Financial Performance Report - December 2022
The December 2022 financial report highlights a positive forecast outturn, with capital expenditure lower than planned and income exceeding expectations. The Trust is committed to achieving a forecast surplus through careful monitoring of expenses and seizing emerging opportunities. Despite challenges in the Community directorate, strategic adjustments are being made to improve overall financial performance.
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Caring, safe and excellent For Information Finance Report December 2022 (Month 9), FY23 Report to Board of Directors Contents Executive Summary 1. Income Statement & Forecast Outturn 2. Forecast Movement from Previous Month 3. Forecast Risks & Opportunities 4. Directorate Financial Performance 5. Provider Collaborative Financial Performance 6. Covid-19 costs 7. Pay Trends 8. Agency Analysis 9. Cost Improvement Plan 10. Out of Area Placements 11. Statement of Position 12. Cash-flow 13. Working Capital Indicators 14. Capital Investment Programme 15. Reconciliation to NHSE/I 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
Caring, safe and excellent Executive Summary Capital Expenditure YTD - 4.8m, lower than plan Forecast - 2.6m above funding allocation including risks. Income & Expenditure position YTD - 2.2m better than plan Forecast - 3.0m better than plan The forecast continues to be better than plan by 3.0m Cash Actual 81.0m Forecast 59.0m Risks = 6.1m Opportunities = 8.8m Net = 2.7m Highlights: The Trust has committed to a forecast outturn of 3.0m better than plan with the Buckinghamshire, Oxfordshire & Berkshire West Integrated Care System (BOB ICS). This takes into account agreed non-recurrent spend for this year. The Community directorate continues to be the main area of concern with a forecast outturn of 8.3m worse than plan. The month 9 position included an increase in the personal injury provision of 1.2m due to a settlement reached on a case through HR. This was not in the previous month s forecast. The forecast now includes 1.0m additional spend for Mental Health Out of Area Placements (OAPs) due to an increase in placements in December and January. This was identified as a risk last month. The base forecast also now includes agreed unbudgeted non-recurrent spend in directorate positions. The base forecast has worsened to 2.5m better than plan with these changes, but it is expected that some opportunities will be realised before year-end to make the forecast of 3.0m better than plan still achievable. 2
Caring, safe and excellent 1. Income Statement & Forecast Outturn INCOME STATEMENT Month 9 Year-to-Date Forecast Plan m 38.8 5.8 44.7 27.9 16.2 44.1 0.5 1.3 (0.7) 0.0 (0.7) Actual m 39.1 13.8 52.9 29.3 23.4 52.7 Variance Plan m 345.6 48.9 394.5 255.5 131.1 386.6 7.9 11.5 (3.6) 0.1 (3.6) Actual m 353.5 76.0 429.5 264.2 155.8 420.0 Variance Plan m 465.0 66.3 531.3 343.4 178.8 522.2 9.1 15.3 (6.2) 0.1 (6.1) Forecast Variance m 0.3 7.9 8.2 (1.4) (7.2) (8.6) (0.3) 0.2 (0.1) 0.0 (0.1) m 7.9 27.1 35.0 (8.7) (24.6) (33.4) 1.6 0.6 2.2 (0.1) 2.2 m 472.6 96.0 568.6 352.0 205.8 557.7 10.9 14.5 (3.7) 0.1 (3.6) 0.5 (3.1) m 7.6 29.8 37.3 (8.6) (27.0) (35.5) 1.8 0.7 2.5 0.0 2.5 0.5 3.0 Clinical Income Other Operating Income Operating Income, Total Employee Benefit Expenses (Pay) Other Operating Expenses Operating Expenses, Total EBITDA Financing costs Surplus/ (Deficit) Adjustment for gains on disposal of assets Adjusted Forecast Surplus/ (Deficit) Amounts held to recognise emerging opportunities Forecast Surplus/ (Deficit) 0.2 1.0 9.5 10.8 (1.4) (0.0) (1.4) (0.8) 0.0 (0.8) (6.1) Year-to-Date Performance The Trust reports a 1.4m deficit at month 9, which is 2.2m better than plan. This includes a 5.9m overspend in the Community Directorate, offset by a 5.6m underspend on Covid-19 funding, a breakeven position across Mental Health Directorates, 1.3m unutilised reserves, favourable variances in Oxford Pharmacy Store ( 0.4m), Research & Development ( 0.8m) and Corporate ( 0.6m) and a 0.6m underspend on Financing costs. 3
Caring, safe and excellent Forecast Outturn The Trust s Forecast Outturn is for a 3.1m deficit, which is 3.0m better than plan. Last month the forecast included a 2.6m of contingency for risks and additional spend for known backlogs across several services that the Trust is addressing with non recurrent resources. This additional spend has now been agreed and this is included in the base forecast. The forecast discounts the agreed additional spend amounts by 0.5m agreed due to the operational challenge of delivering these activities before the end of March. The forecast is based on the YTD trend continuing with adjustments for known changes. The main points to note are: Costs related to the Warneford Park project of 1.4m have been included. Additional non-recurrent spend agreed by the Executive Team is included: 1.8m for urgently required maintenance, 1.5m in Mental Health directorates, 0.2m for beds in Community Hospitals, 0.1m for HR system development, 0.4m for additional neuro-developmental collaborative assessments in CAMHS. 0.3m has been included in the year-to-go position for costs relating to the system outage. Overtime payments in the clinical systems team have not yet been paid and additional admin staff are expected to be required to enter backlog information onto the new systems. Additional costs for winter pressures have been included in the forecast for Community Hospitals and the GP Out of Hours service but not other services. Income will be deferred for Provider Collaboratives underspends (so that this can be invested next year) and unspent System Development Funding (SDF) will also be deferred as has been done in previous years Reductions in agency spend due to initiatives from the Improving Quality Reducing Agency programme are not in the forecast and are an opportunity for it to improve. The new staff bank arrangements are due to be in place from 23 January. Costs for the implementation of the new clinical information systems are included in the forecast The forecast for Oxford Pharmacy Store includes 1.1m of additional profit above plan from contracts with the Department for Health & Social Care. An increase of 1.0m in the forecast spend on Mental Health Out of Area Placements due the increase in placements in December and January. An assumption that 1.1m of unspent funding in BSW CAMHS will be deferred to next year. 4
