Oxford University Hospitals
TB2011.60
Trust Board: Thursday 3 November 2011
TB2011.60
Title
Financial Performance to 30 September 2011
Purpose of paper
To update the Board on the Trust’s financial
performance to 30 September 2011
Board Lead(s)
Mr Mark Mansfield, Director of Finance and Procurement
TB2011.60_Financial Performance Month 6
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Oxford University Hospitals
TB2011.60
Key purpose – make bold the
relevant worS(s)
Strategy
Assurance
Strategic Objectives
All and specifically
Policy
Performance
SO5 To meet the challenges of the current economic
climate and the changes in the NHS and become a
resilient, flexible and successful Foundation Trust
Links to Board Assurance
Framework/Trust Key Risks/CQC
Registration
Risks to the delivery of planned financial performance
throughout the year are included within the BAF and the
TRR
Resource and financial impact
As discussed in the text
Consideration of legal/ equality
/diversity/engagement/risk issues
TB2011.60_Financial Performance Month 6
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Oxford University Hospitals
TB2011.60
Financial Performance to 30 September 2011
1. Introduction
1.1
This report summarises the financial performance of the Oxford Radcliffe
Hospitals NHS Trust for the period 1 April 2011 to 30 September 2011.
1.2
The report contains the following appendices:
Appendix 1
Content
1
Summary Income and Expenditure
2
Analysis of Income by Category
3
Analysis of PCT Income by Commissioner
4
Analysis of Income and Expenditure by Division
5
Analysis of Cost Improvement Programme performance
6
Capital Programme Expenditure position
7
Balance Sheet as at 30 September 2011
8
Cashflow report at Month 6
9
Foundation Trust Financial Risk Rating
2. Summary
2.1
At 30 September the Trust reported a surplus for income and expenditure of
£4.07m. This was £1.97m below target for this stage in the financial year
(Section 3.1).
2.2
The Trust continues to project a surplus of £6.35m for the year (Section 3.5).
2.3
The Trust is currently recording overperformance against targets for income
derived from PCTs of £7.54m (Section 3.6.2). This is currently being reviewed
by Commissioners (Section 3.6.3).
2.4
The Trust faces a number of risks to its current income and expenditure forecast
(Section 7).
2.5
Trust performance against the Better Practice Payment Code as at 30 September
was 90% (by number) and 84% (by value). This performance, which is
consistent with its August level, falls below the national target level of 95%.
TB2011.60_Financial Performance Month 6
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Oxford University Hospitals
3.
TB2011.60
Income and Expenditure
3.1
At 30 September 2011 the Trust reported a surplus for income and expenditure
of £4.07m. This was £1.97m below the target level for this stage in the financial
year.
3.2
The table below summarises the Trust-wide position, which is shown in more
detail in Appendix 1 to this report.
Summary Income and Expenditure as at end of September 2011
Current Month
Budget Actual Variance
£m
£m
2011-12
Plan
£m
£m
£m
45.02
0.87
9.34
45.85
0.74
9.19
0.83
-0.13
-0.15
266.42
5.65
56.00
274.11
5.36
55.65
7.69
-0.30
-0.36
6.85
-0.17
-0.21
534.56
10.97
112.15
Total Income
55.23
55.79
0.55
328.08
335.11
7.03
6.48
657.68
Expenditure Pay
Non-Pay
31.84
18.47
31.73
19.28
0.10
-0.81
180.86
113.30
188.95
114.59
-8.09
-1.29
-8.19
-0.47
366.51
229.05
Total Expenditure
50.30
51.01
-0.71
294.16
303.53
-9.37
-8.66
595.57
EBITDA
4.93
4.77
-0.16
33.92
31.58
-2.34
-2.18
62.11
Depreciation and Impairments
Interest and Dividends
2.56
2.08
2.43
2.38
0.13
-0.30
15.37
12.50
14.42
13.09
0.96
-0.59
0.82
-0.29
30.75
25.01
Surplus/Deficit
0.28
-0.04
-0.32
6.04
4.07
-1.97
-1.65
6.35
Commissioning
PP/Overseas
Other
£m
Month 5
Variance
£m
Income
£m
Cumulative
Budget Actual Variance
Appendix Reference
Appendices 1-4
Appendix 4
Appendix 4
3.3
As is outlined in the table above, the Trust continues to record year to date
overspends in the areas of pay and non-pay expenditure. The total level of
overspend for pay budgets is £8.09m. During Month 6 this overspend
decreased by £0.1m. Actual pay expenditure was consistent with prior months,
but the plan was higher than previous months owing to expected application of
reserves.
3.4
The overspends in expenditure budgets are partially compensated for by the
level of income over-recovery. The level of income for clinical activities from
PCTs and NHS commissioners exceeds the Trust’s initial target by £7.69m,
despite the fact that most contract income is subject to marginal price
agreements for overperformance. Section 3.6 below and Appendices 2 and 3
provide more detail on this performance.
3.5
The Trust continues to project a surplus of £6.35m for the year. However, this is
subject to a number of risks, which are outlined in section 7.2 of this report.
TB2011.60_Financial Performance Month 6
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Oxford University Hospitals
3.6
TB2011.60
Income
3.6.1 Appendix 2 provides an analysis of income estimated for Month 6 and for
the year to date.
82% of income has been derived from NHS
Commissioners and Appendix 3 provides a sub-analysis of this source by
PCT.
3.6.2 The Trust is demonstrating a level of income overperformance in all areas
of activity. At full cost the value of overperformance in the main
categories of activity is as follows:
£m
%
Elective
1.80
3.2%
Emergency
9.53
12.1%
Outpatient
2.35
5.3%
The impact of these levels of overperformance is reduced by the marginal
rates included in the locally adopted version of the national contract for
NHS Acute Services, such that actual overperformance is estimated to be
£7.55m or 2.7% of the total at Month 6.
