Financial Performance Report FY22 September 2021 Summary
The Finance Report for September 2021 highlights a positive financial performance against the plan for the year-to-date. The Executive Summary indicates a surplus in EBITDA and Income & Expenditure, with favorable variances in capital expenditure and cash position. Challenges such as overspend in services and high agency usage are being addressed through action plans. Overall, the report recommends the Board of Directors to note the financial position and seek further assurances as necessary.
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Confidential Circulated outside of a Board meeting Report to Board of Directors For Information Finance Report September 2021 (Month 6), FY22 Contents Executive Summary 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Income Statement Clinical Income Non-Clinical Income Agency Cost Improvement Plan Statement of Position Cash-flow Working Capital Indicators Capital Investment Programme Reconciliation to NHSI Template A risk assessment has been undertaken around the legal issues that this paper presents and there are no issues that need to be referred to the Trust Solicitors. 1
Confidential Executive Summary EBITDA performance I&E performance Cost Improvement Plan Capital Expenditure Cash Month 6 Year-to-Date 2.4m surplus, 1.0m favourable to plan 1.6m surplus, 1.1m favourable to plan 0.1m, 0.1m adverse to plan 0.7m, 0.3m adverse to plan Decrease of 7.5m 8.2m surplus, 0.2m adverse to plan 3.1m surplus, 0.1m favourable to plan 0.8, 0.6m adverse to plan 2.2m, 3.9m adverse to plan 52.7m, 2.0m favourable to plan The year-to-date I&E position at month 6 is a 3.1m surplus, 0.1m favourable to plan. EBITDA is a 8.2m surplus, 0.2m adverse to plan. The FY22 plan is for a breakeven position with a 3.0m surplus in the first half of the year and a 3.0m deficit in the second half of the year. The favourable position is driven by slippage on investments and by 2.7m underspend against the allocation for Covid-19 costs. This is despite overspend in services in particular the Oxon & BSW MH directorate ( 3.7m) compounded by high agency usage. Finance are working with the directorate on the causes of this overspend and an action plan to address it. CIP savings YTD are 0.8m, 0.6m adverse to plan due to a delay in CIP engagement as a result of Covid-19. Capital spend is 2.2m, 3.9m adverse to plan. The closing cash position at the end of September was 52.7m, 2.0m favourable to plan. Recommendation: The Board of Directors are asked to note the Finance Report against plan and seek any further assurances as required. 2
1. Income Statement INCOME STATEMENT Prior Year Month 6 Year-to-Date YTD Actual M6 Change Plan m 45.8 5.1 50.9 Actual m 41.0 Variance Plan m 212.8 29.8 242.6 Actual m 213.1 43.4 256.5 Variance m m 63.6 -3.1 60.6 % m % m 0.3 13.6 13.9 % . -4.8 2.7 -2.1 149.5 46.5 196.0 42.6% Clinical Income -6.6% Other Operating Income 30.9% Operating Income, Total -10.5% 53.2% -4.1% 0.1% 45.5% 5.7% 7.8 48.8 139.8 50.0 189.9 -26.4 -32.1 -58.5 -18.9% Employee Benefit Expenses (Pay) -64.1% Other Operating Expenses -30.8% Operating Expenses, Total 34.4 15.1 49.5 31.0 15.3 46.4 3.3 -0.2 3.1 9.7% -1.3% 6.3% 156.2 78.1 234.3 166.2 82.1 248.3 -10.0 -4.0 -14.1 -6.4% -5.2% -6.0% 0.0 0.0 0.0% Non-Operational Income 0.0 0.0 0.0 0.0% 0.0 0.0 0.0 0.0% 6.1 2.1 33.8% EBITDA 1.4 2.4 1.0 72.7% 8.4 8.2 -0.2 -2.2% 0.0 3.5 0.0 0.5 0.5 1.7 0.0 0.3 0.0 0.0 0.1 0.6 0.0% Profit/(Loss) on asset disposal 8.6% Depreciation and Amortisation 0.0% Asset Impairment 0.0% Interest 20.7% Other Finance Charge 36.0% PDC Dividend 0.0 0.5 0.0 0.1 0.1 0.2 0.0 0.5 0.0 0.1 0.1 0.2 0.0 0.0 0.0 0.0 0.0 0.1 0.0% 1.1% 0.0% 8.1% 0.0% 23.4% 0.0 3.1 0.0 0.5 0.4 1.4 0.0 3.1 0.0 0.4 0.4 1.1 0.0 -0.1 0.0 0.0 0.0 0.3 0.0% -2.0% 0.0% 4.4% -10.0% 22.5% 0.0 3.1 0% Surplus/ (Deficit) 0.5 1.6 1.1 213.9% 3.0 3.1 0.1 2.0% The year-to-date I&E position at month 6 is a 3.1m surplus, 0.1m favourable to plan ( 1.5m surplus, 1.0m adverse to plan at month 5). EBITDA is a 8.2m surplus, 0.2m adverse to plan. The FY22 plan is for a breakeven position with a 3.0m surplus in the first half of the year and a 3.0m deficit in the second half of the year. The favourable position is driven by slippage on investments and by 2.7m underspend