partum Haemorrhage Following Elective Caesarean Jun-10 0 Monthly 0 Not available Not available Not availableX07 Intravenous Administration of Mis-selected Concentrated Potassium Chloride Jun-10 0 Monthly 0 Not available Not available Not availableTotalQUALITY INDICATORS - SCHEDULE 3, PART 4 - PERFORMANCE SUMMARY2.48 7.28 14.95*Initial improvement period (with no penalty) aligned to consequence period applies.Notes:A01 The national Trajectory adds up to 9 cases for the full year.A10 Quarters 1-3 target is 88%, Quarter 4 is 90%A11 Quarters 1-2 target is 86.2%. Quarters 3-4 target is 88.1%A12 Quarters 1-2 target is 86.2%. Quarters 3-4 target is 88.1%A13 Quarters 1-2 target is 52.9%. Quarter 3 target is 54.9%. Quarter 4 target is 60.8%B02 Measured against a monthly target maximum of 8.33, which equates to 100 cases for the year.Agenda Item 7 (iii) Page 3 of 3

Trust Board26th August 2010Agenda Item 7 (iv)Income and Expenditure Report July – 20101. The summary income and expenditure statement shows a surplus of £2,331k for the firstfour months of the financial year. Details of the breakdown of this surplus can be foundin Table I and E 3a.2. Division of Diagnostic and Therapies. G Overview – The Division reports a favourable variance of £10k to the end of July, anG improvement of £3k in the month.Variance at Variance Variance to30 th June this month 31 st JulyFav/(Adv) Fav/(Adv) Fav/(Adv)Pay 45 9 54Non Pay (129) (28) (157)Operating Income 53 11 64Income from Activities 38 11 49Totals 7 3 10Memorandum CRES ytd (23) (153) (176)Pay budgets show a favourable variance of £54k, an improvement of £9k in themonth. Backdated Comprehensive Local Research Network (CLRN) funding hasbeen awarded to cover the costs of new posts working within Clinical Trials in thePharmacy department. This has offset the cost of arrears associated with unsocialhours worked within Pathology. This goes back as far as 2007 and is beinginvestigated.Non Pay budgets show an adverse variance of £157k, a worsening of £28k in themonth. Costs associated with increased activity (particularly within Pathology andMEMO noted below) have been incurred. There is a reported shortfall on CRES nonpaybudgets of £28k to the end of July. This is driven primarily by slippage withinthe implementation of the Managed Equipment Service project within Pathology.Income from Operations budgets show a favourable variance of £64k, animprovement of £11k in the month. This represents additional income generated bysupplying drugs on behalf of GSK Services, commercial trials (PPD Global amongstothers) and a further stage payment in respect of the Southmead Avon OrthopaedicCentre plant decant project (MEMO, Medical Gases). Income targets have beenadjusted where planned income is clearly identifiable.Income from Activities budgets show a favourable variance of £49k, an improvementof £11k in the month.Cash Releasing Efficiency Savings (CRES) 2010/11 Programme – The Division hasachieved savings of £365k to month 4 against a phased target of £392k or against areal (ie evenly profiled) target of £541k. The Division has achieved the targetsavings for CRES 2009/10 carried forward of £35k for the first four months of thefinancial year.

3. Division of MedicineROverview - The Division reports an adverse variance of £595k to the end of July, whichis a deterioration of £270k since last month.Variance at30 th JuneVariancethis monthTransfer reCRES LOSShould bePayVariance to31 st JulyFav/(Adv) Fav/(Adv) Fav/(Adv) Fav/(Adv)Pay (253) (71) (115) (439)Non Pay (346) (386) 115 (617)Operating Income 0 (10) (10)Income from Activities 274 197 471Totals (325) (270) 0 (595)Memorandum CRES ytd (29) (183) 0 (212)Pay budgets show an adverse variance of £439k, a deterioration of £186k in themonth. This is due primarily to a correction in the phasing of the CRES target into1/12ths for the pay schemes that have not yet started (£174k, of which £115k relatesto the Length of Stay scheme). Nursing budgets show a £277k adverse variance, adeterioration of £15k in month. This is £62k less than the forecast projection for theyear to date, and relates to the impact of the tighter controls that have beenintroduced.Non-pay budgets show an adverse variance of £617k at the end of July, which is adeterioration of £271k since last month (excluding the transfer of £115k which is aCRES phasing correction for the ‘reduction in length of stay’ scheme).Further deteriorations in non pay can be explained by the additional activity seen inthe Division above the plan since 1 st April. The key adverse variances in month 4 aredrugs £198k (£95k deterioration), clinical supplies £163k (£49k deterioration),catering £53k (£30k correction), blood £32k (£19k deterioration), bank officerecharge £61k (£14k deterioration), cleaning £15k and MEMO £16k.There is some concern about increases in drugs expenditure in Gastroenterology andHepatology this month which are being reviewed with the Lead Clinician andDivisional Pharmacist. The Division are continuing to review processes intoensuring that the correct income is obtained for NICE and non-PbR drugs.Income from Activities budgets show a favourable variance of £471k at the end ofmonth 4 due to a significant over-performance in activity against the 2010/11 planand the same period last year. However income has been adjusted to take intoaccount the 30% marginal rate agreed for emergency activity over-performance.This amount has then been apportioned across all Divisions using the standardapportionment rates, leaving the Division with an average of 24% of tariff foremergency spells.Cash Releasing Efficiency Savings (CRES) 2010/11 programme – the Division hasachieved savings of £400k to month 4 against a target of £612k. There are schemesthat are planned to start later in the year, including the main reducing length of stayproject which should reduce the underperformance on CRES in the latter half of theyear. The Division has achieved the target savings for CRES 2009/10 carriedforward of £425k in month 4.File: Item 7 (iv) - Aug 2010 Expenditure Report Page 2 of 9

4. Division of Specialised ServicesROverview - The Division reports an adverse variance of £459k to the end of July, whichis a deterioration of £99k since last month. The underlying reason for the currentfinancial position is unachieved CRES of £578k offset by gains on income.Variance at30 th JuneVariance thismonthVariance to31 st JulyFav/(Adv) Fav/(Adv) Fav/(Adv)Pay 28 (11) 17Non Pay (688) (301) (989)Operating Income 54 19 73Income from Activities 246 194 440Totals (360) (99) (459)Memorandum CRES ytd (426) (205) (631)Pay budgets show a favourable variance of £17k, a deterioration of £11k in themonth. Medical staffing budgets contribute to the adverse variance with extra sessionpayments in cardiac surgery, cardiology and cardiac anaesthesia to meet performancetargets coming to a combined total of £20k in month. CRES schemes have been rephasedacross the whole year; this has resulted in a small adverse variance for Pay.The Division has received funding contributions for a nursing post from SurgeryHead and Neck and Medicine Divisions resulting in a gain of £16k.Non-pay budgets show an adverse variance of £989k at the end of July, adeterioration of £301k. £113k of this deterioration relates to unachieved andunidentified cash releasing efficiency savings. Blood budgets are over spent by £32kin the month , careful monitoring continues to ensure that charging is correct. Nonpay CRES schemes have been re-phased across the whole year which represents anadverse variance of £48k in the month. Year to date unachieved and unallocatedCRES schemes represent a £499k adverse variance, with blood budgets being £237kover spent year to date. The overspend on blood was not addressed this month in theexercise to rebase Divisional, budgets this will be actioned in month 05 and thisoverspend will be corrected.Income from Activities budgets show a favourable variance of £440k, animprovement of £194k. This largely reflects overachievement on at Cost activity.The 2010/11 cash releasing efficiency savings programme has achieved savings of£46k against a target of £596k; this is a consequence of the Division still havingunidentified CRES of £1m for the year; this is an improvement on the start of yearposition, when unidentified CRES totalled £1.4m. The Division has achieved thetarget savings for CRES 2009/10 carried forward with savings of £390k to month 4.Actions being taken to address current overspend:The Divisional Board is working to achieve a phased balanced operating plan overthe next two financial years.The Division is completing a budget restructuring with re-assignment of budgetholders to improve budgetary control. Due to time constraints this exercise was notfinalised this month, however most key areas have been resolved, further areas willbe addressed in month 05 including blood.File: Item 7 (iv) - Aug 2010 Expenditure Report Page 3 of 9

5. Division of Surgery, Head and Neck. Overview – The Division reports an adverse variance of £1,344k to the end of July, aRdeterioration of £831k in the month. The position to date is adverse compared with theshortfall forecast in the Division’s Operating Plan.Varianceat 30 thJuneVariance thismonthFav/(Adv)Variance to 31st JulyFav/(Adv) Other Fav/(Adv)Pay 107 9 116Non Pay (990) (489) (1,479)Operating Income 25 50 75Income from Activities 345 (401) (56)Totals (513) (831) (1,344)Memo CRES ytd (706) (223) (929)Pay budgets show a favourable variance of £116k, an improvement of £9k in themonth. There is pressure on pay budgets due to the cost of WLI/Premium payments,which showed an adverse variance of £202k at the end of July. This is offset byfavourable variances on dental and medical staff of £214K.Non Pay budgets show an adverse variance of £1,479k, a worsening of £489k in themonth. The Division has as part of realigning budgets with its Operating Plan,funded Non Pay headings in accordance with this plan. This has created an expecteddeficit line within Non pay which represents the Operating Plan expected shortfall todate. In month 4 this deteriorated by £213k as expected. However other non payheadings have continued to overspend over and above expected and funded levels.Key areas are clinical supplies of £161k (of which £80k relates to a catch up of spendfrom previous months including EVAR’s), drugs have worsened by £55k acrossvarious specialties and blood £32k of which £25k was in ITU and relates to mainly toa specific patient.Income from Activities budgets show an adverse variance of £56k, a deterioration of£401k in the month. This deterioration is due to variable contract income. The keyareas showing this are the Ilizarov Frames, (£318k) where the overperformance inJune was due to a recording error, and the Q1 reduction in tariff to 30% foremergency work (£99k).Cash Releasing Efficiency Savings (CRES) 2010/11 Programme – The Division hasachieved savings of £1,495k to month 4 against a target of £2,423k. The Division hasachieved the target savings for CRES 2009/10 carried forward of £1,195k to date.Actions being taken to address current overspend include: Gains arising from the trust wide external Outpatient efficiency review Reduction in non pay spend within B E H theatres with the use of an external consultant,£160k estimate. Working with procurement consortium to achieve forecast savings Reduction in premium rate paymentFile: Item 7 (iv) - Aug 2010 Expenditure Report Page 4 of 9

6. Division of Women’s and Children’sGGOverview – The Division reports an adverse variance of £178k (0.7%) to the end of July,a deterioration of £220k in the month. The Division’s Operating Plan assumed breakevenfor the year and this remains the forecast, albeit with greater risks. The main causes ofthe deterioration are £112k re-profiling of savings targets, £77k drug overspends and£33k adverse income variance.Variance to30 th JuneVariancethis monthVariance to31 st JulyMEMO:BMTServiceLineFav/(Adv) Fav/(Adv) Fav/(Adv) Fav/(Adv)Pay (3) (8) (11) 1Non Pay (161) (175) (336) (100)Operating Income 8 (3) 5 2Income from Activities 199 (35) 164 254Totals 43 (221) (178) 157Memorandum CRES ytd (128) (301) (429)Pay budgets show an adverse variance of £11k, a deterioration of £8k in the month.Pay budgets include a 2% vacancy factor. The deterioration mainly relates toreprofiling of CRES budgets for nursing (bed closures), consultants (job planning) andA&C (Children’s hospital admin review) due to begin later in the year. Savings arestill assumed within the forecast. Without this there were continuing underspendsagainst delegated budgets for both nursing in both Children’s and Midwifery due tovacancies, and consultants due to vacancies and extra PAs for research and deanerywork.Non Pay budgets are £336k adverse, incorporating unachieved and unidentifiedCRES. There are significant overspends against drugs in the month in BMT,Oncology, Respiratory, Gastroenterology and Metabolic disorders. All of these arebeing investigated, in many cases drugs are PbR exclusions however there does notseem to be any corresponding income to offset this. Blood variances have alsoincreased, renal plasma exchange used in exceptional circumstances has beenrecovered through exceptional funding, however one PCT have refuted this andtherefore this usage is causing a budget overspend. Twelve Gynaecology cases havebeen sub-contracted to Spire this month because they could not treated at the ISTCcausing a £21k overspend.Income from Activities budgets are £164k favourable, a deterioration of £35k in themonth. NICU is underrecovering income, occupancy remains high but the case-mix islower than planned. PbR exclusions were adverse this month, despite cost overspendson drugs and devices. Activity was lower in Paediatric Cardiac Surgery, T&O,Paediatric Surgery and Renal.Cash Releasing Efficiency Savings (CRES) 20010/11 programme – the Division hasachieved savings of £564k to end of July an underachievement of £163k against theplan, of which £74k is unidentified and £89k is deficits on existing schemes. There isa further deficit of £269k due to phasing of plans due to start later in the year. Theforecast shortfall against target is £684k. The small 2009/10 carry forward CRES isfully achieved.File: Item 7 (iv) - Aug 2010 Expenditure Report Page 5 of 9

