Monthly Finance Performance Report - March 2022 Overview
The March 2022 Monthly Finance Performance Report highlights key financial metrics for the period, including cash balance, income breakdown, expenditure, and variances against plans. The report indicates a surplus in working capital, variance in income related to activity delivery, and notable expenditure trends. Insights include temporary staffing increases, bank and agency costs, and non-pay cost reductions. Overall, the report outlines financial performance, activity levels, and resource allocations for the Trust.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Monthly Finance Performance Report For the period ended 31stMarch 2022 (Month 12) Presented by Jonathan Wilson; Chief Financial Officer Justin Betts; Deputy Chief Finance Officer Amit Patel; Head of Financial Management Lubna Dharssi, Head of Financial Control Richard Allen; Head of Income and Contracts Prepared by
Monthly Finance Performance Report For the period ended 31st March (Month 12) Key Messages Statement of Financial Position Statement of Comprehensive Income For March the Trust is reporting:- Financial Position The cash balance as at the 31st March was 69.3m, an increase of 0.9m since the end of March 2021. Cash and Working Capital Position 3.08m surplus in month including support 17.77m deficit year to date pre COVID support and top-up funding; 37.55m of COVD support and top-up funding, resulting in a; 19.77m surplus year to date. The Better Payment Practice Code (BPPC) performance in March was 96% (volume) and 96% (value) against a target of 95% across both metrics. Total trust income was 23.01m in March, a 0.42m adverse variance to plan, largely linked to activity delivery. Material variances include:- Income Capital Capital expenditure to 31st March totalled 14.8m, against a plan of 18.1m predominantly linked to network strategy decision timelines surrounding consolidation which meant schemes were not be able to be executed in this financial year and have been incorporate into 2022/23 TIF funding schemes, and slippage within schemes such as London Claremont Centre. 23.01m in month Commissioned Clinical Income 0.66m adverse ( 21.18m YTD); Other Clinical Income 0.17m adverse ( 0.66m YTD); Commercial Income 0.16m favourable ( 0.35m YTD); COVID top up payments included a further 1.0m distribution received from the NCL system reserve notified on 25th March. (both gross capital expenditure and CDEL) Current use of resources monitoring remains suspended. Use of Resources Activity levels recorded in March compared to 2019/20 activity levels were 69% of A&E activity, 88% Elective, 81% for Outpatients (excluding additive capacity or 91% inclusive), and 105% of Injection activity. Excess funding over activity levels contributed 0.13m in month and 16.72m year to date to the Trusts surplus reported position. Pay is reporting expenditure of 12.43m in March, 0.26m adverse to plan. The key points to note are:- Temporary staffing levels increased in March across clinical staff groups in primarily cover covid sickness and annual leave. Bank and agency costs were 2.06m against the cumulative trend of 1.38m. a 1.035m accrual for unpaid 2021/22 and prior year CEA awards. annual leave provision releases of 1.3m, reducing expenditure Expenditure 21.37m in month (pay, non pay, excl financing) Non-pay costs were 1.53m favourable to plan in March, with drugs cost reduction due to lower than planned hight cost (voretigene) drugs treatments. Other non pay favourable movements include a multi-year one off property rates rebate ( 1.1m) and a backdated credit note from St Georges related to non-utilisation of QMR theatres ( 0.21m) during the pandemic. 2