3.6.3 It is notable that the level of liability recorded against the commissioners
in Appendix 3 is subject to change. The Trust is in discussions with NHS
Oxfordshire and Buckinghamshire Cluster regarding the current levels of
performance against those contracts.
South Central Specialist
Commissioning have invoked standard contract clause 32 requiring a
remedial action plan as the Trust is currently over performing by £1.7m
against plan (reflected in Appendix 3). The outcome to these discussions
could impact materially on the projected out-turn for the Trust.
3.7
Divisional Performance
3.7.1 Appendix 4 contains details of the income and expenditure position for
the divisions within the Trust. These positions are summarised in the
table below.
TB2011.60_Financial Performance Month 6
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Oxford University Hospitals
Neurosciences, Trauma, Specialist Surgery
Cardiac Medicine and Surgery
Children’s and Women’s
Emergency Medicine, Therapies and
Ambulatory
Surgery and Oncology
Critical Care, Theatres, Diagnostics and
Pharmacy
Corporate
Other
Total
TB2011.60
Year to Date
Plan Actual Variance
£m
£m
£m
23.37
23.20
(0.17)
9.97
8.34
(1.63)
17.47
16.56
(0.91)
9.82
9.41
(0.41)
Month 5
Variance
£m
(0.01)
(1.28)
(0.32)
28.23
(32.59)
26.27
(35.20)
(1.96)
(2.61)
(1.02)
(1.77)
(32.44)
(17.80)
(32.66)
(11.85)
(0.23)
5.95
(0.30)
3.19
6.04
4.07
(1.97)
(1.65)
3.7.2 Significant underperformance against targets is being recorded in a
number of divisions. The quarterly performance reviews with these
divisions have highlighted a number of trends which require immediate
action so as to mitigate the risks to the Trust’s corporate financial position.
3.7.3 There have been significant deteriorations in the performance of the
Surgery and Oncology and Critical Care, Theatres, Diagnostics and
Pharmacy (CCTDP) divisions during month 6. In the case of Surgery and
Oncology the in-month overspend has been driven by a failure to manage
cost pressures, some of which are related to the nature of activity, and
difficulties in delivering cost improvement programmes. Following its
quarterly review the division will be introducing more stringent
expenditure controls so as to move towards discharging its financial
duties. The CCTDP division continues to exhibit overspends across the
range of its activities. Whilst these overspends are to some extent related
to activity volumes the principal explanation is the failure to manage cost
pressures. The division is likely to be subject to special measures for the
remainder of the financial year.
3.7.4 In other divisions the Month 6 position represents a continuation of trends
identified in previous months. It is expected that these divisions will
work towards a break-even out-turn; the most significant risk to this
expectation is in cardiac surgery where the rate at which referral patterns
are being redirected to Oxford is less than has been anticipated.
3.8
Cost Improvement Programme
3.8.1 The income and expenditure position is critically dependent on the
delivery of the cost improvement programme (CIP) for the year.
TB2011.60_Financial Performance Month 6
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Oxford University Hospitals
TB2011.60
3.8.2 Appendix 5 contains an analysis of the year to date delivery of the
programme which is, of course, included in the position reported above.
The summary analysis shows that the overspend against plan is partly
driven by shortfalls in the delivery of CIPs in-year. However, it is notable
that much of the underachievement is seen in programmes which are
impacted by the higher than expected activity levels being recorded in the
Trust (for example, agency, theatres and workforce measures).
3.8.3 This remains an area of some risk to the Trust; £22.22m represents 42% of
the total requirement for CIP in 2011/12 and, whilst it was always
anticipated that savings would be delivered disproportionately in the last
quarter, the requirement for further remedial measures is evident from the
tables in Appendix 5.
4.
5.
Balance Sheet
4.1
Appendix 7 contains the balance sheet for the organisation at 30 September
2011.
4.2
As at 30 September the Trust held cash and cash equivalents of £20.99m.
Appendix 8 provides an analysis of cash flow during the year to date and an
outline plan for the remainder of the financial year. The Trust will continue to
review its approach to the management of cash and provide further
information to the Board at its forthcoming meetings.
4.3
The Trust’s cash position must be viewed in the context of both the level of
“Payables” and “Receivables” recorded in Appendix 7 and performance against
the Better Practice Payment Code. As the Board is aware, the target is that 95%
of payments are made within thirty days of the receipt of invoice. In September
the Trust delivered only 91% (by number) and 87% (by value). The cumulative
position for the year at 30 September remains at its August level of 90% (by
number) and 84% (by value). The Trust has found it difficult in the past to meet
this target as goods are procured on multiple sites.
4.4
In parallel with the work referred to in 4.3 the Trust will also focus on
improving the position with regard to debtors, where there has been a
deterioration during the year. This is especially evident in the area of NHS debt
where commissioners have not paid for overperformance pending resolution of
the issues referred to in 3.6.3 above.
Capital
5.1
Appendix 6 contains detail of the Capital Programme for the Trust and
performance against the budget during the year to date.
TB2011.60_Financial Performance Month 6
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Oxford University Hospitals
5.2
6.
7.
TB2011.60
It is anticipated that, notwithstanding the slippage recorded at Month 6, the
programme will be delivered.
Financial Risk Ratings
6.1
Appendix 9 provides detail of the financial risk rating (FRR) for the Trust
against the criteria applied by Monitor to existing and aspirant Foundation
Trusts.
6.2
The FRR weighted average remains at 3.3 at Month 6. However, the poor
liquidity ratio for the Trust means that the rating is restricted to a score of 2.
The FRR will reduce from the present level during the rest of the financial year
even if planned surpluses are delivered.
Risks
7.1
The Trust faces a position of some operational volatility as it enters the latter
half of the financial year and this translates into a series of risks to the delivery
of its targets, and the income and expenditure position in particular.