against the allocation for Covid-19 costs. This is despite overspend in services in particular the Oxon & BSW MH directorate ( 3.7m) compounded by high agency usage. Finance are working with the directorate on the causes of this overspend and an action plan to address it. Budgets have been set for mental health new investment funding in line with plans although this does not represent all off the new investment. In addition, the planned contribution from these investments is accrued for in the month 6 position and assumed to be linear throughout the year. Month 6 includes the cost of the backdated pay award c. 3.5m for which corresponding income has been assumed. The I&E performance in FY22 is 3.1m better than in FY21. The financial regime in the first 6 months of FY21 was to report a breakeven position with a retrospective top-up payment to cover Covid-19 costs. (For FY22 there is a fixed expenditure allowance for Covid cost recovery.) 3
Confidential Breakdown of Covid-19 Costs NHSI/E category '000s Expanding workforce Decontamination Existing After Care and Support Costs Segregation of patient pathways PPE associated costs Total workforce additional shifts Employee Benefits (Pay) Other Operating Expenses Total 5,881 106 70 16 54 49 6,176 11 381 2,584 63 3,039 5,881 117 70 397 2,638 112 9,215 The Trust is receiving an allocation of 11,164k for the first 6 months of the year ( 1,861k per month) to cover costs associated with Covid-19. Planning assumptions assume a underspend of 1,196k ( 199k per month) on this Covid allocation to meet the plan for the first half of the year. The spend at month 6 is 9,215k, 1,949k below the funding and 753k below plan. The Covid-19 costs incurred at month 6 as per the NHSE/I categories were: Expanding workforce 5,881k additional bank and agency staff, agency housekeepers, costs associated with the 24/7 Mental Health Helpline, additional costs in the GP Out of Hours service, and other increased staff costs to create additional capacity Decontamination 117k minor Estates works, staff testing and mask testing kits Existing Workforce additional shifts 70k spend on staff working additional hours After Care and Support costs 397k mainly the cost of providing food to staff, which has stopped at the end of June Segregation of patient pathways 2,6387k the cost of independent sector beds for mental health patients due to the requirements to run mental health wards at 85% occupancy PPE associated costs 112k the cost of the PPE warehouse In addition to these costs the Trust is also incurring costs for running 3 mass vaccination centres and the payments made to final year nursing students (April only) for which retrospective top-up payments are received from NHSE/I based on the costs incurred. These costs at month 6 were: Payments to final year students 78k Covid-19 vaccination centres 11,418k 4
Confidential Performance against Plan Plan YTD M6 FY22 Actual YTD M6 FY22 Actual YTD M6 FY21 Variance Change '000 187,852 6,289 2,949 1,599 11,382 2,698 '000 188,837 6,373 2,796 1,599 10,611 2,798 '000 984 % '000 125,076 6,266 2,673 1,353 11,352 2,721 '000 63,761 106 124 246 -741 % Block Cost & Volume Cost Per Case CQUIN Local Authority Section 75 (pooled budget) Private Patients Clinical Income Total Education And Training Research & Development FRF/Top Up Payment Accommodation Catering Non-Patient Care to Other Bodies Other Income Parking Oxford Pharmacy Sales Other Operating Income Total Permanent Flexible Agency Employee Benefits Expenses Clinical Services & Supplies Drugs PFI Car Park Security Premises And Fixed Plant Premises - Business Rates Secondary Commissioning Establishment Expenditure Insurance Audit Fees External Audit Fees Internal Clinical Negligence Consultancy General Supplies And Services Legal Fees Losses And Special Payments NHS Services Other Non-Pay Expenditure Other Services Patient Travel Provisions Redundancy Costs Training & Conferences Transport - Business Travel Transport - Other Total Other Operating Expenses EBITDA Total 1% 1% -5% 0% -7% 4% 198% 0% 14% 4% 0% 4% 0% 181% -13% -100% -4% 46% 17% -306% -926% -6% -7% 1% -50% 0% -16% -2% -5% -11% -7% 33% 22% 0% 92% 41% -132% 27% -47% -33% -3% 0% -1185% 51% 2% 5% 18% -7% 3% 67% 43% 28% 36% -50% -2% 0% 144% -22% 100% 37% -6% -9% -13% -108% 19% 