Caring, safe and excellent 2. Forecast movement from previous month Increase = Favourable change Decrease = Adverse change The month 9 base forecast worsened by 3.2m from the forecast at month 8 and the graph above illustrates the main movements. The adjusted forecast has remained the same with a favourable variance to plan of 3.0m as the non-recurrent spend has now been agreed and included in the base forecast. The release of SDF income relates to income released to match expenditure which has been already incurred following an exercise to reconcile what has been spent so far. 5
Caring, safe and excellent 3. Forecast Risks & Opportunities Risks Additional winter pressures Balance sheet adjustments Residential care s117 risk Agreed non-recurrent spend '000 1,000 3,000 1,800 281 6,081 Likelihood High Medium Medium Medium There are 6.1m of risks and 8.8m of opportunities to the forecast. This gives a forecast range of between 11.8m better than plan and 3.1m worse than plan. Taking into account only those risks and opportunities assessed as high likelihood there is a forecast range of between 3.5m better than plan and 2.0m better than plan. Opportunities Underspend on agreed NR spend Additional income Release of provision for wellbeing day Underspend on agreed NR spend Agency reduction OPS more DHSC contracts Estates works in R&D forecast that may not happen Restatement of DHSC loan '000 Likelihood 500 1,488 1,005 1,000 1,000 700 100 3,006 8,799 The forecast assumes that the Trust will defer at least 15.5m of income at year-end, of which 10.9m relates to Provider Collaboratives. High Medium Medium Medium Medium Medium Medium Low The balance sheet adjustments risk represents the risk of audit opinion requiring the Trust to adjust balance sheet values with an effect on the revenue position. Forecast range - all risks and opportunities Forecast range - high likelihood risks and opportunities Full Year Budget Upside Forecast -6,129 Downside Forecast -6,129 Full Year Actual -2,629 -4,129 Forecast Outturn to Plan 3,500 2,000 Full Year Budget -6,129 -6,129 Full Year Actual 5,670 -9,210 Forecast Outturn to Plan 11,799 -3,081 '000 '000 Upside Forecast Downside Forecast 6
Caring, safe and excellent 4. Directorate Financial Performance Month 9 Year-to-Date Forecast Plan m 2.2 0.3 0.3 0.2 0.7 3.7 1.0 (5.3) 0.0 (0.1) 0.1 1.0 0.5 Actual m Variance Plan m 16.9 7.8 2.4 1.5 6.6 35.2 9.2 (47.7) 0.2 (0.6) 1.2 10.3 7.9 Actual m 18.4 Variance Plan m 23.6 11.8 3.3 2.1 8.8 49.5 12.3 (63.5) 0.3 (0.8) 1.6 9.7 9.1 Forecast Variance Directorate Oxfordshire & BSW Mental Health Buckinghamshire Mental Health Forensic Mental Health Learning Disabilities Provider Collaboratives MH Directorates Total Community Services Corporate Oxford Pharmacy Store Research & Development Covid-19 Costs Reserves EBITDA m (0.6) (0.3) (0.3) 0.2 (0.1) (1.1) (0.8) (0.2) 0.2 0.4 0.6 0.6 (0.3) m 1.4 (1.2) (0.7) 0.3 0.2 (0.0) (5.9) (0.6) 0.4 0.8 5.6 1.3 1.6 m 21.9 9.2 2.2 2.4 8.8 44.5 4.0 (67.0) 1.5 (0.2) 9.1 19.0 10.9 m (1.6) (2.5) (1.1) 0.3 0.0 (4.9) (8.3) (3.6) 1.1 0.6 7.5 9.3 1.8 1.6 (0.0) 0.0 0.3 0.6 2.5 0.3 (5.5) 0.2 0.4 0.8 1.6 0.2 6.5 1.7 1.8 6.8 35.2 3.2 (48.2) 0.7 0.1 6.8 11.7 9.5 The Corporate position includes 4.7m of agreed spend which is not budgeted for but which offsets with the Reserves underspend - made up of: 1.5m for clinical system costs that were originally in the capital plan, 1.4m for costs related to the Warneford Park development and 1.8m for non-recurrent necessary maintenance costs. The Provider Collaboratives position is reported as breakeven as any underspends will be carried forward for investment next financial year. The actual position against budget of the Provider Collaboratives is detailed in this section below. The following pages include more details on the financial position of each directorate. 7
Caring, safe and excellent Oxfordshire & BSW Mental Health Month 9 Year-to-Date Forecast Plan '000 228 (585) (139) (524) 350 (89) (86) 198 82 2,529 45 227 40 (127) 138 41 96 (85) (115) (36) 24 (39) 23 2,195 Actual '000 154 (725) (255) (791) 221 (70) (52) Variance Plan '000 2,036 (5,298) (1,261) (4,713) 3,139 (804) (784) 1,788 709 22,721 390 2,029 356 (1,144) (552) 365 859 (772) (1,826) (328) 219 (347) 153 16,937 Actual '000 1,358 (6,441) (2,042) (6,895) 3,196 (459) (713) 828 3,726 24,304 244 1,228 579 (3,264) 463 957 994 (680) (1,399) (336) 302 (525) 2,940 18,365 Variance Plan '000 2,720 (7,054) (1,678) (6,284) 3,967 (1,070) (1,043) 2,382 956 30,603 525 2,709 476 (1,525) (135) 707 1,146 (1,026) (2,432) (438) 292 (462) 221 23,558 Forecast '000 1,820 (8,636) (2,716) (9,208) 3,983 (653) (975) 1,076 4,392 32,703 Variance Service Line Adolescent Mh Inpatient Adult Mh - Acute Inpatient Adult Mh -Picu Adult Support Adults Management & Indirect Complex Needs Service Early Intervention Service Eating Disorders Inpatient Iapt Mh Community Teams Older People Community Mh Older People Mh Inpatient Ox Comm Adult Eating Disorders Oxford Out Of Area Oxon Camhs Oxon Mental Health Urgent Care Oxon Perinatal Service Psychiatric Liaison Services Psychological Therapy Services Recovery College Residential Care Sil Contracts BSW Camhs EBITDA '000 (73) (140) (116) (268) (129) 19 35 (166) 313 101 (30) (86) 25 (404) (49) 62 36 34 (32) (8) '000 (678) (1,143) (781) (2,182) '000 (899) (1,582) (1,037) (2,924) 58 345 71 (960) 3,017 1,583 (146) (801) 223 (2,120) 1,015 592 135 16 417 69 32 395 2,630 15 140 65 (531) 89 102 132 (51) (147) (44) 25 (50) 316 1,601 (1,306) 3,436 2,100 (273) (1,063) 297 (3,110) 912 725 149 252 1,646 773 (4,635) 777 1,432 1,295 (954) (1,993) (426) 391 (672) 2,245 21,919 92 427 (8) 83 (179) 2,788 1,429 72 439 12 99 (210) 2,024 (1,639) 1 (11) 293 (594) 8
