Summary Report Version 1.0 25 th June 2013 1. Contents 2 1.Finances and Recovery Plan 1.Cash position 2.2013/14 performance against plan 3.Cost run rate.

1

Summary Report

Version 1.0

25th June 2013

2

Contents

1. Finances and Recovery Plan

1. Cash position2. 2013/14 performance against plan3. Cost run rate and CIP delivery update

2. Board governance

4. Governance review update5. Executive capacity (e.g. substantive appointments)

3. EPR update

4. Mortality review report

5. A&E performance

6. Performance Q1 to date 7. Trajectory for recovery

6. AOB

3

Cash – 26 week cash flow forecast to November 2013Short term cash flow

Actual

£'m w/e 07-Jun 14-Jun 21-Jun 28-Jun 05-Jul 12-Jul 19-Jul 26-Jul 02-Aug 09-Aug 16-Aug 23-Aug 30-Aug 06-Sep 13-Sep 20-Sep 27-Sep 04-Oct 11-Oct 18-Oct 25-Oct 01-Nov 08-Nov 15-Nov 22-Nov 29-Nov

IncomeNHS block contract income 13.0 2.9 - 0.3 12.7 - 3.4 0.3 12.7 - 3.4 - 0.3 12.7 - 3.4 - 12.9 - 3.4 - 0.3 12.7 3.4 - 0.3 NHS non contract income 0.0 0.5 0.2 0.2 0.4 0.2 0.4 - - 0.4 0.2 0.4 - 0.2 0.4 0.2 0.2 0.2 0.2 0.4 0.2 - 0.4 0.2 0.2 0.2 Other * 0.1 0.0 0.6 0.6 0.1 0.2 0.2 0.1 0.3 0.1 0.2 0.2 0.6 0.0 0.2 0.2 0.4 0.3 0.2 0.2 0.4 0.3 0.0 0.2 0.2 0.4

13.2 3.5 0.8 1.1 13.1 0.4 4.1 0.3 12.9 0.5 3.8 0.6 0.9 12.9 0.6 3.9 0.6 13.4 0.4 4.1 0.6 0.5 13.1 3.8 0.4 0.9 PaymentsSalaries/Wages - - - (7.8) - - - (7.0) - - - - (7.0) - - - (7.0) - - - (7.0) Tax & NI & Superannuation - - (4.8) - - - (2.0) (3.0) - - (1.8) (2.7) - - - (4.5) - - - (1.8) (2.7) - - - (4.5) - PRL Payments (1.5) (2.6) (1.5) (1.1) (1.5) (1.2) (1.2) (1.1) (1.5) (1.2) (1.0) (1.1) (1.3) (1.5) (1.2) (1.1) (1.2) (1.3) (1.2) (1.5) (1.1) (1.3) (1.2) (1.5) (1.1) (1.2) Capital expenditure - - - - - - - - - - - - - - - - - - - - - - - - - - Loan repayment - - (1.1) - - - - - - - - - - - - (0.3) - - - - - - - - - - Loan interest - - (0.2) - - - - - - - - - - - - (0.1) - - - - - - - - - - PDC Dividend - - - - - - - - - - - - - - (1.1) - - - - - - - - - - - Other ** (0.0) (0.5) - - - (0.5) - - - - (0.5) - - - (0.5) - - - (0.5) - - - - (0.5) - -

(1.5) (3.1) (7.6) (9.0) (1.5) (1.7) (3.2) (11.2) (1.5) (1.2) (3.3) (3.8) (8.3) (1.5) (2.7) (6.0) (8.2) (1.3) (1.7) (3.3) (10.8) (1.3) (1.2) (2.0) (5.6) (1.2)

Operating cash flow 11.7 0.4 (6.8) (7.9) 11.6 (1.3) 0.8 (10.8) 11.4 (0.8) 0.5 (3.2) (7.4) 11.4 (2.2) (2.1) (7.6) 12.1 (1.3) 0.8 (10.2) (0.8) 11.9 1.8 (5.2) (7.3)

Off /(onto) deposit (12.7) 4.1 5.1 7.0 (11.5) 1.5 0.5 10.5 (10.0) - - 4.0 6.5 (12.0) 2.8 4.0 5.8 - - - - - - - - -

Net cash movement (1.0) 4.4 (1.7) (0.9) 0.1 0.2 1.3 (0.3) 1.4 (0.8) 0.5 0.8 (0.9) (0.6) 0.6 1.9 (1.8) 0.1 0.7 0.9 (0.2) (0.4) 1.4 3.8 (2.8) (0.6)

