1
Item 4c
Monthly Finance Report For
November 2014
Prepared by:
Stephen Dunham
Financial Controller
Charlotte Sparrow
Head of Financial Performance and Decision Support
Steven Davies
NHS Finance Director & Deputy Chief Financial Officer
Presented By:
Charles Nall
Chief Financial Officer
Action for Board:

For information

For consideration

For decision

Board of Directors Meeting
18th December 2014
Date produced
December 2014
11th
2
Contents of Main Report
Page Number
Executive Financial Summary
3
Detailed Income and Expenditure Position
4
Underlying Position
5
NHS Income
6
NHS Operating Expenditure
8
Efficiency Scheme Performance
11
Research & Development and Commercial Trading Position
12
Cashflow
13
Debtors Management and Credit Control
14
3
Executive Financial Summary
Overall Position Surplus / (Deficit)
NHS
(exc. R&D)
Income
Expenditure
Overall Position
In Month
Plan (£M)
Actual (£M)
0.7
(0.3)
(1.0)
Actual (£M)
12.5
11.7
13.1
12.6
0.2
(0.1)
Actual (£M)
4.4
3.4
Actual (£M)
0.6
(0.9)
98.0
92.1
104.4
95.3
(0.3)
0.8
4.0
Full Year % forecast
74%
2.5
In Month
Actual (£M)
0.1
Commercial
Trading Unit
Position
Plan (£M)
Actual (£M)
0.5
(0.2)
Plan (£M)
Actual (£M)
5.0
2.0
Actual (£M)
1.7
0.0
Actual (£M)
6.4
(3.2)
148.3
141.3
156.3
145.6
8.0
(4.3)
3.2
(0.9)
2.7
3.8
Actual (£M)
0.7
1.0
In Month
Plan (£M)
Actual (£M)
4.4
3.2
Var (£M)
0.3
(0.7)
Indicator
Plan (£M)
Actual (£M)
2.8
(1.7)
4
4
Continuity of Service Risk Rating
4
(1.2)
Plan (£M)
Actual (£M)
1.2
1.1
0.1
(4.5)
Plan (£M)
Actual (£M)
4.7
(1.7)
Debtors
Key Income and Expenditure Risks:
 The net position in month is below plan for both the NHS
and Commercial Trading Units. The year to date position
benefits from non-recurrent items.
 Commercial position was a deficit of £0.2M in month and
the full year forecast is a deficit of £1.7M.
 NHS income is above plan in month by £0.6M but is more
than offset by expenditure overspends of £0.9M. Additional
capacity being provided is increasing the clinical pay cost
base but not generating sufficient additional clinical activity.
 No confirmation has yet been given of the R&D
infrastructure funding.
Actions:
 Focus on NHS expenditure control. Ensure utilisation levels
of both inpatient and outpatient capacity are improved.
 Focus on commercial trading unit recovery plan
 Focus on temporary staff expenditure and external
consultancy expenditure (actions commenced).
Comment
Rating of 4 (highest rating) is maintained in November.
Year End
2013/14
End of
Quarter 1
End of
Quarter 2
Prior Month
Current
Month
Forecast Qtr
3
Forecast
Year End
(Qtr 4)
24.29
17.76
16.91
18.45
15.44
12.39
10.84
6 Mths +
(£M)
3- 6 Mths
(£M)
2 Mths
(£M)
1 Mth
(£M)
Total
(£M)
Overdue Debts
Var (£M)
(6.4)
Cash Balance (£M)
Cash Flow
Var (£M)
Full Year Forecast
Var (£M)
YTD
Debt Service Cover
Liquidity
Var (£M)
Full Year Forecast
Year to Date
Var (£M)
Var (£M)
Full Year Forecast
Var (£M)
(0.8)
Plan (£M)
(3.0)
Plan (£M)
Year to Date
Var (£M)
Key Risks and Actions Required
Var (£M)
Full Year Forecast
Var (£M)
Year to Date
70%
40%
0.1
(1.0)
Plan (£M)
% Full Year achieved
Plan (£M)
Full Year Forecast
Var (£M)
Year to Date
Var (£M)
Plan (£M)
Research &
Development
Position
Continuity of
Service Risk Rating
Plan (£M)
In Month
Plan (£M)
YTD % achieved
Efficiency Scheme
Performance
Year to Date
Var (£M)
Last Qtr
Total
(£M)
NHS Contract Debts
1.43
1.60
3.30
0.79
7.12
7.59
Commercial Debts
2.08
0.74
0.34
0.53
3.69
3.60
Other
TOTAL
0.44
3.95
0.24
2.58
0.09
3.73
0.77
2.09
1.53
12.34
1.01
12.20
Cashflow and Balance Sheet Risks:
 Debt recovery. Overdue debts total £12.4M, with £7.1M of
NHS contract debts.
