edUNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST

TRUST BOARD MEETING

To be held on 27 April 2011Agenda No 10a

Report of: / Tim Bennett, Director of Finance
Patrick McGahon, Director of Service and Commercial Development
Paper Prepared by: / Tim Bennett, Director of Finance
Patrick McGahon, Director of Service and Commercial Development
Date of Paper: / 20 April 2011
Subject: / Financial and Business Plan 2011/12
Care Quality Commission Standards: / Outcomes 1 and 15
Assurance Framework Link: / Strategic Objective
Principal Objective
Background Papers:
Item Considered at Earlier Committees
(pls detail mtgs): / Trust Board Time-out 19th January 2011
Trust Board 26th January 2011
Trust Board 16th March 2011
Trust Board 1st April 2011
Finance sub-committee 9th February 2011
Finance sub-committee 9th March 2011
Finance sub-committee 20th April 2011
Patient & Public Involvement:
In case of query, please contact: / Patrick McGahon
46666
Purpose of Paper:
*Key issues:
1. Summary of 2011-12 Budget, CIP and Business Plans.
The Board is asked to:
  1. Ratify the previously agreed plans.

AGENDA ITEM NO 10a

TRUST BOARD MEETING: 27 APRIL 2011

SUMMARY BUDGET AND COST REDUCTION PLAN 2011/12

  1. Introduction

This report summarises the Trust’s budgets, CIP and business plans for 2011-12, as agreed at previous meetings of the Board and its sub-committees.

  1. Summary Budget 2011-12

A detailed budget proposal was approved by the Trust Board at its meeting on 1st April 2011. Further details, in the form of a budget book showing divisional and other budgets, were provided to the Finance sub-committee of the Board at its meeting on 20th April 2011.

The table below summarises the Trust’s budget for 2011-12 as approved by the Board and the Finance sub-committee.

Total Start Budgets / wte / £
INCOME BUDGETS
Patient Care Income / 213,218,478
Levies & Other Income / 6,038,000
Total Income / 219,256,478
DIVISIONAL BUDGETS
Medical Services / 964 / 57,747,061
Surgery & Critical Care / 1,053 / 60,163,949
Family & Clinical Services / 1,290 / 60,497,371
Facilities / 602 / 19,794,282
Corporate Services / 325 / 20,078,454
Knowledge, Education, Learning & Development / 86 / 895,158
Use of Assets / 0 / 4,654,000
Other Expenditure / 4,389,203
Total Divisional Budgets / 4,320 / 228,219,478
Savings plans / (14,765,000)
Financing Costs / (5,802,000)
TOTAL TRUST BUDGET SURPLUS/(DEFICIT) / 4,320 / 0
  1. Cost Reduction Plan 2011/12

The Board approved the cost reduction plan 2011/12 at its meeting on 1 April 2011. A summary of the impact by Division/Department is given below.

Cost Reduction Plan 2011/12 – Divisional Split
Area / Value of Schemes
(£’000s)
Medicine / 1,260
Family and Clinical Services / 1,520
Estates and Facilities / 1,148
Surgery / 1,015
Trustwide (Prescribing) / 708
Trustwide (General) / 4,071
Procurement / 1,167
Additional / 3,876
TOTAL / 14,765

Within the above the following key schemes will commence in Quarter 1:

Cost Reduction Plan 2011/12 – Key Quarter 1 Schemes
Scheme description / Expected saving in 2011/12
(£’000s)
Paybill (performance related increments, half pay, sickness absence management)
Drug savings – changes in prescribing practise and products
Procurement savings (purchasing of supplies)
Improving length of stay across the Trust
Stopping some external subscriptions
Training review / 1,100
650
500
600
150
100
TOTAL / 3,100

The managers and clinicians have updated all schemes within the Savings Monitoring Tool (SMT) for risk rating and Quality Impact Assessments (QIAs). In line with last year’s process the Non Executive Directors on the Clinical Quality and Safety Committee (CQSC) will review QIAs as part of the assurance process.

  1. Business Plan 2011/12

The Trust’s Integrated Business Plan (IBP) 2009/14 outlined the key initiatives proposed by the Trust over a five year period.

The Business Plan 2011/12 uses the Integrated Business Plan as the basis for the plan but it has been updated to reflect significant national changes stemming from:

  1. Operating Framework 2011/12
  2. Primary Care Trust Commissioning Intentions 2011/12
  3. Financial Settlement 2011/12
  4. Acute Standard Contract 2011/12

The Trust’s strategic objectives continue to be relevant and form the backbone to the plan for 2011/12.

  1. In partnership with stakeholders to continuously improve in-patient safety and satisfaction
  2. To be recognised as a top performing healthcare provider
  3. To maximise the potential involvement of the public, patients, their families and carers in developing clinical services.
  4. To develop and deliver the workforce needed to support improvements in patient services.
  5. To provide excellent value for money for tax payers and provide sustained long term financial viability.
  6. To ensure that the appropriate infrastructure exists to support the long-term delivery of the Integrated Business Plan.

The Council of Governor’s Strategy Group on 25 January 2011 debated the impact of the national factors, particularly financial situation, on the Trust’s current service strategy. It was concluded, and reported to the Board, that there is a clear need for a comprehensive review of services across the health economy in MorecambeBay, taking a fuller account of need, to ensure in future years we deliver safe, clinically viable, operationally deliverable and financially sustainable services to our population. This work will be a key component of the Trust’s focus during 2011/12.