7. Division of Facilities & Estates.AOverview – The Division reports an adverse variance of £64k to the end of July, aworsening of £16k in the month.Variance to Variance Variance to30 th June this month 31 st JulyFav/(Adv) Fav/(Adv) Fav/(Adv)Pay 19 57 76Non Pay (113) (64) (177)Operating Income 34 3 37Income from Activities 12 (12) 0Totals (48) (16) (64)Memorandum CRES ytd (53) (98) (151)Pay budgets show a favourable position of £76k at the end of July, an improvementof £57k. Estates Trade staff has continued to improve in line with the forecasttrajectory. In addition, the latest sickness figures show a reduction in absence levelsfrom 7.2% in March to 6.5%, which is reflected in the reduction of backfill costs.Non Pay budgets show an adverse variance of £177k, a worsening of £64k in themonth. This is due to two areas. Firstly, there is an under-achievement to date onCash Releasing Efficiency Savings of £151k, against the 12 month profiling.Secondly the increase in the level of voids paid within Residences continues at £10kper month. Following a review of the options by the Trust Operating Group this costpressure will end in August. This adverse variance is partly offset by the allocationof Contract Income to the non pay budgets totalling £13k and additional internalrecharge income (£36k).Income from Activities budgets show a break even position, a worsening of £12k inthe month. The change in the month represents the allocation Facilities & Estatesshare of the increased activity across the Trust to the relevant non pay budgets.Income from Operations budgets show a favourable variance of £37k, animprovement of £3k during the month. This is due to additional income following arates rebate.Cash Releasing Efficiency Savings (CRES) 2010/11 Programme – the Division hasachieved savings of £177k (54%) of the £329k plan to the end of July. The plan forthe year is £986k. The Division is currently forecasting an achievement of £801k(81%). The Division are reviewing the options available for the sale of surplusEuropean Union Emissions Trading Scheme (EU ETS) in order to mitigate thecurrent shortfall on CRES achievement. The Division has achieved the targetsavings for CRES 2009/10 carried forward of £8k in month 4.File: Item 7 (iv) - Aug 2010 Expenditure Report Page 6 of 9

8. Division of Trust ServicesAMNNNNNVVVAOverview – The Division reports an adverse variance of £50k at the end of July, animprovement of £25k during the month.Variance to Variance Variance to30 th June this month 31 st JulyFav/(Adv) Fav/(Adv) Fav/(Adv)Pay (10) 9 (1)Non Pay (34) (35) (69)Operating Income (31) 51 20Income from Activities 0 0 0Totals (75) 25 (50)Memorandum CRES ytd (16) (36) (52) Finance – has an adverse variance of £8k at the end of July, an improvement of £12kin the month. Additional temporary staffing costs incurred during April and Mayhave now ceased. In addition, Interest Receivable improved by £12k this month.Trust Headquarters – has an adverse variance of £48k this month, a worsening of£5k. The year to date position consists of £24k due to an under achievement on CashReleasing Efficiency Savings and £19k due to unfunded printing costs within TrustHeadquarters. Unfunded posts within Non NHS Patient Income account for a further£26k. This is partly offset by vacancies within Corporate Development.Corporate Human Resources – has a favourable variance of £44k at the end of July,an improvement of £36k. The improvement this month is due to the rebasing inOccupational Health with partner organisations leading to a balanced financialposition.Information Technology – has a favourable variance of £3k at the end of July whichis in line with the previous month.Central Services – has an adverse variance of £51k at the end of July, a worsening of£20k. The deterioration this month is due to additional costs (£28k) incurred relatingto the Ward 99 overflow area. A paper will be presented to the Trust OperationsGroup to decide which Division should account for the additional expenditure. Community – has a favourable variance of £10k at the end of July, an improvementof £2k during the month.Cash Releasing Efficiency Savings (CRES) 2010/11 Programme – the Division hasachieved savings of £227k (81%) of the £279k plan to the end of July. The plan forthe year is £837k. The Division is currently forecasting an achievement of £777k(93%). The Division has achieved the target savings for CRES 2009/10 carriedforward of £66k in month 4.9. Research & InnovationGThe Research & Innovation Division reports a favourable variance of £36k at the end ofJuly. The key reason for this position is an over recovery of commercial overhead income£25k.File: Item 7 (iv) - Aug 2010 Expenditure Report Page 7 of 9

10. Miscellaneous Support ServicesMiscellaneous Support Services reports a favourable variance of £136k. Key reason forthis is a favourable variance of £143k on Road Traffic Accident Income.11. Skills for HealthGSkills for Health is reporting a £1k favourable position at the end of July 2010.Variance at Variance Variance to30 th June this month 31st JulyFav/(Adv) Fav/(Adv) Fav/(Adv)Pay (224) (23) (247)Non Pay 224 24 248Operating Income 0 0 0Income from Activities 0 0 0Totals 0 1 1Pay budgets show an adverse variance of £247k at the end of July, the shift in monthis an adverse £23k. The main area contributing to the adverse variance this month isexpenditure on Agency Admin & Clerical £30k, £10k due to additional resourcewithin payroll, £10k Local Workforce Solutions directorate the rest is small amountsacross the remaining directorates.Non-Pay is reporting a £248k favourable variance at the end of July. In month Nonpay has improved by £24k.Income continues to report a breakeven position.12. Depreciation and Public Dividend Capital Depreciation and Public Dividend Capital budgets shows a breakeven position at theend of July.13. Subjective Analysis of Income and Expenditure to date. (See Table I and E 3b)This table illustrates the year to date financial position by income and expenditureheadings. To date: The explanation below excludes Skills for Health. Income shows a favourable variance of £3,675k. Key areas include service levelagreement income of £3,085k, patient transport services Income £96k and road trafficaccident income £143k. Pay shows an adverse variance of £214k this represents a continuation of the payoverspending. Key overspends to date are on agency staff £1,063k, consultants £236k.Key underspends include medical staff other £554k , healthcare assistants £434k andpay reserves £236k Non Pay shows an adverse variance of £4,711k. Key overspends to date are on drugsand blood £699k, clinical supplies £490k, premises and fixed plant £533k (including£219k in Facilities and Estates relating to Engineering Contracts £202k) services fromother bodies £235 and other expenditure £2,596k.Key reasons for the overspend on other operating expenditure includeFile: Item 7 (iv) - Aug 2010 Expenditure Report Page 8 of 9

‣ Medicine – Unachieved CRES targets £238k and shortfall on centralcharges re Temporary Staffing Bureau £61k‣ Specialised Services – Unachieved unidentified CRES targets £581k andshortfall on Operating Plan position to date £244k.‣ Surgery Head and Neck – Unachieved/Unidentified CRES Targets andshortfall versus Operating Plan position to date. £682k Financing costs show a favourable variance of £15k.File: Item 7 (iv) - Aug 2010 Expenditure Report Page 9 of 9

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Summary Income & Expenditure StatementTable I and E 1ApprovedBudget / Plan2010/11HeadingVarianceFav / (Adv)£'000 £'000 £'000 £'000 £'000 £'000Income (as per Table I and E 2)PlanPosition as at 31st JulyActual to 30thJune391,026 From Activities 128,051 131,295 3,244 96,820 396,510114,395 Other Operating Income 39,257 39,688 431 29,938 113,730505,421 Sub totals income167,308 170,983 3,675 126,758 510,240ActualForecastOutturnExpenditure(296,879) Staffing (99,834) (100,295) (461) (75,483) (302,898)(150,989) Supplies and services (52,721) (59,840) (7,119) (43,253) (174,204)(447,868) Sub totals expenditure(152,555) (160,135) (7,580) (118,736) (477,102)(23,142) Reserves Reserves (2,656) - 2,656 - -(23,142) Sub Total Reserves (2,656) - 2,656 - -34,411 EBITDA12,097 10,848 (1,249) 8,022 33,1386.81 EBITDA Margin - %6.34 6.33 6.49- Profit / loss on asset disposals - - - - -(1,220) Fixed asset impairments - - - - 1,220(17,955) Depreciation & Amortisation (5,547) (5,549) (2) (4,492) (17,947)149 Interest Receivable 50 59 9 40 200(443) Interest payable on loans & leases (148) (140) 8 (109) (443)(8,662) PDC Dividend (2,887) (2,887) - (2,166) (8,668)6,280 NET SURPLUS / (DEFICIT)3,565 2,331 (1,234) 1,295 7,5001.24 Net margin - %1.36 1.02 1.5Agenda Item 7 (IV) Page : 1 of 15

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - UHB Healthcare Services Segment Income and ExpenditureTable I and E 1ApprovedBudget / Plan2010/11HeadingPlanPosition as at 31st JulyVarianceFav / (Adv)ForecastOutturn£'000 £'000 £'000 £'000 £'000 £'000Income (as per Table I and E 2)389,526 From Activities 127,551 130,795 3,244 96,445 395,01079,018 Other Operating Income 27,465 27,896 431 21,164 83,353468,544 Sub totals income155,016 158,691 3,675 117,609 478,363Expenditure(284,515) Staffing (95,713) (95,927) (214) (72,202) (288,094)(126,476) Supplies and services (44,550) (51,917) (7,367) (37,384) (157,132)(410,991) Sub totals expenditure(140,263) (147,844) (7,581) (109,586) (445,226)(23,142) Reserves Inflation (2,656) - 2,656 - -(23,142) Sub Total Reserves (2,656) - 2,656 - -34,411 EBITDA12,097 10,847 (1,250) 8,023 33,1377.34 EBITDA Margin - %6.84 6.82 6.93- Profit / loss on asset disposals - - - - -(1,220) Fixed asset impairments - - - - 1,220(17,955) Depreciation & Amortisation (5,547) (5,549) (2) (4,492) (17,947)149 Interest Receivable 50 59 9 40 200(443) Interest payable on loans & leases (148) (140) 8 (109) (443)(8,662) PDC Dividend (2,887) (2,887) - (2,166) (8,668)6,280 NET SURPLUS / (DEFICIT)3,565 2,330 (1,235) 1,296 7,4991.33 Net margin - %1.5 1.10 1.6ActualActual to 30thJuneAgenda Item 7 (IV) Page : 2 of 15

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Skills for Health Segment Income and ExpenditureTable I and E 1ApprovedBudget / Plan2010/11HeadingPlanPosition as at 31st JulyVarianceFav / (Adv)Actual to 30thJuneForecastOutturn£'000 £'000 £'000 £'000 £'000 £'000Income (as per Table I and E 2)1,500 From Activities 500 500 - 375 1,50035,377 Other Operating Income 11,792 11,792 - 8,774 30,37636,877 Sub totals income12,292 12,292 - 9,149 31,876Expenditure(12,364) Staffing (4,121) (4,368) (247) (3,281) (14,804)(24,513) Supplies and services (8,171) (7,923) 248 (5,869) (17,072)(36,877) Sub totals expenditure(12,292) (12,291) 1 (9,150) (31,876)- Reserves Reserves - - - - -- Sub Total Reserves - - - - -0 EBITDA0 1 1 (1) -- EBITDA Margin - %0.01 - 0.010.0- Fixed asset impairments - - - - -- Depreciation & Amortisation - - - - -- Interest Receivable - - - - -- Interest payable on loans & leases - - - - -- PDC Dividend - - - - -0 NET SURPLUS / (DEFICIT)0 1 1 (1) -- Net margin - %0.01 - 0.010.0ActualAgenda Item 7 (IV) Page : 3 of 15

Table I and E 2UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Summary Income ReportApprovedBudget / Plan2010/11ServicePlanPosition as at 31st JulyActualVarianceFav / (Adv)Variance to30th JuneFav / (Adv)ForecastOutturn£'000 £'000 £'000 £'000 £'000 £'000Income from Activities379,391 Primary Care Trusts 124,113 127,297 3,184 1,791 393,132115 Dept of Health 38 - (38) (29) -8,454 Territorial Bodies2,818 2,757 (61) (342) -Non NHS Income2,204 Private Patients796 808 12 64 2,42321 Overseas Patients (Non Recip)7 2 (5) (3) 6773 Road Traffic Act256 398 142 101 76368 Other Non NHS Income23 33 10 10 186391,026 Sub Total Income from Activities 128,051 131,295 3,244 1,592 396,510Other Operating Income1,109 Patient Transport Services370 466 96 73 1,39850,951 Education / Training / Research16,789 16,873 84 (6) 51,795195 Charity / Other Contribution134 178 44 71 534113 Transfer from Donation Reserve38 37 (1) - 11262,027 Other21,926 22,134 208 73 59,891114,395 Sub Total Other Operating Income39,257 39,688 431 211 113,730505,421 Totals167,308 170,983 3,675 1,803 510,240Agenda Item 7 (iv) Page : 4 of 15

Table I and E 2UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - UHB Healthcare Services Segment - Income ReportApprovedBudget / Plan2010/11ServicePlanPosition as at 31st JulyActualVarianceFav / (Adv)Variance to30th JuneFav / (Adv)ForecastOutturn£'000 £'000 £'000 £'000 £'000 £'000Income from Activities377,891 Primary Care Trusts123,613 126,797 3,184 1,791 391,632115 Dept of Health38 - (38) (29)8,454 Territorial Bodies2,818 2,757 (61) (342)Non NHS Income2,204 Private Patients796 808 12 64 2,42321 Overseas Patients (Non Recip)7 2 (5) (3) 6773 Road Traffic Act256 398 142 101 76368 Other Non NHS Income23 33 10 10 186389,526 Sub Total Income from Activities 127,551 130,795 3,244 1,592 395,010Other Operating Income1,109 Patient Transport Services370 466 96 73 1,39850,951 Education / Training / Research16,789 16,873 84 (6) 51,795195 Charity / Other Contribution134 178 44 71 534113 Transfer from Donation Reserve38 37 (1) - 11226,650 Other10,134 10,342 208 73 29,51579,018 Sub Total Other Operating Income27,465 27,896 431 211 83,354468,544 Totals155,016 158,691 3,675 1,803 478,364Agenda Item 7 (iv) Page : 5 of 15

Table I and E 2UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Skills for Health - Income ReportApprovedBudget / Plan2010/11ServicePlanPosition as at 31st JulyActualVarianceFav / (Adv)Variance to30th JuneFav / (Adv)ForecastOutturn£'000 £'000 £'000 £'000 £'000 £'000Income from Activities1,500 Primary Care Trusts500 500 - - 1,500- Territorial Bodies- - - - -Non NHS Income- Private Patients- - - - -- Overseas Patients (Non Recip)- - - - -- Road Traffic Act- - - - -- Other Non NHS Income- - - - -1,500 Sub Total Income from Activities 500 500 - - 1,500Other Operating Income- Patient Transport Services- - - - -- Education / Training / Research- - - - -- Charity / Other Contribution- - - - -- Transfer from Donation Reserve- - - - -35,377 Other11,792 11,792 - - 30,37635,377 Sub Total Other Operating Income11,792 11,792 - 0 30,37636,877 Totals12,292 12,292 - 0 31,876Agenda Item 7 (iv) Page : 6 of 15