 Higher total capital spend and lower operational cash
performance forecast for 2014/15 imply lower than
budgeted cash balances.
Actions:
 Maintain high level dialogue with relevant NHS
organisations and levy interest charges where appropriate.
 Monitor cash position carefully in conjunction with
authorisation of capital purchases.
4
Detailed Income and Expenditure Position - Surplus / (Deficit)
In Month
Overall Trust I&E Summary
Year to Date
Full Year Forecast
Prior Year YTD
Budget
Actual
Variance
Budget
Actual
Variance
Budget
Actual
Variance
Actual
Variance
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
NHS Clinical Income
Commercial Trading Units
Other Income
Total Income
11,677
2,985
1,707
16,369
12,191
2,157
1,760
16,107
514
(828)
53
(262)
91,007
22,633
14,168
127,808
93,723
17,409
17,521
128,653
2,716
(5,223)
3,353
846
138,003
34,745
21,043
193,790
141,916
26,639
24,745
193,300
3,913
(8,106)
3,703
(490)
78,133
21,250
13,348
112,730
15,590
(3,840)
4,174
15,923
NHS Expenditure
Pay Exenditure
Medical
Nursing
Scientific, Theraputic & Technical
Admin and Clerical
Ancillary Services
Research & Development Pay
Total Pay Expenditure
2,363
1,771
951
2,053
167
593
7,899
2,473
1,971
897
2,008
165
590
8,104
(110)
(200)
55
44
2
4
(205)
18,532
13,796
7,290
16,157
1,332
4,807
61,914
19,732
14,380
7,018
15,849
1,305
4,506
62,791
(1,200)
(584)
272
307
26
301
(877)
27,997
20,887
11,035
24,145
1,990
7,160
93,214
29,996
21,864
10,608
24,034
1,967
7,160
95,629
(1,999)
(977)
427
111
22
0
(2,415)
16,137
11,767
6,655
12,400
1,262
4,076
52,298
(3,595)
(2,612)
(363)
(3,449)
(43)
(430)
(10,493)
Non-Pay Exenditure
Drugs
Clinical Supplies and Services
Premises
Other Expenditure
Research & Development Non-Pay
1,584
1,169
698
952
166
1,610
1,260
767
1,441
150
(26)
(91)
(70)
(489)
16
12,612
8,845
5,510
7,977
1,515
13,029
9,433
5,556
9,045
1,171
(417)
(588)
(45)
(1,068)
343
19,097
13,519
8,269
14,353
2,165
20,137
14,493
8,554
13,951
1,923
(1,040)
(973)
(285)
401
242
8,787
7,810
5,422
8,029
739
(4,242)
(1,624)
(133)
(1,016)
(432)
Total Non-Pay Expenditure
4,568
5,228
(661)
36,460
38,234
(1,775)
57,403
59,058
(1,655)
30,787
(7,447)
Total NHS Expenditure
12,466
13,332
(866)
98,374
101,025
(2,651)
150,617
154,687
(4,070)
83,085
(17,940)
Commercial Trading Unit Costs
2,362
2,259
103
18,806
18,181
625
28,455
26,919
1,536
17,002
(1,179)
Total Expenditure
14,828
15,591
(764)
117,180
119,206
(2,026)
179,072
181,606
(2,534)
100,087
(19,119)
EBITDA
EBITDA Margin %
1,541
9.4%
516
(1,026)
10,628
8.3%
9,447
(1,181)
14,718
7.6%
11,694
(3,024)
12,643
11%
(3,196)
3.2%
NHS Interest, Dividends, Depreciation
663
653
9
5,237
5,186
51
8,130
8,218
(87)
4,432
(754)
Trading Unit Interest, Depreciation, Dividends
Surplus / (Deficit) - before impairment
134
124
10
(997)
1,588
5,000
155
