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«PAPER - SFT 1878 TITLE - MINUTES FROM THE FINANCE COMMITTEE MEETING HELD ON 23 JUNE 2008 AND DRAFT MINUTES FROM THE FINANCE COMMITTEE MEETING HELD ON ...»

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SALISBURY NHS FOUNDATION TRUST

PAPER - SFT 1878

TITLE - MINUTES FROM THE FINANCE COMMITTEE

MEETING HELD ON 23 JUNE 2008 AND DRAFT

MINUTES FROM THE FINANCE COMMITTEE

MEETING HELD ON 21 JULY 2008

PURPOSE OF PAPER

To advise the Board of items discussed/decisions taken/actions agreed.

ACTION REQUIRED BY THE BOARD

The Board is asked to note the minutes.

Luke March Chairman

SALISBURY NHS FOUNDATION TRUST

Minutes of the Finance Committee Held on Monday 23 June 2008 Mr L March Chairman

Present:

Mr N Atkinson Non-Executive Director Mr B Bull Non-Executive Director Mr R Burrows Non-Executive Director Mr P Hill Director of Operations, and acting Chief Executive Mr B Richardson Deputy Director of Finance Mr M Cassells Director of Finance &

Apologies:

Procurement For Item 3

In Attendance:

Mr P Casson Managing Director, Odstock Medical Ltd Professor I Swain Director, Odstock Medical Ltd For Item 5 Mrs E Liversage Head of Procurement For Item 6 Mrs J Bulgin Directorate Finance Manager Mr G Park General Manager, Laundry and Linen Services Mr R Perry Facilities Director For Item 7 Mr L Arnold Head of Corporate Development Mr J Williams Secretary to the Committee 1. MINUTES The minutes of the meeting held on 21 April were accepted as a true record.

2. MATTERS ARISING Odstock Private Care Ltd – Granting of Charitable Status PAC Ltd – Progress with formation of Company In the absence of MC updates on these two items were deferred to the next Finance Committee meeting on 21 July 2008. MC Odstock Private Care Ltd – Private Patient Income CAP LM advised that Monitor had launched the consultation on the interpretation and application of the Private Patient Income CAP.

The consultation will close on 9 September 2008.

LM asked BR to arrange for MC to prepare a draft response for the BR/MC Committee to consider on 21 July 2008.

Position with ENI UK and Gas Debt BR advised that the debt with the supplier of gas to the former Laundry site at the Old Manor Hospital had been settled in the sum of £40,000. This was against an original claim which ranged between £87,000 and £1.9m. The settlement agreed by the Trust was in accordance with advice given by the Trust’s solicitors who had been involved since the receipt of the first claim.

The Committee noted the information provided under these various headings.

3. ODSTOCK MEDICAL LTD BB presented the minutes from the meetings held on 21 April 2008 and 23 May 2008 together with the profit and loss account for the year to 31 March 2008 and the budget profit and loss account for the year to 31 March 2009.

BB then introduced Philip Casson (PC) who had taken over as Managing Director at the end of April 2008 and who was accompanied by Ian Swain (IS). PC tabled a summary of the company’s performance in 2007/08, the 2008/09 projections, a brief swot analysis and an action plan for the year ahead. This culminated in a request for Research and Development funding of £112,100 but which was expected to produce a greater revenue sum. To support PC articulated his approach to pricing, market share and sales growth.

The Committee noted the information supplied, approved the funding BB/MC/ required and asked for OML Board minutes to continue to be PC presented monthly and for the profit and loss figures (actual to budget) to be provided quarterly.

4. FINANCE REPORT TO 31 MAY 2008 (MONTH 2) BR reported that earnings before interest, tax, depreciation and amortisation (EBITDA) amounted to £2.39m which translated into an income and expenditure surplus of £0.90m compared with £0.86m in the FT plan.

Income totalled £27.11m, £0.77m above the planned figure of £26.34m while expenditure stood at £24.72m, £0.80m over the planned figure of £23.92m.