295% 28% 15% 0% -2% 6% -2% -4% 10% 2% -27% 40% 363% -21% 84% -26% 37% -4% 7% 0% 0% 0% 64% 27% 37% 64% 34% 83 -152 0 -771 100 58 302 1,150 291 11,365 78 35 29 87 52 212,798 8,176 6,539 213,100 9,325 6,829 11,365 149,492 7,261 5,031 22,789 63,608 2,064 1,799 -11,425 0 462 481 19 0 491 -10 0 0 0 0 810 721 38 2,278 626 1,468 -95 -38 -526 13,633 26,235 -10,087 -26,193 -10,045 -2,410 935 805 -12 1,344 -179 0 12 13,090 29,835 150,058 3,297 2,829 156,184 35,783 13,909 12,564 43,468 123,822 13,384 29,022 166,229 38,194 13,744 9,185 46,485 114,030 11,842 13,932 139,804 9,676 10,741 3,379 -3,017 -9,793 -1,542 -15,090 -26,425 -28,518 -3,003 164 -146 294 440 384 -56 0 0 0 0 0 6,612 680 5,557 3,796 239 7,693 695 5,813 4,208 257 -1,081 -15 -257 -411 -18 7,883 657 5,930 4,372 233 190 -38 116 165 -24 -1 14 -118 43 50 414 33 29 39 414 14 11 0 31 28 53 296 3 1 -2 2,527 115 1,488 266 1,039 -152 1,887 145 399 -122 9 7 3 9 2 784 1,154 4,465 292 -369 -1,098 843 -310 198 -19 3,367 284 4,663 273 -9 0 0 0 0 0 0 28 0 363 73 730 -335 -73 295 900 -114 -4,030 -139 153 45 446 808 521 -29 -284 -216 -192 1,025 1,924 599 78,074 8,375 29% 47% -19% -5% -2% 1,024 714 82,104 8,236 50,047 6,126 -31,847 2,109 Please see next page for notes 5
Confidential Performance against Plan EBITDA is a 8.2m surplus, 0.2m adverse to plan at month 6( 5.8m surplus, 1.2m adverse to plan at month 5). The main drivers of the position are: 1. Block Income 1.0m favourable -additional income for the risk share in Childrens Continuing Healthcare ( 1.3m) partly offset by less than expected income for Ageing Well service, 0.3m . 2. Local Authority Income 0.8m adverse deferred income in respect of Bucks CAMHS 0.4m adverse due to delay in expenditure; underperformance in Community Care Support team 0.4m. 3. Education and Training 1.2m favourable - 0.2m favourable by Health Education England LDA income for apprentices and trainees IAPT and CAMHS GMH in Bucks Directorate; 0.6m favourableHEE IAPT Trainees in OBSW directorate; increase in apprenticeship funding from HEE, 0.2m; Other 0.2m favourable. 4. FRF/Top up Payment 11.4m favourable this is the retrospective top up payments for Covid-19 costs which are not part of the Covid-19 allocation. 11.3m is for the costs of running the vaccination sites and 0.1m is to cover the costs of paid final year students. 5. Non-Patient Care to other bodies 1.5m favourable. Additional income 0.8m in IM&T for EPMA & 0.5m Community services (in particular Dental), other 0.2m. 6. Oxford Pharmacy Sales 0.5m adverse - due to lower than planned sales in Oxford Pharmacy Store. 7. Employee Benefits Expenses (Pay) 10.0m adverse - 10.0m of this is due to staff at the mass vaccination centres and 0.1m is due to paid final year students. Budgets have not been set for these but the costs are covered by additional income received. There are adverse variances in all the clinical directorates on pay driven by bank and agency costs Oxfordshire & BSW mental health 3.8m, Community 1.0m, Buckinghamshire 0.6m and Specialised 1.0m. These are offset by a 5.1m favourable variance for mental health investments that will be allocated to services once plans are agreed, an underspend of 0.7m on Covid-19 costs and a 0.7m underspend in Research & Development. 8. Clinical Services & Supplies 2.4m adverse - 0.8m in Childrens Continuing Healthcare (offset with additional income); Childrens Community Nursing 0.2m adverse; Tissue Viability service 0.2m adverse; 0.4m adverse due to additional costs for complex patient in LD services; 0.6m subcontracted costs in Oxfordshire & BSW MH for which new investment budget has not yet been set; 0.2m overspend in the Academic Health Science network offset with additional income received. 9. Premises and Fixed Plant 1.1m adverse. 0.5m of this is due the mass vaccination centres. Budgets have not been set for these but the costs are covered by additional income received. 0.3m dental equipment; 0.3m other. 10. General Supplies And Services 1.0m favourable against Community services 0.3m, Covid costs 0.6m and 0.1m other. 11. Other Non-Pay Expenditure 1.1m adverse 0.3m adverse which reflects a budgeted risk in the budget for the first half of the year due to profiling of the plan, which will reduce once budgets for the contribution from new investments has been set and which is expected to be offset with underspends against the Covid-19 allocation. 0.8m R&D less than expected BRC income offset by favourable position on expenditure. 12. Transport - Business Travel 0.9m favourable as consequence of Covid. 6