(1,006)
907
3,354
1,432
(262)
1,040
4,351
133
745
2,044
(2,956)
916
7,295
9
(3,941)
Impairment
Surplus / (Deficit)
0
0
0
745
(262)
(1,006)
0
4,351
0
3,354
(997)
8,500
(3,500)
8,500
(6,456)
(2,956)
0
7,295
0
(3,941)
NHS EBITDA
NHS EBITDA Margin %
NHS Surplus / (Deficit)
918
6.9%
255
618
4.4%
(35)
(300)
6,801
6.5%
1,564
10,219
9.2%
5,032
3,417
8,428
5.3%
298
11,975
7.2%
3,757
3,546
8,395
9%
3,963
1,824
Commercial Trading Unit EBITDA
Commercial Trading Unit EBITDA Margin %
Commercial Trading Unit Surplus / (Deficit)
623
20.9%
489
(102)
-4.7%
(227)
(726)
3,827
16.9%
2,787
(771)
-4.4%
(1,678)
(4,598)
6,290
18.1%
4,702
(281)
-1.1%
(1,713)
(6,570)
4,248
20%
3,332
(5,019)
Income
(290)
(716)
7.3%
0
3,468
(4,465)
6.0%
0
3,459
(6,415)
1,069
(5,010)
5
Underlying Position
In Month
Overall Trust I&E Summary
Qtr 2
Qtr 1
Year to date
Budget
Actual
Budget
Actual
Budget
Actual
Budget
Actual
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
Total Income
16,369
16,107
48,323
50,684
45,626
44,597
127,808
128,653
Total NHS Expenditure
12,466
13,332
37,307
37,925
36,102
35,850
98,374
101,025
2,362
2,259
7,003
7,046
7,020
6,485
18,806
18,181
14,828
15,591
44,309
44,971
43,122
42,335
117,180
119,206
1,541
9.4%
663
134
516
4,013
8.3%
1,914
398
5,712
3.2%
653
124
11.3%
1,949
361
2,504
7.0%
1,974
374
2,262
6.7%
1,901
360
10,628
7.0%
5,237
1,040
9,447
6.7%
5,186
907
745
(262)
1,702
3,402
156
1
4,351
3,354
0
(307)
(307)
Commercial Trading Unit Costs
Total Expenditure
EBITDA
EBITDA Margin %
NHS Interest, Dividends, Depreciation
Trading Unit Interest, Depreciation, Dividends
Surplus / (Deficit)
Adjustment to Reach Underlying Position:
Income
- Release of prior year provision
- Project Oriel
Total Income
(3,486)
0
0
(3,486)
(3,486)
Expenditure
- Non-recurrent benefits
Staff award provision release
Fellow back-pay release
(91)
(211)
NHS rental and facilities charges prior 2013/14
(307)
(3,793)
(91)
(211)
(391)
(391)
- Non-recurrent costs
Project Oriel
88
88
506
Pay Restructuring costs
RTT Enhanced Pay Costs
135
506
264
264
857
857
314
314
351
625
Total Expenditure
88
223
506
780
264
(38)
857
1,103
Total
88
223
506
(2,706)
264
(38)
550
(2,690)
832
(39)
2,208
696
420
(37)
4,900
664
Revised Underlying Position
Notes:

Underlying position in month is break even. NHS income overperformance in month of £0.6M is offset by expenditure overspends of £0.7M when the impact of
enhanced pay costs for RTT are discounted.

The year to date underlying surplus remains at £0.7M compared to a year to date planned surplus of £4.9M.

Non-recurrent expenditure items total £1.1M in the year to date position, with a mixture of benefits and costs.

The full year forecast has reduced to £2.0M surplus before impairments, inclusive of non-recurrent items which total a benefit of £2.7M year to date.