Caring, safe and excellent Oxfordshire & BSW Mental Health (cont.) Year-to-Date Performance The Directorate is reporting a favourable position of 1,429k at the end of December driven by the following: Agency use and premiums within Medical and inpatient services ( 5.8m adverse) Out of area inpatient placements driven by Acute & Female PICU beds ( 2.1m adverse) Slippage in IAPT recruitment against Long Term Plan projections which will be resolved in FY24 ( 3.0m favourable) Vacancies across Oxon CAMHS, BSW CAMHS, MH Community Services, Urgent Care, Complex Needs, Management & Community Eating Disorders, Perinatal & Psychological Therapies ( 6.3m favourable) Forecast Outturn The Directorate is forecast to be 1.6m adverse at the year end which represents a worsening of 3.0m against the year to date position. The main assumptions driving this are: Income deferrals of 1.1m against BSW CAMHS confirmed which were previously shown as a risk. This will enable the service to deliver more activity next financial year. A worsening of 600k against Out of Area Placements due to an increase in placements in December. Additional spend of 1.3m within the directorate for one off spend items approved by the Executive Team. Risks and Opportunities Items not included in the forecast which may represent a risk to the financial position are as follows: 1.8m of income expected from Oxfordshire County Council towards Residential Care overspend linked to Section 117 needs. Items not included in the forecast which may present a benefit to the financial position are as follows: An increase of SDF income for the Crisis & Home Treatment team for which expenditure is already forecast 197k An increase in SDF income for the CAMHS Keyworker Pilot for which expenditure is already forecast 502k Actions Required Further work with Inpatient areas and Medical to reduce agency spend Recurrent plans for the Cost Improvement target (this is being met non recurrently in FY23) 9
Caring, safe and excellent Buckinghamshire Mental Health Month 9 Year-to-Date Forecast Plan '000 (293) 266 353 (86) 17 256 Actual '000 (800) 215 304 251 Variance Plan '000 3,613 950 3,170 (32) 69 7,770 Actual '000 2,236 735 2,804 705 Variance Plan '000 6,217 1,229 4,228 (29) 121 11,765 Forecast '000 3,671 Variance Service Line Buckinghamshire Adults Buckinghamshire Camhs Buckinghamshire Older People Bucks Psychological Therapies Bucks Social Care EBITDA '000 (507) (50) (49) 337 (15) (284) '000 (1,377) (215) (366) 737 (14) (1,235) '000 (2,546) (274) (516) 796 955 3,711 767 121 9,224 2 55 () (27) 6,535 (2,540) Year-to-Date Performance Buckinghamshire Mental Health reports a YTD adverse variance of 1,235k. The main drivers of this position are: Adults - Overspends in Medical ( 1.2m) and Inpatient teams ( 1.1m) driven by agency premiums & an overspend on Out of Area Placements (OAPs) of ( 0.2m). These are offset by 1.1m of underspends in Urgent care, Community Mental Health Teams (driven by Community Mental Health Framework & Additional Roles Reimbursement Scheme (ARRS) underspend), Perinatal & Management teams driven by vacancies and reduced non pay spend due to changes in ways of working. CAMHS Overspends in Medical( 0.3m) & Risk Support ( 0.1m) driven by agency premiums. Unfunded posts in Neurodevelopment ( 0.3m) due to service pressures. Offset by underspend of 0.5m in the Vulnerable, Learning Disabilities, Getting more Help & Mental Health Support teams due to vacancies. Older Adults Overspends on Medical and Inpatient teams driven by agency premiums ( 0.5m) . Offset by 0.1m underspend on Older Adults CMHTs due to vacancies. Psychological Therapies Underspend of 0.7m driven by psychologist vacancies & non pay underspend in IAPT against contracts. Forecast Outturn The Directorate is forecast to be 2.5m adverse to budget with existing agency spend pressures expected to continue in line with current trends. The year end position represents a significant worsening against the YTD position. The main assumptions driving this are: 0.2m of planned spend in Psychological Therapies to help deal with waiting lists and utilise underspend from vacancies. 0.2m of spend on Learning Disabilities nurse support for a complex patient on 2:1 observations. 0.3m of non recurrent spend items as agreed by the Trust s Executive Team. ( 0.6m was agreed but it will be difficult for some of this to be spent this financial year). 0.3m Increased spend for Out of Area Placements due to the current high number of patients in these placements. 10
Caring, safe and excellent Buckinghamshire Mental Health (cont.) Risks and opportunities Items not included in the forecast which may represent a risk to the financial position are as follows: 200k estimated increase in agency related to winter pressures (sickness cover in inpatient areas) 200k estimated potential further Healios spend within CAMHS for neurodevelopmental assessments. 280k of non-recurrent spend not included in forecast due to likelihood it is not spent by year end. Items not included in the forecast which may represent a benefit to the financial position are as follows: 750k related to SDF underspends against Community Mental Health Framework which are expected to be deferred into FY24 550k of Non Recurrent income in CAMHS Neurodevelopment for which only 440k spend proposals have been identified. (Only 295k of the spend and income is in forecast the rest is expected to be deferred into FY24). 100k Winter pressures funding for items of spend currently in the forecast. Actions Required Further work with Inpatient areas and Medical to reduce agency spend Recurrent plans for the Cost Improvement target Begin planning with service leads for next year s budgets Agree plans for SDF underspend and deferral into FY24 Ensure services action non-recurrent spend plans before the end of the financial year 11
Caring, safe and excellent Forensic Services Forensic Services Month 9 Year-to-Date Forecast Plan '000 (20) 85 389 245 (391) (37) 36 (5) 302 Actual '000 (20) Variance Plan '000 (205) 759 3,467 2,174 (3,521) (335) 109 (49) 2,399 Actual '000 (167) 493 3,037 2,200 (3,872) (321) 340 (57) 1,654 Variance Plan '000 (266) 1,014 4,633 2,910 (4,694) (446) 218 (65) 3,304 Forecast '000 (230) Variance Service Line Forensic Community Mh Forensic Mh - Pre Discharge Forensic Mh Services - Msu Forensic Mh Services -Lsu Forensic Support Management & Indirect Prison In Reach Services Recovery College EBITDA '000 '000 38 (266) (430) 26 (350) 14 231 (8) (746) '000 36 (334) (573) (62) (475) (26) 360 (9) (1,084) () 52 233 163 (454) (49) 104 (6) 22 (33) (156) (82) (63) (12) 68 (1) (279) 679 4,060 2,848 (5,169) (472) 578 (75) 2,220 12