Trust Financial Performance - Financial Dashboard Summary FINANCIAL PERFORMANCE INCOME BREAKDOWN RELATED TO ACTIVITY In Month Year to Date Year to Date Forecast Financial Performance m Income Breakdown m Annual Plan Annual Plan Plan Actual Variance Plan Actual Variance % RAG Plan Actual Variance RAG Plan Actual Variance (8)% Income 261.4m 23.4m 23.0m ( 0.4m) 261.4m 241.2m ( 20.2m) NHS Clinical Income 147.0m 147.0m 123.3m ( 23.8m) 147.0m 121.7m ( 25.3m) Pay ( 141.1m) ( 12.2m) ( 12.4m) ( 0.3m) ( 141.1m) ( 141.0m) 0.1m Pass Through 38.1m 38.1m 40.7m 2.6m 38.1m 40.7m 2.6m 0% Non Pay ( 114.4m) ( 10.7m) ( 8.9m) 1.8m ( 114.4m) ( 108.6m) 5.8m Other NHS Clinical Income 9.9m 9.9m 9.2m ( 0.7m) 9.9m 9.4m ( 0.5m) 5% Financing & Adjustments ( 9.5m) ( 0.8m) ( 0.9m) ( 0.0m) ( 9.5m) ( 9.4m) 0.2m Commercial Trading Units 36.8m 36.8m 37.2m 0.3m 36.8m 38.0m 1.2m 2% Research & Development 15.2m 15.2m 16.7m 1.4m 15.2m 15.6m 0.4m CONTROL TOTAL PRE SUPPORT ( 3.6m) ( 0.3m) 0.8m 1.1m ( 3.6m) ( 17.8m) ( 14.2m) COVID Top-up/support 18.8m 1.2m 2.3m 1.1m 18.8m 37.5m 18.8m Other 14.3m 14.3m 14.1m ( 0.2m) 14.3m 12.8m ( 1.5m) CONTROL TOTAL POST SUPPORT 15.2m 0.9m 3.1m 2.2m 15.2m 19.8m 4.6m INCOME PRE TOP-UP 261.4m 261.4m 241.2m ( 20.2m) 261.4m 238.1m ( 23.3m) ERF/COVID Top up funding 18.8m 18.8m 37.5m 18.8m 18.8m 38.1m 19.3m Memorandum Items TOTAL OPERATING REVENUE 280.2m 280.2m 278.7m ( 1.5m) 280.2m 276.2m ( 4.0m) Research & Development ( 1.63m) ( 0.28m) ( 0.91m) ( 0.63m) ( 1.63m) ( 0.64m) 0.99m 61% RAG Ratings Red > 3% Adverse Variance, Amber < 3% Adverse Variance, Green Favourable Variance, Grey Not applicable Commercial Trading Units 4.97m 0.70m 0.81m 0.11m 4.97m 6.14m 1.17m 23% ORIEL Revenue ( 2.26m) ( 0.06m) ( 0.09m) ( 0.03m) ( 2.26m) ( 1.62m) 0.64m 28% PAY AND WORKFORCE CASH, CAPITAL AND OTHER KPI'S In Month Actual Year to Date Actual % Year to Date Actual Forecast Actual Pay & Workforce m Capital Programme m Annual Plan Annual Plan Plan Variance Plan Variance Total Plan Variance RAG Plan Variance Employed ( 138.9m) ( 11.8m) ( 10.3m) 1.5m ( 138.9m) ( 123.1m) 15.8m Trust Funded ( 17.0m) ( 17.0m) ( 14.2m) ( 2.8m) ( 17.0m) ( 16.4m) 0.6m 87% Bank ( 1.1m) ( 0.2m) ( 1.2m) ( 1.1m) ( 1.1m) ( 12.4m) ( 11.3m) Donated/Externally funded ( 1.1m) ( 1.1m) ( 0.7m) ( 0.5m) ( 1.1m) ( 0.8m) ( 0.3m) 9% Agency ( 0.6m) ( 0.1m) ( 0.8m) ( 0.7m) ( 0.6m) ( 4.9m) ( 4.3m) TOTAL 18.1m 18.1m 14.8m ( 3.3m) 18.1m 17.2m ( 0.9m) 3% Other ( 0.5m) ( 0.0m) ( 0.1m) ( 0.0m) ( 0.5m) ( 0.5m) ( 0.1m) 0% TOTAL PAY ( 141.1m) ( 12.2m) ( 12.4m) ( 0.3m) ( 141.1m) ( 141.0m) 0.1m Key Metrics Net Receivables/Ageing m Plan Actual RAG Cash Debtor Days Creditor Days PP Debtor Days 69.3 45 45 65 69.3 31 92 77 Rolling Pay Spend m Rolling Bank & Agency Spend m Substantive Bank -0.5 2.2 Bank Agency Agency Other NHS - CCG Other NHS NON NHS LCC PP Dubai 1.1 13.0 1.5 6.5 0.9 12.5 16.5m 1.3 12.0 1.1 11.5 Use of Resources Plan Actual 7.1 0.9 11.0 10.5 0.7 Capital service cover rating Liquidity rating I&E margin rating I&E margin: distance from fin. plan Agency rating OVERALL RATING - - - - - - - - - - - - 10.0 1.30.7 0-60 Days 0.5 9.5 60-180 Days 0.3 9.0 180+ Days 3.5 8.5 0.1 2019/20 + 8.0 11.1 (0.1) Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 3