7.2
The principal risks to the income and expenditure position are as follows:
7.2.1 Failure to deliver income to the plan outlined in divisional plans (see 3.6.3
and below).
7.2.2 Failure to deliver the current planned levels of activity, leading to a loss of
income and “margin”. The risks in this area are increased if the Trust fails
to reduce costs as activity falls. The example of cardiac surgery (outlined
in 3.7.4 above) provides some indication of this challenge.
7.2.3 Continuing activity pressures which undermine the operational
equilibrium of the organisation. The Board has previously discussed this
risk; essentially, that non-elective pressures remunerated at marginal
levels or, in the case of Delayed Transfers, considerably below that level,
“crowd out” more remunerative elective workload. The effect of this is
increased where elective capacity is then procured at premium rates so as
to deliver targets.
7.2.4 Failure to deliver the current Cost Improvement Programme for areas
largely unaffected by activity trends. Whilst 3.8 above shows some
success in this area the organisation must continue to deliver to plan.
7.2.5 Failure to deliver additional cost improvement measures discussed by the
Board in July, in particular those workstreams associated with workforce.
TB2011.60_Financial Performance Month 6
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Oxford University Hospitals
TB2011.60
7.2.6 A failure to manage non-operational cost pressures, in particular during
the winter period.
7.2.7 A failure to align the medium term organisation change programme to
available resources.
8.
Recommendations
The Board is asked to note the content of this report.
Mr Mark Mansfield
Director of Finance and Procurement
October
TB2011.60_Financial Performance Month 6
2011
9
Oxford University Hospitals
Appendix 1:
Income and Expenditure
Current Month and Year to Date
TB2011.60
Full Year
Plan
Year to Date: Month 6
Plan
£000s
£000s
Income:
Commi s s i oni ng a nd RTA Income
534,558
266,425
PP a nd Overs ea s Income
10,971
5,654
Other Income
112,148
56,002
Total Income
657,676
328,081
Expendi ture:
Pa y
(366,515) (180,861)
Non-Pa y
(229,052) (113,300)
Total Expenditure
(595,567) (294,161)
EBITDA*
62,109
33,920
Depreci a tion
(30,748)
(15,374)
Net Interes t a nd Di vi dends
(25,009)
(12,505)
Exceptiona l s
Trust Surplus/(Deficit)
6,352
6,042
EBITDA %
9.4%
10.3%
*EBITDA = earnings before interest, tax, depreciation and amortisation
Appendix 2:
Income detail
Commi s s i oni ng Income
Income from PCTs
RTA Income
PFI Income
Total Commissioning Income
Total Private Patient & Overseas Income
Other Income
Res ea rch a nd Devel opment Income
Tra i ni ng a nd Educa tion Income
Income Genera tion
NHS Other Income
Non pa tient ca re s ervi ces to other bodi es
Tfr from Dona tion Res erve
Pa tient Tra ns port
Other Income
Total Other Income
Total Income
Current Month: Month 6
Actual
Variance
Plan
Actual
Variance
£000s
£000s
£000s
£000s
£000s
Month 5
YTD
Variance
£000s
274,110
5,357
55,647
335,114
7,685
(297)
(355)
7,033
45,021
873
9,340
55,234
45,853
744
9,191
55,788
832
(129)
(149)
553
6,853
(168)
(206)
6,479
(188,950)
(114,585)
(303,535)
31,579
(14,417)
(13,093)
(8,089)
(1,285)
(9,374)
(2,341)
957
(589)
(31,836)
(18,467)
(50,303)
4,931
(2,562)
(2,084)
(31,734)
(19,279)
(51,014)
4,774
(2,427)
(2,385)
101
(812)
(711)
(157)
135
(301)
(8,190)
(473)
(8,663)
(2,184)
822
(288)
4,069
9.4%
(1,973)
285
8.9%
(38)
8.6%
(323)
(1,650)
Year to Date: Month 6
Current Month: Month 6
Full Year
Plan
Plan
Actual
Variance
Plan
Actual
Variance
£000s
£000s
£000s
£000s
£000s
£000s
£000s
Month 5
YTD
Variance
£000s
532,264
2,100
194
534,558
10,971
265,278
1,050
97
266,425
5,654
272,823
1,190
97
274,110
5,357
7,545
140
0
7,685
(297)
44,830
175
16
45,021
873
45,548
288
16
45,853
744
719
113
0
832
(129)
6,827
27
0
6,853
(168)
27,572
41,805
2,751
7,424
17,408
2,790
197
12,201
112,148
657,676
13,748
20,935
1,375
3,738
8,675
1,395
98
6,037
56,002
328,081
13,441
20,571
1,422
3,607
8,544
0
98
7,963
55,647
335,114
(307)
(364)
47
(131)
(131)
(1,395)
(0)
1,926
(355)
7,033
2,291
3,482
229
614
1,447
233
16
1,027
9,340
55,234
2,402
3,357
247
564
1,211
(785)
16
2,179
9,191
55,788
110
(124)
17
(51)
(236)
(1,017)
(0)
1,151
(149)
553
(418)
(240)
29
(80)
105
(378)
(0)
775
(206)
6,479
TB2011.60_Financial Performance Month 6
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Oxford University Hospitals
Appendix 3:
Income by Commissioner
Oxfords hi re PCT
Oxfords hi re PCT - TV Spec
Bucki ngha ms hi re PCT
Bucki ngha ms hi re PCT - TV Spec
Northa mptons hi re PCT
Northa mptons hi re PCT - Ea s t Mi ds Spec
Mi l ton Keynes PCT
Berks hi re Wes t PCT
Mi l ton Keynes PCT - TV Spec
Berks hi re Wes t PCT - TV Spec
Swi ndon PCT SW SCG
Berks hi re Ea s t PCT - TV Spec
Swi ndon PCT
NCG Ki dney & Pa ncrea tic Tra ns pl a ntation
Bedfords hi re PCT
Gl ouces ter PCT SW SCG
Wa rwi cks hi re PCT - SLA
Others
TOTAL
TB2011.60
Full Year
Plan
£000s
289,970
37,149
25,729
18,118
15,912
16,733
10,829
12,019
8,863
8,650
8,136
6,452
5,636
4,211
3,933
5,122
4,629
50,174
532,264
Year to Date: Month 6
Plan
£000s
144,712
18,560
12,834
9,052
7,940
8,356
5,404
5,997
4,428
4,320
4,064
3,223
2,810
2,106
1,963
2,558
2,310
24,641
265,278
Actual
£000s
148,089
18,696
13,887
9,693
8,609
8,553
6,109
5,162
4,726
4,471
3,988
3,213
3,064
2,519
2,429
2,300
2,275
25,039
272,823
Variance Actual % of
Total
£000s
3,377
54%
136
7%
1,053
5%
641
4%
669
3%
198
3%
704
2%
(835)
2%
298
2%
151
2%
(76)
1%
(10)
1%
255
1%
413
1%
466
1%
(257)
1%
(35)
1%
398
9%
7,545
Month 5
YTD
Variance
£000s
3,955
109
658
444
1,010
(49)
462
(795)
331
133
(108)
(83)
254
352
452
(418)
42
78
6,827
Note: the figure for “others” is different to that published last month as the list of commissioners has
altered slightly with Gloucester replacing Berkshire East.