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Divisional Income & Expenditure StatementTable I and E 3aApprovedBudget / Plan2010/11DivisionTotal NetExpenditure /Income to DatePayPosition as at 31st July [Favourable / (Adverse)]Non PayOperatingIncomeIncome fromActivitiesTotal Varianceto dateMemorandumCRES Varianceto DateCumulativeVariance to30th JuneForecastOutturnVariance£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000Service Agreements385,009 Service Agreements 125,584 - - - - - - 2 -(700) SLA Performance (3,427) - (3,415) - 2,032 (1,383) - (932) -40,358 NHSE Income 13,477 - - - - - - - -424,667 Sub Total Service Agreements 135,634 - (3,415) - 2,032 (1,383) - (930) -Clinical Divisions(41,747) Diagnostic & Therapies (13,836) 54 (157) 64 49 10 (176) 7 24(51,926) Medicine (18,143) (324) (732) (10) 471 (595) (212) (325) (1,260)(62,881) Specialised Services (20,571) 17 (989) 73 440 (459) (631) (360) (1,000)(81,868) Surgery Head & Neck (28,130) 116 (1,479) 75 (56) (1,344) (929) (513) (2,706)(81,187) Women's & Children's (27,470) (11) (336) 5 164 (178) (429) 43 -(319,609) Sub Totals (1) (108,150) (148) (3,693) 207 1,068 (2,566) (2,377) (1,148) (4,942)Corporate Services(1,758) Central Services (642) (67) 16 - - (51) (8) (31) (60)(56) Community (8) - 10 - - 10 (1) 8 20(6,762) Trust HQ (2,362) (6) (84) 42 - (48) (24) (43) (120)(4,665) Human Resources (1,495) 95 (21) (30) - 44 6 8 110(4,877) Information Technology (1,670) 28 (40) 15 - 3 - 3 -(5,452) Finance (1,828) (51) 50 (7) - (8) (26) (20) -(24,880) Facilities & Estates (8,160) 76 (177) 37 - (64) (152) (48) (100)(9,088) Misc Support Services (3,599) (59) (28) 79 144 136 (4) 172 78,464 Research and Development 2,633 (82) 32 86 - 36 - 141 125(1,220) Impairment - - - - - - - - 1,220(25,381) Capital Charges (8,023) - (2) 2 - - - (1) -(75,675) Sub Totals (2) (25,154) (66) (244) 224 144 58 (208) 189 1,202(395,284) Sub Totals (1) and (2) (133,304) (214) (3,937) 431 1,212 (2,508) (2,585) (959) (3,740)- Skills for Health 1 (247) 248 - - 1 - (1) -(395,284) Totals I & E (133,303) (461) (3,689) 431 1,212 (2,507) (2,585) (960) (3,740)Reserves(23,103) General - - 2,656 - - 2,656 - 1,553 4,960- NICE - - - - - - - - -- CQUINS - - - - - - - - -(23,103) Sub Total Reserves - - 2,656 - - 2,656 - 1,553 4,9606,280 TRUST TOTALS 2,331 (461) (4,448) 431 3,244 (1,234) (2,585) (337) 1,220Agenda Item 7 (iv) Page : 7 of 15

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTSubjective AnalysisAs at end of July 2010 Month 4 [Favourable / (Adverse)]Table I and E 3bIncome / Expenditure Heading Womens and Childrens Medicine Surgery Head and Neck Specialised Services Diagnostics & Therapies Estates and FacilitiesOther Trust Services Trust Total Excluding SfHSkills for Health Trust TotalBudgetYtDSpendYtDVarianceYtDBudgetYtDSpendYtDVarianceYtDBudgetYtDSpendYtDVarianceYtDBudgetYtDSpendYtDVarianceYtDBudgetYtDSpendYtDVarianceYtDBudgetYtDSpendYtDVarianceYtDBudgetYtDSpend YtDVarianceYtDBudget YtD Spend YtD Variance YtD£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000BudgetYtDSpend YtDVarianceYtDBudget YtDSpend YtDVarianceYtDIncomeIncome From Activities 539 703 164 66 537 471 491 435 (56) 897 1,337 440 226 275 49 13 13 - 125,319 127,495 2,176 127,551 130,795 3,244 500 500 - 128,051 131,295 3,244Income From Operations 981 986 5 279 269 (10) 1,162 1,237 75 164 237 73 2,566 2,630 64 1,315 1,352 37 20,998 21,185 187 27,465 27,896 431 11,792 11,792 - 39,257 39,688 431Total Income 1,520 1,689 169 345 806 461 1,653 1,672 19 1,061 1,574 513 2,792 2,905 113 1,328 1,365 37 146,317 148,680 2,363 155,016 158,691 3,675 12,292 12,292 - 167,308 170,983 3,675ExpenditurePayAdmin & Clerical & Estates (1,470) (1,500) (30) (1,122) (1,161) (39) (1,712) (1,690) 22 (732) (785) (53) (912) (926) (14) (1,438) (1,314) 124 (3,142) (3,207) (65) (10,528) (10,583) (55) (1,087) (1,032) 55 (11,615) (11,615) -Agency (17) (204) (187) - (217) (217) (191) (342) (151) (7) (26) (19) (98) (134) ) 36((16) (388) (372) (13) (94) (81) (342) (1,405) (1,063) (115) (196) (81) (457) (1,601) (1,144)Dental Staff Consultants - - - - - - (482) (481) 1 - - - - - - - - - - - - (482) (481) 1 - - - (482) (481) 1Dental Staff Other - - - (6) - 6 (1,146) (1,036) 110 - - - - - - - - - - - - (1,152) (1,036) 116 - - - (1,152) (1,036) 116Execs And Sen Managers (261) (267) (6) (200) (231) (31) (328) (317) 11 (212) (199) 13 (281) (296) (15) (249) (268) (19) (3,063) (2,986) 77 (4,594) (4,564) 30 (2,845) (3,140) (295) (7,439) (7,704) (265)Healthcare Assistants (104) (117) (13) (81) (89) (8) (648) (619) 29 (46) (35) 11 (58) (58) - (4,435) (4,021) 414 (3) (2) 1 (5,375) (4,941) 434 - - - (5,375) (4,941) 434Medical Staff Consultants (5,068) (5,126) (58) (2,212) (2,175) 37 (4,293) (4,406) (113) (2,466) (2,557) (91) (1,518) (1,577) (59) - - - (1,131) (1,083) 48 (16,688) (16,924) (236) - - - (16,688) (16,924) (236)Medical Staff Other (3,327) (3,330) (3) (2,436) (2,213) 223 (3,935) (3,708) 227 (1,585) (1,541) 44 (836) (772) 64 - - - (156) (157) (1) (12,275) (11,721) 554 - - - (12,275) (11,721) 554Nurses And Midwives (10,602) (10,370) 232 (8,074) (8,276) (202) (7,513) (7,592) (79) (4,942) (4,841) 101 (208) (218) (10) (15) (15) - (1,322) (1,368) (46) (32,676) (32,680) (4) - - - (32,676) (32,680) (4)Other Clinical Staff (1,243) (1,206) 37 (288) (323) (35) (2,383) (2,407) (24) (1,346) (1,381) (35) (8,803) (8,857) (54) - - - (140) (133) 7 (14,203) (14,307) (104) - - - (14,203) (14,307) (104)Pay Recharges 451 468 17 325 374 49 866 939 73 338 379 41 859 643 (216) 55 56 1 (3) (91) (88) 2,891 2,768 (123) - - - 2,891 2,768 (123)Pay Recode - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Pay Reserves (S) - - - 107 - (107) (10) - 10 (5) - 5 (390) 4 394 72 - (72) (63) (57) 6 (289) (53) 236 (74) - 74 (363) (53) 310Pay Total (21,641) (21,652) (11) (13,987) (14,311) (324) (21,775) (21,659) 116 (11,003) (10,986) 17 (12,245) (12,191) 54 (6,026) (5,950) 76.00 (9,036) (9,178) (142) (95,713) (95,927) (214) (4,121) (4,368) (247) (99,834) (100,295) (461)Non PayClinical Supplies & Serv (1,985) (2,114) (129) (816) (927) (111) (3,542) (3,800) (258) (3,311) (3,218) 93 (2,117) (2,096) 21 (6) (57) (51) (16) (71) (55) (11,793) (12,283) (490) - (1) (1) (11,793) (12,284) (491)Drugs And Blood (2,884) (3,046) (162) (2,404) (2,646) (242) (2,389) (2,707) (318) (6,249) (6,416) (167) (1,258) (1,182) 76 (10) (8) 2 (41) 71 112 (15,235) (15,934) (699) - - - (15,235) (15,934) (699)Establishment Expenses (233) (251) (18) (65) (82) (17) (165) (176) (11) (99) (90) 9 (179) (138) 41 (198) (185) 13 (426) (362) 64 (1,365) (1,284) 81 (646) (606) 40 (2,011) (1,890) 121General Supplies & Serv (90) (126) (36) (185) (191) (6) (278) (364) (86) (96) (125) (29) (8) (51) (43) (1,325) (1,357) (32) (63) (70) (7) (2,045) (2,284) (239) (14) (42) (28) (2,059) (2,326) (267)Other Expenditure (812) (742) 70 (253) (591) (338) (80) (862) (782) (236) (1,100) (864) 569 666 97 449 560 111 (9,988) (10,878) (890) (10,351) (12,947) (2,596) (6,875) (6,672) 203 (17,226) (19,619) (2,393)Premises And Fixed Plant (141) (156) (15) (87) (102) (15) (208) (231) (23) (172) (176) (4) (259) (535) (276) (2,308) (2,527) (219) (708) (689) 19 (3,883) (4,416) (533) (636) (601) 35 (4,519) (5,017) (498)Services From Other Bodies (1,026) (1,072) (46) (96) (99) (3) (2) (3) (1) (7) (34) (27) (1,141) (1,214) (73) - (1) (1) (262) (346) (84) (2,534) (2,769) (235) - (1) (1) (2,534) (2,770) (236)Total Non Pay (7,171) (7,507) (336) (3,906) (4,638) (732) (6,664) (8,143) (1,479) (10,170) (11,159) (989) (4,393) (4,550) (157) (3,398) (3,575) (177) (11,504) (12,345) (841) (47,206) (51,917) (4,711) (8,171) (7,923) 248 (55,377) (59,840) (4,463)Total Expenditure (28,812) (29,159) (347) (17,893) (18,949) (1,056) (28,439) (29,802) (1,363) (21,173) (22,145) (972) (16,638) (16,741) (103) (9,424) (9,525) (101) (20,540) (21,523) (983) (142,919) (147,844) (4,925) (12,292) (12,291) 1 (155,211) (160,135) (4,924)EBITDA (27,292) (27,470) (178) (17,548) (18,143) (595) (26,786) (28,130) (1,344) (20,112) (20,571) (459) (13,846) (13,836) 10 (8,096) (8,160) (64) 125,777 127,157 1,380 12,097 10,847 (1,250) - 1 1 12,097 10,848 (1,249)Depreciation and Amortisation - - - - - - - - - - - - - - - - - - (5,547) (5,549) (2) (5,547) (5,549) (2) - - - (5,547) (5,549) (2)Fixed Asset Impairment - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Public Dividend Capital - - - - - - - - - - - - - - - - - - (2,887) (2,887) - (2,887) (2,887) - - - - (2,887) (2,887) -Other financing costs - - - - - - - - - - - - - - - - - - (98) (81) 17 (98) (81) 17 - - - (98) (81) 17Net Surplus/Deficit (27,292) (27,470) (178) (17,548) (18,143) (595) (26,786) (28,130) (1,344) (20,112) (20,571) (459) (13,846) (13,836) 10 (8,096) (8,160) (64) 117,245 118,640 1,395 3,565 2,330 (1,235) - 1 1 3,565 2,331 (1,234)Notes: These notes exclude Skills for HealthShows a favourable variance of £3,675k, income from activities reports a favourable variance of £3,244k this is due to an overachievement on service level agreement income of £3,085k and a favourable variance on private patient income and other non protected income of £159k. Income from operations reports aIncomefavourable variance of £431k this consists of a favourable variance of £96k on patient transport services and other various small variances on all types of operating income.Pay budgetsNon Pay budgetsFinancing costsShow an adverse variance of £214k. Significant factors within this include adverse variances on medical staff consultants £236k, other clinical staff £104k, agency staff £1,063k. This is offset by favourable variances on dental med staff £117k, healthcare assistants £434k, medical staff other £554k and pay reserves £236k.Show an adverse variance of £4,711k. Significant factors within this include adverse variances on drugs and blood £699k,clinical supplies and services £490k general supplies and services £239k, premises and fixed plant 533k, services from other bodies £235k. These are offset by favourable variances on establishmentexpenses £81K.Show a favourable variance of £15kAgenda Item 7 (iv) Page : 8 of 15