Trust Income and Expenditure Performance Commentary FINANCIAL PERFORMANCE On a like for like comparison, clinical activity levels recorded were 88% for Daycase and 81% for Outpatients during March compared to 2019/20 levels, with activity-based income totalling 14.55m, 0.66m below the level of block funding. Other significant variances included:- Operating Income In Month Year to Date Statement of Comprehensive Income m Annual Plan Plan Actual Variance Plan Actual Variance % RAG 0.42m adverse to plan pre Income Commercial Trading income was 3.44m; 0.16m favourable to plan. Research and Development income was 2.34m; a break-even position Other income was 0.22m favourable to plan in month, reflecting additional HEE monies reported in month. COVID top up payments included a further 1.0m distribution received from the NCL system reserve notified on 25th March. support (11)% NHS Commissioned Clinical Income 185.11 15.22 14.55 (0.66) 185.11 163.93 (21.18) (7)% Other NHS Clinical Income 9.91 0.85 0.68 (0.17) 9.91 9.24 (0.66) Commercial Trading Units 36.85 3.28 3.44 0.16 36.85 37.19 0.35 1% Research & Development 15.23 2.30 2.33 0.03 15.23 16.67 1.44 9% Other Income 14.30 1.78 2.00 0.22 14.30 14.13 (0.17) (1)% Pay in March is reported as 12.43m against a cumulative trend of 11.68m. Employee Expenses (8)% Total Income 261.40 23.43 23.01 (0.42) 261.40 241.17 (20.23) Bank and agency costs totalled 2.06m in March; an increase on the 1.28m reported in March 2020. Although the Trust has experienced a reduction in activity levels, temporary staffing costs remained high due to sickness and annual leave taken in March. Operational restrictions in clinical areas and temporary staffing expenditure in corporate areas (mainly linked to the IMT remediation plans) have caused costs to remain high. Clinical divisions (including Hercules) temporary staffing costs are 1.10m against 0.76m in March 2020. Further notable items to highlight include, a 1.035m accrual for unpaid 2021/22 and prior year CEA awards, offset by the annual leave provision reduction totalling 1.3m. Operating Expenses 0.26m adverse to plan in month Pay (141.09) (12.17) (12.43) (0.26) (141.09) (140.96) 0.14 0% Drugs (42.62) (3.60) (3.38) 0.22 (42.62) (39.39) 3.23 8% Clinical Supplies (20.96) (2.16) (2.33) (0.17) (20.96) (21.25) (0.29) (1)% Other Non Pay (50.79) (4.96) (3.22) 1.74 (50.79) (47.98) 2.82 6% 2% Total Operating Expenditure (255.47) (22.90) (21.37) 1.53 (255.47) (249.57) 5.90 5.93 0.53 1.64 1.11 5.93 (8.40) (14.33) EBITDA (242)% Financing & Depreciation (10.13) (0.88) (0.87) 0.01 (10.13) (9.79) 0.34 3% Non-Pay costs in March were 8.94m against a cumulative trend of 9.06m. Non Pay Expenses Donated assets/impairment adjustments 0.59 0.05 (0.01) (0.05) 0.59 0.41 (0.18) (30)% Drugs expenditure was 0.22m favourable to plan reflecting no Voretegene treatments in month, and lower wholesale drug activity for LCC. Actual expenditure was 3.38m in month against prior month expenditure of 2.82m. Clinical supplies expenditure was 0.17m adverse in month reflecting increased expenditure in City Rd Theatres, in line with trend. Actual expenditure was 2.33m in March against 1.72m in February due to the recognition of DHSC Donated PPE stock for which income has also been received. Other non pay includes a multi-year one off property rates rebate ( 1.1m) and a backdated credit note from St Georges related to non-utilisation of QMR theatres ( 0.21m) during the pandemic. Control Total Surplus/(Deficit) Pre ERF/Block and Top Up Payments (393)% (3.61) (0.31) 0.76 1.07 (3.61) (17.77) (14.16) 1.53m favourable to plan in month Elective Recovery Funding 4.29 - - - 4.29 5.81 1.52 (non pay and financing) Block funding in excess of activity - - 0.13 0.13 - 16.72 16.72 COVID Top Up Payments 14.51 1.23 2.19 0.95 14.51 15.02 0.51 Control Total Surplus/(Deficit) Post ERF/Block and Top Up Payments 15.19 0.93 3.08 2.15 15.19 19.77 4.59 4