TB2011.60_Financial Performance Month 6
11
Oxford University Hospitals
Appendix 4a:
Income and Expenditure
for all Clinical Divisions
Neurosciences Trauma Specialist Surgery
Commi s s i oni ng a nd RTA Income
PP a nd Overs ea s Income
Other Income
Total Income
Pa y
Non-Pa y
Total Expenditure
Net Position
Cardiac Medicine and Surgery Division
Commi s s i oni ng a nd RTA Income
PP a nd Overs ea s Income
Other Income
Total Income
Pa y
Non-Pa y
Total Expenditure
Net Position
Childrens and Womens Division
Commi s s i oni ng a nd RTA Income
PP a nd Overs ea s Income
Other Income
Total Income
Pa y
Non-Pa y
Total Expenditure
Net Position
Emergency Medicine Therapies and Ambulatory
Commi s s i oni ng a nd RTA Income
PP a nd Overs ea s Income
Other Income
Total Income
Pa y
Non-Pa y
Total Expenditure
Net Position
Surgery and Oncology Division
Commi s s i oni ng a nd RTA Income
PP a nd Overs ea s Income
Other Income
Total Income
Pa y
Non-Pa y
Total Expenditure
Net Position
Critical Care Theatres Diagnostics and Pharmacy
Commi s s i oni ng a nd RTA Income
PP a nd Overs ea s Income
Other Income
Total Income
Pa y
Non-Pa y
Total Expenditure
Net Position
Net Position all Clinical Divisions
Commi s s i oni ng a nd RTA Income
PP a nd Overs ea s Income
Other Income
Total Income
Pa y
Non-Pa y
Total Expenditure
Net Position
TB2011.60
Full Year
Year to Date: Month 6
Current Month: Month 6
Month 5
Cumulative
Variance
£000s
Plan
Plan
Actual
Variance
Plan
Actual
Variance
£000s
£000s
£000s
£000s
£000s
£000s
£000s
103,498
898
856
105,252
(38,830)
(18,623)
(57,453)
47,799
51,647
449
428
52,524
(19,706)
(9,444)
(29,150)
23,374
54,685
453
298
55,436
(21,827)
(10,405)
(32,233)
23,203
3,038
4
(130)
2,912
(2,121)
(961)
(3,082)
(171)
8,755
75
71
8,901
(3,182)
(1,496)
(4,678)
4,223
9,485
71
1
9,557
(3,747)
(1,751)
(5,498)
4,059
730
(4)
(70)
656
(565)
(255)
(820)
(165)
2,308
8
(60)
2,256
(1,556)
(706)
(2,262)
(6)
48,653
2,112
796
51,561
(18,880)
(12,859)
(31,739)
19,823
24,271
1,056
398
25,725
(9,312)
(6,438)
(15,751)
9,974
23,057
1,013
364
24,434
(9,370)
(6,723)
(16,093)
8,341
(1,214)
(43)
(34)
(1,291)
(58)
(284)
(343)
(1,633)
4,132
176
66
4,375
(1,580)
(1,084)
(2,664)
1,711
3,996
111
61
4,168
(1,615)
(1,200)
(2,815)
1,353
(136)
(65)
(5)
(206)
(35)
(117)
(152)
(358)
(1,079)
22
(29)
(1,085)
(23)
(168)
(191)
(1,276)
92,540
748
1,059
94,347
(50,915)
(8,163)
(59,078)
35,268
46,165
486
523
47,174
(25,638)
(4,067)
(29,705)
17,469
46,443
432
598
47,473
(26,414)
(4,499)
(30,913)
16,560
278
(54)
75
299
(777)
(432)
(1,208)
(909)
7,769
35
81
7,885
(4,139)
(682)
(4,821)
3,064
7,563
20
86
7,669
(4,415)
(784)
(5,198)
2,471
(206)
(15)
5
(216)
(276)
(101)
(377)
(593)
484
(39)
70
516
(501)
(330)
(831)
(316)
86,815
427
1,472
88,715
(51,459)
(18,183)
(69,642)
19,072
43,360
189
742
44,290
(25,529)
(8,945)
(34,474)
9,817
45,043
234
733
46,010
(27,027)
(9,576)
(36,602)
9,408
1,683
45
(9)
1,719
(1,498)
(630)
(2,128)
(409)
7,239
36
122
7,397
(4,199)
(1,539)
(5,737)
1,659
7,323
49
110
7,481
(4,466)
(1,622)
(6,088)
1,394
84
13
(13)
85
(267)
(83)
(350)
(265)
1,599
32
4
1,635
(1,231)
(547)
(1,778)
(143)
159,446
2,038
5,477
166,961
(55,672)
(54,059)
(109,731)
57,229
79,571
1,019
2,738
83,328
(27,918)
(27,175)
(55,093)
28,235
80,316
735
2,553
83,604
(28,989)
(28,342)
(57,330)
26,273
745
(284)
(185)
276
(1,071)
(1,166)
(2,237)
(1,962)
13,490
170
456
14,116
(4,702)
(4,363)
(9,065)
5,051
13,596
156
411
14,162
(4,843)
(5,208)
(10,051)
4,112
106
(14)
(45)
46
(141)
(845)
(985)
(939)
640
(270)
(140)
230
(930)
(322)
(1,252)
(1,022)
34,620
5,332
13,919
53,871
(87,739)
(29,790)
(117,528)
(63,657)
17,229
2,666
6,949
26,843
(44,438)
(14,996)
(59,434)
(32,591)
18,794
1,984
7,242
28,020
(46,545)
(16,679)
(63,224)
(35,203)
1,566
(682)
293
1,177
(2,107)
(1,683)
(3,790)
(2,613)
2,969
444
1,152
4,565