Caring, safe and excellent Forensic Services (cont.) Year-to-Date Performance Forensic Services report a 746k adverse YTD position due in main to a 670k overspend on Forensic Wards (agency costs, numbers above establishments due to acuity, and penalties for bed day occupation), and 350k adverse position in Forensic Support due to agency Consultant usage and pressure on the PFI budget. These are offset with favourable positions in the new Prisons service due to the current high level of vacancies ( 231k). Forecast Outturn The forecast outturn is 1,084k adverse to budget driven by continued pressure on Forensic wards (although agency usage is reducing throughout, and bed occupancy has improved apart from Thames House). Additionally, the forecast assumes that Consultant agency usage within Forensic Support will continue, along with the PFI spend. CIP plans are not based around a direct reduction in spend, so this is currently showing as a pressure offset against a forecast favourable position in the new Prison Service, which is very understaffed currently and the forecast includes a substantial underspend ( 360k) for this service. Risks and opportunities The main risks to the forecast outturn are any worsening on bed occupancy or agency usage. Opportunities are centred around developing CIP plans. Actions required The Directorate Accountant to work with Financial Accounts to see how much budget can be transferred from Interest Payable, to assist with covering the increasing PFI cost profile in Forensics. CIP plans need to be developed to meet the CIP targets recurrently Continued focus on reducing agency spend 13
Caring, safe and excellent Learning Disabilities Learning Disabilities Month 9 Year-to-Date Forecast Plan '000 174 174 Actual '000 341 341 Variance Plan '000 1,546 1,546 Actual '000 1,810 1,810 Variance Plan '000 2,067 2,067 Forecast '000 2,379 2,379 Variance Service Line Lds Pathway EBITDA '000 167 167 '000 263 263 '000 311 311 Year-to-Date Performance Learning Disabilities are currently in a 263k favourable position, due to having a large number of vacant posts throughout the year (pay is 692k favourable as a result, there are plans to recruit in FY24), and 100k of income received over budget (mainly one-off funding from FY22 for equipment purchases in FY23), offset against 528k adverse variance in non-Pay expenditure, mainly in relation to inpatient admissions over budgeted level. Forecast Outturn The Forecast Outturn is 311k favourable variance at year, which is a continuation of the current high level of vacancies (with some recruitment in Q4), and a reduction in inpatient admissions spend as service users are discharged. Risks and opportunities Current risks are centred around inpatient admissions Learning Disabilities admissions are extremely expensive, so can materially affect the financial position. Opportunities are centred around developing CIP plans (FY23 remaining target 48k). Actions required Development of CIP plans Working towards a two-team Community structure for FY24, and recruitment to vacancies 14
Caring, safe and excellent Community Services Month 9 Year-to-Date Forecast Plan '000 41 99 418 (1) (7) 154 (239) 568 Actual '000 (50) Variance Plan '000 311 891 3,719 (5) (44) 1,358 (2,160) 5,090 Actual '000 (162) 873 108 (14) (1,533) 2,771 (2,428) 3,625 -22 3,218 Variance Plan '000 436 1,189 4,973 (7) (64) 1,821 (2,876) 6,795 Forecast '000 Variance Service Line Children & Yp Care Community Dental Service Community Rehabilitation Complex Care Community Service First Contact & Primary Care Integrated Intensive Community Care Management Planned & Preventive Care Primary Care Services EBITDA '000 (91) (24) (245) '000 (473) (18) (3,611) '000 360 (25) (5,409) 796 1,164 (436) 75 173 () (9) 0 7 (394) 360 (351) 461 (387) 206 (112) (108) (1,489) 1,413 (268) (1,465) (22) (5,943) (2,103) 3,159 (3,359) 4,805 (22) 4,002 (2,040) 1,338 (483) (1,990) (22) (8,266) 0 0 0 0 0 1,036 275 (761) 9,161 12,268 15
Caring, safe and excellent Community Services (cont.) Year-to-Date Performance The Community YTD position is 5,943k adverse to budget. The main drivers for the position are the following: Community Hospitals 3,611k adverse due to pay variance of 3,476k with 1,842k Agency spend and 1,645k Sessional staff expenditure. First Contact and Primary Care 1,489k adverse driven by 1,348k pay expenditure due to high agency spend in GP Out of Hours and the Minor Injuries Units at 994k and 554k respectively. Sessional staffing spend is 510k across the pathway. This includes a pay uplift of 40% which was agreed for all staff for the Christmas and New Year Period. The Directorate leadership team have undertaken an innovation week redesign of the service clinical and operating model of GP Out of Hours, leading to development of a new costed model with an operational saving on paper of c. 1 million per year, although further work is ongoing to verify this position. Continuing Healthcare (CHC) is 904k adverse to budget due to high agency spend in Buckinghamshire and Oxfordshire CHC totalling 1,043k; 179k adverse in Oxfordshire CHC due to over establishment and unfunded care packages; Children s CHC unfunded care packages and over establishment 167k adverse. These are offset by 582k favourable variance in Buckinghamshire CHC due to high vacancies. Forecast Outturn Community forecast outturn is 8,266k adverse to budget based on the continuation of pressures in the Community Hospitals, GP Out of Hours and Continuing Healthcare adjusted for winter pressures modelled on the trend for the last 3 years. The forecast takes into account the additional income of 620kfor Children s Integrated Therapies and 425k for the Children s Virtual Ward. Risks and opportunities There is always some uncertainty as to the accuracy of the forecast due to winter pressures being more or less than the modelling used in the forecast. Community Hospitals, the GP Out of Hours (OOH) and Urgent Care Response (UCR) services are under increased pressure this time of year, so there is a possibility that the forecast will be worse as a result of additional shifts in GP OOH services and the need to offering higher pay rates to fill them, and the increase of agency usage in the other areas. Actions needed Agency spend across the directorate is very high especially in Community Hospitals a plan to reduce this is needed. Finance to support service developments and transformation work. 16