Current a/c b/f 1.3 0.2 4.7 3.0 2.1 2.2 2.3 3.7 3.3 4.7 4.0 4.4 5.3 4.3 3.7 4.3 6.1 4.3 4.4 5.0 5.9 5.7 5.3 6.7 10.4 7.7 Current a/c c/f 0.2 4.7 3.0 2.1 2.2 2.3 3.7 3.3 4.7 4.0 4.4 5.3 4.3 3.7 4.3 6.1 4.3 4.4 5.0 5.9 5.7 5.3 6.7 10.4 7.7 7.0

Cash on deposit 24.8 20.7 15.6 8.6 20.1 18.6 18.1 7.6 17.6 17.6 17.6 13.6 7.1 19.1 16.4 12.4 6.6 18.6 16.6 16.5 6.5 6.1 16.6 14.6 12.2 5.5

Cash and cash equivalents b/f 13.3 25.0 25.4 18.6 10.7 22.3 20.9 21.8 10.9 22.3 21.6 22.0 18.9 11.4 22.8 20.6 18.5 10.9 22.9 21.6 22.3 12.1 11.3 23.2 25.0 19.8 Cash and cash equivalents c/f 25.0 25.4 18.6 10.7 22.3 20.9 21.8 10.9 22.3 21.6 22.0 18.9 11.4 22.8 20.6 18.5 10.9 22.9 21.6 22.3 12.1 11.3 23.2 25.0 19.8 12.5

* Income other - Non NHS income, chip & pin, cash collections, returned BACS and VAT refunds** Payments other - NHSLA payments, bank charges & petty cash

Weekly summary

Key issues

Current position

Trend

Risks

EPR payments

The current cash position is £25.4m, £3.4m higher than plan due to the early receipt of contract income.

The cash balance will fall later on this month with the final redundancy payments. The EPR milestone payment was made this week that had an estimated payment date of September 2013. Despite this payment, the payment run was 0.3m less than forecast.

As highlighted previously, there has been a change in the arrangements for the key contract receipts following the commissioning switch to CCG. A risk has been highlighted that this could be delay the timing of receipt. RMBC are closing their ledger for 3 weeks in July for an upgrade - They have said that they will pay Julys contract payment in June. The invoice has been issued & factored into June & a corresponding reduction in income in July's cash flow.

The forecast does not include settlement of Doncaster and Bassetlaw (net accrual of £1.1m) who are now looking to make a settlement.CCG contract receipts will be via SBS going forward which could delay the timing. This remains a risk (despite the timely receipts in April) as significant effort was required to deliver the receipt. The forecast assumes that the main receipt will be at the beginning of each month but the sensitivity in May highlights the potential impact.

The original forecast had a payment of £1.3m in September & the recovery plan in December - the September payment has been paid this week.

Commissioner receipts

Forecast

-

5,000

10,000

15,000

20,000

25,000

30,000

35,000

Cas

h £

'000

Daily cash forecast to 29 November

Actual Forecast Sensitised after mitigation

4

Consolidated trading results (Month 2 YTD)Key points

1. Net Surplus / (Deficit) - £0.4m (£0.5m YTD) net favourable variance to plan in M2 driven by expenditure savings.

2. Clinical Income - £0.5m adverse variance to plan at M2 mainly due to shortfalls in Elective activity and £0.3m provision against receipt of CQUIN / Non-Recurrent income.

3. Other Operating Income – YTD adjustment in M2 reflects timing differences against 1/12ths plan profile and prudent approach to FY14 receipts not yet quantified.

4. Pay – Continued downward trend. Underlying run rate at £12.2m

5. Non Pay - £0.2m favourable variance to plan at M2 due to tactical cost controls and tight budgetary management.

Rotherham Foundation TrustConsolidated Trading Results (May-13)

actual plan variance actual plan variance

£m £m £m £m £m £mRevenue

Clinical Income 17.1 17.4 (0.3) 34.2 34.7 (0.5)Education and Training 0.4 0.4 0.0 0.7 0.7 0.0Other Operating Income 1.2 1.4 (0.2) 2.6 2.8 (0.2)

18.6 19.2 (0.6) 37.5 38.2 (0.7)

ExpenditurePay (11.9) (12.8) 0.9 (24.5) (25.5) 0.9Non Pay (5.5) (5.6) 0.1 (10.9) (11.1) 0.2

(17.4) (18.4) 0.9 (35.4) (36.6) 1.2

EBITDA (pre Exceptionals) 1.2 0.8 0.4 2.1 1.6 0.56.6% 4.4% 2.2% 5.6% 4.2% 1.4%

Restructuring Costs (0.4) (0.4) 0.0 (0.7) (0.7) 0.0

EBITDA (post Exceptionals) 0.9 0.5 0.4 1.4 0.9 0.5

Depreciation (0.6) (0.6) 0.0 (1.3) (1.3) (0.1)Asset Impairment 0.0 0.0 0.0 0.0 0.0 0.0Interest (0.1) (0.0) (0.0) (0.1) (0.1) (0.0)PDC (0.2) (0.2) 0.0 (0.4) (0.4) 0.0