At the Council of Governors Strategy Group on 7 March 2011, it was agreed the following views would be incorporated within the formal submission to the Council of Governors:-

  1. In terms of the strategic review this needs to take account of needs assessment
  2. Local strategic discussions with GP Consortia need to take full account of the implications around the ‘Any Willing Provider’ approach proposed in the Health Bill.
  3. Electronic Document management business case should be included as a key driver for change around the Electronic Patient and Medical Records.

The draft Business Plan 2011/12 was submitted to the Council of Governors meeting on 14 March 2011. The Council of Governors requested a ‘target’ be included in the Business Plan around cardiac services. This has been included.

The Board approved the Business Plan 2011/12 on 1 April 2011. The key deliverables are shown at Appendix A

A Summary Business Plan 2011/12 leaflet will be produced. This will be posted on the Trust’s internet site and referenced in the Weekly News.

Appendix A

Business Plan 2011/12

Key Deliverables

No / Area/Action / Lead Director / Delivery Target Date / Source
Foundation Trust / Q1 / Q2 / Q3 / Q4
1 / Secure 7,000 public Foundation Trust members / Director of Nursing & Modernisation / Trust
Strategy
2 / Development of new strategy – Clinical/Operational/
Financial / Chief Executive / Trust
National Standards/Targets
3 / CQC Registration / Director of Nursing & Modernisation / CQC
4 / Venous Thromboembolysis (VTE) Risk Assessment Standards / Medical Director / Operating Framework 2011/12
5 / Emergency Readmissions Standards / Director of Operations & Performance / Operating Framework 2011/12
6 / Delivery of Healthcare acquired infection (MRSA and Clostridium Difficile) / Director of Nursing & Modernisation / Operating Framework 2011/12
7 / Delivery of 18 week referral to treatment standard / Director of Operations & Performance / Operating Framework 2011/12
8 / Delivery of quality indicators (5 measures) / Director of Operations & Performance / Operating Framework 2011/12
9 / Delivery of National Cancer standards / Director of Operations & Performance / Operating Framework 2011/12
10 / Delivery of Stroke Targets / Director of Operations & Performance / Operating
Framework
2011/12
Patient Experience/Safety
11 / Achieving compliance with Eliminating Same Sex Accommodation (EMSA) plan requirements / Director of Nursing & Modernisation / Operating Framework 2011/12
12 / Maintaining current PEAT Scores (cleanliness) inspections / Director of Nursing & Modernisation, Director of Operations & Performance / Operating Framework 2011/12
13 / Safety Express (Reducing patient Harm Rollout) / Director of Nursing & Modernisation / Trust Initiative/
Operating Framework 2011/12
14 / Production of Quality Account / Medical Director, Director of Nursing & Modernisation / Department of Health
15 / Improve national patient satisfaction survey scores / Director of Nursing & Modernisation / Operating Framework 2011/12
Informatics
16 / Electronic Document Management system – Business case/rollout / Director of Service & Commercial Development / IM&T Strategy
17 / Rollout of Electronic Patient Record System (Lorenzo) Release 1.9/2 / Director of Service & Commercial Development / IM&T Strategy
18 / Rollout of electronic transfer of clinical correspondence to Primary Care / Director of Service & Commercial Development / IM&T Strategy
Service Development (All developments are subject to securing Contractual/ Funding Agreements)
19 / Introduction of Mohs Surgery Service / Director of Operations & Performance/ Director of Service & Commercial Development / Integrated Business Plan 2009-14 (Awaiting Specialist
Commissioners approval)
20 / Pathology Services Cross-Trust review / Director of Operations & Performance / Trust
21 / Development of the Children’s Services Cumbria Consortium / Director of Operations & Performance/ Director of Service & Commercial Development / NHS Cumbria Child & Family Strategy (2009)
22 / Introduction of wet Age-related Macular Degeneration (AMD) service / Director of Operations & Performance/ Director of Service & Commercial Development / Integrated Business Plan 2009-14 Collaborative Commissioning
23 / Introduction of Day Case Chemotherapy Services at WGH (Kendal) / Director of Operations & Performance/ Director of Service & Commercial Development / Integrated Business Plan 2009-14
24 / Plan expansion of breast screening service to extend to all women aged 47-73 by 2012 / Director of Operations & Performance / Operating Framework 2011/12
25 / Draft business case for a cancer centre at WGH (Kendal) / Director of Service & Commercial Development / PCT Commissioning Strategy Collaborative Commissioning feasibility Business case to be submitted March 2011
26 / Production of RLI Estate Business Case / Director of Operations & Performance / Integrated Business Plan 2009-14
Business case reviewed by Board (Jan 2011)
Human Resources
27 / Monitor and achieve sustained improvements in the annual staff survey / Director of Human Resources & Organisational Development / Operating Framework 2011/12
28 / Ensure all staff have an annual appraisal and PDP / Director of Human Resources & Organisational Development / Trust/
Operating Framework 2011/12
29 / Reduce Sickness Absence in line with Trust target of 3.5% for 2011/12 / Director of Human Resources & Organisational Development / Trust
Financial
30 / Delivery of planned financial position / Director of Finance / Trust Budget 2011/12
31 / Delivery of Trust’s stabilisation (Cost Reduction Plan) 2011/12 / Director of Finance/ Director of Service & Commercial Development / Trust Budget 2011/12