Confidential Performance against Prior Year The EBITDA position is 2.1m better than last financial year. The significant changes from FY21 are: 1. Block income is 63.8m higher than last year due to uplift on block contract values ( 0.6m, 0.5%), new income for Provider Collaboratives ( 30.0m) and Covid funding now being reported as block income rather than FRF income ( 11.1m). The remaining change is primarily due to new investment in mental health services. 2. Local Authority 0.7m less than last year Mainly due to residential care income( 1.2m Full Year Value) being coded to OCCG- OBC contract ( 0.8m). 0.3m reduction in CCS and Children CHC services partially offset by Bucks LA income is 0.4m. 3. Education & Training income is 2.1m higher than last year due to additional income in IAPT services to support trainees ( 0.5m), higher apprenticeship income ( 0.4m) in L&D, higher numbers of trainees in the Oxford Institute of Psychology training ( 0.5m), 0.6m income in the Oxfordshire Training Hub following the transfer of this service from OxFed from April. 0.3m favourable driven by Health Education England LDA income for apprentices in Bucks; Other 0.2m adverse. 4. Research & Development income is 1.8m higher than last year due to additional grant and study income of which 0.2m relates to Covid-19 related research. 5. FRF/Top Up Payment is 11.4m lower than last year. The Covid-19 allocation and top up payments were reported in this category last year but they are now in clinical income. The income reported in this category this year is to cover the costs of the mass vaccination sites and paid final year students. 6. Non-Patient Care to Other Bodies 1.3m higher than las year due to additional income in IM&T, HR and Community directorates. 7. Oxford Pharmacy Sales are 3.3m higher than last year. At the beginning of FY21 sales were low due to the effect of Covid-19 on acute hospital activity. 8. Permanent staff costs have increased by 9.8m from last year- 4.3m new costs in Oxfordshire & BSW MH and Buckinghamshire MH directorates as a result of investment in these services; FY22 pay award 3.5m (3%); 0.3m increase in costs in Research & Development as a result of higher grant and study income; 1.0m IM&T, 0.7m L&D and 0.2m Estates and Facilities. Other decreases 0.2m. 9. Flexible staff costs have increased by 1.5m from last year, of which 0.3m is due to staffing the Covid-19 mass vaccination centres, 0.1m is an increase in Covid-19; 0.6m increase across clinical directorates; 0.3m increase in costs in Research & Development; Other 0.2m. 10.Agency staff costs have increased by 15.0m from last year, of which 10.2m is attributable to the Covid-19 mass vaccination centres, 0.7m Covid prevention, 1.4m is in Community Hospitals, 0.6m is the costs of additional staffing required for a Learning Disabilities patient on the 136 suite, with the remaining 1.8m increase across multiple services in particular OxBSW directorate 1.3m. 11.Clinical Services & Supplies are 28.5m higher than last year due to 25.5m payments to other providers as part of the CAMHS and Secure Provider Collaboratives, 0.7m additional sub-contract costs in IAPT services due to investment in these services, 0.6m inpatient placement costs in Learning Disabilities and 0.2m additional costs in the Academic Health Science Network offset with additional income. The remaining difference is across various other services. 12.Drugs costs are 3.0m higher than last year due to higher sales in Oxford Pharmacy Store. 7
Confidential Out of Area Treatments (OATs) OATs are 331k overspent at month 6 ( 672k overspend in Oxfordshire offset with a 341k underspend in Buckinghamshire). This excludes the costs of a 18 bed contract with Elysium and acute OATs which are reported under Covid-19 costs. This is a further spend of 1,373k. Infection Control & Prevention guidelines are currently that Mental Health wards should operate at 85% capacity and until these guidelines change the OATs costs are unlikely to reduce. 8