6
NHS Income
Commentary:
 NHS income is above plan in
November by £0.6M, £0.5M from
clinical activity and £0.1M from
other income.
 The overperformance in clinical
activity income is driven mainly by
outpatient income which is an
improvement to the year to date
trend and also clinical activity at
Bedford.
 Outpatient income increases are
mainly due to agreed contract
changes around visual field tests in
outpatient
appointments.
The
impact was seen across most areas
but particularly in glaucoma,
medical retina and corneal services
at City Road and within Moorfields
North at Ealing and Northwick Park.
 Elective income is £0.1M below
plan, a deterioration on the year to
date trend. This is despite the
additional pay expenditure for extra
lists to address RTT. Activity
decreased significantly in surgical
specialities at City road, particularly
cataract and adnexal. Moorfields
North saw low activity in St Ann’s.
7
Elective Activity Analysis (Inpatients and Outpatients)
Elective income is below target this month,
a change to the overperformance seen in
the last 3 months. Income per working day
fell to £141k, the lowest since July which
was before additional lists for RTT started.
Activity decreased particularly in the
surgical specialities in City Road. The RTT
Saturday lists for cataracts were not run in
November.
20
17
21
23
18
22
20
20
129
130
129
132
133
134
146
146
142
13
151
21
131
1
134
2
161
28
144
10
153
6
141
(5)
18
148
21
146
20
146
22
Workings Days Inc. adjustments
145 Target per working day (£'000)
Actual per working day (£'000)
Variance (£'000)
This decrease was not in the forecast for
November
and
discussions
have
commenced with the relevant directorate.
The overperformance forecast for the last
3 months of the year relies on surgical
activity in City Road to remain at the levels
seen in August to October. Moorfields
North have reduced their forecast in the
remaining four months by £0.4M across St
Ann’s and Darrent Valley.
Outpatient income is above plan in
November. The positive variance is a price
variance due to an agreed contractual
change.
Actual income per working day has
increased up to £254k, from £242k in
October. The increase is across most
areas.
The forecast is to continue to achieve plan.
20
227
222
(5)
17
228
233
5
21
227
221
(7)
23
222
212
(10)
18
235
235
1
22
233
234
1
23
236
242
7
20
237
254
16
18
239
21
237
20
237
22 Workings Days Inc. adjustments
236 Target per working day (£'000)
Actual per working day (£'000)
Variance (£'000)
8
NHS Operating Expenditure – Pay Costs by Staff Group and Area
Staff Group & Directorate
Average Monthly Expenditure (£'000)
Staff Group & Directorate
Medical
Year to Date Current Month
Increase /
2014/15
2014/15
(Decrease)
183
237
54
379
411
32
1,057
1,016
(41)
786
766
(20)
21
2
(19)
41
41
0
2,466
2,473
6
Nursing
Moorfields North
Moorfields South
Outpatient & Diagnostic Servs
Surgical Services
Additional Enhanced RTT costs
Corporate Departments
Total
- Costs this month are £6k above the monthly average but have
decreased since the high value of £2,780k in October.
- The Surgical Services decreases this month are a correction in allocation
of costs of one post, transferred to Moorfields North which has an
increase in costs. Additional sites explain a further £5k increase for
Moorfields North.
- Outpatients & Diagnostics medical costs have decreased in paediatrics
and medical retina.
Other Clinical
Moorfields North
Moorfields South
Outpatient & Diagnostic Servs
Surgical Services
Corporate Departments
Total
Year to Date Current Month Increase /
2014/15
2014/15
(Decrease)
49
65
16
29
29
0
739
739
(1)
58
59
2
2
4
2
877
897
19
- Expenditure this month in other clinical staff is £19k (2%) above the
year to date monthly average.
- Increases are in Moorfields North at Northwick Park.