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Summary of Cash Releasing Efficiency Savings 2010/11 ProgrammeProgress to July2010-11 Forecast OutturnTable I and E 4aDivisionPlanActualVarianceFav / (Adv)12ths ProfileVarianceFav / (Adv)PlanForecast CYEVarianceFav / (Adv)Forecast FYEFinancial Performance £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000Diagnostics & Therapies 392.0 365.4 (26.6) (175.6) 1,623.0 1,574.5 (48.5) 2,209.0Medicine 438.8 400.1 (38.7) (211.9) 1,836.0 1,482.5 (353.5) 1,192.0Specialised Services 596.1 45.8 (550.3) (578.2) 1,872.0 847.6 (1,024.4) 1,273.4Surgery Head and Neck 800.9 163.8 (637.1) (812.5) 2,929.0 763.4 (2,165.6) 1,010.0Women's and Children's 727.5 564.3 (163.2) (432.0) 2,989.0 2,295.2 (693.8) 3,272.0Estates and Facilities 238.3 177.4 (60.9) (151.3) 986.0 801.0 (185.0) 877.9Finance 38.6 38.6 - (25.7) 193.0 193.0 - 295.0Corporate HR 53.5 53.6 0.1 5.6 144.0 144.0 - 36.0IM&T 61.4 61.3 (0.1) - 184.0 184.3 0.3 184.3Trust Headquarters 71.1 59.3 (11.8) (23.7) 249.0 213.5 (35.5) 256.5Central Services 21.6 14.0 (7.6) (7.7) 65.0 41.9 (23.1) 41.9Corporate Schemes 333.3 333.3 - - 1,000.0 1,000.0 - 1,000.0Capital Charges 333.3 333.3 - - 1,000.0 1,000.0 - 1,000.0Old Community 0.7 - (0.7) (0.7) 2.0 - (2.0) -Miscellaneous Support Services 137.0 133.3 (3.7) (3.7) 411.0 400.0 (11.0) 400.0Totals 4,244.1 2,743.5 (1,500.6) (2,417.4) 15,483.0 10,940.9 (4,542.1) 13,048.0Staffing Wte Wte Wte Wte Wte WteDiagnostics & Therapies 13.5 6.5 (7.0) 16.5 16.5 -Medicine 12.6 9.6 (3.0) 43.6 14.6 (29.0)Specialised Services 0.1 - (0.1) 0.1 0.1 -Surgery Head and Neck 1.0 - (1.0) 16.0 - (16.0)Women's and Children's 2.1 2.1 - 16.8 17.8 1.0Estates and Facilities - - - 1.0 1.0 -Finance - - - 5.0 5.0 -Corporate HR 2.9 1.9 (1.0) 2.9 1.9 (1.0)IM&T 1.0 1.0 - 1.0 1.0 -Trust Headquarters 0.5 0.5 - 1.3 1.3 -Central Services 2.2 0.6 (1.6) 2.2 0.6 (1.6)Corporate Schemes - - - - - -Capital Charges - - - - - -Old Community - - - - - -Miscellaneous Support Services - - - - - -Totals 35.9 22.2 0.0 106.4 59.8 (46.6)Agenda Item 7 (iv) Page : 9 of 15

Table I and E 4bStaffingUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Cash Releasing Efficiency Savings by Workstream 2010/11 ProgrammeVarianceVarianceGroup Division PlanActualPlan ForecastFav / (Adv)Fav / (Adv)£'000 £'000 £'000 £'000 £'000 £'000All Staff Specialised Services 3.3 1.1 (2.2) 10.0 8.3 (1.7)Women's and Children's 33.4 20.0 (13.4) 258.0 94.0 (164.0)36.7 21.1 (15.6) 268.0 102.3 (165.7)AHP's Specialised Services 6.7 - (6.7) 20.2 20.2 -6.7 - (6.7) 20.2 20.2 -Admin and Clerical Specialised Services 2.2 - (2.2) 6.5 6.5 -Surgery Head and Neck 1.2 19.6 18.4 38.4 38.4 -Women's and Children's 6.3 5.0 (1.3) 108.3 96.3 (12.0)9.7 24.6 14.9 153.2 141.2 (12.0)Consultants Diagnostics & Therapies 8.9 8.9 - 80.0 80.0 -Medicine - - - 25.0 25.0 -Specialised Services - - - - 11.0 11.0Surgery Head and Neck 45.4 46.8 1.4 176.0 176.0 -Women's and Children's 11.5 44.8 33.3 200.0 200.0 -65.8 100.5 34.7 481.0 492.0 11.0Junior Doctors Medicine - - - 28.9 28.9 -Specialised Services 1.7 1.7 - 5.0 5.0 -Surgery Head and Neck - - - 95.3 95.3 -Women's and Children's 21.0 21.0 - 63.0 63.0 -22.7 22.7 - 192.2 192.2 -Non Clinical Staff Diagnostics & Therapies 17.7 36.0 18.3 152.5 177.5 25.0Finance - - - 33.0 33.0 -IM&T 27.4 26.5 (0.9) 82.0 79.5 (2.5)Medicine 25.9 8.3 (17.6) 112.5 40.0 (72.5)Specialised Services 7.1 - (7.1) 17.1 27.7 10.6Central Services 9.3 - (9.3) 28.0 - (28.0)Corporate HR 45.2 45.3 0.1 119.0 119.0 -Trust Headquarters 45.6 43.3 (2.3) 172.5 165.5 (7.0)178.2 159.4 (18.8) 716.6 642.2 (74.4)Nursing Staff Central Services 9.0 14.0 5.0 27.0 41.9 14.9Medicine 253.9 246.3 (7.6) 1187.6 815.1 (372.5)Specialised Services 14.1 - (14.1) 42.4 62.4 20.0Surgery Head and Neck 1.2 26.7 25.5 141.0 30.0 (111.0)Women's and Children's 122.9 94.1 (28.8) 697.7 519.9 (177.8)401.1 381.1 (20.0) 2095.7 1469.3 (626.4)Medical Agency Surgery Head and Neck 20.0 42.6 22.6 60.0 60.0 -20.0 42.6 22.6 60.0 60.0 -Other Clinical Staff Diagnostics & Therapies 109.0 96.4 (12.6) 428.7 368.7 (60.0)Estates and Facilities 25.1 25.1 - 101.0 101.0 -Specialised Services - - - 10.0 12.3 2.3Surgery Head and Neck - 0.9 0.9 6.7 6.7 -134.1 122.4 (11.7) 546.4 488.7 (57.7)Scientific and Technical Staff Medicine 6.7 6.7 - 20.0 20.0 -6.7 6.7 - 20.0 20.0 -Total - Staffing881.7 881.1 (0.6) 4,553.3 3,628.1 (925.2)Agenda Item 7 (iv) Page : 10 of 15

Table I and E 4bSupplies and ServicesUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Cash Releasing Efficiency Savings by Workstream 2010/11 ProgrammeVarianceVarianceGroup Division PlanActualPlan ForecastFav / (Adv)Fav / (Adv)£'000 £'000 £'000 £'000 £'000 £'000All budgets Specialised Services 1.2 1.2 - 3.5 3.5 -1.2 1.2 - 3.5 3.5 -Blood Medicine 4.3 4.3 - 13.0 13.0 -Specialised Services 27.5 - (27.5) 122.4 - (122.4)Surgery Head and Neck 8.0 - (8.0) 24.0 - (24.0)39.8 4.3 (35.5) 159.4 13.0 (146.4)Capital Charges Capital Charges 333.3 333.3 - 1000.0 1000.0 -333.3 333.3 - 1000.0 1000.0 -Corporate Schemes Corporate Schemes 333.3 333.3 - 1000.0 1000.0 -333.3 333.3 - 1000.0 1000.0 -Clinical Supplies & Services Diagnostics & Therapies 173.4 133.9 (39.5) 628.0 599.5 (28.5)Specialised Services 5.7 5.7 - 55.2 408.7 353.5Surgery Head and Neck 36.2 - (36.2) 261.5 232.5 (29.0)215.3 139.6 (75.7) 944.7 1240.7 296.0Drugs Diagnostics & Therapies 28.2 28.2 - 149.0 149.0 -Medicine 63.3 76.6 13.3 190.0 283.0 93.0Specialised Services 12.0 23.0 11.0 36.0 198.0 162.0Women's and Children's 117.0 117.0 - 351.0 351.0 -220.5 244.8 24.3 726.0 981.0 255.0Establishment Expenses Diagnostics & Therapies 3.1 14.8 11.7 22.5 37.5 15.0Finance 1.3 1.3 - 4.0 4.0 -IM&T 11.0 11.0 - 33.0 33.0 -Medicine 15.6 4.3 (11.3) 47.0 78.0 31.0Surgery Head and Neck 8.7 17.9 9.2 26.0 26.0 -Trust Headquarters 2.7 2.7 - 8.0 8.0 -42.4 52.0 9.6 140.5 186.5 46.0General Supplies & Services Diagnostics & Therapies 0.8 - (0.8) 5.0 5.0 -Estates and Facilities 12.4 20.3 7.9 67.0 65.6 (1.4)IM&T 13.0 13.8 0.8 39.0 41.8 2.8Medicine 15.9 8.4 (7.5) 52.5 39.0 (13.5)Surgery Head and Neck 2.5 - (2.5) 17.5 7.5 (10.0)44.6 42.5 (2.1) 181.0 158.9 (22.1)Other Diagnostics & Therapies 37.5 37.5 - 112.5 112.5 -Finance 28.4 28.4 - 108.0 108.0 -Medicine 6.7 6.7 - 20.0 20.0 -Surgery Head and Neck 16.4 3.7 (12.7) 49.0 49.0 -Trust Headquarters 11.6 11.6 - 35.0 35.0 -Women's and Children's 125.8 47.1 (78.7) 417.0 300.0 (117.0)226.4 135.0 (91.4) 741.5 624.5 (117.0)Premises & Fixed Plant Estates and Facilities 118.7 110.7 (8.0) 558.0 554.4 (3.6)IM&T 10.0 10.0 - 30.0 30.0 -128.7 120.7 (8.0) 588.0 584.4 (3.6)Procurement Medicine 15.5 12.5 (3.0) 46.5 37.5 (9.0)15.5 12.5 (3.0) 46.5 37.5 (9.0)VAT Savings Miscellaneous Support Services 83.3 83.3 - 250.0 250.0 -83.3 83.3 - 250.0 250.0 -Total - Supplies and Services1,684.3 1,502.5 (181.8) 5,781.1 6,080.0 298.9Agenda Item 7 (iv) Page : 11 of 15

Table I and E 4bIncomeUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Cash Releasing Efficiency Savings by Workstream 2010/11 ProgrammeVarianceVarianceGroup Division PlanActualPlan ForecastFav / (Adv)Fav / (Adv)£'000 £'000 £'000 £'000 £'000 £'000Contract Income Specialised Services 17.3 6.7 (10.6) 52.0 44.0 (8.0)17.3 6.7 (10.6) 52.0 44.0 (8.0)Income from Commercial Activities Corporate HR 8.3 8.3 - 25.0 25.0 -Diagnostics & Therapies 3.3 1.3 (2.0) 11.3 11.3 -Estates and Facilities 25.4 21.3 (4.1) 90.0 80.0 (10.0)Medicine 21.0 21.0 - 63.0 63.0 -Trust Headquarters 1.7 1.7 - 5.0 5.0 -Women's and Children's 205.0 205.0 - 640.0 640.0 -264.7 258.6 (6.1) 834.3 824.3 (10.0)Income from Private Patients Diagnostics & Therapies 5.1 5.1 0.0 18.5 18.5 -Medicine 10.0 5.0 (5.0) 30.0 20.0 (10.0)Specialised Services 15.7 6.4 (9.3) 47.0 40.0 (7.0)Surgery Head and Neck 2.7 3.2 0.5 8.0 8.0 -33.5 19.7 (13.8) 103.5 86.5 (17.0)Other Operating Income Diagnostics & Therapies 3.3 3.3 - 10.0 10.0 -Finance 8.9 8.9 - 48.0 48.0 -Surgery Head and Neck 68.1 2.4 (65.7) 254.0 34.0 (220.0)Women's and Children's 10.3 10.3 - 31.0 31.0 -90.6 24.9 (65.7) 343.0 123.0 (220.0)Service Agreement Income - Coding Changes Diagnostics & Therapies 1.7 - (1.7) 5.0 5.0 -1.7 - (1.7) 5.0 5.0 -RTA Income Miscellaneous Support Services 50.0 50.0 - 150.0 150.0 -50.0 50.0 - 150.0 150.0 -Total - Income457.8 359.9 (97.9) 1,487.8 1,232.8 (255.0)Unidentified £'000 £'000 £'000 £'000 £'000 £'000Unidentified Estates and Facilities 56.7 - (56.7) 170.0 - (170.0)Central Services 3.3 - (3.3) 10.0 - (10.0)Old Community 0.7 - (0.7) 2.0 - (2.0)Miscellaneous Support Services 3.7 - (3.7) 11.0 - (11.0)Specialised Services 481.6 - (481.6) 1444.7 - (1,444.7)Surgery Head and Neck 590.5 - (590.5) 1771.6 - (1,771.6)Trust Headquarters 9.5 - (9.5) 28.5 - (28.5)Women's and Children's 74.3 - (74.3) 223.0 - (223.0)1220.3 - (1,220.3) 3660.8 - (3,660.8)Total - UnidentifiedGrand Total1,220.3 - (1,220.3) 3,660.8 - (3,660.8)4,244.1 2,743.5 (1,500.6) 15,483.0 10,940.9 (4,542.1)Agenda Item 7 (iv) Page : 12 of 15