(7,211)
(2,504)
(9,715)
(5,150)
2,896
226
1,212
4,335
(7,679)
(2,644)
(10,323)
(5,988)
(73)
(218)
60
(230)
(468)
(140)
(608)
(838)
1,638
(464)
233
1,408
(1,639)
(1,543)
(3,182)
(1,774)
525,573
11,554
23,579
560,706
(303,495)
(141,677)
(445,172)
115,534
262,242
5,864
11,778
279,884
(152,540)
(71,066)
(223,607)
56,278
268,338
4,851
11,789
284,977
(160,172)
(76,223)
(236,395)
48,581
6,095
(1,013)
11
5,092
(7,632)
(5,157)
(12,789)
(7,696)
44,354
936
1,949
47,239
(25,013)
(11,668)
(36,681)
10,558
44,859
632
1,881
47,373
(26,764)
(13,209)
(39,973)
7,399
506
(303)
(68)
134
(1,752)
(1,541)
(3,292)
(3,158)
5,590
(710)
79
4,958
(5,880)
(3,616)
(9,496)
(4,538)
TB2011.60_Financial Performance Month 6
12
Oxford University Hospitals
Appendix 4b:
Income and Expenditure
for Non-Clinical Divisions
Operations and Service Improvement Division
Commissioning and RTA Income
PP and Overseas Income
Other Income
Total Income
Pay
Non-Pay
Total Expenditure
Net Position
Corporate Division
Commissioning and RTA Income
PP and Overseas Income
Other Income
Total Income
Pay
Non-Pay
Total Expenditure
Net Position
Biomedical Research Division
Total Income
Total Expenditure
Net Position
Trust Wide Services Division
Total Income
Total Expenditure
Net Position
Operating Expenses Division
Total Income
Total Expenditure
Net Position
Net Position Non-Clinical Divisions
Commissioning and RTA Income
PP and Overseas Income
Other Income
Total Income
Pay
Non-Pay
Total Expenditure
Net Position
TB2011.60
Full Year
Year to Date: Month 6
Current Month: Month 6
Plan
Plan
Actual
Variance
Plan
Actual
Variance
£000s
£000s
£000s
£000s
£000s
£000s
£000s
Month 5
Cumulative
Variance
£000s
0
2,153
82
2,235
(6,093)
(426)
(6,519)
(4,284)
0
1,077
41
1,117
(3,049)
(213)
(3,262)
(2,144)
0
502
25
527
(3,083)
(139)
(3,223)
(2,695)
0
(575)
(15)
(590)
(34)
74
39
(551)
0
179
7
186
(500)
(35)
(535)
(349)
0
112
3
115
(500)
(46)
(546)
(431)
0
(68)
(4)
(71)
0
(11)
(11)
(82)
0
(507)
(12)
(519)
(35)
84
50
(469)
0
0
15,488
15,488
(27,764)
(52,506)
(80,270)
(64,782)
0
0
7,684
7,684
(13,929)
(26,191)
(40,120)
(32,436)
0
4
7,855
7,859
(14,992)
(25,529)
(40,521)
(32,662)
0
4
171
175
(1,063)
662
(401)
(225)
0
0
1,301
1,301
(2,313)
(4,378)
(6,691)
(5,391)
0
0
1,208
1,208
(2,361)
(4,162)
(6,523)
(5,315)
0
(0)
(92)
(92)
(49)
217
168
76
0
4
264
268
(1,015)
446
(569)
(301)
17,949
(17,949)
0
8,974
(8,974)
0
8,683
(8,683)
0
(291)
290
0
1,496
(1,496)
0
1,605
(1,605)
0
109
(109)
(0)
(400)
399
0
58,509
(45,599)
12,910
29,027
(18,150)
10,877
31,919
(14,716)
17,203
2,892
3,433
6,326
4,780
(4,898)
(118)
5,124
(2,367)
2,757
344
2,531
2,875
2,549
902
3,451
2,890
(55,916)
(53,026)
1,445
(27,978)
(26,533)
1,206
(27,564)
(26,358)
(239)
414
175
241
(4,656)
(4,416)
372
(4,821)
(4,449)
131
(165)
(33)
(371)
579
208
8,985
(584)
88,669
97,070
(63,020)
(143,233)
(206,253)
(109,182)
4,183
(210)
44,274
48,247
(28,321)
(70,162)
(98,483)
(50,236)
5,773
506
43,916
50,195
(28,778)
(65,929)
(94,707)
(44,512)
1,590
716
(358)
1,948
(457)
4,233
3,776
5,724
667
(62)
7,399
8,004
(6,823)
(11,454)
(18,277)
(10,273)
994
112
7,319
8,424
(4,970)
(10,892)
(15,861)
(7,438)
326
174
(80)
420
1,853
562
2,415
2,836
1,264
542
(278)
1,528
(2,310)
3,671
1,361
2,888
TB2011.60_Financial Performance Month 6
13
Oxford University Hospitals
Appendix 4c:
Reconciliation of Appendices 4a and 4b to
Table 1
Total Clinical Divisions (Appendix 5a)
Commissioning and RTA Income
PP and Overseas Income
Other Income
Total Income
Pay
Non-Pay
Total Expenditure
Net Position
Total Non-Clinical Divisions (Appendix 5b)
Commissioning and RTA Income
PP and Overseas Income
Other Income
Total Income
Pay
Non-Pay
Total Expenditure
Net Position
Total Trust
Commissioning and RTA Income
PP and Overseas Income
Other Income
Total Income
Pay
Non-Pay
Total Expenditure