Moorfields North
Moorfields South
Outpatient & Diagnostic Servs
Surgical Services
Additional Enhanced RTT costs
Corporate Departments
Total
Average Monthly Expenditure (£'000)
Year to Date Current Month
2014/15
2014/15
380
426
274
289
492
525
649
632
55
141
28
32
1,879
2,046
Increase /
(Decrease)
46
15
34
(17)
86
4
167
- Costs remain high at £2,046k which is £167k (9%) above the year to date
amount. This is due to bank rates remaining at the enhanced level to
support additional RTT work.
Non-Clinical
Moorfields North
Moorfields South
Outpatient & Diagnostic Servs
Surgical Services
Corporate Departments
Total
Year to Date Current Month
2014/15
2014/15
184
208
156
147
366
338
247
276
1,174
1,200
2,126
2,169
Increase /
(Decrease)
24
(9)
(28)
29
26
43
- Increase in expenditure of £43k (2%) compared to year to date average.
- Increase in Surgical Services is in health records library. Directorate is
still within budget for non-clinical pay in month.
- Corporate departments are £26k (2%) above the year to date average.
- Moorfields North increases due to additional admin support in Bedford
and Northwick Park.
NB. Research and Development Pay is excluded from the tables above and shown as part of the Research and Development position on page 11. Research and Development have a separate quarterly board report.
9
NHS Operating Expenditure – Pay Costs Agency and Bank Analysis
Staff Type
Current Month
Year To Date Average
Average Prior Year
Nursing Expenditure Current
Month
Nursing Expenditure YTD
Average
Average Nursing
Expenditure Prior Year
Employed
Bank
Agency
Employed
Bank
3%
Nursing
Employed
76%
Bank
Agency
Employed
0%
Bank
Employed staff costs as a % of total
expenditure have decreased which is also
linked to the enhanced rates for bank
rather than a decrease in employed staff
overall.
91%
Other Clinical Expenditure YTD
Average
5%
Agency
2%
82%
Other Clinical Expenditure
Current Month
Employed
Bank
Agency
Average Other Clinical
Expenditure Prior Year
Employed
5%
Bank
Agency
0% 5%
95%
Non Clinical Expenditure Current
Month
Employed
Non-Clinical
Bank
Employed
15%
Bank
18%
7%
Agency
Average Non Clinical
Expenditure Prior Year
Employed
0%
Bank
Agency
76%
Non-clinical pay costs have increased by
2% in month compared to the year to
date average with increase employed
staff and bank usage. Enhanced bank
rates do not apply to non-clinical staff.
17%
6%
78%
Staff Type
Nursing
Other Clinical
Non-clinical
Agency
Increase in costs compared to last year is
now 5%, still below other staff groups.
95%
Non Clinical Expenditure YTD
Average
Increase in costs by 2% compared to the
year to date average. Agency usage
remains at 5% of total costs.
Increase in costs for this staff group for
some areas like optometry are achieved
through overtime of employed staff.
Other Clinical
95%
Increase in nursing costs is due to bank
expenditure driven by enhanced rates
agreed to encourage bank availability to
assist in achievement of RTT targets.
7%
15%
21%
0%
Agency
3%
Comments
83%
Current Month (£'000)
Year To Date Average (£'000)
Average Prior Year (£'000)
Employed Bank
Agency Total
% Change Employed Bank
Agency Total
% Change Employed Bank
Agency Total
1,567
425
54
2,046
9%
1,536
290
54
1,879
21%
1,411
104
38
1,553
850
0
47
897
2%
836
1
40
877
5%
795
2
40
837
1,699
158
312
2,169
2%
1,620
125
381
2,126
21%
1,457
2
303
1,762
Increase in costs on non-clinical pay
expenditure compared to last financial
year is 21% and matches the increase in
nursing costs.
10
NHS Operating Expenditure – Non-Pay Costs
Comments:
After the significant increase in non-pay expenditure in October, it
has fallen in November by £0.6M and is £0.2M below forecast for the
month.
Drugs and clinical consumables expenditure is £0.6M below last
month and back to average year to date levels.
Comments:
Corporate department’s non-pay costs have increased in month
above budget and year to date trend.
This month expenditure under “Other Costs” is £0.2M above the
previous month. This includes £0.1M on external consultancy for
achievement of RTT targets. A further £0.1M is for projects
principally Project Oriel.