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Summary of Cash Releasing Efficiency Savings 2009/10 Carried ForwardTable I and E 4cDivisionPlanActualProgress to JulyVarianceFav / (Adv)12ths ProfileVariance Fav/ (Adv)Plan2009-10 NR Forecast OutturnForecast CYEVarianceFav / (Adv)Forecast FYEFinancial Performance £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000Diagnostics & Therapies 35.3 35.0 (0.3) (0.3) 105.9 105.0 (0.9) 105.0Medicine 424.6 424.6 - (0.1) 1,274.0 1,274.0 - 1,274.0Specialised Services 390.7 390.4 (0.3) (52.6) 1,329.0 1,345.6 16.6 1,270.7Surgery Head and Neck 1,263.8 1,330.8 67.0 (116.9) 4,343.0 4,370.0 27.0 4,473.0Women's and Children's 20.0 23.4 3.4 3.4 60.0 70.0 10.0 70.0Estates and Facilities 8.6 8.3 (0.3) (0.4) 26.0 25.0 (1.0) 25.0Central Services 19.7 19.7 - - 59.0 59.0 - 59.0Corporate HR 3.0 3.0 - - 9.0 9.0 - 9.0Trust Headquarters 44.3 43.8 (0.5) (0.5) 133.0 131.0 (2.0) 135.0Totals 2,210.0 2,279.0 69.0 (167.3) 7,338.9 7,388.6 49.7 7,420.7Staffing Wte Wte Wte Wte Wte WteDiagnostics & Therapies 1.8 1.8 - 1.8 1.8 -Medicine - - - - - -Specialised Services 7.7 7.7 - 5.6 5.7 0.1Surgery Head and Neck 2.3 1.0 (1.3) 2.8 3.6 0.8Women's and Children's - - - - - -Estates and Facilities 1.0 1.0 - 1.0 1.0 -Central Services - - - - - -Corporate HR - - - - - -Trust Headquarters 1.9 1.9 - 1.9 1.9 -Totals 14.7 13.4 (1.3) 13.1 14.0 0.9Agenda Item 7 (iv) Page : 13 of 15

Table I and E 4dUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Cash Releasing Efficiency Savings by Workstream 2009/10 Carried ForwardStaffingVarianceVarianceGroup Division Plan ActualPlanForecastFav / (Adv)Fav / (Adv)£'000 £'000 £'000 £'000 £'000 £'000Admin and Clerical Specialised Services 9.7 11.9 2.2 28.9 28.9 -Surgery Head and Neck 30.8 37.6 6.8 135.0 159.0 24.0Women's and Children's 5.0 5.0 - 15.0 15.0 -45.5 54.5 9.0 178.9 202.9 24.0Agency Medical Staff Surgery Head and Neck 212.3 190.3 (22.0) 637.0 637.0 -212.3 190.3 (22.0) 637.0 637.0 -AHP's Specialised Services 14.0 18.1 4.1 42.1 42.1 -14.0 18.1 4.1 42.1 42.1 -All Staff Medicine 10.0 10.0 - 30.0 30.0 -10.0 10.0 - 30.0 30.0 -Consultants Surgery Head and Neck 247.6 247.7 0.1 902.0 823.0 (79.0)Specialised Services 25.0 - (25.0) 75.0 56.2 (18.8)272.6 247.7 (24.9) 977.0 879.2 (97.8)Dental Medical Staff Surgery Head and Neck 19.7 17.6 (2.1) 59.0 59.0 -19.7 17.6 (2.1) 59.0 59.0 -Healthcare Assistant & Other Support Staff Surgery Head and Neck 12.3 11.1 (1.2) 37.0 37.0 -12.3 11.1 (1.2) 37.0 37.0 -Junior Doctors Specialised Services 4.4 4.4 - 13.2 13.2 -Surgery Head and Neck 72.0 74.6 2.6 72.0 72.0 -76.4 79.0 2.6 85.2 85.2 -Other Medical staff Surgery Head and Neck 61.0 54.7 (6.3) 183.0 183.0 -61.0 54.7 (6.3) 183.0 183.0 -Non Clinical Staff Estates and Facilities 5.0 5.0 - 15.0 15.0 -Trust Headquarters 41.0 33.8 (7.2) 123.0 105.0 (18.0)Specialised Services - 21.9 21.9 - - -46.0 60.7 14.7 138.0 120.0 (18.0)Nursing Staff Central Services 19.7 19.7 - 59.0 59.0 -Medicine 108.3 108.3 - 325.0 325.0 -Specialised Services 80.7 94.8 14.1 273.3 274.3 1.0Surgery Head and Neck 185.4 230.1 44.7 737.0 678.0 -59.0Women's and Children's 15.0 18.4 3.4 45.0 55.0 10.0409.1 471.3 62.2 1439.3 1391.3 -48.0Other Clinical Staff Diagnostics & Therapies 35.0 35.0 - 105.0 105.0 -Specialised Services 28.7 28.7 - 86.2 86.2 -Surgery Head and Neck 28.0 25.1 (2.9) 84.0 84.0 -91.7 88.8 (2.9) 275.2 275.2 -Total - Staffing1,270.6 1,303.8 33.2 4,081.7 3,941.9 (139.8)Supplies and ServicesAll Budgets Specialised Services 84.2 77.6 (6.6) 252.6 247.6 (5.0)84.2 77.6 (6.6) 252.6 247.6 (5.0)Clinical Supplies & Services Specialised Services 72.5 63.3 (9.2) 194.4 201.9 7.5Surgery Head and Neck 86.7 43.6 (43.1) 562.0 540.0 (22.0)159.2 106.9 (52.3) 756.4 741.9 (14.5)Drugs Specialised Services 11.7 8.8 (2.9) 89.5 88.3 (1.2)Surgery Head and Neck 33.3 31.2 (2.1) 100.0 100.0 -45.0 40.0 (5.0) 189.5 188.3 (1.2)FIle: Item 7 (iv) - Aug 2010 - Expenditure : CRES Workstreams NR 0910 Page : 14 of 15

Table I and E 4dUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Cash Releasing Efficiency Savings by Workstream 2009/10 Carried ForwardGroup Division Plan ActualVarianceVariancePlanForecastFav / (Adv)Fav / (Adv)£'000 £'000 £'000 £'000 £'000 £'000Establishment Expenses Surgery Head and Neck 3.8 - (3.8) 19.0 19.0 -3.8 - (3.8) 19.0 19.0 -General Supplies & Services Surgery Head and Neck 0.6 - (0.6) 5.0 5.0 -Specialised Services 17.8 9.2 (8.6) 53.3 46.9 (6.4)18.4 9.2 (9.2) 58.3 51.9 (6.4)Services Received from Non NHS Bodies Surgery Head and Neck 58.7 52.6 (6.1) 176.0 176.0 -58.7 52.6 (6.1) 176.0 176.0 -- 7.7 7.7 - 23.0 23.0- 7.7 7.7 - 23.0 23.0Premises & Fixed Plant Estates and Facilities 3.3 3.3 - 10.0 10.0 -Trust Headquarters 2.3 2.3 - 7.0 3.0 (4.0)5.6 5.6 - 17.0 13.0 (4.0)Total - Supplies and Services374.9 299.6 (75.3) 1,468.8 1,460.7 (8.1)IncomeContract Income Specialised Services - - - 94.6 135.0 40.4- - - 94.6 135.0 40.4Income from commercial activities Corporate HR 3.0 3.0 - 9.0 9.0 -3.0 3.0 - 9.0 9.0 -Income from Private Patients Surgery Head and Neck 8.7 14.1 5.4 26.0 26.0 -8.7 14.1 5.4 26.0 26.0 -Other Operating Income Specialised Services 41.7 51.7 10.0 125.0 125.0 -Surgery Head and Neck 60.9 100.5 39.6 183.0 346.0 163.0102.6 152.2 49.6 308.0 471.0 163.0Service Agreement Income - Other Medicine 306.3 306.3 - 919.0 919.0 -Surgery Head and Neck 142.0 200.0 58.0 426.0 426.0 -448.3 506.3 58.0 1345.0 1345.0 -Total - Income562.6 675.6 113.0 1,782.6 1,986.0 203.4UnidentifiedUnidentified Diagnostics & Therapies 0.3 - (0.3) 0.9 - (0.9)Estates and Facilities 0.3 - (0.3) 1.0 - (1.0)Specialised Services 0.3 - (0.3) 0.9 - (0.9)Trust Headquarters 1.0 - (1.0) 3.0 - (3.0)1.9 - (1.9) 5.8 - (5.8)Total - UnidentifiedGrand Total1.9 - (1.9) 5.8 - (5.8)2,210.0 2,279.0 69.0 7,338.9 7,388.6 49.7FIle: Item 7 (iv) - Aug 2010 - Expenditure : CRES Workstreams NR 0910 Page : 15 of 15

Executive SummaryCapital Report – July 2010Trust Board29 th August 2010Agenda Item 7 (v)This report provides an update on the Trust’s Capital programme. The main points are: The capital programme has increased by £241k to £31.619m The expenditure at the end of July 2010 was £5.490m against a profiled budget of £7.761m,representing a variance of £2.271m. The forecast expenditure for the end of the financial year is £32.621m against a plannedprogramme of £31.619m, this however will be reviewed.1. IntroductionThe Trust’s indicative capital programme for 2010 - 2017 is set out in table Capital 1. The detailedsources and applications for the 2010/11 capital programme are set out in tables Capital 2 and 3.2. Movement in Capital Programme from June 2010The capital programme has increased by £241k to £31.619m as a result of additional donated fundsfor equipment within the Bristol Eye Hospital development scheme and net transfer from revenue.3. 2010/11 Capital Programme at July 2010Source of Funds (Capital 2)Capital expenditure of £5.490m has been funded from depreciation costs included in tariff of£5.135m and cash balances of £355k.Application of Funds (Capital 3)Capital expenditure is £5.490m, £2.271m below the profiled budget for the month of £7.761m.This variance is mainly attributable to the following schemes:Specialist Paediatrics (£146k) and BRI Redevelopment (£615k) – the profile is based on the originalbusiness cases for these schemes. The schemes are currently being reviewed and an updatedprofile will be provided.Major Medical - 2010/11 allocation (£406k) and 2009/10 allocation (£255k) – the variances relate tocapital allocations in three clinical divisions. The divisions have confirmed the items have beenordered however there have been unexpected delays in the procurement process and in preinstallation works coordinated by the Estates Department.Core labs level 8 Queens Building (£249k) – the scheme was completed during August 2010 withfinal payment expected in September 2010.4. Capital Forecast for 2010/11The forecast outturn is £32.621m against a programme of £31.619m. The forecast position will beupdated following the review of the specialist paediatric and BRI redevelopment schemes. Thereviewed position is likely to result in further slippage in 2010/11 over and above that currentlyreported.5. Long Term Capital ProgrammeThe ten year capital programme will be reviewed in preparation for the reporting of the significanttransactions to Monitor. A full report will be provided to the September Finance Committee.6. RecommendationsThe Trust Board is asked to:• Ratify the movement in the capital programme as detailed in section 2• Note the content of this report.

University Hospitals Bristol NHS Foundation Trust Capital 1Budget ManagerPreviousYears (whereapplicable)Plan 2010/11Indicative Plan2009-10 Slippage2010/11AllocationTotals 2011-12 2012-13 2013-14 2014- 15 2015 - 16 2016 - 17 TOTAL£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000SOURCE OF FUNDSA. Public Dividend CapitalSpecialist Paediatrics P Mapson - - - - 2,500 5,000 2,500 - - - 10,000Sub-Total - - - - 2,500 5,000 2,500 - - - 10,000B. RevenueOther transfers to/from Revenue - - 50 50 - - - - - - 50Sub-Total - - 50 50 - - - - - - 50C. New System FundingDepreciation From Long Term Plan P Tanner - - 16,905 16,905 17,961 18,486 18,544 19,709 21,604 22,258 135,467Prudential Borrowing P Tanner - - - - 20,000 25,000 15,000 - - - 60,000Sub-Total - - 16,905 16,905 37,961 43,486 33,544 19,709 21,604 22,258 195,467D. DonationsBHOC Upgrade Sp Svs DGM 1,830 - 1,830 - - - - - - 1,830Specialised Services - Research funding K Liddington - 10 10 - - - - - - 10BEH Coffee Lounge SHN DGM 15 - 15 - - - - - - 15BEH Development Paediatrics SHN DGM 250 291 541 - - - - - - 541Sub-Total - 2,095 301 2,396 - - - - - - 2,396E. DisposalsBuildings - - - - - - - - - -Sale of BGH P Mapson - - - - - 2,000 3,000 2,000 - - 7,000Sale of BRI Old Building P Mapson - - - - - - - - 3,000 3,000 6,000Sale of Brentry site P Mapson - - - - - 1,200 - - - - 1,200Sale of Residences P Mapson - - - - 1,000 1,300 - - - - 2,300Sub-Total - - 0 - 1,000 4,500 3,000 2,000 3,000 3,000 16,500F. Cash BalancesCash Balances b/fwd P Tanner 73,033 9,407 2,861 12,268 7,968 5,092 6,388 10,742 (4,091) (8,116) 103,284Cash Balances In Year I&E Surplus - - - - - - - - - - -Sub-Total 73,033 9,407 2,861 12,268 7,968 5,092 6,388 10,742 (4,091) (8,116) 103,284Grand Total Sources 73,033 11,502 20,117 31,619 49,429 58,078 45,432 32,451 20,513 17,142 327,697Item 7 (v) 1/7 19/08/2010 08:51