Confidential Variance to Plan by Month PLAN Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 m 29.9 4.7 34.6 m 34.0 5.1 39.1 m 34.1 5.0 39.1 m 34.9 5.0 39.9 m 34.0 5.0 38.9 m 45.8 5.1 50.9 Clinical Income Other Operating Income Operating Income Total Employee Benefits Expenses Other Operating Costs Operating Expenses Total 24.3 8.9 33.2 24.6 13.1 37.7 24.8 12.9 37.7 24.5 14.0 38.5 23.5 14.0 37.5 34.4 15.1 49.5 EBITDA 1.4 1.4 1.4 1.4 1.4 1.4 ACTUAL Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 m 30.7 5.5 36.2 m 35.1 6.9 42.1 m 34.9 7.0 41.9 m 36.1 8.0 44.1 m 35.3 8.2 43.5 m 41.0 7.8 48.8 Clinical Income Other Operating Income Operating Income Total Employee Benefits Expenses Other Operating Costs Operating Expenses Total 26.0 9.2 35.2 26.7 13.9 40.6 26.6 14.8 41.5 28.3 14.4 42.6 27.6 14.6 42.1 31.0 15.3 46.4 EBITDA 1.0 1.5 0.4 1.5 1.4 2.4 VARIANCE Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 m 0.7 0.8 1.5 m 1.1 1.8 3.0 m 0.8 1.9 2.8 m 1.1 3.1 4.2 m 1.4 3.3 4.6 m 4.8 2.7 2.1 Clinical Income Other Operating Income Operating Income Total - - Employee Benefits Expenses Other Operating Costs Operating Expenses Total - - - 1.7 0.3 1.9 - - - 2.1 0.7 2.9 - - - 1.8 1.9 3.7 - - - 3.7 0.4 4.1 - - - 4.0 0.6 4.6 - 3.3 0.2 3.1 EBITDA - 0.4 0.1 - 1.0 0.1 0.0 1.0 9
Confidential 1 2 3 4 5 6 7 8 9 Clinical Income Other Operating Income 50.0 9.0 45.0 8.0 40.0 7.0 PLAN 35.0 PLAN 6.0 30.0 ACTUAL 5.0 ACTUAL m m 25.0 4.0 20.0 3.0 10 11 12 13 14 15 16 15.0 2.0 10.0 1.0 5.0 - - Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 1 2 3 4 5 6 7 8 9 Other Operating Costs Employee Benefits Expenses 18.0 16.0 40.0 14.0 PLAN 35.0 PLAN 12.0 30.0 ACTUAL ACTUAL 10.0 25.0 m m 8.0 20.0 6.0 15.0 10 11 12 13 14 15 16 4.0 10.0 2.0 5.0 - - Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 EBITDA 3.0 2.5 2.0 m 1.5 PLAN ACTUAL 1.0 0.5 - 10
Confidential 2. Clinical Income CLINICAL INCOME YTD at month 6 Plan '000 1,705 Actual '000 1,705 Variance '000 Variance % Clinical income is 302k favourable to plan at month 6. Material variances to the plan are: Any Qualified Provider Bath & NE Somerset Block Berkshire Block Buckinghamshire Block Buckinghamshire Block - IAPT Buckinghamshire County Council Buckinghamshire S75 (pooled budget) Cost per Case Income CQUIN provision Department of Health & Social Care Income from NHS Trusts Nene Block NHS BSW NHS England Block NHS England Cost & Volume NHS England New Care Models NHS England FCAMHS NHS Northamptonshire Other CCGs Income Other Local Authority Oxfordshire Block - IAPT Oxfordshire Block - Learning Disabilities Oxfordshire Block - main contract Oxfordshire Block - OBC Oxfordshire Block - CAMHS Oxfordshire Cost & Volume Oxfordshire County Council Oxfordshire S75 (pooled budget) Personal Injury Compensation Private Patients Swindon Block Wales Cost & Volume Wiltshire Block Wiltshire Borough Council Clinical Income Total 0 0 0% 0% 0% 2% 0% -8% 6% -11% 0% 100% 5% 0% -24% 1% 0% 0% 0% -5% 23% -120% 8% 0% 4% -6% 1% 2% -6% 0% -30% 198% 0% 0% 0% 0% 0% 0 0 95 94 (0) 639 26,260 26,899 1. Bucks Block 639k favourable due to release of investment income to match expenditure 2. BCC 399k adverse due to Camhs Management & Neuro where budgets have been set for MHIS/SDF but the income is not yet allocated into the directorate position. 3. Additional Bucks S75 income 100k favourable. 4. Cost per case 135k adverse due to less income than planned in Oxfordshire Mental Health Community Teams. 5. BSW 1,843k adverse deferred investment income. 6. NHS England Block 305k favourable due to extra due to extra packages of care in inpatient CAMHS and secure 7. Other CCGs income 1,086 favourable due to additional income for which budget has not yet been set including income deferred from FY21 and additional income in the Buckinghamshire Continuing Healthcare service 8. Oxfordshire Block IAPT 364k favourable additional investment to match expenditure. 9. Oxfordshire Block Main - 324k favourable due to release of MHIS for which budget yet to be set. 10.OCC 350k adverselow productivity levels in Complex Care 0 0 0 5,102 1,796 1,209 4,703 1,896 1,073 (399) 100 (135) 0 0 0 0 0 0 941 991 50 0 0 0 7,713 52,996 329 5,870 53,301 329 (1,843) 305 0 0 0 0 0 546 467 4,649 546 443 5,735 (24) 1,086 (21) 364 17 (3) 4,508 3,451 53,968 30,015 5,716 3,612 6,003 902 4,871 3,451 56,070 28,237 5,801 3,696 5,653 902 (0) 2,102 (1,778) 85 83 (350) (0) (17) 56 29 0 452 39 87 0 452 58 0 0 0 0 302 0 0 259 259 212,798 213,100 11