Net Position as per Table 1
TB2011.60
Full Year
Year to Date: Month 6
Current Month: Month 6
Plan
Plan
Actual
Variance
Plan
Actual
Variance
£000s
£000s
£000s
£000s
£000s
£000s
£000s
Month 5
Cumulative
Variance
£000s
525,573
11,554
23,579
560,706
(303,495)
(141,677)
(445,172)
115,534
262,242
5,864
11,778
279,884
(152,540)
(71,066)
(223,607)
56,278
268,338
4,851
11,789
284,977
(160,172)
(76,223)
(236,395)
48,581
6,095
(1,013)
11
5,092
(7,632)
(5,157)
(12,789)
(7,696)
44,354
936
1,949
47,239
(25,013)
(11,668)
(36,681)
10,558
44,859
632
1,881
47,373
(26,764)
(13,209)
(39,973)
7,399
506
(303)
(68)
134
(1,752)
(1,541)
(3,292)
(3,158)
5,590
(710)
79
4,958
(5,880)
(3,616)
(9,496)
(4,538)
8,985
(584)
88,669
97,070
(63,020)
(143,233)
(206,253)
(109,182)
4,183
(210)
44,274
48,247
(28,321)
(70,162)
(98,483)
(50,236)
5,773
506
43,916
50,195
(28,778)
(65,929)
(94,707)
(44,512)
1,590
716
(358)
1,948
(457)
4,233
3,776
5,724
667
(62)
7,399
8,004
(6,823)
(11,454)
(18,277)
(10,273)
994
112
7,319
8,424
(4,970)
(10,892)
(15,861)
(7,438)
326
174
(80)
420
1,853
562
2,415
2,836
1,264
542
(278)
1,528
(2,310)
3,671
1,361
2,888
534,558
10,971
112,248
657,776
(366,515)
(284,909)
(651,424)
6,352
266,425
5,654
56,052
328,131
(180,861)
(141,229)
(322,090)
6,042
274,110
5,357
55,704
335,172
(188,950)
(142,153)
(331,103)
4,069
7,685
(297)
(348)
7,040
(8,089)
(924)
(9,013)
(1,973)
45,021
873
9,348
55,242
(31,836)
(23,122)
(54,958)
285
45,853
744
9,200
55,797
(31,734)
(24,100)
(55,835)
(38)
832
(129)
(149)
554
101
(978)
(877)
(323)
6,853
(168)
(199)
6,486
(8,190)
54
(8,136)
(1,650)
Appendix 5a:
CIP Position Year to Date
FYE of 2010/11 s chemes
Di vi s i ona l genera l effi ci ency
Procurement
Staff Productivi ty
Revi ew of Speci a l i s t Nurs es
Agency
Cons ul tant Job pl a ns
Ra di ol ogy retention
Revi ew of Reception
Other Workforce Mea s ures
Productive Outpa tients - Util i s a tion of Cl i ni cs
El ective Ca re - Reduce Pre-opera rtive LOS
Medi ci nes Ma na gement
Productive Thea tres
Es tates Ma na gement
Wa rd Moves
Reduci ng 18 week wa i t premi um cos ts
R & D Income
Total
Year to Date: Month 6
Plan
Achieved Variance
£000s
£000s
£000s
5,280
5,280
0
6,206
9,085
2,879
2,120
1,438
(682)
50
909
167
200
0
2,258
167
160
1,750
500
0
400
2,333
750
23,250
TB2011.60_Financial Performance Month 6
0
154
86
0
0
984
0
0
1,750
0
0
365
2,333
750
22,225
(50)
(755)
(81)
(200)
0
(1,274)
(167)
(160)
0
(500)
0
(35)
0
0
(1,025)
14
Oxford University Hospitals
TB2011.60
Appendix 5b:
CIP Savings Programme by Theme
FYE of 2010/11 s chemes
Di vi s i ona l genera l effi ci ency
Procurement
Staff Productivi ty
Revi ew of Speci a l i s t Nurs es
Agency
Cons ul tant Job pl a ns
Ra di ol ogy retention
Revi ew of Reception
Other Workforce Mea s ures
Productive Outpa tients - Util i s a tion of Cl i ni cs
El ective Ca re - Reduce Pre-opera rtive LOS
Medi ci nes Ma na gement
Productive Thea tres
Es tates Ma na gement
Wa rd Moves
Reduci ng 18 week wa i t premi um cos ts
R & D Income
Grand Total
Target
Target %
Apr-11
2,858
5%
May-11
3,051
6%
Jun-11
3,091
6%
Appendix 6:
Capital Programme Report for 2011-12
Bui l di ngs
Ca rri ed Forwa rd -Va ri ous from 2010-11
Es tates Progra mme( i ncl .Ba ckl og-i mprove)
Es tates Progra mme- JR Wi ndow upgra de
JR Thea tres enha ncement
Ca rdi a c repa tri a tion s cheme
Ma terni ty Pa thwa y Improvements
Neona tal Interi m Devel opment
Level 1 X-ra y rooms (x2)
El i mi na tion of MSA a nd wa rd moves
Hea d a nd Neck Rel oca tion s cheme
3rd Pa rty Commi tments
Buildings Total
Equi pment
Medi ca l Equi pment
La bora tory Equi pment a nd Thea tre l i ghts
Ma na ged Equi pmt Repl a cement for CH PFI
Equipment Total
Informa tion Technol ogy
GOMLA/Ora cl e fi na nce s ys tems
IT: EPR a nd Infra s tructure
PACS
Automa ted Sens i tivi ty Tes ting Sys tem