Caring, safe and excellent Corporate Services Month 9 Year-to-Date Forecast Plan '000 (985) (1,666) (326) (853) (463) (48) (481) (436) Actual Variance '000 (1,252) (1,869) (491) (607) (453) (49) (464) (446) 146 (16) (5,500) Plan '000 (8,893) (15,021) (2,950) (7,899) (4,175) (436) (4,422) (3,928) Actual '000 (9,800) (15,648) (4,040) (6,947) (4,120) (337) (3,848) (3,911) Variance '000 (907) (627) (1,089) Plan '000 Forecast '000 (13,487) (22,002) (5,635) (9,673) (5,589) (465) (5,261) (5,299) Variance '000 (1,638) (1,985) (1,705) Service Line Digital & Transformation Estates & Facilities Finance Human Resources Medical Services Mental Health Directors Nursing & Clinical Standards Office Of Ceo Ox Inst Of Clin Psych Training Staff Bank EBITDA '000 (267) (204) (164) 247 10 (1) 16 (10) 147 (16) (241) (11,849) (20,017) (3,929) (10,459) (5,564) (581) (5,865) (5,235) 952 55 99 574 17 400 (31) (558) 785 (25) 116 604 (64) 378 (31) (1) 46 445 (31) 42 421 (31) (5,260) (47,679) (48,237) (63,457) (67,020) (3,563) Year-to-Date Performance The Corporate Services YTD position is 558k adverse against budget. The main drivers of this are: The Finance overspend of 1,089k mainly due to the Warneford Park project which is not budgeted for ( 893k YTD) and which is being temporarily held in Finance. Digital & Transformation is 907k adverse, mainly due to costs that were in the capital plan now being accounted for as revenue costs. Estates & Facilities 0.6m adverse due to pressure on SCAS contract, and starting works on one-off back log maintenance. The Human Resources underspend of 952k, made up of 130k vacancies in HR, 138k from non-pay underspend which is due to additional budget for HR systems to be spent in this financial year and reflected in the forecast for M10-12, BOB ICS income for Workforce Development 78k, Backdated apprenticeship income for End point assessments & Nurse top up programmes 250k, Oxfordshire Training Hub contribution of 74k. The balance is driven by non pay underspend due to ongoing discussions around estates use at Unipart and 120k of invoices outstanding for secondments into Health Education England funded project posts. The Nursing & Clinical Standards underspend of 574k is driven by new transformation funding in the Oxford Health Improvement team resulting in vacancies which are actively being recruited to the forecast assumes that these vacancies will be filled in the coming months. The Oxford Institute of Clinical Psychology Training favourable variance of 400k is due to additional cost per case income and contribution on Health Education England income contracts. 17
Caring, safe and excellent Corporate Services (cont.) Forecast Outturn The Forecast Outturn for Corporate Services is 3.6m worse than budget. This includes 4.7m of agreed spend which is not budgeted - 1.5m for clinical system costs that were originally in the capital plan (Digital & Transformation), 1.4m for costs related to the Warneford Park development (Finance) and 1.8m for non-recurrent backlog maintenance costs (Estates & Facilities). Other pressures include an increase in the South Central Ambulance Service patient transport contract in Estates & Facilities ( 407k) partly offset with other underspends and a historical pressure on clinical contracts with Oxford University Hospitals (mainly Pathology) show in the Finance position ( 305k). These are offset with continued underspends in Human Resources, Nursing & Clinical Standards and the Oxford Institute of Clinical Psychology Training. Risks and opportunities The forecast may improve if additional costs included in the year-to-go position for clinical system development and backlog maintenance costs are less than planned due to the time constraint of completing the work before the end of March 2023. The forecast for the Warneford Park development needs to be worked on in more detail which could result in a change in the forecast. Actions Required Close monitoring of the additional spend in the YTG position to determine how much is likely to be committed by year-end to ensure the forecast is updated accurately each month. A project to re-tender for patient transport services to determine the budget required for this going forward. Budget setting to adequately budget for the Oxford University Hospitals contracts currently held within the Finance Directorate. The Corporate Services directorates have 359k of unmet CIP targets. These are being offset in year by non-recurrent underspends but Directorates need to develop plans for them recurrently. 18
Caring, safe and excellent Research & Development Month 9 Year-to-Date Forecast Plan '000 (53) (3) (57) Actual Variance '000 332 29 361 Plan '000 (607) (30) (637) Actual '000 161 (26) 134 Variance '000 Plan '000 (805) (40) (845) Forecast '000 (166) Variance '000 Service Line Research & Development Academic Health Science Network EBITDA '000 385 32 418 768 639 4 (35) (201) 5 772 644 Year-to-Date Performance Research & Development is currently 772k favourable against budget. This is from the release of Novavax vaccine trial income of 446k andManagement savings including vacancies and maternity leave of 172k. Forecast Outturn The forecast outturn is predicted to be 644k favourable at the year end, the main reason for the reduction in the variance is 100k for a new laboratory in the Clinical Research Facility at the Warneford Hospital. The bulk of the forecast underspend is from the release of Novavax income, expected to be 545k at the year end and R&D Management vacancy savings of 92k. Risks and opportunities Included in the forecast is 100k of costs for Estates work to create a new laboratory at the Clinical Research Facility at the Warneford Hospital. There is a risk that this work won't take place this year, increasing the forecast favourable variance further. Actions required R&D Clinical Research Facility Management Team are liaising with Estates currently, in the hope that the laboratory work will begin in early March. 19
Caring, safe and excellent Oxford Pharmacy Store Month 9 Year-to-Date Forecast Plan '000 32 32 Actual Variance '000 200 200 Plan '000 236 236 Actual '000 669 669 Variance '000 Plan '000 329 329 Forecast '000 1,465 1,465 Variance '000 1,136 1,136 Service Line Oxford Pharmacy Store EBITDA '000 168 168 433 433 Year-to-Date Performance The YTD position is 433K better due to one off Covid-19 drugs distribution and savings on pay & non pay costs. Forecast Outturn The Forecast Outturn is 1,136K better than plan due to a one-off contract with NHS England for Covid-19 drugs distribution. Risks and opportunities There is an opportunity for further contracts with NHS Scotland/Wales/NI to distribute Covid-19 drugs with a medium likelihood of an improvement in the forecast position of at least 50k. There is always a risk of lower than anticipated sales as they can be very unpredictable due to the nature of the dynamic market. Actions required The Senior Management Team to discuss implementing new measure to bring in new business and also review existing business to fill the sales gap. 20