Confidential 3. Non-Clinical Income NON-CLINICAL INCOME YTD at month 6 Plan '000 8,176 15,121 6,539 29,835 Actual '000 9,325 27,313 6,829 43,468 Variance '000 1,150 12,192 Variance % Education & Training Other Operating Income Research & Development Non- Clinical Income Total 14% 81% 4% 46% 291 13,633 Education & Training income 1,150k favourable due to 200k favourable by Health Education England LDA income for apprentices and trainees IAPT and CAMHS GMH in Bucks Directorate; 600km favourableHEE IAPT Trainees in OBSW directorate; increase in apprenticeship funding from HEE; 200k Other 150k favourable. Other Operating Income 12,192k favourable due to retrospective top up payments for the costs of the mass vaccination centres ( 11,365k), payments to final year students ( 78k), IM&T ( 774k) and 201k across other services (in particular Community Directorate services); partially offset with lower than planned sales in Oxford Pharmacy Store ( 526k). Research & Development income is 291k favourable due to additional income for the Novavax 221k study and additional income for the Academic Health Science Network ( 76k); other 6k adverse. 12
Confidential 4. Agency Temporary Staffing as % Total Pay Spend Temporary Staffing Spend Bank as % of Total pay Agency as % of Total pay Agency Actuals Bank Actuals Total Temp Staffing Actuals 27.00% 6,200,000.00 5,200,000.00 22.00% 4,200,000.00 17.00% 3,200,000.00 12.00% 2,200,000.00 7.00% 1,200,000.00 200,000.00 2.00% The Trust does not budget for agency costs but has included expected agency costs of 24.3m for months 1-6 in the plan submitted to NHSE/I. This includes 8.2m for the cost of staffing the mass vaccination centres. Excluding mass vaccination centres expected agency costs are 16.1m At month 6 16.7m has been spent on agency staff (excluding 12.3m for Covid related agency), 0.6m above plan. This is 11% of total staff costs (excluding covid related staff costs). Note that the graphs above exclude spend in the Covid-19 vaccination centres to show a normalised position. Please refer to the HR report for further details. 13
Confidential 6. Cost Improvement Plan PIP (CIP) Delivery at month 06 FY22 Project YTD Plan YTD Actual YTD Variance '000 '000 0 846 510 1,356 Full Year Plan Forecast '000 216 1,694 1,619 3,529 Forecast Variance '000 '000 '000 -216 -168 -519 -903 Agency Direct Enagagement Non Pay Expenditure Agency Reduction - improved recruitment Total 0 0 0 763 -83 -510 -593 1,526 1,100 2,626 0 763 The FY22 CIP Target is 3.5m phased 1.3m in H1 and 2.2m in H2. The target represents 0.9% of turnover which is less than pre-Covid-19. The savings as at the end of month 5 are 0.7m arsing from reduction in non-pay expenditure such as business miles and room hire costs. The YTD and forecast savings are 0.5m & 0.8m adverse to plan respectively. The primary reason for this is delay in CIP engagement due to Covid-19. 25
Confidential 7. Statement of Financial Position Statement of Financial Position as at 30th September 2021 Movement 31 March 2021 Month 5 FY21 Month 6 FY22 Year to date In month 1. Non-current assets have decreased by 2m in-year and increased 0.05m in month. The in-year decrease is largely driven by the M1- 6 depreciation charge of 3.1m and offset by capital additions of 1.1m. '000 '000 '000 '000 '000 Non-current assets Intangible Assets Property, plant and equipment Trade and other receivables 4,359 145,308 3,551 144,036 3,466 144,176 (893) (1,133) (85) 140 2. The in-year increase in the inventories balance of 1.3m is largely due to the rollout of a new DHSC backed surgery drug (to make up for shortages in the equivalent Pfizer drug). 