(0.9) (0.9) 0.0 (1.8) (1.7) (0.1)

Net Surplus/(Deficit) 0.0 (0.4) 0.4 (0.4) (0.9) 0.5

Year to Date (Month 2)Current Month

5

Run rate analysisRotherham FTAnalysis of Monthly PerformanceFY 13 and FY 14

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Qtr 1 Qtr 2 Qtr 3 Qtr 4£m £m £m £m £m £m £m £m £m £m £m £m £m £m £m £m £m £m £m

RevenueClinical Income 16.7 18.8 16.1 16.6 17.9 16.6 20.6 17.2 16.8 18.0 17.6 18.2 17.1 17.1 0.0 17.2 17.0 18.2 17.9Education and Training 0.4 0.4 0.3 0.3 0.4 0.3 0.5 0.3 0.3 0.6 0.5 0.7 0.4 0.4 0.0 0.4 0.3 0.4 0.6Other Operating Income 1.2 1.2 1.3 1.4 1.3 1.4 1.5 1.3 1.4 1.8 1.6 2.0 1.4 1.2 0.0 1.2 1.3 1.4 1.8

18.2 20.4 17.7 18.3 19.5 18.3 22.6 18.9 18.5 20.4 19.7 20.9 18.9 18.6 0.0 18.8 18.7 20.0 20.3

ExpenditurePay (12.6) (12.8) (12.8) (12.7) (12.7) (12.7) (12.6) (12.4) (12.6) (12.4) (12.2) (12.2) (12.3) (12.2) 0.0 (12.8) (12.7) (12.5) (12.3)Non Pay (5.0) (6.1) (5.3) (5.7) (5.4) (6.0) (6.2) (5.5) (5.2) (6.5) (5.6) (6.5) (5.4) (5.5) 0.0 (5.4) (5.7) (5.6) (6.2)

(17.6) (18.9) (18.1) (18.3) (18.1) (18.7) (18.8) (17.9) (17.8) (19.0) (17.8) (18.7) (17.7) (17.7) 0.0 (18.2) (18.4) (18.2) (18.5)

EBITDA (pre Exceptionals) 0.6 1.5 (0.4) (0.0) 1.4 (0.4) 3.8 1.0 0.8 1.4 1.9 2.3 1.2 0.9 0.0 0.6 0.3 1.8 1.93.4% 7.2% -2.2% -0.1% 7.1% -2.1% 16.8% 5.2% 4.1% 7.1% 9.5% 10.7% 6.2% 5.0% 2.8% 1.6% 8.7% 9.1%

Restructuring Costs 0.0 (0.0) (0.1) 0.0 (0.1) 0.2 (3.0) 0.1 (0.6) 0.6 (0.3) 0.1 (0.4) (0.4) 0.0 (0.0) 0.0 (1.2) 0.1

EBITDA (post Exceptionals) 0.6 1.5 (0.5) (0.0) 1.3 (0.2) 0.8 1.0 0.1 2.0 1.6 2.4 0.8 0.6 0.0 0.5 0.4 0.7 2.0

Depreciation (0.6) (1.6) (1.1) 0.4 (0.7) (0.9) (0.7) (0.8) (0.7) (0.7) (0.7) (0.7) (0.7) (0.6) 0.0 (1.1) (0.4) (0.7) (0.7)Asset Impairment (0.3) 0.5 0.0 (1.6) (0.6) 0.0 0.0 0.0 0.0 0.0 0.0 (0.0) 0.0 0.0 0.0 0.1 (0.7) 0.0 (0.0)Interest (0.0) (0.1) (0.1) (0.1) (0.1) (0.1) (0.1) (0.1) (0.1) (0.1) (0.1) (0.2) (0.0) (0.1) 0.0 (0.1) (0.1) (0.1) (0.1)PDC (0.2) (0.2) (0.2) (0.2) (0.2) (0.2) (0.2) (0.2) 0.0 (0.2) (0.2) (0.1) (0.2) (0.2) 0.0 (0.2) (0.2) (0.1) (0.2)

(1.1) (1.3) (1.3) (1.5) (1.5) (1.1) (1.0) (1.0) (0.7) (0.9) (1.0) (1.0) (0.9) (0.9) 0.0 (1.3) (1.4) (0.9) (1.0)

Net Surplus/(Deficit) (0.5) 0.1 (1.8) (1.5) (0.3) (1.3) (0.1) (0.0) (0.6) 1.1 0.6 1.3 (0.1) (0.3) 0.0 (0.7) (1.0) (0.3) 1.0