Caring, safe and excellent 5. . Provider Collaboratives Financial Performance - Secure ANNUAL PLAN 2022/2023 YTD PLAN 2022/2023 YTD ACTUALS 2022/2023 YTD VARIANCE FY23 FORECAST FY23 Variance Service Item Description FORENSIC SERVICES OBD EPC Forensic Community 68,978,194 1,857,208 1,848,464 51,733,646 1,392,906 1,386,348 50,965,838 1,404,474 1,386,348 767,808 - 11,568 67,954,450 1,872,632 1,848,464 1,023,744 - 15,424 0 0 Total PCA 72,683,866 54,512,900 53,756,660 756,240 71,675,546 1,008,320 Infrastructure 1,743,845 1,307,884 1,053,042 254,842 1,743,845 0 Investment 11,150,215 8,362,661 8,362,661 0 11,150,215 0 Total contract Value 2022/23 85,577,926 64,183,445 63,172,363 1,011,082 84,569,606 1,008,320 NB: position based on Tariff inflator and prices at 2.4%. Further adjustments pending Year-to-Date Performance The Secure Provider Collaborative (PC) YTD position is 1,011k favourable against budget. Patient care activity (PCA) is 756k favourable: Occupied beddays (OBD) are 767k favourable offsetting overspend on extra packages of care (EPC) which are 12k adverse. The PCA position is reported as breakeven in the Trust overall position in line with the principles of the PC to reinvest savings into services. Infrastructure costs are 255k favourable due to less than planned expenditure across the Forensic Intellectual and Neurodevelopment Disabilities (FIND) service and provider collaborative teams. Forecast Outturn The Forecast Outturn for the Secure PC is 1,008k favourable to budget. This does not include potential benefits of accrued recharges and savings in respect of FY22 which is c. 2.4m. The principles of the PC are that savings are considered for re-investment over the period of the contract term and the underspend is not included in the Trust forecast. 21
Caring, safe and excellent Provider Collaboratives Financial Performance - CAMHS ANNUAL PLAN 2022/2023 YTD PLAN 2022/2023 YTD ACTUALS 2022/2023 YTD VARIANCE FY23 FORECAST FY23 Variance Service Item Description CAMHS Services OBD EPC Bekshire Day Care 20,669,383 1,796,354 1,992,537 15,502,037 1,347,266 1,494,403 13,952,418 1,584,071 1,494,403 1,549,619 - 236,806 18,603,224 2,112,095 1,992,537 2,066,159 - 315,741 0 0 Total PCA 24,458,274 18,343,706 17,030,892 1,312,813 22,707,857 1,750,417 Infrastructure 923,000 692,250 686,025 6,225 914,700 8,300 Total contract Value 2022/23 25,381,274 19,035,956 17,716,917 1,319,038 23,622,557 1,758,717 NB: position based on Tariff inflator and prices at 2.4%. Further adjustments pending Year-to-Date Performance The CAMHS Provider Collaborative (PC) YTD position is 1,319k favourable against budget. Patient care activity (PCA) is 1,313k favourable : occupied beddays (OBD) are 1,550k favourable offsetting overspend on extra packages of care (EPC) which are 237k adverse. The PCA position is reported as breakeven in the Trust overall position in line with the principles of the PC to reinvest savings into services. Infrastructure costs are 6k favourable due less than planned expenditure across the provider collaborative team. Forecast Outturn The Forecast Outturn for the CAMHS PC is 1,758k favourable to budget. This does not include potential benefits of accrued recharges and savings in respect of FY22 which is c. 3.8m. The principles of the PC are that savings are considered for re-investment over the period of the contract term and are not included in the Trust forecast. 22
Caring, safe and excellent Provider Collaboratives Financial Performance Adult Eating Disorder (AED) ANNUAL PLAN 2022/2023 YTD PLAN 2022/2023 YTD ACTUALS 2022/2023 YTD VARIANCE FY23 FORECAST FY23 Variance Service Item Description CAMHS Services OBD EPC Transformation Funding Total PCA 7,271,935 5,453,951 6,162,379 - 708,428 8,124,295 - 852,360 0 0 0 0 0 0 0 0 - 708,428 5,453,951 708,428 - 850,000 7,274,295 850,000 - 2,360 7,271,935 5,453,951 0 Infrastructure 658,565 493,924 369,160 124,764 658,565 0 Total contract Value 2022/23 7,930,500 5,947,875 5,823,111 124,764 7,932,860 - 2,360 NB: position based on Tariff inflator and prices at 2.4%. Further adjustments pending Year-to-Date Performance The AED Provider Collaborative (PC) YTD position is 125k favourable against budget. Patient care activity (PCA) is breakeven: occupied beddays (OBD) are 708k adverse offset by transformation funding to support the transition to the integrated step care model (ISCM) of care. Infrastructure costs are 125k favourable due to less than planned expenditure across the provider collaborative team. Forecast Outturn The Forecast Outturn for the AED PC is breakeven supported by transformation funding of 850k available in FY23 to support the double running during the implementation of ISCM. 23
Caring, safe and excellent 6. Covid-19 Costs Month 9 Year-to-Date Forecast Plan '000 132 132 Actual Variance '000 758 758 Plan '000 1,191 1,191 Actual '000 6,808 6,808 Variance '000 5,617 5,617 Plan '000 1,589 1,589 Forecast '000 9,071 9,071 Variance '000 7,482 7,482 Service Line Covid-19 Costs EBITDA '000 626 626 Year-to-Date Performance There is a 5,617k underspend on Covid-19 budgets YTD. The majority of this is Covid-19 funding which is being used to offset pressures elsewhere in the Trust ( 5,635k), offset with a small overspend ( 20k) on the PPE Warehouse. The vaccination centres are shown as on plan while waiting for additional expected income to be confirmed by NHS England. Forecast Outturn The forecast is for a favourable variance of 7,482k. This is made up of 7,502k Covid-19 funding offset with 20k adverse variance on the PPE Warehouse. Risks and opportunities The income position is likely to be better than forecast. A meeting has been arranged with NHS England to confirm the income the Trust is due. Actions required The vaccination cost centres need to be moved into the Community Directorate as the vaccination service is now being managed by the Community leadership team. The finance team will meet with NHS England to confirm the income figures. 24