The forecast is for expenditure to remain above plan to the end of the
year. This will be revised next month to take in to account the recent
review of external consultant usage.
11
Efficiency Scheme Performance
Breakdown of Forecast Achievement
Efficiency Schemes Profile and Forecast
400
Clinical Supplies
10%
47%
350
22%
300
Amount (£'000)
12%
9%
250
Non-clinical supplies
Pay
Revenue
200
Target
Summary of Performance:
Actual
150
Forecast
50
0
Period
YTD Target
(original phased
budget)(£)
YTD Amount
Achieved (£)
- Year to date (YTD) achievement is £2,052k, 71% of YTD target and 47% of the full year
target.
- The year to date shortfall against the original phased target (including a phased share of
unidentified schemes) is £826k.
- Total schemes worth £4,151k have been identified. This is 95% of the full year target and
has increased by the replacement scheme in IT.
- Full year forecast delivery however, is only 75% of the target at £3,257k as achievement
against identified schemes decreases due to delays in implementation. All schemes not
delivering will be re-assessed for their potential full year recurrent value as part of setting
the budget for next financial year.
100
Directorate / Corporate Department
Drugs
Year to Date %
YTD Variance (£) Achievement
Value of
Full Year Target Schemes
(£)
Identified (£)
Full Year
Forecast
Amount (£)
Forecast %
YTD Amount
Achievement of Achieved as % of
Target
Full Year Target
Actions on Shortfall and Unidentified Amount
Although the full year forecast amount will exceed the original target, it is £184k
below the value of schemes identified. The schemes that have underperformed
66% are all related to additional revenue.
Moorfi el ds North
318,634
273,093
-45,541
86%
413,676
648,083
468,486
113%
Moorfi el ds South
203,935
172,160
-31,775
84%
325,359
325,359
276,084
85%
Outpa ti ent & Di a gnos ti c Servi ces
1,042,110
778,973
-263,137
75%
1,579,730
1,457,366 1,201,725
76%
Surgi ca l Servi ces
741,454
2,306,134
7,216
17,436
20,832
29,018
42,775
19,070
214,436
93,907
45,315
402,930
1,627,156
7,216
17,436
20,832
29,018
0
19,070
214,436
93,907
10,467
-338,524
-678,977
0
0
0
0
-42,775
0
0
0
-34,848
54%
71%
100%
100%
100%
100%
0%
100%
100%
100%
23%
1,082,281
3,401,046
10,819
26,154
31,248
43,527
61,014
31,096
399,748
140,860
67,972
748,901
603,584
3,179,709 2,549,879
10,819
10,824
26,154
26,154
31,248
31,248
43,527
43,527
50,909
0
28,605
28,605
321,654
321,654
140,860
140,860
15,700
15,700
56%
75%
100%
100%
100%
100%
0%
92%
80%
100%
23%
Unidentified amount of the full year target is £123k, however forecast
49% achievement is £378k below the target.
Unidentified amount has remained at £333k. Forecast full year achievement is
37% £604k, which is £478k below the full year target.
48%
67%
67%
67%
67%
0%
61%
54%
67%
15% Unidentified amount of £52k
70,000
18,800
707,372
55%
100%
74%
Original scheme around staffing resource will not achieve any savings this year
due to ongoing difficulties with recruiting permanent staff to replace contract
staff. A non-recurrent replacement scheme around the managed print service will
offset this shortfall by £70k. Next year the managed print service initiative will
0% deliver futher savings.
67%
44%
4,150,981 3,257,251
75%
Clinical Directorates
Chi ef Executi ve's Offi ce
Chi ef Opera ti ng Offi cer
Corpora te Governa nce
Di rector of Nurs i ng
Di rector of Stra tegy
Educa ti on
Es ta tes a nd Fa ci l i ti es
Fi na nce
Huma n Res ources
Informa ti on Technol ogy
Qua l i ty a nd Sa fety
Corporate Department Initiatives
TRUST TOTAL
31,509
12,533
534,047
0
12,533
424,915
-31,509
0
-109,132
0%
100%
80%
126,716
18,800
957,954
2,840,180
2,052,071
-788,109
72%
4,359,000
282,996
18,800
971,272
53% Forecast achievement remains at 85%.
