The outturn financial position for the Trust at 31 March 2015 was a surplus of £0.27m compared to a revised plan surplus of £0.2m summited to Monitor in December. A detailed analysis of the significant variances between forecast outturn and the actuals for the year across the categories of income, pay and non pay can be found on page 4.

For the month of March, the actual performance was a deficit of £0.3m against a surplus plan of £0.45m. There were a number of significant non pay variances within this, including a £0.7m provision for backdated Novell maintenance costs which the Trust continues to seek legal advice on. Also there was £0.4m of blood product expenditure accounted for in month. These items were offset in part by an upward revaluation of fixed assets (due to significant changes in the building indices) which has resulted in a £0.5m favourable accounting adjustment to the bottom line in month.

The Trust had agreed with the Commissioners and the Auditors a method of forecasting month 12 income based on the first 2 weeks of activity in April. This was to meet the tight reporting deadlines for year end given the timing of the Easter holidays . The reported financial position reflects this forecast income with a provision in for actual activity delivered in the last 2 weeks of April . Excluding the income provision shown as non pay, clinical income for month 12 was £0.5m above plan, with Medicine over-performing across all points of delivery including electives, outpatients, A&E and cost per case, whilst Surgery and Critical Care was slightly below plan (please refer to page 2 for details).

Pay expenditure moved out by £0.9m in month, however a significant amount of this was offset by over recovery of non clinical income, including research and recharged income.

Non pay moved out by £1.4m in month above the forecast outturn position, this included unexpected expenses such as the Novell licence issue (£0.7m), income provision (£0.35), and blood product invoices (£0.4m).

Full year efficiency delivery against the target of £6.78m was £4.99m (73%). However within this, there were £1.6m of non recurrent plans, therefore recurrently the Trust delivered 50% of the full year target. The level of carry forward efficiency target is therefore £3.1m which includes £1.5m of unidentified schemes.

REPORT TO THE TRUST BOARD OF DIRECTORSHELD IN PUBLIC ON 28 APRIL 2015

Finance Report – 12 Months to 31st March 2015 

Summary of key points

1

2

Does not include items accrued last month of £973k

The efficiency target for 2014/15 was £5.1m, added to this was unachieved efficiency targets from the previous year of £1.68m. As a result, a total efficiency target of £6.78m was required to be delivered in 2014/15 for the Trust to meet it’s overall financial plan. Of the target for the year, circa £5.3m of plans were identified (£4.4m at month 11), this included £1.6m of non recurrent plans (£0.8m last month).

For the year, efficiency schemes delivered a total saving of £4.99m (£3.6m last month), this significant increase in month was due to the recognition of non recurrent plans including the release of capacity funding and over recovery of income in specific specialties. Achievement against the full year target was 73% (58% as at month 11). However, this reduces to 50% when non recurrent plans are excluded. This is a significant recurrent shortfall which needs to be factored into the financial plan for the new year. A different approach is being taken to address the 2015/16 efficiency targets which includes a number of corporate schemes led by the Project Management Office and numerous division specific schemes.

Table 1 - Summary of Trust’s Efficiencies

3

Performance Against Reforecast Income and Activity Plans (Surgery & Critical Care and Medicine)

4

Financial Run Rate

5

Year End Forecast Position V Month 12 Actuals

6

The Trust delivered a surplus of £0.27m for the year against a reforecast plan of £0.2m surplus. Although the performance was only £0.07m better than plan, there were some significant variances within income, pay and non pay. Some of these variances were reflected in the internal budgets in the last quarter, for instance, where there was an agreement to increase contract payment from commissioners. The variances shown above are therefore against the original reforecast plan submitted to Monitor, but the analysis on page 1 include contractual changes which have been reflected in the internal budget.

Pay expenditure was £0.7m above the revised plan, this was due to a combination of winter pressure expenditure together with costs associated with delivering the recovery plan , and expenditure on agency staffing.

Total agency spend for the year was £4.2m compared to £3.3m last year, an increase of £0.9m. Last year Medical agency staff spend was £0.7m compared to £1.3m this year, staffing issues across all the 3 clinical divisions around recruitment have had a significant impact in 2014/15. In addition to this there was a £0.4m increase in Admin and Clerical agency spend mainly in Non Clinical Support, which was due to a combination of staff vacancies, additional resources required following the implementation of Medway, exacerbated by the HMRC ruling on not allowing VAT reclaim for admin and clerical staff.