Information Technology Total
Contingency
Total Capital Programme
Jul-11
4,750
9%
Aug-11
4,750
9%
Target
£000
10,560
12,411
4,402
Green
£000
10,560
15,163
3,504
100
2,000
500
400
0
6,577
500
400
3,500
999
700
1,200
7,000
1,500
52,749
Sep-11
4,750
9%
Amber
£000
Red
£000
Unidentified
£000
0
0
1,860
(6,774)
0
355
0
2,162
543
100
236
269
559
130
37
158
984
2,142
107
0
95
3,170
0
375
0
365
7,000
1,500
42,751
300
700
Oct-11
4,916
9%
Current Month: Month 6
Plan
Actual
Variance
£000s
£000s
£000s
Nov-11
4,917
9%
6,355
Dec-11
4,917
9%
2,913
Jan-12
4,916
9%
Year to Date: Month 6
Plan
Actual
Variance
£000s
£000s
£000s
Feb-12
4,917
9%
Plan
£000s
0
1,205
(57)
363
0
3,451
298
400
330
624
0
535
0
0
730
Mar-12
4,917
9%
Full Year
Forecast
£000s
Total
52,749
100%
Variance
£000s
41
154
25
8
50
47
42
55
58
98
305
882
189
413
1
0
0
19
0
104
41
31
(21)
778
(133)
(259)
24
8
50
28
42
(49)
17
67
326
119
334
837
150
50
298
281
250
329
350
586
1,830
5,295
311
472
52
0
0
19
0
106
82
493
288
1,823
23
453
98
50
298
262
250
223
268
93
1,542
3,560
493
1,850
300
100
596
562
500
658
700
1,172
3,660
10,591
493
1,850
300
100
596
562
500
658
700
1,172
3,660
10,591
0
0
0
0
0
0
0
0
0
0
0
0
175
47
61
283
61
0
446
507
114
47
(385)
(224)
1,050
282
364
1,696
405
41
446
892
645
240
(82)
804
2,100
563
728
3,391
2,100
563
728
3,391
0
0
0
0
46
250
33
13
342
25
1,532
(10)
573
1
0
565
14
1,863
56
(323)
32
13
(223)
11
(317)
123
1,500
200
75
1,898
150
9,039
123
1,091
15
0
1,228
14
3,957
0
409
185
75
670
136
5,170
123
3,000
400
150
3,673
300
17,955
123
3,000
400
150
3,673
300
17,955
0
0
0
0
0
0
0
TB2011.60_Financial Performance Month 6
15
Oxford University Hospitals
Appendix 7:
Statement of Financial Position as at
September 11
TB2011.60
Opening
Balance
(1 April 11)
£000s
Non-Current Assets
Property, Pl a nt a nd Equi pment
Inta ngi bl e As s ets
Inves tment Property
Other Fi na nci a l As s ets
Tra de a nd Other Recei va bl es
Total Non-Current Assets
Current Assets
Inventori es
Tra de a nd Other Recei va bl es
Other Fi na nci a l As s ets
Other Current As s ets
Ca s h a nd Ca s h Equi va l ents
Current Assets
Non-Current As s ets hel d for s a l e
Total Current Assets
Current Liabilities
Tra de a nd Other Pa ya bl es
Other Li a bi l i ti es
DH Worki ng Ca pi ta l Loa n
DH Ca pi ta l Loa n
Borrowi ngs
Other Fi na nci a l Li a bi l i ti es
Provi s i ons for Li a bi l i ti es a nd Cha rges
Total Current Liabilities
Net Current Assets/(Liabilities)
Total Assets less Current Liabilities
Non-Current Liabilities
DH Worki ng Ca pi ta l Loa n
DH Ca pi ta l Loa n
Borrowi ngs
Tra de a nd Other Pa ya bl es
Provi s i ons for Li a bi l i ti es a nd Cha rges
Total Non-Current Assets
Total Asseets Employed
Financed by Taxpayers Equity
Publ i c Di vi dend Ca pi ta l
Reta i ned Ea rni ngs
Reva l ua ti on Res erve
Other Res erve
Total Taxpayers Equity
Current
Month
(Sep 11)
£000s
Movement
In Year
£000s
603,110
4,063
0
0
2,587
609,760
592,042
4,600
0
0
2,517
599,159
(11,068)
537
0
0
(70)
(10,601)
10,834
25,851
0
0
19,477
56,162
0
56,162
11,307
43,421
0
71
20,992
75,792
0
75,792
473
17,570
0
71
1,515
19,630
0
19,630
(78,522)
0
(3,332)
(1,404)
(11,211)
(3,358)
(97,827)
(41,665)
568,095
(91,214)
0
(3,332)
(1,404)
(11,211)
0
(842)
(108,002)
(32,211)
566,949
(12,692)
0
0
0
0
0
2,516
(10,175)
9,454
(1,146)
(3,326)
(9,215)
(271,111)
(60)
(1,032)
(284,744)
283,351
(1,660)
(8,513)
(266,311)
(45)
(3,000)
(279,529)
287,420
1,666
702
4,800
15
(1,968)
5,215
4,069
174,547
3,275
103,786
1,743
283,351
174,547
7,344
103,786
1,743
287,420
0
4,069
(0)
0
4,069
TB2011.60_Financial Performance Month 6
16
Oxford University Hospitals
Appendix 8:
Cash Flow - Source and Application of Funds
Source of Funds
Commi s s i oni ng a nd RTA
PP + Overs ea s
Educa tion & tra i ni ng (SCSHA)
Other i ncome
New l oa n