47%
12
Research and Development Position
In Month
Year to Date
Full Year
Budget
Actual
Variance
Budget
Actual
Variance
Budget
Forecast
Variance
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
Total Income
872
809
(63)
7,192
6,824
(368)
10,725
10,392
(332)
Expenditure
Pay Costs
Non-Pay Costs
Total Expenditure
Interest, Dividends, Depreciation
593
166
759
11
590
150
740
11
4
16
19
0
4,807
1,515
6,321
153
4,506
1,171
5,677
153
301
343
644
0
7,160
2,165
9,324
220
7,160
1,923
9,082
220
0
242
242
(0)
Total Contribution to overhead
101
58
(44)
717
993
276
1,180
1,090
(90)
Research and Development
Income:

Income is £0.1M behind plan in month and adverse year to date by £0.4M. Income is forecast to end the year below plan by £0.3M.
Expenditure

Expenditure is on plan in month and £0.6M favourable year to date. Expenditure is forecast to end the year £0.2M below plan as additional income receipts are
anticipated to be spent in year. Contribution remains significantly below the level for full cost recovery.
Commercial Trading Unit Position
In Month
Commercial Trading Units
Year to Date
Budget
Actual
Variance
Budget
Actual
Full Year
Variance
Budget
Forecast
Prior Year YTD
Variance
Actual
Variance
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
Total Income
3,051
2,179
(872)
23,130
17,642
(5,488)
35,525
26,975
(8,551)
21,885
(4,243)
Expenditure
Pay Costs
Non-Pay Costs
Total Expenditure
873
1,489
2,362
885
1,374
2,259
(12)
115
103
6,936
11,870
18,806
7,240
10,941
18,181
(304)
929
625
10,503
17,952
28,455
10,669
16,251
26,919
(166)
1,702
1,536
6,740
10,262
17,002
(500)
(679)
(1,179)
690
(80)
(769)
4,324
(538)
(4,862)
7,070
55
(7,015)
4,883
(5,421)
Commercial Trading Unit EBITDA
Commercial Trading Unit EBITDA Margin %
22.6%
-3.6%
18.7%
-3.1%
19.9%
0.2%
Interest, Dividends, Depreciation
134
124
10
1,040
907
133
1,588
1,432
155
22%
916
9
Commercial Trading Unit Surplus / (Deficit)
555
(204)
(759)
3,284
(1,445)
(4,729)
5,483
(1,377)
(6,860)
3,967
(5,412)
Internal Sales
(66)
(23)
(43)
(497)
(233)
(264)
(781)
(336)
(445)
(635)
402
Commercial Trading Unit Surplus / (Deficit) discounting internal sales
489
(227)
(716)
2,787
(1,678)
(4,465)
4,702
(1,713)
(6,415)
3,332
(5,010)
Income:

Income is £0.9M behind plan in month and adverse year to date by £5.5M. Income is forecast to end the year below plan by £8.6M.
Expenditure

Expenditure is £0.1M behind plan in month and £0.6M favourable year to date. Expenditure is forecast to end the year £1.5M favourable to plan.
Overall Position

£0.2M deficit in the month with a year to date deficit position of £1.7M. Position is forecast to end the year with a £1.7M deficit.
