PUBLIC
Minutes of the Finance and Investment Committee, 21 September2017
Finance and Investment Committee
[DRAFT] Minutes of the meeting held on
Thursday 21 September2017 at 09:00
in the Warneford Boardroom, Warneford Hospital, Headington, OxfordOX3 7JX
Chris Hurst / Non-Executive Director (the Chair/CH)
John Allison / Non-Executive Director (JA)
Mike McEnaney / Director of Finance (the DoF/MME)
Martin Howell / Trust Chair (MH)
Stuart Bell / Chief Executive (SB) part meeting
In attendance:
Dominic Hardisty
Adam Perryman
Claire Dalley
Hannah Smith
Kerry Rogers
Laura Smith / Chief Operating Officer (DH)part meeting – by phone
Financial Controller (AP)
Director of Estates and Facilities (CD)part meeting
Assistant Trust Secretary (HS)
Director of Corporate Affairs & Company Secretary (KR)
Corporate Governance Officer (LS) (Minutes)
1.
a / Welcome and Apologies for absence
Apologies for absence were received from Paul Dodd, Deputy Director of Finance and from Dominic Hardisty, Chief Operating Officer.
2.
a
b
c
d / Minutes of the meeting held on 05 July 2017
The minutes of the meeting held on 05 July 2017 were approved as a true and accurate record.
Matters Arising
The Committee confirmed that the following actions from the 14 March 2017 Summary of Actionswould be held over to the next meeting: 4(c), 4(d) and 10(b).
The Committee confirmed that the following actions from the 05 July 2017 Summary of Actions had been completed, actioned or were on the agenda for the meeting: 4(d), 5(e), 9(b),
The following actions would be held over until the next meeting: 3(c) and 11(b).
3.
a
b
c
d
e
f
g
h
i
j
k / Cost Improvement Programme Highlight Report
The Chief Operating Officer joined the meeting by phone.
The Chief Operating Officer presented paper FIC 31/2017 and explained the focus was on key opportunities including temporary spend, non-pay, new income opportunities and existing schemes (Forensic New Care Model and Learning Disability Service.
The Chief Operating Officer has been working with the Directorate leads toexplore opportunities and specific actions to achieve these which would be available for the next meeting. Two possible schemes suggested were focused on community hospital pressures and step down care for mental health inpatients.
The Director of Finance reported that month 5 forecastwas that CIP delivery would be £3.5m below the £7.5m Targetat the end of the year. He added that the current total of CIP plans(£3m)was not enough. He added that the Operational Team need to create detailed work plans to deliver current CIP plans and then look in detail at one-off mitigations, opportunities and risks.
The Chair saidthat, in his experience, there are five important characteristics that influence CIP delivery:
- the underlying quality of the savings ideas
- the commitment of staff to deliver them (culture and engagement)
- appropriate resourcing (ie. the skills and capacity to support delivery)
- effective monitoring arrangements; and
- effective arrangements for holding staff/teams to account for delivery.
The Chief Executive agreed that community hospitals were the biggest opportunity for recovery of cost pressure and noted the imminent inspection on delayed transfers of care in the Oxfordshire system.
John Allison said he was grateful to have attendedthe recent CIP Delivery Group meeting but noted sense of acceptance that CIP delivery would fall short. He said the Trust needed to ensure deliverability of plans at the outset and not six months in.
The Chief Executive left the meeting.
The Chair asked the Director of Finance and Chief Operating Officerto discuss resourcing CIP delivery with the Executive Team
The Chief Operating Officer left the meeting.
The Director of Finance said the Operational Team had acknowledged that they have run out of ideas and alternatives now need to be examined.
The Trust Chair said next year the Trust mustensurethat all CIPs are included in budgets from the outset and the Director of Finance agreed that was what they were working towards.
The Director of Corporate Affairs asked what the NHS Improvement view was on CIPs. The Director of Finance explained that it was still important however their current priorities were control totals and agency spend.
The Committee noted the report. / DH/ MM
4.
a
b / Financial Sustainability Plan and utilisation of reserves update
The Director of Finance provided an oral update and reported that the Trust was £1.5m off underlying (£0.5 not including £1m of one offs). He said this was manageable however needed to get the CIP element to get this up to the £5m forecast.
The Committee noted the oral update.
5.
a
b
c
d
e / Estates Capital Programme Board Progress
The Director of Estates and Facilities presented paper FIC 40/2017 and reported that a number of projects had stalled and remained at amber, particularly engineering works, however they should be able to deliver within the year when the team was back at capacity. Due to the delay all projects would be re-assessed to make sure the more serious risks areprioritised to take up unavoidable slippage in the programme.
The Chair said he was reassured that the Estates Team would re-prioritise and proceed with the most critical programmes.
The Trust Chair said the top priority needed to be safety issues such as windows and staffing solutions.
John Allison said he was not able to differentiate the importance of each of the projects and the Trust Chair suggested the report could be simplified to focus on amber items. The Director of Estates agreed to produce an exception report for amber and red items, which includes the risk number and risk rating in future.