Caring, safe and excellent 7. Pay Trends The increase in pay costs and budget in September 2021 and September 2022 reflect when the pay award was paid to staff along with back pay. The increased costs in March 2022 reflect year-end accounting adjustments for pension costs 25
Caring, safe and excellent The increase in budget in Forensics in October 2022 is due to budget which was transferred from Reserves this was growth funding received from NHS England and mainly covers existing cost pressures. 26
Caring, safe and excellent 8. Agency Analysis At month 9 34.8m has been spent on agency staff (excluding 7.0m for agency staff at the Covid mass vaccination sites). This is 13% of total staff costs. Note that the graphs above exclude spend in the Covid-19 vaccination centres to show a normalised position. The Trust s agency target set by NHS England is 40.5m. The forecasted agency spend for the year is 52.4m including the mass vaccination sites and 44.1m excluding them. The forecast takes into account winter pressures but is not adjusted for any expected savings relating to the move to NHS Professionals and the new contracts being put in place for agency staff, and therefore is likely to improve in February and March when these savings start. Please refer to the HR report for further details. 28
Caring, safe and excellent 9. . Cost Improvement Programme (CIP) CIP / PIP Delivery at Month 09 FY23 FY FY Plan '000 6,067 9,044 YTD Target '000 5,947 5,383 YTD Actual '000 4,431 1,982 YTD Variance '000 -1,516 -3,401 Forecast Variance '000 -1,865 -5,917 Forecast Target '000 7,929 9,044 Projects '000 6,065 3,128 CIP Programme PIP Schemes / Agency Reduction Covid Costs Reduction Total 0 0 0 0 0 0 0 16,974 15,111 11,330 6,414 -4,916 9,192 -7,782 CIP Programme: In line with NHS efficiency requirements that Trust has a CIP target of 7.9m. Budget reductions totalling 7.9m were applied to all Directorates at the start of Financial year. These were reduced by 2.8m in month 7 through allocating reserves to directorates recurrently and this is now shown as CIP delivery. This was a result of agreement by the Executive Team to use available reserves to reduce the requirement for CIPs. Plans to deliver the 7.9m target total 6.1m. Savings reported as at the end of month 8 are 4.4m, 1.5m adverse to target. PIP Programme Schemes : The PIP programme encompasses schemes that are cost avoidance i.e. expenditure items for which there is no funding. It is centred on initiatives to reduce agency costs e.g. price reductions and usage. The target is a 9.0m reduction. The Improving Quality Reducing Agency (IQRA) programme has delivered 2.0m reductions as at the end of month 9, 3.4m adverse to target. Several initiatives for this programme are starting in January which should result in increased savings, notably the move of bank staff to NHS Professionals and a master vendor contract for agency staff. Covid Cost Reduction: Covid cost reductions is a cost avoidance programme to address the continuance of expenditure incurred during the 2 year covid period. It is centred on initiatives to reduce staffing costs and the use of independent sector provider contracted beds that have become business as usual and to challenge their validity in the context of the retained covid budget of 7.3m. 29
Caring, safe and excellent 10. Out of Area Placements (OAPs) Out of Area Placements are 2.2m overspent at month 9 - 2.1m adversein Oxfordshire and 115k adversein Buckinghamshire. This includes the cost of the Elysium block contract beds at Potters Bar and Chadwick Lodge, which reduced from 21 beds in April to 4 as of November. These costs exclude Secure Transport spend which is currently 327k across the two directorates. An additional 350k PICU Budget was allocated to the budget in month 8. The large movement in month 9 is due to an increase in Acute patients being sent out of area, there is a 48% increase on month 8 admissions. 30
Caring, safe and excellent Oxon & Bucks OAPS Spend by bed type The above graphs show spend a sharp increase in cost against Acute beds in month 1 of FY23. This is due to allocations of costs prior to this period being reclaimed from national COVID funding. There was a sharp decrease in cost for Oxfordshire Acute OAPs in month 4 due to release of an FY21 provision A small increase against PICU beds in Buckinghamshire can be seen there are limited PICU beds available within the trust and this is a male only ward meaning that all female patients requiring a PICU bed are placed out of area There is a sharp decrease in cost for Buckinghamshire PICU Placements in month 8 due to the release of an old year provision. Increase in costs for month 9 is due to out of area acute admissions, an increase of 12 patients in Oxfordshire and 3 patients in Buckinghamshire compared to month 8 admissions. Still out at the end of December: Oxfordshire has 16 Acute, 5 PICU, 6 Rehab and 1 Continuing Care beds being used and in Buckinghamshire there is 7 Acute, 1 PICU and 1 Rehab bed. 31
Caring, safe and excellent 11. Statement of Financial Position 1. Non-current assets have increased by 24.1m in-year. The in-year increase is driven by the capitalisation of 27.8m of leased assets in accordance with the accounting standard IFRS16 which was adopted by the Trust from the 1st April, and capital additions of 4.8m in the first 9 months of the year. These additions were offset by depreciation of 8.5m. Statement of Financial Position as at 31st December 2022 31 March 2022 Movement Month 8 FY22 Month 9 FY23 Year to date '000 In month '000 '000 '000 '000 2. Inventories increased by 7.9m in year and 7.7m in month. The increase is largely due to expenditure on remdesivir stock ( 7.4m). OPS are currently the sole supplier of this covid antiviral treatment across the NHS following an agreement with NHSE. Non-current assets Intangible Assets Property, plant and equipment Finance Leases Trade and other receivables 6,390 155,907 5,688 156,475 24,279 5,598 156,948 23,870 (792) 1,041 23,870 (90) 473 (408) 0 487 499 499 12 0 (25) 162,784 Total non-current assets 186,941 186,916 24,132 3. Trade and other receivables have increased by 14.1m in year. Most of this increase is due to an increase in outstanding debt of 16.2m (of which 11.5m is current debt < 30 days old). Prepayments have increased by 1.0m and Accrued Income and the Trust's VAT debtor have decreased by ( 3.5m). Current Assets Inventories Trade and other receivables Non-current assets