One-off adjustments (key items only):Income Unperformance reinvestment 1.9

Bad debt provis ion (1.2)Pay EPR capita l to revenue (1.7)

Provis ion (0.3) 0.3Non-pay EPR capita l to revenue (0.7)

Demol ition (0.8)Extra accruals/provis ions (0.5)

Impairments (0.6)Reported (management a/c.s) (2.3) (0.4) 0.0

FY13Monthly Averages

FY13 FY14Quarter 1Quarter 1 Quarter 2 Quarter 3 Quarter 4

6

Payroll Analysis

9,065 9,081 8,991 8,982

8,867 8,813 8,898

8,818

225 222

224 223

222 224

216 229

193 182 324 198

203 215

234

208

113 64 72

70

68 69

89

70

215 228

210

181

216 224

276

211

113 107

114

115 122 132

120

139

56 61

59

41 36 45

45

50

80

319

507

369

57

614

109 474

8,500

9,000

9,500

10,000

10,500

11,000

Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13

£'00

0 Payroll Breakdown

One offpayment

Other

Expenses

Maternity Pay

Bank

On Call

Overtime

Additionalcontracted time

Non Variable

Staff Group Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13Add Prof Scientific and Technic135 137 138 139 138 140 140 140 140 137

Additional Clinical Services 593 593 591 586 584 590 586 584 577 577

Administrative and Clerical 795 791 789 787 773 760 759 750 737 731

Allied Health Professionals 284 287 288 288 287 284 281 280 281 278

Estates and Ancillary 286 287 288 288 287 287 287 286 284 284

Healthcare Scientists 47 47 47 47 47 47 47 47 46 48

Medical and Dental 286 283 282 280 280 279 277 276 278 278

Nursing and Midwifery Registered1,132 1,124 1,125 1,125 1,113 1,105 1,091 1,087 1,083 1,085

Students 13 16 14 13 13 10 10 7 15 15

Totals 3,571 3,566 3,562 3,553 3,521 3,502 3,477 3,456 3,441 3,433

FTE as at month end

7

Contents



2. Board governance


3. EPR update


5. A&E performance


6. AOB

Governance update

8

• Following a mini-tender process, Deloitte were selected by the Trust to carry out the external governance review, with Jay Bevington as lead partner

• Monitor approved the scope and appointment of Deloitte

• Therefore Deloitte were commissions and the project commences Monday 24th July 2013

• Deloitte have committed to produce the final report and recommendations in line with the line with the deadline from the revised Monitor Enforcement Undertakings, i.e. final report by Wednesday 31st July 2013

• The report will be jointly addressed to the Trust and to Monitor

Executive capacity (e.g. substantive appointments)• Verbal update

9

Contents



2. Board governance


3. EPR update


5. A&E performance


6. AOB

EPR Update• The PID and project plan have now been finalised (see next slide and

report) and signed off by Board• Recent code drops have enhanced both usability, speed and reporting

functions • Re-configuration of the Health Informatics Directorate is now complete.• Data Quality Team now in place and action plan being developed for both

user inputting and coding improvements.• Weekly project/team meetings to ensure project kept on track including

Meditech and Filtek• Regular additional meetings planned with Meditech Development lead to

ensure continued resource allocation and support against the plan• We continue to recruit to the team to ensure adequate resource to deliver

the plan, additional clinical leads currently being advertised

10

11

12

Contents



2. Board governance


3. EPR update


5. A&E performance


6. AOB

Mortality Update• Mortality figures reviewed and increasing trend identified.• Investigation identified issues with (see report):

Coding of palliative care epsiodes vs EoLife

Primary and secondary diagnosis recording

Depth of coding

Activity reductions lowering the denominator

Pneumonia cases review underway

All actions re coding issues currently being completed –re-review of October to march data will be in July once all data available

Regular monthly monitoring and quarterly monitoring underway

13

14

Contents



2. Board governance


3. EPR update


5. A&E performance


6. AOB

A&E performance (for week ending 23rd June 2013) Weekly Performance = 96.31% June Performance to date = 97.31%

· 1519 attendances (inc 27 EPAUS)

· 56 breaches

· Average daily attendances for Mon-Fri = 215 for ED and 5 for EPAU

· Average daily attendances for Sat-Sun = 208 for ED

Qtr 1 and YTD performance = 93.93%

15

16

A&E Recovery Trajectory to achieve 2013-14 target (Q2-4)

17

Contents



2. Board governance


3. EPR update


5. A&E performance


6. AOB

Summary Report Version 1.0 25 th June 2013 1. Contents 2 1.Finances and Recovery Plan 1.Cash position 2.2013/14 performance against plan 3.Cost run rate.

Documents

project plan

action plan

ae performance performance

mortality review report

external governance

final report

ths plan profile

governance update8following