University Hospitals Bristol NHS Foundation Trust Capital 1APPLICATION OF FUNDSBudget ManagerPreviousYears (whereapplicable)2009-10 SlippagePlan 2010/112010/11AllocationIndicative PlanTotals 2011-12 2012-13 2013-14 2014- 15 2015 - 16 2016 - 17 TOTALCommitted SchemesA. Major Strategic SchemesBRI REDEVELOPMENT - (Per phasing 05/02/10)Phase 3 - BRI Redevelopment A Headdon 2,476 - 8,227 8,227 22,022 29,336 17,777 3,062 - - 82,900Phase 4 - BRI Redevelopment KEB A Headdon 50 - - - - - 298 5,434 518 - 6,300Sub Total 2,526 - 8,227 8,227 22,022 29,336 18,075 8,496 518 - 89,200STRATEGIC DEVELOPMENT PROJECTS -(Per phasing 05/02/10)Specialist Paediatrics A Headdon 862 - 2,000 2,000 7,517 9,479 7,242 4,300 - - 31,400BGH Re-provision A Headdon 25 - 182 182 1,067 - - - - 1,274Air Ambulance Access A Headdon 400 (32) 32 - 2,819 - - - - - 3,219OTHER STRATEGIC SCHEMES -Bristol Heart Institute A Headdon 60,915 268 - 268 - - - - - - 61,183Electrical Supply Infrastrusture N Phillips 1,080 97 - 97 - - - - - - 1,177BRI Phase 1 - BRI Redevelopment L Griffiths 1,313 2,629 - 2,629 - - - - - - 3,942BRI Phase 2 - Decommissioning G Cross 113 393 - 393 - - - - 506BHOC Labs Upgrade Sp Svs DGM 438 7 - 7 - - - - - - 445BHOC Upgrade Sp Svs DGM 480 1,446 100 1,546 - - - - - - 2,026South Bristol Community Hospital - DentalT Ranzetta - - - - 600 - - - - -600South Bristol Community Hospital T Ranzetta - - 376 376 1,924 - - - - - 2,300IM&T Hub & Office to Boiler Room G Cross 4,449 - - - - - - - - - 4,449Adult BMT service P Wilde - - - - 840 1,260 - - - - 2,100Sub-Total 72,601 4,808 10,917 15,725 36,789 40,075 25,317 12,796 518 - 203,821B. Medical EquipmentMajor Medical Programme - 2010/11 DGMs - (26) 3,869 3,843 2,380 2,380 2,380 2,580 2,580 2,580 18,723Major Medical Programme - Slippage from DGMs- 2,672 - 2,672 - - - - - -2009/102,672Additional Emergency Medical EquipmentCPG- - 323 323 300 300 300 300 300 3002,123Minor Medical DGMs - 68 - 68 - - - - - - 68Dental SIFT Programme M Wheeler - 286 200 486 400 400 400 450 450 450 3,036BioMedical Research Unit - MRI unit A Grooms - 50 - 50 - - - - - - 50Linacc / Scanner Replacement C Walsh - - - - 2,420 2,420 2,420 2,420 2,420 2,420 14,520Sub-Total - 3,050 4,392 7,442 5,500 5,500 5,500 5,750 5,750 5,750 41,192C. Information TechnologyPCs Replacement CPG - - 500 500 600 600 600 650 650 650 4,250IM&T - NCRS A Hooper - 134 1,000 1,134 3,000 2,000 - - 250 - 6,384Datawarehouse A Hooper 35 115 115 - - - - - - 150IM&T - General A Hooper - 30 500 530 500 500 500 600 600 600 3,830Core Financial System C Noble 283 - 50 50 - - - 300 - - 633Pathology Modernisation D Watteau 45 82 - 82 - - - - - - 127HP Swift A Hooper 32 103 103 - - - - - - 135Electronic Discharge System X Whittaker 22 24 - 24 - - - - - - 46SEMS System P Smithson - 160 - 160 - - - - - - 160VPLS Replacement server A Hooper - 118 118 - - - - - - 118Sub-Total 417 648 2,168 2,816 4,100 3,100 1,100 1,550 1,500 1,250 15,833Item 7 (v) 2/7 19/08/2010 08:51

University Hospitals Bristol NHS Foundation Trust Capital 1Budget ManagerPreviousYears (whereapplicable)2009-10 SlippagePlan 2010/112010/11AllocationIndicative PlanTotals 2011-12 2012-13 2013-14 2014- 15 2015 - 16 2016 - 17 TOTALD. Roll Over SchemesWorks Replacement N Phillips - (511) 2,000 1,489 2,000 2,000 2,200 2,200 2,200 2,300 14,389Bristol General Works Replacement G Cross - - 200 200 - - - - - - 200Vehicle Replacement D Ponsford - - 75 75 75 75 75 75 75 75 525Fire Precautions compliance G Cross - 18 150 168 150 150 150 150 150 150 1,068St Michaels Fire Improvement (Pre Commitment) B Pepper(514) 350 (164)-- - - - - - (164)Health & Safety M Fewkes - - 50 50 50 50 50 50 50 50 350Feasability Fees B Pepper - - 100 100 100 100 100 100 100 100 700Compliance with Lease Obligations G Cross - 257 100 357 100 100 100 100 100 100 957Sub-Total - (750) 3,025 2,275 2,475 2,475 2,675 2,675 2,675 2,775 18,025E. RefurbishmentsTrust HQ G/F Re-furbishment P Tanner - 25 - 25 - - - - - - 25Bathrooms and Toilets G Cross - (123) 350 227 - - - - - - 227Bed Store KE building N Phillips - 151 - 151 - - - - - - 151Level 6 King Edwards G Cross - 293 - 293 - - - - - - 293Other G Cross - 66 - 66 - - - - - - 66Fire Compliance B Pepper - - 900 900 900ITU Refurb (Pre Commitment) C Thompson - (31) 1,500 1,469 - - - - - - 1,469Dental SIFT - Waiting room M Wheeler - - 200 200 - - - - - - 200Dental Lifts B Pepper 15 216 - 216 - - - - - - 231Sub-Total 15 597 2,950 3,547 - - - - - - 3,562F. MiscellaneousResidences Fees G Cross - 13 - 13 - - - - - - 13Divisional Capital - Surgery Head & Neck C Thompson - - 143 143 - - - - - - 143Divisional Capital - Women's & Children I Barrington - - 153 153 - - - - - - 153Divisional Capital - Medicine L Salmon - - 123 123 - - - - - - 123Divisional Capital - Specialised Services R Chatfield - - 74 74 - - - - - - 74Divisional Capital - Diagnostic & Therapies G Higgins - - 143 143 - - - - - - 143Divisional Capital - Trust ServicesB Pepper/C134 134Perry- -- - - - - - 134Divisional Capital DGMs - - - - 1,100 1,100 1,100 1,100 1,150 1,150 6,700Sub-Total - 13 770 783 1,100 1,100 1,100 1,100 1,150 1,150 7,483G. Operational Capital2009/10 Operational Capital - slippageEnabling Core lab level 8 Queens HPA &L Worsam - 597 - 597 - - - - - - 597Pathology Decontamination moves compliance M Hornsby - 231 - 231 2,000 1,000 - - - - 3,231Wristband Implementation A Landon - 25 - 25 - - - - 25Bristol Eye Hospital Development M Vonk - 1,521 291 1,812 - - - - - - 1,812Blood Tracking G Higgins - 275 - 275 - - - - 275Refurbishment Clinic 7, Level 2 BRI L Salmon - 47 - 47 - - - - - - 47Relocation of Vascular Studies from BRI Level 7 C Walsh - 14 - 14 - - - - - - 14Respiratory dept L Salmon - 86 - 86 - - - - - - 86Item 7 (v) 3/7 19/08/2010 08:51

University Hospitals Bristol NHS Foundation Trust Capital 1Budget ManagerPreviousYears (whereapplicable)2009-10 SlippagePlan 2010/112010/11AllocationIndicative PlanTotals 2011-12 2012-13 2013-14 2014- 15 2015 - 16 2016 - 17 TOTAL2010/11 Operational CapitalSpend to save schemes CPG - - 300 300 - - - - - - 300BRHC Swipe Card B Pepper - - 30 30 - - - - - - 30Augmented Care J Vass - - 53 53 - - - - - - 53Clinical Trials G Higgins - - 215 215 - - - - - - 215Colposcopy refit J Vass - - 98 98 - - - - - - 98Decontamination compliance C Thompson - - 600 600 - - - - - - 600Estates help desk N Philips - - 65 65 - - - - - - 65Obstetrics records J Vass - - 261 261 - - - - - - 261Phase 5 bathrooms G Cross - - 173 173 - - - - - - 173Respiratory - accommodation L Salmon - - 580 580 - - - - - - 580Contingency CPG - 340 (65) 275 - - - - - - 275General Operational Capital CPG - - - - 5,000 5,200 5,400 5,700 5,900 6,100 33,300Sub Total - 3,136 2,601 5,737 7,000 6,200 5,400 5,700 5,900 6,100 42,037Total Committed Schemes 73,033 11,502 26,823 38,325 56,964 58,450 41,092 29,571 17,493 17,025 331,953H. Scheme Slippage @___ %- 25 - 25 25 25 25 25 25Expected Slippage 10/11 - (6,706) (6,706) 6,706Expected Slippage 11/12 (14,241) 14,241Expected Slippage 12/13 (14,613) 14,613Expected Slippage 13/14 (10,273) 10,273Expected Slippage 14/15 (7,393) 7,393Expected Slippage 15/16 (4,373) 4,373Expected Slippage 16/17 (4,256) (4,256)- (6,706) (6,706) (7,535) (372) 4,340 2,880 3,020 117 (4,256)Total Applications 73,033 11,502 20,117 31,619 49,429 58,078 45,432 32,451 20,513 17,142 327,697Item 7 (v) 4/7 19/08/2010 08:51

University Hospitals BristolNHS Foundation TrustCapital Programme 2010/11 Capital 2Total ApprovedPlanPlan to 31stJulyActual to 31stJulyVarianceUnder / (Over)ForecastSlippage /OverspendSOURCE OF FUNDS£'000 £'000 £'000 £'000 £'000 £'000A. Public Dividend CapitalDepartment of Health - - -Sub-Total - - - - - -B. RevenueTransfers from revenue reserves 50 50 50 - - -Sub-Total 50 50 50 - - -C. New System FundingDepreciation From Long Term Plan 16,905 5,635 5,135 500 16,722 183D. DonationsSub-Total 16,905 5,635 5,135 500 16,722 183BHOC Upgrade (note 1) 1,830 - - - 1,830 -Specialised Services - Research funding 10 - - - 10 -BEH Staff Coffee Lounge 15 - - - 15 -BEH Clinical Research Unit/Paed Expansion (note 1) 541 - - - 250 -E. DisposalsSub-Total 2,396 - - - 2,105 -- - - - - -Sub-Total - - - - - -F. Cash BalancesCash Balances 12,268 2,076 305 1,771 13,794 (1,185)Sub-Total 12,268 2,076 305 1,771 13,794 (1,185)Grand Total Sources 31,619 7,761 5,490 2,271 32,621 (1,002)Note 1Funds will be received on completion of the schemeAgenda Item 7 (v)5/7Printed on: 19/08/2010

University Hospitals BristolNHS Foundation TrustCapital Programme 2010/11 Capital 3Total ApprovedPlanPlan to 31st JulyActual to 31st JulyVarianceUnder / (Over)ForecastSlippageOverspend£'000 £'000 £'000 £'000 £'000 £'000 £'000APPLICATION OF FUNDSA. Major Strategic SchemesBristol Heart Institute 268 165 118 47 268 - -Electrical Supply Infrastructure 97 97 97 - 97 - -Specialist Paediatrics 2,000 313 168 145 1,500 500 -Phase 1 - BRI Redevelopment 2,629 1,008 627 381 2,652 - (23)Phase 2a - Decommissioning 393 50 53 (3) 100 293 -Phase 2b - BGH Re-provision 182 - - - 136 46 -Phsae 3 - BRI Redevelopment 8,227 1,422 807 615 6,170 2,057 -BHOC Refresh 1,553 426 453 (27) 1,553 - -South Bristol Community Hospital 376 - 5 (5) 282 94 -IM&T Hub Move - - 9 (9) 9 - (9)Sub-Total 15,725 3,481 2,337 1,144 12,767 2,990 (32)B. Medical EquipmentMajor Medical Programme 2010/11 3,863 758 332 426 3,720 100 43Major Medical Programme slipped from 2009/10 2,655 919 681 238 2,649 - 6Emergency medical equipment 320 - - 0 320 -Minor Medical Equipment 68 40 82 (42) 101 - (33)Dental SIFT Programme - Equipment 486 19 73 (54) 386 100 -BioMedical Research Unit - MRI Scanner 50 34 50 (16) 50 - -Sub-Total 7,442 1,770 1,218 552 6,906 520 16C. Information TechnologyPCs Replacement 500 175 261 (86) 500 - -IM&T - NCRS1,134 34 94 (60) 884 250 -IM&T - DataWarehouse115 - 15 (15) 115 - -IM&T - General530 240 202 38 530 - -Core Financial System50 50 48 2 50 - -Pathology Modernisation 82 - - - 82 - -HP Swift 103 - - - 103 - -Electronic Discharge System 24 - - - 24 - -SEM System 160 136 10 126 160 - -VPLS Replacement server - 2010/11 major medical 118 - - - 118 - -Sub-Total 2,816 635 630 5 2,566 250 -D. Roll Over SchemesWorks Replacement 1,489 270 123 147 1,035 454 -Works Replacement - BGH 200 - - - 150 50 -St Michael New Water System - - 19 (19) 19 - (19)Vehicle Replacement 75 - - - 75 - -Fire Precautions compliance 4 4 7 (3) 7 - (3)Health & Safety 50 10 6 4 50 - -Feasability Fees 100 30 30 - 75 25 -Compliance with Lease Obligations 357 51 56 (5) 337 20 -Sub-Total 2,275 365 241 124 1,748 549 (22)Agenda Item 7 (v) 6/7 Printed on: 19/08/2010