Working Capital including cash balances remained strong at £13.86m while 85% of the cost improvement savings target had been achieved. As formally agreed by the Trust Board in a public meeting on 9 June 2008 the overdraft facility with NatWest Bank had been reduced from £13m to £7m. (The facility had never been used since the Trust was authorised on 1 June 2006 and this decision saved on fees). The composite risk rating remained unchanged at four.

Activity was ahead of plan in all aspects apart from short stay nonelective which, at 577, was 65 under the plan figure of 642. Day cases at 3,939 were 600 ahead of the target of 3,339 while both initial out-patient appointments and follow up out-patient appointments were significantly ahead of plan at 13,035 compared to 11,862 and 22,012 compared to 19,974 respectively.

BR commented that the plan was based on the agreed 16 week Referral to Treatment Time (RTT) but it was known that Wiltshire PCT were keen to follow the South West Strategic Health Authority guidance and achieve a 13 week RTT by 31 March 2009. As a consequence it was not surprising activity was ahead of plan and it might be that the plan figures would, at some point in the year, need to be formally re-drafted to reflect this aspiration. In the meantime Wiltshire PCT had appointed a commissioning auditor to review patient activity recording and counting processes.





Collectively the Directorate budgets were £69,000 overspent with a range of individual positions. Only two Directorates were actually overspent, Critical Care at £99,000 and Medicine at £48,000.

The Capital Programme spend totalled £523,000 against available funds of £8.71m.

Overall the Trust had made a positive financial start to the 2008/09 year but, in conclusion, BR drew the Committee’s attention to three risk areas as follows: The potential challenge of having to meet a 13 week RTT for Wiltshire PCT on capacity and costs linked to the probable use by the PCT of New Hall for some orthopaedic activity.

• The announcement that an ISTC Facility will be established in Devizes offering diagnostic and day surgery capability.

• The possible need to re-visit the cost savings programme as the National Pay Award of 2.75% for 2008/09 had been centrally under funded by around £600,000.

The Committee noted the report.

5. PROCUREMENT DEPARTMENT, ANNUAL REVIEW FOR YEAR

TO 31 MARCH 2008 EL presented a detailed report setting out the general achievements of the Procurement Department in the year to 31 March 2008 together with a summary of the performance against the specifically targets agreed for the year.

The increased activity undertaken by the Trust in 2007/08 was reflected in the workload of the Procurement Team who had performed well in terms of meeting cost savings targets and managing the higher level of contracting with suppliers. The report was structured under six headings which were consistent with the Trust’s Organisation Strategy. These were:

–  –  –

6. LAUNDRY REPORT As requested by the Finance Committee at the meeting on 21 April RP, GP and JB provided a written report, supported by a short presentation setting out the results of the independent appraisal of the laundry activity which had been conducted during April. The main benefits from this exercise had been to ensure there was a robust system in place to measure activity, understand the costs on a contract by contract basis and to assess prices accordingly via a ‘score card’ which identified the volume and price per unit.

With the growth in throughput achieved during 2007/08, both internally following the introduction of scrubs and externally from New Business gained, and the ability to price accurately against costs, the forecast figures for 2008/09 showed a reduction in the subsidy provided by the Trust from some £309,000 in 2007/08 (which had been budgeted for at the start of the year) to around £55,000 for 2008/09 (against the budgeted figure of £250,000). The pricing of external contracts would also be reviewed to ensure a reasonable margin was being achieved.

GP shared details of plans to trial an alternative type of NHS bed linen for the Trust which does not require ironing. If successful this would significantly reduce Labour costs.

The Committee noted the report and recognised the work that had gone into establishing the laundry business since its move to the Trust site from the Old Manor in the Autumn of 2006. The Committee asked for quarterly financial information to continue to be presented and for the Laundry Management Team to attend the RP/GP/ meeting on 20 October 2008 to give a half year report. JB

7. PROPOSED CAPITAL SCHEME TO ENABLE THE RETENTION

OF WILTON WARD AS A CLINICAL AREA

In order to facilitate the paediatric element of the Phase 3 scheme, (agreed by the Trust Board in August 2007) it was proposed that the library would move from its current location to Wilton Ward. At that time Wilton was operating as a winter pressure ward which had opened in November 2007.