held for sale Cash and cash equivalents Total current assets 2,003 19,702 2,271 33,758 9,956 33,781 7,953 14,079 7,686 22 0 4,885 12,593 0 0 0 89,517 111,223 76,147 112,176 81,032 124,769 (8,485) 13,546 4. Cash has increased by 4.9m in month and decreased by 8.4m in year. These movements are in line with the cash flow statement. The year-to-date decrease is largely due to cash payments against financing activities of ( 6.8m), payments for capital assets of ( 10.3m), including FY22, and net working capital outflows of 7.6m. Current Liabilities Trade and other payables Borrowings Other financial liabilities Finance Leases Provisions Deferred income (75,128) (2,817) (75,238) (2,074) (1,788) (5,447) (2,685) (22,485) (89,456) (2,116) (1,788) (5,431) (2,094) (21,108) (14,328) (14,218) (43) 701 (1,788) (5,431) 379 1,676 0 0 16 591 1,377 (2,473) (22,784) 5. Trade and other payables have increased by 14.3m in year and 14.2m in month. Increases in accrued expenditure of 19.9m in year have been offset by decreases in other payable balances of 5.5m (103,203) Total Current Liabilities (109,718) (121,994) (18,792) (12,277) Non-current Liabilities Trade and other payables Borrowings Finance Leases Provisions Other Liabilities Total non-current liabilities Total assets employed 0 0 0 0 6. Short term finance lease liabilities have increased by 5.4m in year following the capitalisation of leased assets see note1. (15,784) (15,564) (19,353) (4,555) (1,132) (40,604) 148,795 (15,514) (18,992) (6,100) (1,132) (41,737) 147,954 270 50 361 (1,544) 0 (1,133) (842) 0 (18,992) (1,575) (4,524) (1,132) (21,440) 149,364 7. Deferred income has decreased by 1.4m in month and 1.7m in year. 0 (20,297) (1,410) 8. Long term finance leases have increased by 19.0m in year and decreased by 0.4m in-month (repayments against liability) following the capitalisation of leased assets see note 1. Financed by (taxpayers' equity) Public Dividend Capital Revaluation reserve Other reserves Income & expenditure reserve 107,619 27,469 107,619 27,446 107,619 27,446 1 0 0 0 (23) 9. Provisions increased by 1.5m in months and year to date. This is due to a new long term permanent injury provision. 0 0 0 14,276 13,730 12,888 (1,388) (842) 10. The in-year movements in the I&E reserve reflect the Trust s reported deficit for the year of 1.4m. 149,364 Total taxpayers' equity 148,795 147,954 (1,410) (842) 32
Caring, safe and excellent 12. Cash Flow STATEMENT OF YEAR TO DATE CASH FLOWS Month 9 FY23 Summary Notes Actual '000 Plan '000 Variance '000 The cash flow movements are consistent with the comments made on the Statement of Financial Position. Cash flows from operating activities Operating surplus/(deficit) from continuing operations Operating surplus/(deficit) from discontinuing operations Operating surplus/(deficit) 1,007 507 500 The closing cash position at the end of December was 81m. 0 0 0 1,007 507 500 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 8,541 8,528 13 0 0 0 0 0 0 (14,337) (7,953) 19,027 1,280 (15,617) 0 (16,907) (5,250) 312 0 (11,530) (7,953) 35,934 5,362 884 112 1,196 0 0 7,594 19,124 Cash flows from investing activities Interest received Purchase of Non Current Assets Sale of PPE Net cash generated from/(used in) investing activities 982 195 787 (10,250) (8,664) (1,586) 0 0 0 (9,268) (8,469) (799) 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 0 0 0 0 0 0 0 (669) (3,472) (301) (317) (193) (481) (1,378) (6,811) (669) (4,005) (450) (321) (193) (723) (1,310) (7,671) 533 149 4 0 242 (68) 859 (8,485) 89,517 81,032 (27,670) 89,517 61,847 19,185 Increase/(decrease) in cash and cash equivalents Cash and Cash equivalents at 1st April Cash and Cash equivalents at 31st December 0 19,185 33
Caring, safe and excellent 13. Working Capital Indicators Working Capital Ratios Ratio Target Actual Risk Status Debtor Days 30 22 Debtors % > 90 days 5.0% 8.7% Creditor Days 30 57 BPPC NHS - Value of Inv's pd within target (ytd) 95.0% 91.4% BPPC Non-NHS - Value of Inv's pd within target (ytd) 95.0% 90.4% Cash ( m) 68.8 81.0 Summary Notes Debtor days at month 9 are better than plan. Debtors % over 90 days is marginally below plan. This is mostly due to unpaid invoices from NHS debtors, specifically in relation to outstanding provider collaborative invoices totalling 1,052k and Frimley Park 275k. The Creditor days position is worse than plan, due to high accrual levels for NHS and Non-NHS suppliers, and BPPC figures being below target. NHS Better Payment Practice Code (BPPC) (which represents 20% of non-pay expenditure) is below target for the year, but broadly on target in month at 94.5% Non-NHS BPPC (which represents 80% of non-pay expenditure) is below target for the year, and below target in month at 87.9% . Cash is better than plan, as outlined in section 9. 34
Caring, safe and excellent 14. Capital Investment Programme The Trust has a capital expenditure plan of 15,593k against capital funding of 14,151k in FY23, an overspend/funding gap of 1,442k. The Trust is now forecasting an overall overspend against funding of 118k (Forecast spend of 14,269k against funding of 14,151k). Although the YTD expenditure is low, there is a real risk that the overspend will significantly overshoot. This is due to the sale of Shrublands and Harlow slipping into FY24 ( 1,382k) and the reduced recovery of VAT against the PICU project and fit out costs ( 1,148k). This could result in an overspend of 2,648k. Estates and Facilities teams are considering mitigating actions in case needed. In light of these events, the Trust has flagged a potential overspend of up to 2,000k with the ICS and this will be managed within the ICS s overall capital allocation. Year to date expenditure is 4,813k and new leases anticipated in FY23 (signed and unsigned) have a capital additions value of 9,305k. 35
Caring, safe and excellent 15. 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 9 FY23 Nationally supplied PPE Remove Section 75 Income and Costs Category Changes Board Report NHSI Template m m -1.7 m m m Clinical Income Other Operating Income Operating Income, Total 353.5 76.0 429.5 351.8 76.0 427.8 -1.7 0.0 0.0 Employee Benefit Expenses (Pay) Other Operating Expenses Operating Expenses, Total 264.2 155.8 420.0 -1.6 -0.1 -1.7 262.6 155.7 418.3 0.0 0.0 Non-Operational Income 0.0 0.0 EBITDA 9.5 0.0 0.0 0.0 9.5 Financing costs 10.8 10.8 Surplus/ (Deficit) -1.4 0.0 0.0 0.0 -1.4 36