University Hospitals BristolNHS Foundation TrustCapital Programme 2010/11 Capital 3Total ApprovedPlanPlan to 31st JulyActual to 31st JulyVarianceUnder / (Over)ForecastSlippageOverspend£'000 £'000 £'000 £'000 £'000 £'000 £'000E. RefurbishmentsTrust HQ Ground Floor 25 6 13 (7) 25 - -Bathrooms and Toilets 227 227 227 - 227 - -Ward 11 - 2 cubicles 41 8 - 8 41 - -Bed Store King Edwards Building 151 - - - 151 - -Level 6 decant King Edwards 293 7 1 6 293 - -Other 25 8 15 (7) 25 - -Fire Improvement 900 - 57 (57) 900 - -ITU Refurbishment 1,469 147 72 75 1,094 375 -Dental SIFT Programme - Waiting room refurbishment 200 - - - 200 - -Dental Lift 216 135 130 5 216 - -Sub-Total 3,547 538 515 23 3,172 375 -F. MiscellaneousResidences Disposals 13 13 13 - 13 - -Divisional Capital - Surgery Head & Neck 143 - - - 143 - -Divisional Capital - Women's & Children 153 - - - 111 42 -Divisional Capital - Medicine 123 - - - 92 31 -Divisional Capital - Specialised Services 74 - - - 56 19 -Divisional Capital - Diagnostic & Therapies 143 - - - 107 36 -Divisional Capital - Trust Services 134 20 - 20 126 8 -Sub-Total 783 33 13 20 648 135 -G.Operational Capital2009/10 Operational Capital slipped from 2009/10Enabling Core Lab L8 Queens 597 597 348 249 597 - -Wristband implementation 25 - - - 25 - -Bristol Eye Hospital Development 1,812 182 98 84 1,812 - -Blood tracking IT systems 275 - - - 275 - -Refurb clinic 7, level 2 BRI 47 - - - 47 - -Relocation of Vascular Studies from BRI level 7 14 3 2 1 14 - -Respiratory Dept 86 17 6 11 86 - -2010/11 Operational Capital -Energy scheme 141 60 8 52 106 35 -Energy scheme 159 - - - 119 40BRHC Swipe Card 30 - - - 23 7 -Augmented Care 53 - - - 40 13 -Clinical Trials 215 - - - 161 54 -Colposcopy 98 - - - 73 25 -Decontamination compliance 831 80 74 6 611 220 -Estates Help desk 65 - - - 65 - -Obstetrics records 261 - - - 195 66 -Phase 5 bathrooms 173 - - - 130 43 -Respiratory - standard of accommadation 580 - - - 435 145 -General Operational Capital - Contingency 275 - - - - 275 -Sub-Total 5,737 939 536 403 4,814 923 -Grand Total of Schemes 38,325 7,761 5,490 2,271 32,621 5,742 (38)G. Scheme SlippageExpected Slippage 2010/11 (6,706) - - - - (6,706)Sub-Total (6,706) - - - - (6,706) -Grand Total of Applications 31,619 7,761 5,490 2,271 32,621 (964) (38)Agenda Item 7 (v) 7/7 Printed on: 19/08/2010

University Hospitals Bristol NHS Foundation TrustFinance Report July 2010 - Statement of Financial PositionTable BS1AssetsAssets, Non-CurrentUHB Healthcare @ 31 July 2010 Skills for Health @ 31 July 2010Total @ 31 July 2010 Forecast 31 March 2011UHB Skills forPlan Actual Variance Plan Actual Variance Plan Actual VarianceTotalHealthcare Health£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000Intangible Assets, Net 2,183 2,128 (55) - - - 2,183 2,128 (55) 1,791 - 1,791Property, Plant and Equipment, Net 285,085 284,360 (725) - - - 285,085 284,360 (725) 291,143 - 291,143Trade and Other Receivables, Net, Non-Current -Other Receivables, Non-Current 0 - - - - - - - - -Trade and Other Receivables, Net, Non-Current, TotalAssets, Non-Current, Total 287,268 286,488 (780) - - - 287,268 286,488 (780) 292,934 - 292,934Assets, CurrentInventories 5,821 6,020 199 - - - 5,821 6,020 199 5,898 - 5,898Current Tax Receivables 674 681 7 - - - 674 681 7 683 - 683Trade and Other Receivables, Net, Current -NHS Trade Receivables, Current 11,216 17,327 6,111 2,526 7,909 5,383 13,742 25,236 11,494 15,258 26 15,284Non NHS Trade Receivables, Current 3,258 2,731 (527) 976 226 (750) 4,234 2,957 (1,277) 3,923 367 4,290Other related party receivables - - - - - 0 0 - 0 - - -Other Receivables, Current 2,146 2,451 305 0 2,146 2,451 305 2,174 2,174Trade and Other Receivables, Net, Current, Total 16,620 22,509 5,889 3,502 8,135 4,633 20,122 30,644 10,522 21,355 393 21,748Other Financial Assets, CurrentAccrued Income 1,638 2,241 603 4,454 4,454 1,638 6,695 5,057 1,660 1,660Other Financial Assets, Current 148 146 (2) - - 0 148 146 (2) 150 - 150Other Financial Assets, Current, Total 1,786 2,387 601 0 4,454 4,454 1,786 6,841 5,055 1,810 - 1,810Prepayments, CurrentPrepayments, Current, non-PFI related 1,050 2,800 1,750 137 168 31 1,187 2,968 1,781 1,203 - 1,203Prepayments, Current, Total 1,050 2,800 1,750 137 168 31 1,187 2,968 1,781 1,203 - 1,203Cash and Cash EquivalentsCash 39,317 42,284 2,967 1,147 2,008 861 40,464 44,292 3,828 26,564 4,634 31,198Current Asset Investments - - - - - - - -Cash and Cash Equivalents, Total 39,317 42,284 2,967 1,147 2,008 861.0 40,464 44,292 3,828 26,564 4,634 31,198Other Assets, CurrentNon-Current Assets held for sale - - - - - - - - - - - -Other Assets, Current, Total - - - - - - - - - - - -Assets, Current, Total 65,268 76,681 11,413 4,786 14,765 9,979 70,054 91,446 21,392 57,513 5,027 62,540ASSETS, TOTAL 352,536 363,169 10,633 4,786 14,765 9,979 357,322 377,934 20,612 350,447 5,027 355,474LiabilitiesLiabilities, CurrentInterest-Bearing Borrowings, CurrentBank Overdraft - - - - - - - - - - - -Drawdown in Committed Facility - - - - - - - - - - - -Loans, commercial, Current - - - - - - - - - - - -Interest-Bearing Borrowings, Current, Total - - - - - - - - - - - -Deferred Income, Current 10,469 8,848 (1,621) 2,060 9,660 7,600 12,529 18,508 5,979 4,908 2,500 7,408Deferred Government Grant Income, Current 0 162 162 - - - 0 162 162 - -Provisions, Current 629 963 334 - - - 629 963 334 638 - 638Post-Employment Benefit Obligation, Current - - - - - - - - - - - -Current Tax Payables 6,475 - (6,475) - - - 6,475 (6,475) 6,561 - 6,561Sub Total 17,573 9,973 (7,600) 2,060 9,660 7,600 19,633 19,633 0 12,107 2,500 14,607Trade and Other Payables, CurrentNHS Trade Creditors, Current 13,405 14,161 756 200 359 159 13,605 14,520 915 12,606 2,359 14,965Other Creditors, Current 4,621 14,518 9,897 180 173 (7) 4,801 14,691 9,890 4,696 168 4,864Capital Creditors, Current 1,881 1,403 (478) 0 1,881 1,403 (478) 1,883 - 1,883Trade and Other Payables, Current, Total 19,907 30,082 10,175 380 532 152 20,287 30,614 10,327 19,185 2,527 21,712Other Financial Liabilities, CurrentAccruals, Current 11,211 12,089 878 2,346 4,571 2,225 13,557 16,660 3,103 10,914 - 10,914Payments on Account - - - - 0 - - - - - -Finance Leases, Current 148 140 (8) - 0 - 148 140 (8) 164 - 164PDC dividend creditor, Current 2,921 2,887 (34) - 0 - 2,921 2,887 (34) - - -Interest payable on commercial interest bearing borrowings - - - - 0 - - - - - - -Other Accrued Financial Liabilities, Current - - - - 0 - - - - - - -Other Financial Liabilities, Current - - - - 0 - - - - - - -Other Financial Liabilities, Current, Total 14,280 15,116 836 2,346 4,571 2,225 16,626 19,687 3,061 11,078 - 11,078Other Liabilities, CurrentDonated Assets deferred Income - - - - - - - - - - - -Other Accrued Liabilities, Current - - - - - - - - - - - -Other Liabilities, Current - 5,302 5,302 - - - - 5,302 5,302 5,408 - 5,408Other Liabilities, Current, Total - 5,302 5,302 - - - - 5,302 5,302 5,408 - 5,408Liabilities, Current, Total 51,760 60,473 8,713 4,786 14,763 9,977 56,546 75,236 18,690 47,778 5,027 52,805NET CURRENT ASSETS (LIABILITIES) 13,508 16,208 2,700 0 2 2 13,508 16,210 2,702 9,735 - 9,735Liabilities, Non-CurrentInterest-Bearing Borrowings, Non-CurrentLoans, Non-Current, commercial - - - - - - - - - - - -Interest-Bearing Borrowings, Non-Current, Total - - - - - - - - - - - -Non-Interest-Bearing Borrowings, Non-CurrentDeferred Income, Non-Current - - - - - - - - - - - -Deferred Government Grant Income, Non-Current - - - - - - - - - - - -Provisions, Non-Current 288 55 (233) - - - 288 55 (233) 292 - 292Post-Employment Benefit Obligation, Non-Current - - - - - - - - - - - -Non-Interest-Bearing Borrowings, Non-Current Total 288 55 (233) - - - 288 55 (233) 292 - 292Other Financial Liabilities, Non-Current - - -Finance Leases, Non-current 6,251 6,259 8 - - - 6,251 6,259 8 6,142 - 6,142Other Financial Liabilities, Non-Current, Total 6,251 6,259 8 - - - 6,251 6,259 8 6,142 - 6,142Other Liabilities, Non-CurrentDonated Assets deferred Income, Non-Current - - - - - - - - - - - -Other Liabilities, Non-Current 0 - 0 - - - 0 - - -Other Liabilities, Non-Current, Total - - 0 - - - 0 0 - - - -Liabilities, Non-Current, Total 6,539 6,314 - 225- - - 6,539 6,314 (225) 6,434 - 6,434TOTAL ASSETS EMPLOYED 294,237 296,382 2,145 - 2 2 294,237 296,384 2,147 296,235 - 296,235Taxpayers' and Others' EquityTaxpayers EquityPublic dividend capital 191,011 191,011 0 - - - 191,011 191,011 0 191,011 - 191,011Retained Earnings 21,879 23,169 1,290 - 2 2 21,879 23,171 1,292 26,420 - 26,420Donated Asset Reserve 11,174 10,432 (742) - - - 11,174 10,432 (742) 11,827 - 11,827Other ReservesRevaluation Reserve 70,088 71,685 1,597 - - - 70,088 71,685 1,597 66,892 - 66,892Miscellaneous Other Reserves 85 85 - - - - 85 85 - 85 - 85Other Reserves, Total 70,173 71,770 1,597 - - - 70,173 71,770 1,597 66,977 - 66,977TAXPAYERS EQUITY, TOTAL 294,237 296,382 2,145 - 2 2 294,237 296,384 2,147 296,235 - 296,235Agenda Item 7 (vi) 6

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Cash and CashflowTable BS260Monthly Closing Cash Balance 2010-11 (£'m)90In Month Balances 2010-11 (£'m)80507040605030402030201010PlanActual/ForcastLowHigh0Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar0Apr May Jun JulAgenda Item 7 (v) Page : 2 of 6

ActualActualUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUST2010/11 FORECAST CASH FLOW (Actual data to July 2010)Table BS3MonthSourcesApplicationsBalanceNHS ReceiptsInterest Other(see detailB/Fwd New PDC New LoansTotalsSLAs Other Received Incomebelow)Balance C/Fwd Original Plan£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000April 37,787 - - 34,253 11,405 9 1,786 47,453 (35,813) 49,427 37,889May 37,889 - - 30,839 4,774 17 1,596 37,226 (38,525) 48,128 44,283June 42,497 31,311 5,132 6 1,839 38,288 (45,011) 41,405 42,791July Plan 41,405 - - 31,626 9,934 17 2,470 44,047 (41,927) 43,525 40,464July Actual 41,405 - - 31,893 9,687 24 2,625 44,229 (41,383) 44,251 40,464August 44,251 - - 31,626 9,842 38 2,270 43,776 (43,804) 44,223 47,552September 44,223 - - 30,626 15,183 18 2,270 48,097 (46,281) 46,039 49,109October 46,039 - - 31,626 9,669 17 2,270 43,582 (42,006) 47,615 49,909November 47,615 - - 31,626 3,988 17 2,270 37,901 (43,044) 42,472 45,466December 42,472 - - 30,626 7,972 20 2,270 40,888 (42,448) 40,911 44,170January 40,911 - - 31,626 8,997 17 2,270 42,910 (42,853) 40,968 44,721February 40,968 - - 31,626 3,962 17 2,270 37,875 (42,842) 36,000 39,829March 36,000 - - 33,262 5,240 17 2,270 40,789 (45,641) 31,148 30,807Totals- - 380,940 95,849 217 26,006 503,012 (509,651)ApplicationsMonthPayroll Advances Traders Capital Tax / NI & OPG NHS PDCAccountSuper Payments RepaymentPDC Dividend Interest Paid Totals£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000April (14,861) (12) (4,484) (1,665) (9,934) (4,857) - - - (35,813)May (14,606) (10) (9,765) (620) (10,093) (3,287) (144) (38,525)June (14,632) (15) (11,522) (1,997) (10,221) (6,624) - - - (45,011)July Plan (14,734) (20) (10,597) (2,846) (10,299) (3,287) - - (144) (41,927)July Actual (14,963) (18) (11,031) (575) (10,636) (4,160) - - - (41,383)August (14,734) (20) (10,597) (2,750) (10,103) (5,456) - - (144) (43,804)September (14,834) (20) (10,820) (2,750) (10,221) (3,287) - (4,349) - (46,281)October (14,734) (20) (10,597) (2,925) (10,299) (3,287) - - (144) (42,006)November (14,734) (20) (10,597) (3,134) (10,103) (4,456) - - - (43,044)December (14,834) (20) (10,820) (3,266) (10,221) (3,287) - - - (42,448)January (14,734) (20) (10,860) (3,509) (10,299) (3,287) - - (144) (42,853)February (14,734) (20) (10,020) (3,509) (10,103) (4,456) - - - (42,842)March (14,834) (20) (10,194) (2,626) (10,299) (3,287) - (4,381) - (45,641)Totals(177,234) (215) (121,307) (29,326) (122,532) (49,731) - (8,730) (576) (509,651)Agenda Item 7 (vi) Page : 3 of 6