The number of whole time equivalent staff employed by the Trust and going through payroll increased by 72 compared to last year, but was 92 below budget at the year end. Detailed analysis of increase WTE from February 2014 to March 2015 by Division and by department is provided in the table shown on the next page which excludes capitalised staff.

Staff Whole Time Equivalent (WTE) Analysis

Analysis of Agency Spend

7

8

Increase in Whole Time Equivalents (WTE) From March 2014 to March 2015 By Division

In the table above, all Divisions are showing an adverse contribution position against the original budget plan with the exception of CWAMH, HR and R&I who are on plan or better.

Surgery and Critical Care is showing the most significant adverse variance of £3.6m from plan. In the month of March, the Division’s income position deteriorated slightly from its £2.5m underperformance reported last month. Throughout the year, there were staffing issues within the Division which impacted on activity delivery. In the final quarter, Surgery and Critical Care’s income performance was expected to deteriorate by a further £0.4m against the original plan, however, it deteriorated by a further £0.3m.

The Division of Medicine is also showing a significant variance from plan of £3.3m. Although income seemed to be over performing, this was due to cost per case activity and was offsetting pay and non pay overspends. Outpatient and Elective income was £1.2m behind plan for the year. The division was £1.8m overspent on pay which included unidentified efficiency targets and pay pressures associated with covering vacancies.

Note: Red = adverse performance by greater than 5%, Amber = actual performance is within plan by 5% either adverse or favourable, Green = favourable performance by greater than 5%.

Summary Service Line Report by Division (12 Months to 31st March 2015) – Original Plan

9

Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000

IncomeElective (17,714) (16,514) 1,200 (10,453) (10,271) 182 - - - - (5) (5) (28,167) (26,791) 1,377Non Elective (6,331) (5,953) 378 (6,459) (6,423) 36 - () () - (1) (1) (12,790) (12,378) 413Outpatient (8,231) (7,625) 607 (18,398) (17,404) 994 - - - (2,086) (1,775) 311 (28,716) (26,804) 1,912Excess Bed Days (936) (408) 528 (984) (1,164) (180) - - - - - - (1,920) (1,572) 348Other Income from Activities (16,785) (16,441) 343 (13,060) (12,913) 147 (27,066) (26,879) 188 (4,376) (4,349) 26 (61,286) (60,583) 704Cost Per Case (1,080) (1,841) (761) (6,264) (8,296) (2,033) (65) (26) 39 (64) (230) (166) (7,473) (10,393) (2,920)Other Operating Income (2,541) (2,229) 312 (3,359) (2,978) 381 (1,481) (2,002) (521) (5,896) (5,587) 309 (13,277) (12,796) 481Total Income (53,619) (51,011) 2,607 (58,977) (59,451) (474) (28,613) (28,907) (294) (12,421) (11,946) 475 (153,629) (151,316) 2,314

- -Pay 30,020 30,815 795 28,758 30,531 1,772 21,895 21,966 71 13,157 12,931 (226) 93,831 96,243 2,412Non Pay 8,697 9,149 452 11,577 13,152 1,576 1,900 1,983 83 6,210 6,248 38 28,384 30,532 2,148Total Expenditure 38,717 39,964 1,247 40,335 43,683 3,348 23,795 23,949 154 19,368 19,179 (188) 122,215 126,775 4,561

Gross Contribution (14,901) (11,047) 3,854 (18,642) (15,768) 2,874 (4,818) (4,958) (140) 6,947 7,233 286 (31,415) (24,540) 6,875% 27.79% 21.66% -6.14% 31.61% 26.52% -5.09% 16.84% 17.15% 0.31% -55.93% -60.55% -4.62% -15.53%

Support Service Recharges 1,637 1,353 (284) 5,741 6,075 334 9 21 12 (7,388) (7,449) (62) () ()

Net Contribution Margin (13,264) (9,694) 3,570 (12,901) (9,693) 3,208 (4,809) (4,937) (128) (441) (216) 225 (31,415) (24,540) 6,875% 24.74% 19.00% -27% 21.87% 16.30% -25% 16.81% 17.08% 3% 3.55% 1.81% -51% 20.45% 16.22% -4.23%

Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000

IncomeOther Income from Activities - - - - - - - - - - - - - 73 73 1,212 (1,663) (2,875) 1,212 (1,590) (2,803)Other Operating Income (746) (802) (56) (238) (339) (101) (5,083) (5,330) (247) (1,136) (1,323) (187) (80) (66) 14 (6,010) (5,255) 755 (13,293) (13,115) 179Total Income (746) (802) (56) (238) (339) (101) (5,083) (5,330) (247) (1,136) (1,323) (187) (80) 6 87 (4,798) (6,918) (2,120) (12,081) (14,705) (2,624)

Pay 3,995 4,180 185 2,194 2,118 (76) 5,946 5,913 (33) 960 1,103 143 7,467 7,538 71 4,059 (127) (4,185) 24,620 20,725 (3,895)Non Pay 2,830 2,948 117 3,236 3,557 321 963 1,242 279 361 406 45 2,514 2,709 194 8,776 7,390 (1,386) 18,681 18,252 (429)Total Expenditure 6,825 7,127 302 5,430 5,676 245 6,909 7,155 246 1,321 1,509 188 9,981 10,247 265 12,834 7,263 (5,572) 43,301 38,977 (4,324)

Gross Contribution 6,079 6,326 247 5,192 5,337 145 1,826 1,825 (1) 185 187 2 9,901 10,253 352 8,037 345 (7,692) 31,220 24,272 (6,948)4% 3% 0% 1% 4% -96%

Central Income and Reserves Total - Non ClinicalClinical Support Finance Human Resources Research Non Clinical Support

Total - ClinicalSurgery & Critical Care MEDicine Community, Wellbeing & MH Pharm, Diag and Genetics

The above analysis shows the performance of the divisions against the reforecast plan. In effect the adjustments made have mitigated the reported variances by division by categories of income, pay and non pay for months 1 to 8. As such the variances shown above are that for months 9 to 12 only.

All divisions were able to contain their financial position in line with the plan for the last four months of the year with the exception of Surgery & Critical Care where the income position continued to deteriorate along with continued overspends on pay and non pay.

Summary Service Line Report by Division (12 Months to 31th March 2015) – Revised Plan

10

Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000

IncomeElective (17,714) (16,514) 1,200 (10,453) (10,271) 182 - - - - (5) (5) (28,167) (26,791) 1,377Non Elective (6,331) (5,953) 378 (6,459) (6,423) 36 - () () - (1) (1) (12,790) (12,378) 413Outpatient (8,231) (7,625) 607 (18,398) (17,404) 994 - - - (2,086) (1,775) 311 (28,716) (26,804) 1,912Excess Bed Days (936) (408) 528 (984) (1,164) (180) - - - - - - (1,920) (1,572) 348Other Income from Activities (16,785) (16,441) 343 (13,060) (12,913) 147 (27,066) (26,879) 188 (4,376) (4,349) 26 (61,286) (60,583) 704Cost Per Case (1,080) (1,841) (761) (6,264) (8,296) (2,033) (65) (26) 39 (64) (230) (166) (7,473) (10,393) (2,920)Other Operating Income (2,541) (2,229) 312 (3,359) (2,978) 381 (1,481) (2,002) (521) (5,896) (5,587) 309 (13,277) (12,796) 481Reforecast Adjustment 2,000 (2,000) 1,016 (1,016) (187) 187 443 (443) 3,272 - (3,272)Total Income (51,619) (51,011) 607 (57,961) (59,451) (1,490) (28,800) (28,907) (107) (11,978) (11,946) 32 (150,357) (151,316) (958)

- -Pay 30,020 30,815 795 28,758 30,531 1,772 21,895 21,966 71 13,157 12,931 (226) 93,831 96,243 2,412Reforecast Adjustment 407 (407) 1,246 (1,246) 345 (345) (68) 68 1,930 - (1,930)Non Pay 8,697 9,149 452 11,577 13,152 1,576 1,900 1,983 83 6,210 6,248 38 28,384 30,532 2,148Reforecast Adjustment 351 (351) 863 (863) 32 (32) 106 (106) 1,352 - (1,352)Total Expenditure 39,475 39,964 489 42,444 43,683 1,239 24,172 23,949 (223) 19,406 19,179 (226) 125,497 126,775 1,279

Gross Contribution (12,143) (11,047) 1,096 (15,517) (15,768) (251) (4,628) (4,958) (330) 7,428 7,233 (195) (24,861) (24,540) 321% 23.52% 21.66% -1.87% 26.77% 26.52% -0.25% 16.07% 17.15% 1.08% -62.01% -60.55% 1.46% 0.43%