By converting Wilton into the library the Trust would lose this flexibility and the flexibility to have a decant ward which had proved valuable in recent years. However since that decision was made two factors had changed perspectives. Firstly commissioners were looking to reduce waiting times faster than previously expected requiring the Trust to ensure it maintained elective surgical capacity.

Secondly in April the Trust experienced, in line with much of the NHS, a severe ‘winter bug’ outbreak which resulted in many bays across the hospital being closed to admissions and compromising the Trust’s bed capacity.

Given these pressures, and the absolute need to move children’s services out of its current location, the Trust has reviewed alternative options for the relocation of the library. In so doing it has been mindful of the need to ensure that good access to the library is maintained for its users.

This summary paper was brought before the Finance Committee in light of the additional capital costs which will be incurred by the enabling projects for Phase 3 and the impact this will have on the 2008/09 capital budget.

The proposal was to erect a two or three storey modular build on land opposite the link bridge and outside of O&G Out-patients, next to the Pre-Operative Assessment Department.

The paper set out the options for the use of the new facility, the technical assessment, the advantages of adopting the scheme, indicative costs of both a two storey (400 square metres) and three storey (600 square metres) build; timescales (estimated July 2009) and the risks. The report detailed the impact on the 2008/09 Capital Programme and how this could be flexed to accommodate a spend of £1.16m (two storey) or £1.44m (three storey).

The Committee approved the proposal and delegated responsibility for determining whether to proceed with the two storey or three storey option to the Chair and Acting Chief Executive on the basis LM/PH that the final decision, when made, would be reported back to the Committee.

8. ANY OTHER BUSINESS NatWest Bankline System BR tabled a request, which had been put to the Trust by NatWest Bank to access its commercial banking facilities via the web rather than through the current dial up facility which had been in place for some years. The principal use of this facility is to check real-time information on the bank accounts, make electronic payments and process transfers. The system is governed by industry standard security and is only used by authorised members of staff.

The Committee supported the request and resolved that Malcolm MC Cassells, Director of Finance and Procurement, shall be authorised to sign the application in the form now produced to and approved by the Committee, on behalf of the Board, for provision of Electronic Services (defined within the Electronic Services Terms and Conditions as ‘Services’) for and on behalf of Salisbury NHS Foundation Trust.

9. DATE OF NEXT MEETING The next meeting will be held in the Boardroom on Monday 21 July starting at 9:30am.

–  –  –

MC reminded the Committee that the Charity Commission had ruled that Odstock Private Care Ltd could not be registered as a Charity.

However, the Commission had now registered a new organisation, the Odstock Charitable Trust, as a Charity.

–  –  –

The Committee noted the information given.

3. ODSTOCK MEDICAL LTD (OML) BB presented the minutes from the meeting held on 23 June 2008 and added that the application for a £2m grant referred to under ‘any other business’ had been successful. While these funds were expected to be divided amongst several organisations there would be a flow of money into the Medical Physics Department and a ‘knock-on’ benefit to Odstock Medical Ltd. This led to a discussion about the way in which Medical Physics related partly to the Trust and partly to OML and the need for clarity with reporting lines. PH agreed to check there was a proper understanding of the PH management arrangements.

The Committee noted the minutes and supported the action to ensure there were clear reporting lines in place for the Medical Physics Department.

4. FINANCE REPORT TO 30 JUNE 2008 (Month 3) MC reported that earnings before interest, tax, depreciation and amortisation (EBITDA) amounted to £3.57m which translated into an income and expenditure surplus of £1.26m compared with £1.12m in the FT plan.

Income totalled £40.37m, £1.02m above the planned figure of £39.35m while expenditure stood at £36.80m, £0.91m over the planned figure of £35.89m.

Working Capital including cash balances remained strong at £13.56m while 84% of the cost improvement savings target had been achieved. The composite risk rating remained unchanged at four.

Activity was ahead of plan in all aspects apart from short stay nonelective which at 875 was 82 under the planned figure of 957. Day cases at 5,936 were 928 ahead of target and elective in-patients stood at 1,786 which was 71 ahead of target while both initial outpatient appointments and follow up out-patient appointments were significantly ahead of plan at 19,534 compared to 17,796 and 33,252 compared to 29,967 respectively.



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