Trust Patient Clinical Income Performance Commentary PATIENT ACTIVITY AND CLINICAL INCOME Point of Delivery Activity In Month Activity YTD YTD Income '000 NHS Patient Clinical activity income in March was 14.55m if reimbursed via normal activity based contracting arrangements. Significant items include:- NHS Income Plan Actual Variance % Plan Actual Variance % Plan Actual Variance % AandE 8,388 5,769 (2,619) 69% 98,761 61,623 (37,138) 62% 15,426 9,916 ( 5,510) 64% Daycase / Inpatients 3,166 2,792 (374) 88% 34,914 31,594 (3,320) 90% 39,085 38,688 ( 398) 99% Inpatient activity The trust achieved 88% of baseline activity levels in March (94% in February); High Cost Drugs 4,889 5,091 202 104% 53,990 58,975 4,985 109% 38,777 40,671 1,894 105% Non Elective 235 191 (44) 81% 2,775 2,097 (678) 76% 5,424 4,441 ( 983) 82% OP Firsts 11,391 10,044 (1,347) 88% 125,754 116,344 (9,410) 93% 21,518 19,467 ( 2,051) 90% OP Follow Ups 42,121 38,902 (3,219) 92% 465,163 437,173 (27,990) 94% 47,689 43,375 ( 4,314) 91% Outpatient Activity The trust achieved 91% of baseline activity levels in March (92% in February); however approximately 10% is via additive diagnostic hub activity and a further 2% is A&E attend anywhere activity, meaning like for like outpatient activity outside of these items achieved is 81% of 2019/20 levels. Other NHS clinical income 4,474 3,017 ( 1,457) 67% 70,190 62,789 (7,401) 89% 781,357 707,806 (73,551) 91% 172,393 159,574 ( 12,819) 93% Total Income Figures Excludes CQUIN, Bedford, and Trust to Trust test income. RAG Ratings Red to Green colour gradient determined by where each percentage falls within the range ACTIVITY TREND High Cost Drugs Injections The Trust achieved 105% of baseline activity levels in March (98% in February); The charts to the left demonstrate the in year activity levels compared to the previous three years, highlighting the material shift in activity as a result of COVID, and the pace of recovery towards pre-COVID activity levels. Activity Plans 2019/20 activity levels (pre-COVID) are being used nationally as a proxy to report organisations return and recovery to pre pandemic levels of activity during 2021/22. The red line represents average 2019/20 activity levels pre additive capacity. Where the upper and lower lines increase represent additive capacity such as Hoxton, Brent Cross, and other diagnostic hub investments. 5
Trust Statement of Financial Position Cash, Capital, Receivables and Other Metrics Commentary CAPITAL EXPENDITURE RECEIVABLES The cash balance as at the 31st March was 69.3m, an increase of 0.9m since the end of March 2021, and a reduction 9.0m from the prior month. Cash and Working Capital Year to Date Capital Expenditure m Net Receivables m 0-60 Days 60-180 Days 180+ Days 2018/19 + Annual Plan Total Plan Actual Variance Estates - Trust Funded 0.9 0.9 2.3 1.3 CCG Debt (0.5) 0.0 0.0 - (0.5) Medical Equipment - Trust Funded 4.5 4.5 5.0 0.5 Other NHS Debt 4.4 1.7 