187 187 187 0 0 55 149,854 Total non-current assets 147,774 147,829 (2,025) 3. Trade and other receivables have increased by 14.5m in year and by 7.1m in month. Most of the in-year increase is due to accrued income of 6.8m in relation to retrospective vaccination costs from NHSE for the 2nd quarter, 3.8m of CCG income not received in M6 and 0.8m of M6 NIHR R&D income. The in-month increase is due to an extra months accrued income in relation to vaccination costs of 2.1m, and the 3.8m of CCG income referred to above. Current Assets Inventories Trade and other receivables Non-current assets held for sale Cash and cash equivalents Total current assets 1,609 13,480 3,122 20,848 2,888 28,011 1,279 14,531 (233) 7,163 0 (7,484) (555) 0 0 0 55,697 70,786 60,229 84,199 52,745 83,644 (2,952) 12,858 Current Liabilities Trade and other payables Borrowings Other financial liabilities Provisions Deferred income 4. Cash has decreased by 2.9m in year and 7.4m in month. The-in year decrease is in line with the cash flow statement and the in- month movement reflects the movements on the SOFP, specifically in relation trade and other receivables / payables (notes 3 and 5). (54,258) (1,919) (1,968) (1,741) (9,687) (54,916) (2,211) (1,968) (1,758) (18,938) (52,550) (1,923) (1,968) (1,795) (20,140) 1,708 (3) 2,366 289 0 (36) (1,202) 0 (54) (10,454) 5. Trade and other payables have decreased by 1.7m in year and 2.3m in month. The in-year decrease can largely be accounted for by a 3.9m decrease in trade payables, offset by a 2.2m increase in the Tax/NI & Pension liability due to the recent pay award. (69,573) Total Current Liabilities (79,792) (78,376) (8,803) 1,416 Non-current Liabilities Trade and other payables Borrowings Provisions Other Liabilities Total non-current liabilities Total assets employed 0 0 0 0 (17,723) (3,868) (1,351) (22,942) 128,125 (17,494) (3,709) (1,351) (22,553) 129,628 (16,779) (3,726) (1,351) (21,856) 131,241 944 142 715 (17) 0 698 1,614 6. Deferred income has increased by 10.5m in year and 1.2m in- month. Most of the increase in year can be attributed to the 7.2m ( 5.4m in M5) deferral of SDF/SR funding. This deferred income/expenditure is expected to unwind over the course of the year. 0 1,086 3,116 Financed by (taxpayers' equity) Public Dividend Capital Revaluation reserve Other reserves Income & expenditure reserve 99,119 19,180 99,120 18,941 99,120 18,911 1 0 7. Borrowings have decreased 0.9m in-year in line with the capital repayments against the outstanding PFI liability and DH loan. (269) (30) 0 0 0 0 9,827 11,566 13,210 3,383 1,643 8. The in-year movements in the I&E reserve reflect the Trust s reported surplus for the first half of the year. 128,125 Total taxpayers' equity 129,628 131,241 3,116 1,614 26
Confidential 8. Cash Flow Summary Notes STATEMENT OF YEAR TO DATE CASH FLOWS The cash flow movements are consistent with the comments made on the Statement of Financial Position. Month 6 FY22 Actual '000 Plan '000 Variance '000 The closing cash position at Month 6 was 52.7m. Cash flows from operating activities Operating surplus/(deficit) from continuing operations Operating surplus/(deficit) from discontinuing operations Operating surplus/(deficit) 5,086 5,470 (384) 0 0 0 5,086 5,470 (384) FIC Cashflow Forecast Non-cash income and expense: Depreciation and amortisation Impairments and profit on disposal of assets Income recognised in respect of capital donations (cash and non-cash) (Increase)/Decrease in Trade and Other Receivables (Increase)/Decrease in Inventories Increase/(Decrease) in Trade and Other Payables Increase/(Decrease) in Deferred Income Increase/(Decrease) in Provisions Other Movements in Operating Cashflows NET CASH GENERATED FROM/(USED IN) OPERATIONS 3,149 3,088 61 0 0 0 0 70 (38) (38) (14,523) (1,279) (1,394) (13,129) (123) (1,340) (1,425) 8 0 4,284 60 (1,156) 2,069 11,879 (96) 729 10,454 (88) 50 0 0 40 m 3,489 (795) Actual 30 Forecast Cash flows from investing activities Interest received Purchase of Non Current Assets Sale of PPE Net cash generated from/(used in) investing activities 12 12 0 20 (3,423) (6,101) 2,678 0 0 0 10 (3,411) (6,089) 2,678 0 Cash flows from financing activities Public dividend Capital Received Loans received Loans repaid Capital element of lease rental payments Capital element of Private Finance Initiative Obligations Interest paid Interest element on leases Interest element of Private Finance Initiative obligations PDC Dividend paid Net cash generated from/(used in) financing activities Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 0 0 0 0 0 0 0 0 FY22 (669) (669) 0 0 (276) (344) (253) (351) (22) 7 0 0 0 (532) (1,211) (3,031) (620) (1,258) (3,151) 88 47 120 (2,952) 55,697 52,745 (4,956) 55,697 50,741 2,004 Increase/(decrease) in cash and cash equivalents Cash and Cash equivalents at 1st April Cash and Cash equivalents at 30th September 0 2,004 27