The Committee noted the report. / CD
6.
a
b
c
d / Capital Programme Financial Update
The Director of Finance presented paper FIC 39/2017 and reported that due to slippage they had managed to get through some priority items, including Woodlands House windows. He said there was no risk of overspending the capital budget for the year.
The Director of Finance highlighted a big piece of work underway to fund a 22 bed Low Secure Learning Disability Unit by 01 July 2019, as per the Heads of Terms in the NHS England contract. A rough estimate for the build was £15m, which was not available in capital, and so the Finance Team were looking into funding options.
He added that they were also looking at options for the Slade.
The Committee noted the report.
7.
a / Capital Programme Sub Committee Minutes
The Committee noted the report.
8.
a
b
c / Cash Flow Report
Adam Perryman presented paper FIC 33/2017 andsaid the cash flow forecast remained strong. He said that, if the Trust delivered its within its Control Total, itwouldreceive an additional £1.8m of STF funding at the year end.
The Director of Finance added that if the Trust breacheditsagreed Control Total it would place at risk c.£600k of CQUIN income, which has been assumed in its Budget.
The Committee noted the report.
9.
a
b / Microsoft Update
The Director of Finance presented paper FIC 35/2017 and explained the move to Office 365 would be going ahead. However, after reviewing the security aspects an alternative security provider had been identified which was cheaper with no compromise on quality of service.
The committee noted the report.
10.
a
b
c
d / Electronic Health Record/ IM&T Update
The Director of Finance provided an oral update on progress with Care Notes and reported that there were some concerns regarding Advanced as improvements were not moving rapidly. There had also been problems using Care Notes on iPads because Advanced have not updated its system for updates in iOS, the Apple operating system.
The Director of Finance said that a formal recovery plan would be put in place. He was assured the system was stable, however it would not meet orginal expectations and presented a potential risk to the delivery the digital strategy. There were a number of options to be considered, including building an internal development team.
The Trust Chairsaid it was concerning that Advanced had not updated the operating system, as staff werefinding the use of iPads very beneficial. The Director of Finance said he was in discussion with Advanced regarding this as it was in the contract. He said this would need to be looked at from a strategic perspective including a review of alternatives.
The committee noted the report.
11.
a
b
c / Global Digital Exemplar (GDE) Funding
The Director of Finance presented paper FIC 35/2017 and highlighted no risks.
The Director of Finance asked an item to be added to the agenda for every other meeting to oversee the work.
The committee noted the report. / LS
12.
a
b
c
d
e
f
g / Oxford Pharmacy Store (OPS) Update and minutes of the OPS Board
The Director of Finance presented paper FIC 36/2017 and reported that OPS was running £50-60k short of the plan due to low sales. They were working on opportunities to pull this back and he thought they could achieve the plan by the end of the year.
John Allison said the level of demand must be increasing andasked if it was the level of competition affecting the sales.The Director of Finance explained the availability of products was inconsistent so it was a case of joining up product availability with customers. He said a strength of OPS was that they were plugged into these opportunities.
The Director of Finance said OPS had invested heavily in resource to bolster quality systems to ensure compliance. The Medicines and Healthcare Products Regulatory Agency (MHRA) was due to audit OPS in October and he said they were in a good place and had prepared a schedule for the day to give an overview of the service.
The Director of Finance has had conversations with the NHS Improvement Pharmacy Lead and NHS England Chief Pharmacist and provided them with updates. They were interested in OPS and want to engage more,providing OPS passes the MHRA audit.
The Trust Chair added that passing the MHRA was very important and they would need to re-look at the business case for new premises following this.
The Director of Corporate Affairsnoted there had been a lot of investment in quality over the last year but said this needed to be maintained.
The committee noted the minutes.
13.
a / Oxford Pharmacy Store (OPS) Performance Report
The committee noted the report.
14.
a
b
c
d
e
f / Inquests and Claims Annual Report
The Assistant Trust Secretary presented paper FIC 34/2017 and highlighted the increased cost in spend on solicitors and indemnity cover. She explained that although the level of activity had remained largely the same, the complexity had increased in some areas. She provided an update on the complex jury-based inquests which the Trust had been involved in and noted spend on employment tribunals.
The Assistant Trust Secretary provided a breakdown of NHSLitigation Authority/NHSLA(now NHS Resolution) premiums and highlighted the increase in clinical negligence premiums, due to being part of the NHSLA pool. The Director of Finance confirmed that the Finance Team check and challenge NHSLA on this.
The Committee considered whether there were options to decrease reliance on solicitors by building up more expertise within internal teams. The Director of Finance noted that some work including TUPE agreements could be done more internally.
The Director of Finance said the report showed a good reflection on the Trust, noting the comparative benchmarking data provided in the report.
The Trust Chair expressed his thanks to the Legal Team for their hard work.
The Committee noted the report.
15.
a / Any other business
None to discuss.
The meeting was closed at: 10:53
Date of next meeting: Thursday 09 November 2017: 09:00-11:30
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