0.1 0.3 6.5 IT - Trust Funded 1.2 1.2 2.0 0.7 Non NHS Debt 4.9 0.9 0.8 0.4 7.1 Capital Capital spend to 31st March totalled 14.8m, against a plan of 18.1m predominantly linked to network strategy decision timelines surrounding consolidation which meant they were not be able to executed in this financial year and have been incorporate into 2022/23 TIF funding schemes and slippage within schemes such as London Claremont Centre. ORIEL - Trust Funded 2.6 2.6 2.6 0.1 Commercial Unit Debt 2.3 0.9 0.3 (0.0) 3.4 Expenditure Commercial - Trust funded 4.4 4.4 2.1 (2.3) TOTAL RECEIVABLES 11.1 3.5 1.3 0.7 16.5 Other - Trust funded 3.4 3.4 0.1 (3.2) TOTAL - TRUST FUNDED 17.0 17.0 14.2 (2.8) Debtors Aged Balances m 0-60 Days 180+ Days 2020/21 Debtors 60-180 Days 2019/20 + Covid/Donated/Externally funded 1.1 1.1 0.7 (0.5) 20.0 TOTAL INCLUDING DONATED 18.1 18.1 14.8 (3.3) Use of resources monitoring and reporting has been suspended. Use of 15.0 Resources 10.0 Capital Funding m Annual Plan Not Yet Secured % 5.0 Secured Secured Receivables have increased by 3.5m to 16.5m since the end of the 2020/21 financial year and an increase of 1.8m since last month. The increase is linked to the billing of R&D contracts following formal contract signatures including Hercules I, NIHR and other commercial projects. Receivables 0.0 Planned Total Depreciation Cash Reserves - B/Fwd cash Cash Reserves - Other (ICS) Capital Loan Repayments TOTAL - TRUST FUNDED Externally funded Donated/Charity TOTAL INCLUDING DONATED 8.3 8.3 100% Y/End Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 6.0 6.0 100% Net Receivables m Ageing m 4.5 4.5 100% -0.5 (1.8) (1.8) 100% 1.30.7 NHS - CCG Other NHS NON NHS LCC PP 2.2 0-60 Days 1.1 17.0 17.0 - 100% Payables totalled 27.4m at the end of March, an increase 0.1m since March 2021. Payables 6.5 60-180 Days 0.9 3.5 16.5m 0.9 0.9 100% 180+ Days 0.2 0.2 100% 11.1 2019/20 + Creditor days are 92 at the end of March due to high levels of capital invoice and revenue accruals. These will be paid in the new year and the metric will therefore be closer to the target of 45 days. 7.1 18.1 18.1 0% 100% STATEMENT OF FINANCIAL POSITION OTHER METRICS The trust s performance against the Better Payment Practice Code (BPPC) was 96% (volume) and 96% (value) against a target of 95%. Prior month achievement was 97% and 97% across both areas. Year to Date Statement of Financial Position m Annual Plan Plan YTD Use of Resources Weighting Score Plan Actual Variance Non-current assets - 112.8 112.8 - Capital service cover rating 20% - - Current assets (excl Cash) - 27.1 27.1 - Liquidity rating 20% - - Cash and cash equivalents - 69.3 69.3 - I&E margin rating 20% - - Current liabilities - (53.7) (53.7) - I&E margin: distance from financial plan 20% - - 6 Non-current liabilities - (34.3) (34.3) - Agency rating 20% - - TOTAL ASSETS EMPLOYED - 121.2 121.2 - OVERALL RATING - -
Trust Statement of Financial Position Cashflow Commentary The cash balance at the 31st March is 69.3m, lower than forecast due to large payments of capital spend at the end of March . Cash flow The current financial regime has resulted in block contract payments which gives some stability and certainty to the majority of cash receipts. The Trust currently has 104 days (prior month: 118 days) of operating cash. March saw a cash outflow of 8.9m against a plan of a 4.3m due to the timings of payments to suppliers in particular linked to capital and Oriel. 7