Confidential 9. Working Capital Indicators Working Capital Ratios Ratio Target Actual Risk Status Debtor Days 30 30 Debtors % > 90 days 5.0% 24.9% Creditor Days 30 37 BPPC NHS - Value of Inv's pd within target (ytd) 95.0% 85.4% BPPC Non-NHS - Value of Inv's pd within target (ytd) 95.0% 90.8% Cash ( m) 50.7 52.7 Summary Notes Debtor days at month 6 are on target. Debtors % over 90 days are below target due to overdue invoices, specifically with Oxfordshire CCG 607k and Oxfordshire County Council 413k The Creditor days position is below plan due to the high level of accruals for NHS and Non-NHS suppliers and the below target BPPC figures. NHS BPPC (which represents 24% of non-pay expenditure) is below target (and 91.6% in month) Non-NHS BPPC (which represents 76% of non-pay expenditure) is marginally below target (and 94.2% in month) The BPPC process has been refined and updated and an action plan put in place to resolve many of the underlying issues so these figures will improve going forward. This includes: a specific payables/creditor review to be part of the internal month-end scrutiny and reporting process, a review of all invoices of 10k and over that miss or are going to miss the target, regular communication to approvers and receipters and targeted communications and training for the worst offenders. The existing P2P (procure to pay) improvement project will increase the number of system/PO-backed transactions which will improve the speed and flow of invoice approvals and produce efficiencies. Cash is better than target, as outlined in section 7 and 8. 28
Confidential 10. Capital Investment Programme FY22-CAPITAL EXPENDITURE REPORT-SEPTEMBER ( M6) Year To Date 000 FY22 YTD Actual Expenditure (C) YTD Plan (B) Variance (B-C) Planned Schemes Original Plan (A) Estates IT 6,002 1,230 2,605 410 588 105 2,017 305 PFI Highfield PICU Global Digital Exemplar DoH Funding FY19 Other Project 100 50 10 427 (88) 40 3,800 1,813 1,386 - - 88 Medical Equipment 186 100 84 16 Sub total Revenue Backed Projects Other IT EPMA Other Dental Total Grand Total 11,318 5,064 1,126 3,938 777 314 777 314 777 314 - - 1,091 12,409 1,091 6,155 1,091 2,217 - 3,938 The final FY22 capital plan was submitted to NHSI on the 22nd June for 12.4m in line with the initial ICS allocation of 9.4m and 3.0m of external funding for the PICU project. However, due to a 12.3m funding shortfall in the ICS capital plan for FY22, Oxford Health s capital envelope has been revised downwards by 1.1m to 11.3m. The Trust will therefore underspend against its capital plan for the year by 1.1m ( 1,091k variance as above). The Trust is still committed to spending the full 12.4m as originally planned, so the 1.1m of projects referred to above will be charged to revenue. These include the 0.8m EPMA (part of the Global Digital Exemplar Programme) project and 0.3m of medical equipment. These revenue projects will be funded by the ICS via a separate ERF funding stream. The actual net spend to the end of September 2021 is 2,217k which includes the revenue backed projects totalling 1,091k. 29
Confidential 11. Reconciliation to NHSE/I Template The financial figures reported in this report are taken directly form the finance ledger. The financial figures reported to NHSE/I each month differ from these figures as they exclude income and costs related to the Section 75 pooled budget and are some minor adjustments to the categories certain items are reported under. The table below provides a reconciliation between the figures reported in this board report to the figures reported on the NHSI template. YTD Actuals at month 6 FY22 National supplied PPE Remove Section 75 Income and Costs Category Changes Board Report NHSI Template m m -1.9 m m m Clinical Income Other Operating Income Operating Income, Total 213.1 43.4 256.5 211.2 43.4 254.6 -1.9 0.0 0.0 Employee Benefit Expenses (Pay) Other Operating Expenses Operating Expenses, Total 166.2 82.1 248.3 -1.7 -0.2 -1.9 164.5 81.9 246.4 0.0 0.0 Non-Operational Income 0.0 EBITDA 8.2 0.0 0.0 0.0 8.2 Profit/(Loss) on asset disposal Depreciation and Amortisation Asset Impairment Interest Other Finance Charge PDC Dividend 0.0 3.1 0.0 0.4 0.4 1.1 0.0 3.1 0.0 0.4 0.4 1.1 Surplus/ (Deficit) 3.1 0.0 0.0 0.0 3.1 30