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 10 - DebtorsTable BS4DebtorPreviousMonthTotal DebtThis MonthChange inMonth0 - 30 31 - 60 61 - 90 91+£'000 £'000 £'000 £'000 £'000 £'000 £'000Department of Health 2,936 7,983 5,047 5,006Debt Aged ProfileNumber of days outstanding100 2,816 61NHS Bristol (SWSCG) 1,587 1,197 (390) (389) - 1,974 (388)Action Taken / Progress0 - 30 Days - £5,006m relates to Skills for Health a payment was received on2nd August.61 - 90 Days - £2,816m relates to Skills for Health funding a dispute has beenraised. Credit note to be raised in August.91 + Days - £61k £31k relates to Consultant sessions which have been disputedfurther information has been provided. The remaining balance of £30k relates toa charge for Autism Strategy we have now provided a purchase order. Paymentof both invoices is now being sought.61 + Days - £1,589k relates to Service Level Agreement we are still working toresolve all disputes to enable payment.North Bristol NHS Trust 1,040 1,550 510 452 498 201 39961 + Days - £600k £85k relates to salary recharges £360k relates to PeripheralClinics £155k relates to various provider to provider charges. A returnedstatement from NBT contains minimal information, assured that NBT will beaddressing, meeting scheduled for 25th August with NBT`s Accounts Payableofficer to highlight key invoices where disputes have been raised.Aneurin Bevan LHB 575 709 134 141 - (7) 575NHS South Gloucestershire 694 1,324 630 628 163 687 (154)61 + Days - £568k A schedule of all Welsh outstanding debts and related issuesis now being prepared for UHB Director of Finance to discuss with the Director ofFinance of NHS Wales61 + Days - £533k £233k has been agreed to be paid by the end of the Augustthe remaining balance of £300k continue to pursue for payment.NHS Bristol776 2911 2,135 2,221 283319 8861 - 90 Days - £319k relates to Service Level Agreement charges, a credit notehas been raised and waiting for NHS Bristol to take.91 + Days - £88k relates to various Provider to Provider charges some of whichhave been disputed working to resolve and continue to pursue.Health Commission Wales 1,099 438 (661) - 95 171 17261 + Days - £343k £55k has been agreed. Continue to pursue the remainingoutstanding values with discussions between both organisations.Royal United Hospitals 277 304 27 19 24 - 261NHS Gloucestershire 200 561 361 361 - 200 -91 + Days - £261k £129k relates to Specialist Registrar rotation, and £31krelates to Dental charges which continue to be disputed. The remaining balanceof £119k relates to various charges which continue to be pursed.61 + Days - £200k no disputes have been registered. NHS Gloucestershire haveconfirmed that invoice is awaiting authorisation.Agenda Item 7 (vi) Page: 4 of 6

UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 10 - DebtorsTable BS4DebtorPreviousMonthTotal DebtThis MonthChange inMonthDebt Aged ProfileNumber of days outstanding0 - 30 31 - 60 61 - 90 91+£'000 £'000 £'000 £'000 £'000 £'000 £'000Action Taken / ProgressPrivate Patients 301 480 179 159 126 29 16661 + Days - 195k - 26k relates to 1 Overseas invoice which is actively beingpursued. 9k to be cancelled and re-raised to enable Helath Company to pay.The remaining balance of £160k no disputes registered actively being pursuedwith Patients and Insurance companys.NHS Somerset 179 565 386 428 - 137 -Weston Area Health Trust 310 391 81 127 138 87 39Avon & Wiltshire Mental Health 219 287 68 65 162 60 -61 + Days - £137k Confirmation from NHS Somerset that invoices have nowbeen authorised for payment.61 - 90 Days - £87k Payment of £30k received on 6th August, the remainingbalance of £57k relates to various charges. Non payment will be escalated to theDirector of Finance.91 + Days - £39k £12k relates to Peripheral Clinics which still remain in dispute,the remaining balance of £27k relates to various charges some of which havenow been disputed we have provided further information to enable immediatepayment.61 - 90 Days - £60k relates to various charges no disputes have been registeredcontinue to pursue for payment.University of Bristol 331 1,281 950 1,048 175 (135) 193 61 + Days - £58k payment has now been received on 2nd August 2010.NHS North Somerset 306 1,005 699 884 93 - 2810,830 20,986 10,156 11,150 1,857 6,539 1,440Other Debtors 4,510 4,887 377 2,569 544 228 1,545Total Debtors 15,340 25,873 10,533 13,719 2,401 6,767 2,985Percentage of Total Balance 53 9 26 1291+ Days - £28k £20k relates to HDU patient transport no disputes have beenregistered, a request for more information which we have now provided, theremaining balance of £8k relates to various charges no disputes, Continue topursue for payment.Note: Debtors listed in descending value of amounts owed over 60 days. Totalvalue of invoices raised in the year = £116.7mDebtor Days 13.81 27.23Agenda Item 7 (vi) Page: 5 of 6

% Number of NHS Creditorinvoices paid within 30 days% Number of Non NHS Creditorinvoices paid within 30 daysUNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUSTFinance Report July 2010 - Creditor PaymentsTable BS51008060Non NHS Creditors - Payment PerformanceCommentaryThe Better Payment Practice Code requires the Trust toaim to pay all valid non NHS invoices within 30 days.Payment performance in July was 89% for Non NHSCreditor invoices.4020-09-10 Apr May Jun JulThe total number of invoices paid in July was 12,711with a value of £11.582m.On a cumulative basis 90% of all invoices (87% by value)were paid within 30 days.10080NHS Creditors - Payment PerformancePayment performance in July was 96% for NHS Creditorinvoices (99% by value).604020-09-10 Apr May Jun JulThe total number of invoices paid in July was 349 with avalue of £4.500m.On a cumulative basis 81% of all invoices (86% by value)were paid within 30 days.Agenda Item 7 (vi) Page : 6 of 6

1. IntroductionStatement of Financial Position and Treasury Management – July 2010Trust Board29 th August 2010Agenda Item 7 (vi)This report updates the Trust Board on the Trust’s Statement of Financial Position and TreasuryManagement for the four month period ending 31 st July 2010.2. Statement of Financial PositionThe Statement of Financial Position (Table BS1) shows the Trust (including Skills for Health) has aworking capital balance of £16.210m which is £2.391m higher than the month of June. This has beengenerated by current assets of £91.446m less current liabilities of £75.236m.2.1 Current Liabilities (Variance)Current liabilities of £58.141m at the end of March have increased by £17.095m at the end of July.Mainly attributed an increase in Accruals and Other Liabilities (£5.960m) of which £4.571m relates toSkills for Health. Also increases in Deferred Income (£5.934m) as a result of income received forresearch and development, and Other liabilities (£5.302m) due to the reclassification of Holiday PayAccrual from a non current liability to current. There has been a further increase for PDC Dividendaccruals (£2.887m) which will be paid on account in September.3. CashA summary of the monthly closing cash balances and more detailed information on the source andapplication of funds has been included at Tables BS2 and BS3. The cash balance on the 31 st July was£44.251m which includes £2.008m for Skills for Health, is £0.726m above plan. This represents anincrease of £2.846m from the previous month’s cash balance.The main variances for July includes increased NHS payments of £0.873m which relates to Skills forHealth (£0.506m) and overdue invoices for NHS Supplies (£0.367m) were paid during the month.Also capital cash expenditure is £2.271m lower than plan. The anticipated cash balance at the end ofthe financial year is £31.148m which is broadly in with the Annual Plan of £30.807m.4. Receivables (Debtors) - Aged Debtors AnalysisA summary of invoiced debtors as at 31 st July 2010 is given at Table BS4. The total value of debtors(£25.873m) has increased in July by £10.533m. The major part of this increase relates to Department ofHealth (£5.047m) for Skills for Health core funding, which has been paid during August. Also NHSBristol (£2.135m) University of Bristol (£0.950m) and North Somerset (£0.699m) offset by netincreases in other debtor balances.5. Performance against the Better Payment CodeThe Trust achieved 96% and 89% compliance against the code for payment of NHS and Non NHScreditors respectively during the month for the number of invoices paid within the target.6. RecommendationThe Trust Board is asked to note the contents of this report.

Trust Board26 th August 2010Agenda Item 7 (vii)LEGAL AGREEMENT SIGN OFFWORKING CAPITAL FACILITY1.0 PurposeDemonstrate “due authorisation” of the working capital facility legal agreement following the recenttendering exercise.2.0 IntroductionThe existing working capital facility of £31.75m with Barclays Bank PLC has been in place since 1 stJune 2008 and was due to expire on 31 st May 2010. In April 2010, the Finance Committee received aTender Evaluation paper which recommended Barclays as the provider of a new £37.5m workingcapital facility with effect from 1 st June 2010. However, due to delays in receiving the legalagreement for the new facility, the start of the new facility was postponed until 1 st September 2010and the existing facility extended until 31 st August 2010.The Trust received the legal agreement from Barclays Bank PLC week commencing 26 th July 2010.3.0 Review of the Legal AgreementFirst, the Trust reviewed the legal agreement to ensure the terms within it are not different to thosecontained within the tender offer submitted in March. Once satisfied this was the case, the Trustengaged the legal services of Beachcroft LLP and sought their legal opinion of the legal agreement.Advice received from Beachcroft has pointed out a number of items requiring either the Trust’sconfirmation, and as they had done so two years ago, or have identified a number of potentialamendments to the legal agreement. However, these are only considered desirable and do notpreclude the Trust from signing the legal agreement.4.0 Action requiredThe commencement of the new working capital facility with Barclays Bank PLC requiresdemonstration of “due authorisation” by the Trust. Therefore, the Trust Board is asked to considerand pass the following resolutions:a) approving of the Facility on the terms and conditions stated in the Agreement (annex 1);b) authorising a specified officer, or officers, of the Borrower to countersign and return tothe Bank a duplicate of the Agreement;c) specifying the names of those officers of the Borrower whose instructions (jointly oralone) the Bank is authorised to accept in all matters concerning the Facility and theAgreement;d) containing confirmed specimens of the signatories of those officers referred to in (b) and(c) above, if not already known to the Bank; ande) confirming that the Facility complies with all requirements set by the Regulator in respectof working capital facilities for NHS foundation trusts and that by entering into theAgreement and drawing the full amount of the Facility, the Borrower will not cause anyborrowing or similar limit binding on the Borrower to be exceeded.

5.0 RecommendationThe Trust Board is asked to approve the resolutions and therefore “due authorisation” of the newworking capital facility legal agreement concluding in due course with:f) “Wet” signatures of two Executive Directors on the legal agreement, copy attached asannex 1;g) “Wet” signatures of two Executive Directors on Schedule 4, the Directors’ Certificate,copy attached as annex 2;The two nominated Executive Directors will be:Paul Mapson – Director of FinanceRobert Woolley – Acting Chief Executive17 August 2010

Annex 2SCHEDULE 4DIRECTORS’ CERTIFICATEUniversity Hospitals Bristol NHS Foundation Trust(the “Borrower”)Directors’ CertificateTo Barclays Bank PLC£37,500,000 Revolving Credit Facility Agreement dated 26 th July 2010 between University HospitalsBristol NHS Foundation Trust (as Borrower) and yourselves (as Lender) the (“the Agreement”).Capitalised terms not otherwise defined in this Certificate shall bear the meanings ascribed to them in theAgreement.We Mr Robert Woolley and Mr Paul Mapson are respectively Directors of the Borrower, and hereby certifyon behalf of the Borrower as follows:We are duly authorised to give this Certificate.POWERS AND RATINGSAttached to this Certificate and marked A are certified true copies of:the constitution of the Borrower;the Authorisation, which incorporates evidence, in Schedule 5 of the Authorisation, of the Borrower’scurrent PBL, including maximum cumulative long term borrowing and maximum working capitalfacility;DUE AUTHORISATIONAttached to this Certification and marked B is a certified true copy of the minutes of a duly convenedmeeting of the Board of Directors of the Borrower duly held on 26 th August 2010 at which a duly constitutedquorum of Directors were present throughout and at which resolutions were duly passed:a) approving of the Facility on the terms and conditions stated in the Agreement;b) authorising a specified officer, or officers, of the Borrower to countersign and return to the Bank aduplicate of the Agreement;c) specifying the names of those officers of the Borrower whose instructions (jointly or alone) theBank is authorised to accept in all matters concerning the Facility and the Agreement;d) containing confirmed specimens of the signatories of those officers referred to in (b) and (c) above,if not already known to the Bank; and

e) confirming that the Facility complies with all requirements set by the Regulator in respect ofworking capital facilities for NHS foundation trusts and that by entering into the Agreement anddrawing the full amount of the Facility, the Borrower will not cause any borrowing or similar limitbinding on the Borrower to be exceeded.FINANCIAL CONDITIONA copy of full 2010/11 budget including quarter by quarter income statement, balance sheet and cashflow, showing no material change and continued surpluses.CONFIRMATIONWe confirm that the Borrower is duly incorporated and validly existing under English law and has thenecessary corporate power to enter into the Agreement and to exercise its rights and perform itsobligations under the Agreement. All corporate and other action required by its constitutionaldocuments or by statute to authorise the execution of the Agreement by the Borrower and theperformance of its obligations under the Agreement has been duly taken and the Agreement has beenduly executed and delivered on the Borrower’s behalf.For and on behalf of University Hospitals Bristol NHS Foundation TrustDirector: Mr Robert WoolleyDated:Director: Mr Paul MapsonDated: