Report to: Board of Directors (Public)

Paper number: 2.1

Report for: Monitoring

Report type: Operational Performance

Date: 30 July 2015

Report author: Mike Piercy, Deputy Director of Finance

Report of: David Wragg, Director of Finance

FoI status: Report can be made public

Title: Month 3, 2015/16 - Financial Position & Q1, 2015/16 Monitor Finance Declaration

Executive Summary

This paper updates on the financial position as at the end of June 2015 (month 3).

The Trust has submitted a plan to Monitor based on a full year surplus of £2,000k, which equates to a planned surplus at month 3 of £500k. The Trust has experienced significant and material financial pressures during the first quarter of the new financial year, and is reporting a financial position at month 3 that is materially behind this level, showing a year to date deficit of £397k, which is £897k behind plan.

Trust Strategic Priorities Supported by this Paper

Delivering the highest level of quality and financial performance.

Risk Implications

Achievement of planned outturn position

Recommendations to the Board

The Board of Directors is requested to:

receive and accept the month 3 financial position; and

approve an In-Year Governance Declaration, for finance, that it anticipates the retention of a Continuity of Service rating of 3 or above.

Legal and Compliance Implications

Remain within Monitor’s Licence Terms.

Finance Implications

Delivery of financial plan.

Single Equalities Impact Assessment

N/A

Requirement of External Assessor/Regulator

The financial position supports the financial element of the Trust’s in-year governance declaration to Monitor.

%age of

Turnover

Actual Normalised Outturn Month 3 -£397k deficit -1.2%

Planned Normalised Outturn 3 £500k surplus 1.5%

Planned Actual Normalised Outturn £2,000k surplus 1.5%

EBITDA Month 3 £1,744k surplus 5.2%

Variance from EBITDA target (YTD) -£907k adverse

Cash in held at bank G

Funds deposited with NLF G

Liquidity ratio (days) G

Capital service ratio (times) A

Overall Rating G

Full Year Full Year

Target Forecast

£k Q1 Q2 Q3 Q4 £k

14/15 Headroom b/f 1,000 G G G G 1,000

Acute 1,058 A A A A 1,058

CMH 550 A A A A 550

R&R 789 A A A A 789

SAMH 281 G G G G 281

SMS 110 G G G G 110

Op Management 84 G G G G 84

Medical 228 A A A A 228

Corporate 1,900 A A A A 1,900

Less: Headroom -1,000 -1,000

5,000 5,000

The key financial risks facing the Trust are:

i) the high level of costs associated with the outplacement of private sector and PICU beds

ii) the current inability of run rates to fully accommodate the 2015/16 CIP targets

The Trust has planned for a £5,000k CIP requirement, with an additional £1,000k of CIP

headroom.

The full £6,000k of CIP targets have been devolved to budgets, and all financial reporting is

against this level. At month 3, it appears clear that not all run rates are currently

accommodating these levels. At month 3, all areas where CIP targets are causing a

noticeable financial pressure have been rated Amber.

FINANCIAL PERFORMANCE OVERVIEW AS AT JUNE 2015

Cumulative Net Position

Cash

Threshold*

£7,504

£39,000

Income and Expenditure

Actual

Lower

Overall Rating

£k

2

Temporary Staffing

Continuity of Service Risk Rating - In year achievement

1.7

CIPProgress

The Trust has experienced a first 3 months of 2015/16 that has been extremely

challenging from a financial perspective, and as a result has returned a £397k deficit

(£897k behind plan)

The main component of this position is a significant overspend of £1,702k on outsourced

private placement and PICU beds. However, other pressures in the system, relating to the

inability of run rates (in the short term at least) to accommodate 2015/16 CIP targets is

also currently a concern.

Risks

Rating

CIP comments

3

-2.0 487

1.3

*The lower threshold is the point at which each of the respective ratios will

fall from their current level.