Interes t recei va bl e
VAT refund
R & D networks
Total Receipts
Appl i ca tion of Funds
Sa l a ri es & Wa ges
Ta x, NI, Supera nnua tion
Revenue pa yments
PFI fa ci l i ties ma na gement
Ca pi tal pa yments
Repa yments on l oa ns , PFI, l ea s i ng
Interes t pa ya bl e (l oa ns , PFI, l ea s i ng)
TDR (PDC Di vi dend)
Total Payments
Net Increase/(Decrease) in Cash
Apr 11
Actual
£000s
May 11
Actual
£000s
TB2011.60
Jun 11
Actual
£000s
Jul 11
Actual
£000s
Aug 11
Actual
£000s
Sep 11
Actual
£000s
Oct 11
Plan
£000s
Nov 11
Plan
£000s
Dec 11
Plan
£000s
Jan 12
Plan
£000s
Feb 12
Plan
£000s
Mar 12
Plan
£000s
Annual
Plan
£000s
41,502
952
3,276
4,126
0
11
1,301
7,644
58,812
38,843
880
3,075
4,598
0
8
1,564
0
48,968
42,926
937
3,067
5,337
0
9
397
0
52,673
42,822
895
3,148
5,379
0
7
2,747
7,822
62,820
46,813
865
3,056
7,749
0
13
1,297
0
59,794
51,908
976
2,997
5,433
0
9
1,589
0
62,912
46,662
784
3,223
6,729
0
10
1,127
8,099
66,633
45,844
847
3,126
7,262
0
8
1,200
0
58,286
45,844
875
3,126
6,601
0
8
1,200
0
57,654
50,844
847
3,126
6,931
0
8
1,200
7,500
70,456
49,888
847
3,126
6,931
0
8
1,200
0
62,000
52,183
880
3,231
7,262
0
8
1,200
0
64,764
556,079
10,585
37,576
74,338
0
107
16,022
31,065
725,772
19,129
9,785
13,642
0
943
941
217
0
44,655
14,156
19,105
12,536
19,836
5,856
16
1,151
3,092
0
61,592
(12,623)
19,390
12,573
18,771
2,831
586
762
1,407
0
56,319
(3,647)
18,935
12,618
25,172
3,210
68
736
1,357
0
62,096
723
19,366
12,467
17,685
1,851
480
761
1,406
0
54,015
5,778
19,198
12,353
23,589
1,147
2,388
2,819
898
3,395
65,786
(2,874)
19,407
12,632
20,131
4,259
1,496
1,071
2,013
0
61,009
5,625
19,347
12,700
22,936
3,167
1,496
685
1,375
0
61,705
(3,419)
19,347
12,700
22,055
3,167
1,496
685
1,375
0
60,824
(3,170)
19,347
12,700
21,011
3,167
2,540
685
1,375
0
60,824
9,632
19,347
12,700
21,011
3,167
2,540
684
1,375
0
60,823
1,177
19,369
12,800
18,757
3,460
4,040
2,768
3,299
3,668
68,161
(3,397)
231,285
148,564
244,594
35,282
18,088
13,748
19,185
7,063
717,809
7,963
Opening Cash Balances
Closing Cash Balances
19,477
33,633
33,633
21,010
21,010
17,363
17,363
18,087
18,087
23,865
23,865
20,991
20,991
26,616
26,616
23,197
23,197
20,027
20,027
29,659
29,659
30,836
30,836
27,440
19,477
27,440
FIMs Plan
Actual/Forecast Variance to Plan
21,071
12,562
22,963
(1,953)
24,920
(7,556)
27,416
(9,329)
29,811
(5,946)
29,762
(8,771)
30,736
(4,120)
31,670
(8,473)
32,614
(12,587)
31,802
(2,143)
30,832
4
24,521
2,918
24,521
2,918
Notes
1. Other income include car park fees and other miscellaneous receipts.
2. Revenue payments include bank charges, standing orders, staff rent, R&D, VAT element of PFI facilities management and other miscellaneous payments.
Appendix 9:
Financial Risk Rating by Criteria as at
Month 6, September 2011
Achievement of Plan
EBITDA % achieved
Underlying Performance
EBITDA margin
Financial Efficiency
Return on Assets
I & E Surplus Margin
Liquidity
Liquid ratio (days)
Weighted Average
Overall Rating (see rules below)
Scores
Year to date
Weight
5
4
3
2
1
Metric
Score
10%
100%
85%
70%
50%
<50%
93%
4
25%
11%
9%
5%
1%
<1%
9%
4
20%
20%
6%
3%
5%
2%
3%
1%
-2%
-2%
< -2%
< -2%
6%
1%
5
3
25%
60
25
15
10
<10
-20.9
1
3.3
2
Monitor: Rules used to adjust the Financial Risk
Pl a n not s ubmi tted on ti me
Pl a n not s ubmi tted compl ete a nd correct
PDC di vi dend not pa i d i n ful l
One fi na nci a l cri teri on s cored a t '1'
One fi na nci a l cri teri on s cored a t '2'
Two fi na nci a l cri teri a s cored a t '2'
Two fi na nci a l cri teri a a t '1'
Unpl a nned brea ch of Prudenti a l Borrowi ng
Previ ous yea r's a nnua l ra ti ng wors e
Les s tha n 1 yea r a s a n NHS Founda ti on
Defi ci t foreca s t i n yea r 2 or 3
Defi ci t foreca s t i n both yea rs 2 a nd 3
Maximum Rating
3
3
2
2
3
2
1
2
No more tha n 2
4
3
2
TB2011.60_Financial Performance Month 6
17