Report from the Finance and Workforce Committee (FWC) meeting
held on 15 July 2013
Purpose
To summarise the proceedings of the FWC held on 15 July 2013.
Matters Discussed
1.
Capital Programme 2013/14
Changes since the operational capital programme had been prepared has necessitated a
review and re-prioritisation of spend in 2013/14. Hospital Management Board had
discussed this at length and highlighted a number of potential areas which could be
reconsidered in order to close the gap of almost £7.725m. Some of these items include
unforeseen service developments such as the need to expand maternity services as a
result of East Sussex Healthcare developments. Other recommendations include
deferring non-critical items of expenditure. The Committee noted the risks of deferring a
problem in subsequent years without an overarching medium term rolling programme and
welcomed the decision to establish the Capital Review Group to provide this governance.
The arrangements for how this group interfaces with IPG and the Committee are to be
confirmed. Assurances were sought and provided on any safety and quality risks to the
re-prioritisation process.
2.
Investment Programmes. Updates were received on the following projects:
i) Over £30m
a) 3Ts: feedback from the TDA on remaining issues prior to submission to HMT has
been constructive and with a sense of urgency. Transitional costs for the scheme
have now been agreed and the Decant FBC is being finalised for DH loan approval in
September. The TDA are engaged in the plans for the FBC development to ensure
expectations are aligned. Engagement and support from commissioner organisations
remains critical to the ability to proceed.
b) Radiotherapy Services: all 3 related projects to extend service provision, new
modalities and linked units in East and West Sussex are progressing to budget. A
preferred supplier has been selected for brachytherapy with the unit due to open in
October 2013. Tenders are being reviewed for the Linac replacement programme.
Timelines for the completion of the OBC for East and West Sussex require review.
ii) £5-10m
a) St Mary’s Hall: proceeding to time and budget.
b) 3rd Cardiac Theatre: theatre fit out will be complete in November and December but
consideration is required for timing of opening around the Christmas period. Delays
have created a budget pressure of £200k, for which mitigation is being sought.
c) Major Trauma Centre: the remaining work to reconfigure the ED is unlikely to start in
earnest before Jan 2014 due to operational requirements and the roll out of EPR.
i)
a)
b)
c)
Less than £5m
Estates Infrastructure: proceeding to time and budget
PRH Day Surgery unit: will be operational in September 2013.
IR Theatre: additional cost pressures part of the broader operational capital review.
The facility has a scheduled opening date of January 2014.
d) East Sussex Haemodialysis Unit: proceeding to time and budget
3.
Workforce. The Committee considered the sickness absence rate which remains at
3.8%. Staff turnover remains high at 13.8% and a bid to IPG to capture reasons for
voluntary resignations is being made to better understand the root cause of this turnover
rate. Occupational health referrals have increased and appraisal rates remain low.
Further work between the HR and Finance teams has resulted in detailed WTE measures
to better understand efficiency and the wider efficiency rate has improved. There has
been a significant change in grade mix, with fewer senior managers in post. The HR
dashboard data is to be more widely circulated to all managers to provide valuable
information in managing the workforce. However, the Committee noted that the same
issues have remained a priority for a number of months – sickness absence and turnover
rates are high while appraisal rates are low.
4.
Cost Improvement Plans. The Committee noted the performance year to date was
ahead of plan. However, four key work streams are behind plan and are being supported
by over performance in other areas. Whilst the Committee noted that an element of
variance in under and over performance across the schemes was to be expected, the
under performers were those which the Trust has struggled with in previous years. Whilst
assurance was provided as to additional activities underway to change this position, the
Committee remain concerned that the phasing of the plan means that Q2 onwards will be
more challenging and the transformational activities are the ones with the least traction to
date. The Committee also discussed the need for appropriate capability and capacity to
support delivery (including the impact of vacancies within the Delivery Unit) balanced with
the need for delivering efficiency and change being part of everyone’s day job.
5.
In Year Financial performance. The Committee reviewed the month 3 position which
indicated a deficit of £1.066m, slightly ahead of plan. Concerns remain around the run
rate on nursing spend. Whilst agreement has been received for the 3Ts transitional
support, formal confirmation of the same for EPR is still awaited. PBR exclusions are
significant but it is assumed that the contractual arrangements will ensure these are paid
in full. A new contract performance sheet was included in the finance report which is
being further developed as data protection and interrogation issues are progressed. The
Committee sought further assurance on the treasury management arrangements given
the current cash balances and will receive a separate report on this at the August
meeting.
6.
Investment Prioritisation Group (IPG) approvals. The Committee received and noted
the IPG approval report for July 2013.
7.
Risk, Health and Safety Annual Report.
The Committee reviewed this annual report on behalf of the Board. It detailed the
progress against objectives in 2012/13 and the plans for 2013/14, and had previously
been reviewed by the Health and Safety Committee. The Committee noted the
investment bids being made to support further embedding of risk assessments and our
NHSLA submission. The audit programme had considered the statutory responsibilities
and noted key actions to support lone working support and the management of stress in
2013/14. These priorities triangulate with the data in the HR dashboard. Confirmation was
sought regarding the governance of the Committee receiving this report on behalf of the
Board and it was noted that whilst the Chief Executive was accountable under the Health
and Safety at Work Act (1974), the Director of Corporate Affairs was the lead executive
and the report had been through the relevant governance committee.
8.
Fire Safety Annual Report.
The Committee reviewed this annual report on behalf of the Board. It detailed the
progress against objectives in 2012/13 and the plans for 2013/14, and had previously
been reviewed by the Health and Safety Committee. The Committee noted the inclusion
of the assessment against the recently issued DH guidance. Further clarity was sought on
the timelines for the 2013/14 objectives.
9.
Effectiveness Review
The Committee conducted its annual review of effectiveness after the July meeting. The
outcome and recommendations will be discussed with the Chair of the Board and other
Committee Chairs.
Recommendation to the Board
The Board is recommended to note this report.
Julie Nerney
Chair Finance and Workforce Committee
15 July 2013