13
Cash Flow
14
Debtors Management and Credit Control
6 Mths +
5 Mths
4 Mths
3 Mths
2 Mths
1 Mth
May 14
1,155
278
Jun 14
15
751
Jul 14
21
664
Aug 14
0
147
Sep 14
30
3,276
Oct 14
(3)
794
Private Patients
1,433
2,084
766
142
685
202
147
170
3,306
300
791
403
7,128
3,301
1,123
771
8,251
4,072
Pharmacy Sales
0
0
138
86
44
124
392
860
1,252
Sundry Debtors
442
64
68
106
92
765
1,537
1,545
3,082
TOTAL
3,959
972
1,093
509
3,742
2,083
12,358
4,299
16,657
Prior month £k
4,333
308
1,253
1,208
1,885
3,213
12,200
4,521
16,721
Change - £k
(374)
664
(160)
(699)
1,857
(1,130)
158
(221)
(63)
Change - %
(8.6%)
215.6%
(12.8%)
(57.9%)
98.5%
(35.2%)
1.3%
(4.9%)
(0.4%)
Type of Debt
Welsh Debts only
NHS Service Income
Total Contract Debts
Type of Debt
Welsh Debts only
NHS Service Income
Total
Total
Overdue Current
1,218
0
5,910
1,123
Nov 14
Total
1,218
7,033
Oct 14
Oct 14
Overdue Current
1,222
(3)
6,366
1,923
Total
Total
Overdue Current
1,218
0
5,910
1,123
Nov 14
Total
1,218
7,033
% Var
% Var
% Var
Total
1,219
8,289
Overdue
(0.3%)
(7.2%)
Current
(100.0%)
(41.6%)
Total
(0.1%)
(15.1%)
Oct 14
Private Patients
7,128
3,301
1,123
771
8,251
4,072
7,588
3,279
1,920
659
9,508
3,938
(6.1%)
0.7%
(41.5%)
16.9%
(13.2%)
3.4%
Pharmacy Sales
392
860
1,252
317
432
749
23.7%
99.2%
67.2%
Sundry Debtors
1,537
1,545
3,082
1,016
1,510
2,526
51.3%
2.3%
22.0%
12,358
4,299
16,657
12,200
4,521
16,721
1.3%
(4.9%)
(0.4%)
Total Contract Debts
TOTAL
Please note: Values shown in the above tables are for the stated types of debt only.
Additional items comprise overall debt for the Trust, including provisions and accruals.
Monthly highlights
Overdue debts increased slightly by £0.2M
in November to £12.4M. Balances in each
business area remained relatively stable.
January 2015 is expected to see payments
begin as a result of completed
reconciliations of Q1 14/15 performance
invoices. CCG administrative processes
continue to be a concern and are being
addressed at a number of levels within
both sets of organisations.
Within Private Patients, work is ongoing to
deal with historic debt and contracting
activities, with a new structure and new
positions within the PP Finance team
contributing to this aim.
15
Overdue Debts by debtor,
£k as at Nov 2014
4,299
Total Contract Debts
7,128
Private Patients
Pharmacy Sales
Sundry Debtors
1,537
Current
392
3,301
Overdue CCG debts
NEL, NWL and SWL CCGs and London Specialist Commissioning
collectively account for £4.2M (59%) of overdue contract debts, £3.2M of
which is 3 months overdue or less.
NEL had an overdue balance of £1.8M as at M8, of which £0.2M related
to 2013/14. Q1 14/15 performance invoices (£0.7M) should be paid in
January.
NWL has an overdue balance of £1.9M as at M8. The data reconciliation
process with NWL remains slow, and Q1 14/15 performance invoices of
£1.1Min particular remain unreconciled.
NCA (Non-Contract Activity) debt includes Kent & Sussex Area CCGs with
£0.5M overdue as at M8, of which £0.1M related to 2013/14. £0.2M of
this has been settled in December to date. As is the case with all NCA
debts, an individual targeted approach is made for each debtor.
Overdue Debts by age,
£k as at Nov 2014
1,545
3,959
6 Mths +
5 Mths
2,083
4 Mths
3 Mths
Overdue Sundry debts
Overdue sundry debts decreased by 51% in November (£1.0M to £1.5M),
mainly due to a Project Oriel invoice for £367K becoming overdue during
the month and has been escalated to DoF level. The total comprises 345
other debtors, the next largest of which is a commercial supplier to the
R&D function at £94k and should be resolved by early January.
A note on collection and overdue contract debts
2 Mths
972
3,742
1,093
509
1 Mth
Current
Standard NHS payment terms are 30 days from the invoice date. SLA
payments are mostly made on the 15th of each month and, once set up,
tend to run smoothly. Delays in payment occur when data is delayed or
disputed, or queries arise which require investigation. Overdue contract
debts are inevitable to some degree due to entrenched commissionerside behaviours related to withholding total amounts rather than only
disputed amounts.