Support Service Recharges 1,637 1,353 (284) 5,741 6,075 334 9 21 12 (7,388) (7,449) (62) () ()Reforecast Adjustment (313) 313 212 (212) 5 (5) 96 (96) - - -

Net Contribution Margin (10,819) (9,694) 1,125 (9,564) (9,693) (129) (4,614) (4,937) (323) 136 (216) (352) - - - - - - (24,861) (24,540) 321% 20.96% 19.00% -10% 16.50% 16.30% 1% 16.02% 17.08% 7% -1.14% 1.81% -259% 16.53% 16.22% -0.32%

Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance Budget Actual Variance£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000

IncomeOther Income from Activities - - - - - - - - - - - - - 73 73 1,212 (1,663) (2,875) 1,212 (1,590) (2,803)Other Operating Income (746) (802) (56) (238) (339) (101) (5,083) (5,330) (247) (1,136) (1,323) (187) (80) (66) 14 (6,010) (5,255) 755 (13,293) (13,115) 179Reforecast Adjustment (30) 30 (37) 37 7 (7) (77) 77 3 (3) (3,138) 3,138 (3,272) - 3,272Total Income (776) (802) (26) (275) (339) (64) (5,076) (5,330) (254) (1,213) (1,323) (110) (77) 6 84 (7,936) (6,918) 1,018 (15,353) (14,705) 648

Pay 3,995 4,180 185 2,194 2,118 (76) 5,946 5,913 (33) 960 1,103 143 7,467 7,538 71 4,059 (127) (4,185) 24,620 20,725 (3,895)Reforecast Adjustment 164 (164) 21 (21) (72) 72 19 (19) 394 (394) (2,456) 2,456 (1,930) - 1,930Non Pay 2,830 2,948 117 3,236 3,557 321 963 1,242 279 361 406 45 2,514 2,709 194 8,776 7,390 (1,386) 18,681 18,252 (429)Reforecast Adjustment 129 (129) 126 (126) 59 (59) 59 (59) 99 (99) (1,824) 1,824 (1,352) - 1,352Total Expenditure 7,118 7,127 9 5,577 5,676 98 6,896 7,155 259 1,399 1,509 110 10,474 10,247 (228) 8,554 7,263 (1,292) 40,019 38,977 (1,042)

Gross Contribution 6,342 6,326 (16) 5,302 5,337 35 1,820 1,825 5 186 187 1 10,397 10,253 (144) 619 345 (274) 24,666 24,272 (394)0% 1% 0% 0% -1% -44%

Central Income and Reserves Total - Non Clinical

Surgery & Critical Care MEDicine Community, Wellbeing & MH Pharm, Diag and Genetics Total - Clinical

Clinical Support Finance Human Resources Research Non Clinical Support

Divisional Commentaries (Month 12 Variance Only to original plan) – Clinical

11

Income (£391k above plan) - above plan in all areas except Outpatients (even against revised plan.).Pay (overspend by £63k) - due to continued use of agency staff but savings in other areas.Non-pay (overspend by £448k) - mainly due to a mixture of drugs and blood factor products expenditure.

Income variance in March was mainly attributable to test income from the Genetics Diagnostics Service. However for the full year the services was circa £150k below their revised plan. The service will actively manage spend on non pay going forward in order to reduce wastage and costs of developing panels.

Pay underspend was mainly attributable to the release of capacity funding which had been held centrally, but at year end , this was reflected at divisional level.

The division’s outturn position was an overspend of £225k. This was in part attributable to under performance of clinical genetics income which is expected to be non recurrent in nature due to recruitment issues experienced in 2014/15.

Income (original plan) under delivered by £110k, including a £169k deficit on elective activity. However, Non-elective income was £85k ahead of plan and offset some of the elective shortfall.

The pay movement includes £125k cost due to undelivered CIP.

The non-pay position is skewed by the release of capacity funding not utilised (£709k favourable). Otherwise, non-pay was over spent as a result of a negative stock count adjustment (£293k) and costs which are fully rechargeable to commissions (£110k).

The month 12 variance on income was primarily a result of 2 key factors: recognition of additional funding in relation to Children and Young People’s IAPT (£97k) and reduction to income targets associated with Gibson House and the 16/17 year old’s service (£39k).

These income movements were substantially offset by pay expenditure, which fully accounts for the in-month pay over-commitment.

The primary elements affecting the in-month non pay position were: Personal Child Health Records (£20k), School Nursing scanning (£20k), TCS property costs (£20k), IAPT consultancy (£19k), long service/retirement awards (£13k), Speech and Language software (£11k) and fixtures and fittings at Becton (£8k).

Budget Actual VarianceIncome (4,736) (4,665) 71 Pay 2,733 2,872 139 Non Pay 1,437 1,083 (355)Support Service Recharges 126 93 (33)Net Contribution Margin (440) (618) (178)

Surgery & Critical CareBudget Actual Variance

Income (5,139) (5,530) (391)Pay 2,861 2,924 63 Non Pay 876 1,324 448 Support Service Recharges 519 610 91 Net Contribution Margin (884) (672) 211

MEDicine

Budget Actual VarianceIncome (2,435) (2,542) (107)Pay 1,963 2,036 72 Non Pay 194 338 143 Support Service Recharges 1 2 1 Net Contribution Margin (277) (166) 110

Community, Wellbeing & Mental Health

Budget Actual VarianceIncome (983) (1,075) (92)Pay 1,106 989 (117)Non Pay 728 725 (2)Support Service Recharges (646) (705) (59)Net Contribution Margin 205 (65) (270)

Pharm, Diag and Genetics

Divisional Commentaries (Month 12 Variance Only to original plan) – Non Clinical

12

Income variance in the month was due to charitable income received offsetting some of the non pay overspend. In addition to this, there was a £50k overspend on energy & utilities.

The division was showing an overspend of £144k at year end, this was mainly attributable to the increasing costs of managing the estates of the Trust including energy, utilities and minor works.

Income over performed due to higher than planned volume on catering and hospitality sales

The pay position was supported through the release of capacity funding, which offset the continued impact of undelivered CIPs and agency over spending.

The income variance relates to the apportionment of private patient income between Non Clinical Support and the clinical divisions. Work is ongoing between Finance and the Private Patients Manager to agree an appropriate methodology for 2015/16.

The month 12 pay underspend was a function of 2 key factors: 1) allocation of additional funding to support the IM&T organisational structure (£210k), 2) provision of budget in recognition of delivery of the coding efficiency target (£200k).

The principal influences on the in-month non pay position were hardware & software purchases (£74k), telephone services (£42k) and scanning (£28k).

The significant income variance in month was due to over recovery of training and education income, which was directly offsetting non pay overspends.

Budget Actual VarianceIncome (62) (83) (21)Pay 382 368 (14)Non Pay 234 240 6 Gross Contribution 553 524 (29)

Clinical SupportBudget Actual Variance

Income (20) (61) (41)Pay 228 181 (47)Non Pay 266 353 87 Gross Contribution 474 473 (1)

Finance

Budget Actual VarianceIncome (421) (699) (278)Pay 498 513 15 Non Pay 74 343 269 Gross Contribution 151 157 6

Human ResourcesBudget Actual Variance

Income (7) 147 154 Pay 1,041 639 (402)Non Pay 481 648 167 Gross Contribution 1,516 1,434 (81)

Non Clinical Support

The table above details the amount of centrally held budgets at the year end, and which have been released into the Trust’s bottom line to support the reported £0.27m surplus.

Following the Monitor reforecast exercise, the financial plan was adjusted to reduce the original plan surplus of £2.7m to £0.2m. This in effect had increased the centrally held budget balance by £2.5m as shown above.

The £8.5m was released to offset variances against the original financial plan which included £2m underperformance against contract income, £1.8m of unachieved efficiency targets, £2.8m of pay overspends including agency staffing costs and £1.9m of non pay overspends.

Analysis of Contract Income Performance – Year to Date Against Revised Activity Plan for December to March

14

Income Overview by Points of Delivery - Year to Date Against Revised Income Plan for December to March

15

The comments in this section relate to performance against contracted activity targets plus the additional activity target not contracted for.

Emergency Department

A&E activity was 703 cases (1.3%) above plan to the end of March and £229k above year to date financial plan (5%).

Elective Excluding Day Cases and Excess Bed Days

Elective activity was 557 cases (9.4%) below year to date plan or £1m (6.7%) under plan financially. The key underperforming specialties were: ENT (£420k), T&O (£386k) and BMT(£353k).

Day Cases

Day Case activity was 482 cases below year to date plan (3.7%) or £290k (2.4%) in financial terms. Rheumatology (£207k), T&O (£140k) and ENT (£122K) underperformed whilst Dentistry and Metabolics over-performed by (£278k) and (£122k) respectively.

 Non Elective Excluding Excess Bed Days and inc. Marginal Rate

Non Elective activity was 241 spells below plan (2.9%) or £399k under financial plan (3.1%). Underperforming specialities include: Oncology (£209k) and ENT (£189k). Over-performing specialities included Paediatrics (£366k) and Dentistry (£121k).

 Outpatients excluding Diabetes Best Practice

Outpatient activity (including AAU) was 7572 attendances (4.6%) or £1.9m (6.8%) below plan. First attendances were 2494 below plan (£626k), follow-ups 4316 under plan (£884k) and AAU down 762 (£408k) on plan. The key under-performing specialties as at March were Neurology (£404k), Clinical Genetics (£351k) and Paediatrics (£330k).

16

Activity and Income Variance Against Contracts

Price Variance, £ Activity Variance Total Price, £ Total Activity

POD Apr-Feb Mar Apr-Feb Mar YTD YTD

AE 139,989 88,874 126- 829 228,863 703 Block 541,893- 48,153- 1,067- 97- 590,046- 1,164- CF 27,360 2,487 26 2 29,847 28 CPC 2,705,095 246,043 - - 2,951,138 - EL 1,591,388- 221,527 1,102- 62 1,369,862- 1,039- NEL 388,043- 11,008- 248- 7 399,051- 241- OP 1,914,767- 2,973 7,896- 351 1,911,794- 7,544- Other 13,492- 1,215- 83 8 14,707- 91 UNB 339,787- 30,866- 1,229- 112- 370,653- 1,341- XBD 413,075- 65,259 983- 183 347,815- 800-

Grand Total 2,330,002- 535,921 12,542- 1,234 1,794,081- 11,308-

The following graph shows the Trust’s net working capital, alongside the level of working capital cover compared to cash expenditure.

The level of cash has decreased in March by £3.36m. There was Trust funded capital expenditure, in excess of depreciation of £3.4m in the month, which accounts for the decrease in cash, along with a PDC Dividend payment of £997k in the month. Also, the level of trade payables has increased by £1.32m as a result of increased non pay activity in the month, which as a result of the shift in payment policy, has resulted in an inflated cash position.

Due to the New Build and Theatres projects, the level of cash is falling as predicted. It is anticipated that £12.5m of loans will be drawn down in April 2015, with an additional £10m being drawn down in October 2015. This should ensure that for the next 12 months, liquidity is not going to be a significant concern in the short term. However, in 2016/17, the cash position of the Trust is expected to fall as the New Build approaches completion.

Working Capital and Cash Balances

17

Cash Flow – Historical

18

Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15Total Total Total Total Total Total Total Total Total Total Total Total

INCOME

- main SLA Income - Sheffield CCG 3,068,106 2,834,713 2,779,881 2,752,446 2,786,460 2,779,881 2,621,679 2,783,388 2,956,976 3,188,414 2,477,945 3,409,009 - main SLA Income - National Commissioning Board 9,441,419 7,210,886 7,048,295 6,474,439 8,357,842 7,361,763 7,299,402 7,346,067 7,323,950 7,300,062 6,830,877 8,030,688 - other Income from NHS 3,844,967 2,370,443 2,975,040 2,970,566 3,134,670 1,806,773 2,215,060 1,924,401 2,566,062 3,239,255 2,684,863 2,979,151 - VAT Reclaimed 269,303 470,177 - 177,459 124,441 245,276 206,784 127,886 273,971 186,215 110,615 - - Compensation Recovery Unit income 12,387 29,600 16,590 19,058 15,635 8,869 6,682 54,928 - - 45,693 40,395 - Loans - - - - - - - - - 12,500,000 - - - Other Income 244,480 401,265 166,412 587,863 370,452 243,291 314,964 721,297 533,809 437,779 724,099 590,533 - Interest Receivable - Government Banking Service 5,187 9,470 5,324 4,945 5,019 4,694 4,290 4,165 3,896 3,570 5,758 5,679 - Income from Charity - - - - - 500,000 - - - - - 2,227,000 Co-Op    - Credit Card income 102,359 74,812 60,463 94,386 171,238 61,443 132,165 77,545 96,962 86,802 80,326 113,309 - Other Income 3,599 1,976 631 4,011 2,038 5,908 523 11,931 1,137 3,872 4,895 77,253 Total Cash Receipts 16,991,807 13,403,344 13,052,636 13,085,174 14,967,796 13,017,898 12,801,549 13,051,609 13,756,764 26,945,969 12,965,070 17,473,016

PAYMENTS Total Total Total Total Total Total Total Total Total Total Total Total

- Accounts Payable - BACS payments 6,155,191 3,270,463 4,000,684 4,512,292 4,775,411 4,837,363 3,537,954 3,290,514 3,326,946 4,129,872 3,540,376 4,695,375 - Accounts Payable - NHS Litigation Authority 104,914 104,914 104,914 104,914 104,914 104,914 104,914 104,914 104,914 104,914 - - - Accounts Payable - Capital payments 354,000 1,185,471 434,977 537,532 1,067,851 945,339 1,217,000 1,492,179 1,598,000 1,209,000 1,314,000 5,951,093 - Monthly salaries 5,071,746 5,128,779 5,247,668 5,191,841 5,332,168 5,250,043 5,240,387 5,298,437 5,329,909 5,272,961 5,322,642 5,354,544 - Weekly wages 118,723 60,077 4,248 4,305 4,959 3,978 1,936 - - - - - - Salaries & Wages - Pensions 1,497,709 1,533,488 1,529,575 1,557,558 1,547,937 1,568,037 1,556,800 1,559,324 1,561,420 1,570,471 1,566,862 1,558,395 - Salaries & Wages - Pay As You Earn & National Insurance 2,070,342 2,083,032 2,073,178 2,136,598 2,078,183 2,124,987 2,110,882 2,092,282 2,116,295 2,115,266 2,113,022 2,124,635 - Other - - - 5,631 1,315 - 23,050 - 8,166 - - - -GBS charges 91 174 105 194 232 167 154 169 152 159 168 100 - Loans & interest on loans - - - 214,657 - - - - - 213,868 - 73,726 - Public Dividend Capital dividend - - - - - 703,000 - - - - - 997,000 Co-Op - Other 155,433 77,228 145,456 82,846 46,984 97,568 122,667 100,274 76,078 83,256 87,847 81,107 Total Cash Payments 15,528,148 13,443,625 13,540,806 14,348,369 14,959,955 15,635,396 13,915,744 13,938,092 14,121,880 14,699,766 13,944,916 20,835,975

Net cash flows 1,463,660 (40,281) (488,170) (1,263,196) 7,841 (2,617,498) (1,114,195) (886,484) (365,116) 12,246,203 (979,846) (3,362,959)

TOTAL CASH BALANCES brought forward 19,146,447 20,610,106 20,569,825 20,081,655 18,818,459 18,826,300 16,208,802 15,094,607 14,208,123 13,843,007 26,089,210 25,109,364

TOTAL CASH BALANCES carried forward 20,610,106 20,569,825 20,081,655 18,818,459 18,826,300 16,208,802 15,094,607 14,208,123 13,843,007 26,089,210 25,109,364 21,746,405

19

Cash Flow – Projected Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16Total Total Total Total Total Total Total Total Total Total Total Total

INCOME

- main SLA Income - Sheffield CCG 2,800,000 2,800,000 2,800,000 2,800,000 2,800,000 2,800,000 2,800,000 2,800,000 2,800,000 2,800,000 2,800,000 2,800,000 - main SLA Income - National Commissioning Board 7,100,000 7,100,000 7,100,000 7,100,000 7,100,000 7,100,000 7,100,000 7,100,000 7,100,000 7,100,000 7,100,000 7,100,000 - other Income from NHS 3,094,333 3,094,333 3,094,333 3,094,333 3,094,333 3,094,333 3,094,333 3,094,333 3,094,333 3,094,333 3,094,333 3,094,333 - VAT Reclaimed 125,000 125,000 125,000 125,000 125,000 125,000 125,000 125,000 125,000 125,000 125,000 125,000 - Compensation Recovery Unit income 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 - Loans - 12,500,000 - - - - 10,000,000 - - - - - - Other Income 450,000 450,000 450,000 450,000 450,000 450,000 450,000 450,000 450,000 450,000 450,000 450,000 - Interest Receivable - Government Banking Service 5,000 10,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000 - Income from Charity - - - - - - 500,000 - - - - 2,500,000 Co-Op    - - - - - - - - - - - - - Credit Card income 90,000 90,000 90,000 90,000 90,000 90,000 90,000 90,000 90,000 90,000 90,000 90,000 - Other Income 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 Total Cash Receipts 13,684,333 26,189,333 13,684,333 13,684,333 13,684,333 13,684,333 24,184,333 13,684,333 13,684,333 13,684,333 13,684,333 16,184,333

PAYMENTS Total Total Total Total Total Total Total Total Total Total Total Total

- Accounts Payable - BACS payments 3,144,000 3,144,000 3,144,000 4,013,460 3,210,768 4,013,460 3,186,460 3,186,460 3,983,075 3,259,692 3,259,692 4,074,615 - Accounts Payable - NHS Litigation Authority 150,000 150,000 150,000 150,000 150,000 150,000 150,000 150,000 150,000 150,000 - - - Accounts Payable - Capital payments 2,383,400 2,383,400 2,383,400 1,718,200 1,718,200 1,718,200 1,769,600 1,769,600 1,769,600 2,621,300 2,621,300 2,621,300 - Monthly salaries 5,689,667 5,689,667 5,689,667 5,689,667 5,689,667 5,689,667 5,589,667 5,589,667 5,589,667 5,589,667 5,589,667 5,589,667 - Weekly wages - - - - - - - - - - - - - Salaries & Wages - Pensions 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,650,000 1,650,000 1,650,000 1,650,000 1,650,000 1,650,000 - Salaries & Wages - Pay As You Earn & National Insurance 2,200,000 2,200,000 2,200,000 2,200,000 2,200,000 2,200,000 2,250,000 2,250,000 2,250,000 2,250,000 2,250,000 2,250,000 - Other - - - - - 454,661 - - - - - 448,643 -GBS charges 100 100 100 100 100 100 100 100 100 100 100 100 - Loans & interest on loans - - - 1,369,000 - - - - - 1,111,000 - - - Public Dividend Capital dividend - - - - - 991,000 - - - - - 992,000 Co-Op - - - - - - - - - - - Other 30,000 30,000 30,000 30,000 30,000 30,000 30,000 30,000 30,000 30,000 30,000 30,000 Total Cash Payments 15,197,167 15,197,167 15,197,167 16,770,427 14,598,735 16,847,088 14,625,827 14,625,827 15,422,442 16,661,759 15,400,759 17,656,325

Net cash flows (1,512,834) 10,992,166 (1,512,834) (3,086,094) (914,402) (3,162,755) 9,558,506 (941,494) (1,738,109) (2,977,426) (1,716,426) (1,471,992)

TOTAL CASH BALANCES brought forward 21,746,405 20,233,571 31,225,737 29,712,903 26,626,809 25,712,407 22,549,652 32,108,158 31,166,664 29,428,555 26,451,129 24,734,703

TOTAL CASH BALANCES carried forward 20,233,571 31,225,737 29,712,903 26,626,809 25,712,407 22,549,652 32,108,158 31,166,664 29,428,555 26,451,129 24,734,703 23,262,711

The capital programme for 2014/15 was initially £24.3m but this was revised downwards to £19.5m as a result of slippage in the New Hospital Wing Development, although there was not an overall reduction in the level of capital expenditure budgeted for the next 5 years.The main elements of the 2014/15 revised capital programme were: New Hospital Wing (£6.7m), Theatres (£3.4m), 3T MRI (£2.5m) and EPR/PAS (£1m).

The main areas of capital spend for March were: 3T MRI (£2,229k), New Hospital Wing (£1,877k), Theatres 8&9 (£1,340k), MEMG (£179k), IT Schemes (£119k), out of a total capital expenditure for the month of £6.028m.

CIT have now completed the 2015/16 capital plan, after collating risk assessments on the schemes which were put forward for discussion and work is ongoing to model the plan throughout the year, as this will have an impact of the cash flows of the Trust

Capital Expenditure

20

CCG Clinical Commissioning Group

CEA

Clinical Excellence Award

CNST

Clinical Negligence Scheme for Trusts

CQUIN

Commissioning for Quality and Innovation

ESR

Electronic Staff Records

EBITDA

Earnings Before Interest, Tax, Depreciation and Amortisation

FYE

Full Year Effect

NHSLA

NHS Litigation Authority

PDC

Public Dividend Capital

PGME

Post Graduate Medical Education

SCG Specialised Commissioning Group

SLAM

Service Level Agreement Monitoring

QIPP

Quality, Innovation, Productivity and Prevention

SIFT Service Increments for Teaching

WTE Whole Time Equivalent

YTD Year To Date

List of Abbreviations Used In This Document

21