SOUTHPORT & ORMSKIRK HOSPITAL NHS TRUST

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1 SOUTHPORT & ORMSKIRK HOSPITAL NHS TRUST MINUTES OF THE MEETING OF THE FINANCE & PERFORMANCE COMMITTEE HELD ON 27 SEPTEMBER 2007 Present: In Attendance: Apologies: Mrs M Carberry (chair) Sir Ron Watson Mr K Clarkson Mr J Parry Mr C Throp Mr K Walsh Mrs S Finnegan Mrs L Mercer (deputising for Miss J Brookes) Mrs E Yates Dr G Boocock Miss J Brookes Mrs J Citarella Mr M Iskander Mrs S Partington Mr S Taylor 07/042 MINUTES OF THE MEETING HELD ON 28 AUGUST 2007 The Minutes of the meeting held on 28 August 2007 were agreed as a correct record. 07/043 MATTERS ARISING i. Minute No. 07/034 a. Recovery Plan Following a second red pen exercise, the outstanding balance of 150K had been identified from a number of sources ( 400K FYE). b. Capital A formal capital programme had now been produced and, subject to the approval of the Finance & Performance Committee members when reviewed later in the meeting, this would be presented to the Trust Board in November. Regarding the mitigation of the 1.2M risk identified in respect of land sales, it was confirmed that two schemes had been identified (robotics/pharmacy and decontamination) which could, if necessary, be delayed. 07/044 FINANCE DIRECTOR S REPORT Overview The Trust was cumulatively under-spent by 434K as at the end of August. Whilst the position had worsened in-month, it was believed that the cause was a temporary seasonal one relating to the changeover of medical staff and the need to use agency Page 1 of 5

2 staff due to the non-availability of bank staff. The Trust therefore remained on target to achieve the revised year end in-year projected surplus of 1.023M provided activity targets were achieved. It was highlighted that the activity plan had been re-profiled to more accurately reflect the pattern of work taking place within the Trust, including the additional work required to achieve the 18 week target. It was also highlighted that, regarding the baseline SLA, it had been decided to re-profile the activity in straight 12ths to reflect more accurately the overall workload pattern. Income A favourable in-month variance of 33K was reflected on income ( 206K cumulative). It was confirmed that no major movements had taken place during August, although a material benefit was evident from interest receivable. Again, under-performance on PCT SLAs had not been taken into account. SLA Performance Performance against the SLAs as at the end of July was reviewed and it was noted that, overall, the Trust was under-performing by 279K against targets. As indicated above, activity had now been re-profiled over the year resulting in a reduction in activity for April to July and an increase for the remainder of the year, hence the improvement in July s figures compared with the previous month. Individual areas of over and underperformance were highlighted and noted. Further to a query raised at the July meeting regarding excess bed days, it was agreed to provide some comparative figures to Mrs Carberry. Action: K Walsh Expenditure A cumulative under-spend of 228K had been achieved as at the end of August, despite the recovery plan not yet having been fully delivered. Pay expenditure had increased and was over-spent by 10K in-month due to the medical staff change-over and increase in agency use as noted above. Cumulatively, however, pay budgets were 344K underspent notwithstanding the impact of the rebasing reserve, without which the Trust would have effectively been 927K under-spent. Non pay had increased in month across a number of areas, however remained in balance cumulatively. Only one scheme within the recovery plan had been implemented during August, resulting in a 32K deficit on the recovery plan line. Divisional Performance The divisional performance reports were noted. Specific issues were highlighted as follows: Medical Division in respect of pay performance, it was clarified that the costs to be invoiced by other organisations related to procedural changes under MMC and MTAS for payment of House Officers, under which, with effect from 1 st August 2007, the Royal Liverpool recharges the Trust. Surgical Division it was queried whether the in-month unfavourable variance of 57K was due mostly to the additional work taking place to achieve the 18 week target. Whilst this work was certainly having an impact on the position in terms of both pay and non- Page 2 of 5

3 pay, other issues such as long term sickness within PIU and the late receipt of agency invoices in respect of Theatres at Ormskirk were contributory factors. It was anticipated that the position would improve. Specialist & Support Division it was queried whether EWTD regulations might lead to increased use of agency cover in areas other than pathology. Whilst it was recognised that further investment would be necessary to achieve compliant rotas by the 2009 deadline, it was clarified that, at present, the situation in pathology was unique in that there are only two consultants working a one in two rota. Holiday cover was therefore required. Finance & Supplies it was highlighted that, despite the implementation of a stringent policy some months ago, taxi expenditure was beginning to increase. Action would be taken to reduce this. In addition, funeral expenses were over-spent and this area was under review by internal audit. Nursing & Midwifery to date, income had been under-achieved by 7K, due primarily to a reduction in pharmacy income and the income stream in respect of sports & recreation. Both areas were being reviewed. Regarding the pay under-spend ( 103K to date), part of this related to vacancies in COI and Rehabilitation, however it was confirmed that appointments had now been made. Risks The table, highlighting the risks to be taken into consideration against both current and forecast financial performance, was noted. Agenda for Change The increase in the percentage of staff assimilated as at the end of August (98.25%) was noted. The Committee members were reminded that this figure now reflected those staff who had been banded, but had appealed. Recovery Plan 4.613M of the 5M recovery plan had been achieved to date. Balance Sheet The Balance Sheet was reviewed in detail and noted. Financial Outlook Financial performance remained encouraging and, although expenditure had increased in-month, it was not anticipated that this would continue. Activity performance remained key. As indicated above, having re-profiled 18 week activity along with the baseline SLA, marginal under-performance was reflected for July. Any under-performance would, however, be offset by under-spending against the 4.1M reserve for 18 week work. In view of the above, assurance was given that the Trust was on track to deliver the requisite 1.023M under-spend. Page 3 of 5

4 07/045 CAPITAL PROGRAMME 2007/08 The Committee members were reminded that the Trust had been working to a provisional capital programme for 2007/08 pending finalisation of formal guidance, in particular in relation to the treatment of the bridging repayment and retained depreciation. These outstanding issues had now been resolved and a revised programme drawn up following discussion with the main budget holders. This one year programme (a five year plan will be produced as part of the FT application process) was reviewed in detail, approved by the Committee members and would be presented to the Trust Board in November. 07/046 DIRECTORS OF FINANCE DASHBOARD The Dashboard, providing benchmarking information against which the Trust could assess its own performance and compare itself with others, was reviewed and noted. This demonstrated that the Trust was performing satisfactorily. The current size of the peer group would be ascertained as it was believed that this may have changed following the rationalisation of PCTs some time ago. Action: C Throp 07/047 MANPOWER REPORT The report was reviewed briefly. It was noted that 152 vacancies were being carried within the Trust as at the end of August, which were again contributing to the cumulative under-spend on pay. 07/048 PERFORMANCE DASHBOARD Performance as at August against key targets (July for cancer and Q1 for certain other targets) was reviewed and noted. Performance was generally very good, however performance remained behind target in certain areas. The following issues were highlighted: Electronic Choose & Book the PCTs were continuing to try to secure GP engagement.. MRSA remained at 10 cases, with no further reportable cases recorded during August. Sickness Absence there had been a deterioration in month. Remedial action would be discussed with divisional leads and monitored by the HR Director. KSF reviews - remained behind target, although a slight improvement was evident. 07/049 COMMERCIAL STRATEGY The report was reviewed and noted. Particular issue highlighted were: CATPOR it was possible that the Trust might lose activity following the introduction of this initiative, however it was too early to quantify any loss. CATS a meeting had been arranged to review the impact on the Trust s activity of this scheme which was scheduled to become operational in March It was noted, however, that the contract with Netcare still remained unsigned and had been reduced from 170,000 attendances to 50,000 attendances and, due to the timing of implementation, would not assist with regard to the 18 week target. Page 4 of 5

5 07/050 APPROVAL TO TRANSFER TO INTERNET BANKING The Committee members noted the briefing paper and approved the move to internet banking. 07/051 ANY OTHER BUSINESS i. Lease Revisions As part of the recovery plan, Leaseguard had been instructed (on a no win, no fee basis) to re-negotiate the leases on the two modular buildings to achieve a minimum reduction in rental of 250K over the next 4 years and a reduction in the Trust s risk exposure. The lease with the Bank of Scotland had now been re-negotiated, resulting in a gross reduction in annual rentals of 200K ( 50K in excess of target) for 4 years, and the revised schedule of rental payments was reviewed and noted. The Committee members approved the sign-off of the necessary Deed of Variation. Re-negotiation of the lease with the Alliance & Leicester had yet to be completed, however it was hoped to reduce rentals on this lease by 100K over the next 4 years. 07/052 DATE AND TIME OF NEXT MEETING The next meeting will take place on Monday, 29 October 2007 at 9.30am in the Boardroom, Corporate Management Office, Southport DGH. Minutes\fcsept07 Page 5 of 5

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