-0.75-0.50-0.250.000.250.500.751.001.251.501.752.002.252.502.753.00

M1 M2 M3 M4 M5 M6 M7 M8 M9 M10 M11 M12

£m

Financial Position - Normalised Surplus

Actual Plan

-

2.00

4.00

6.00

8.00

10.00

12.00

M1 M2 M3 M4 M5 M6 M7 M8 M9 M10 M11 M12

£m

EBITDA - Performance

Actual Plan

-

0.10

0.20

0.30

0.40

0.50

0.60

0.70

0.80

0.90

1.00

1.10

1.20

1.30

14/15M10

14/15M11

14/15M12

15/16M01

15/16M02

15/16M03

15/16M04

15/16M05

15/16M06

15/16M07

15/16M08

15/16M09

15/16M10

15/16M11

15/16M12

£m

Spend on Temporary Staffing

1. INTRODUCTION

The Trust is budgeting to return a surplus of £2,000k for 2015/16, however the year to date financial position, at month 3, shows expenditure exceeding income, and therefore a deficit of £397k, which is a worsening of the month 2 position of £206k deficit. This is the first time, as a foundation trust, that the Trust is returning year to date deficit positions. The position is behind plan by £897k, which equates to approximately 2.7% of the year to date turnover.

2. SUMMARY POSITION

The table below and the above dashboard provide an overall summary of the position for the year to date. Further detail is shown in Appendices.

3. INCOME

The Trust has agreed all contracts with CCGs and as the majority of the Trust’s income is on a block contract basis, which has minimal scope to vary during the financial year. Whilst some of the Trust’s provider to provider contracts remain outstanding, bills are being raised at levels based on historical levels and on-going discussions. The Trust has secured the significant majority of its income base for 2015/16. Contract negotiations were mainly favourable overall for the Trust, and the overall income base compares favourably with the previous year, and contracts now include a £2,000k overseas visitor element.

The Trust continues to monitor the small number of income streams which have variability incorporated into them. As at month 2, there are still no indicators that these income streams are at risk, however, this will be subject to continued monitoring as the year progresses.

CQUIN income has been agreed but is subject to the achievement of targets. The financial plan assumes full CQUIN recovery. Work is on-going in the Trust to maximise the level of CQUIN income due for the year.

Line Ref Business Unit

Annual

Budget Budget Actual

Variance

(fav) / adv

A B C D=C-B

£'000 £'000 £'000 £'000

1 NON DEVOLVED INCOME (125,931) (31,859) (31,859) (0)

2 Subtotal Direct Services 88,056 22,686 24,853 2,166

3 Subtotal Central Services 27,289 6,522 5,263 (1,259)

4 SUBTOTAL EXPENDITURE 115,345 29,208 30,115 907

5 EBITDA (10,586) (2,651) (1,744) 907

EBITDA M argin 8.1% 8.0% 5.2% -2.8%

6 Depreciation 4,501 1,125 1,125 (0)

7 Dividend Payment 4,219 1,055 1,055 0

8 Interest (134) (29) (40) (11)

9 NORMALISED (SURPLUS) / DEFICIT (2,000) (500) 397 897

Normalised I&E Surplus M argin 1.5% 1.5% -1.2% -2.7%

10 Normalised Costs 1,100 0 0 0

11 RETAINED (SURPLUS) / DEFICIT (900) (500) 397 897

Retained I&E Surplus M argin 0.7% 1.5% -1.2% -2.7%

FINANCIAL POSITION AS AT MONTH 3

4. OUTTURN POSITION AT MONTH 3

The first 3 months of the new financial year have seen the financial position come under significant pressure, and currently the Trust is £897k behind plan (£539k at month 2), and the Trust is in an overall deficit of £397k. Within this position is a material increase in the costs of external PICU/Private Placements, with costs of £2,315k being reported year to date.

The Trust has identified and planned for a CIP requirement of £5,000k, and has prudently included headroom of £1,000k in an overall £6,000k programme. Service and corporate budgets have been allocated CIP targets for the full £6,000k (£1,500k year to date). Opening budgets have been adjusted for these amounts, and the month 3 position reports against the reduced budgetary level, however it seems clear that run rates are currently struggling to accommodate the 2015/16 CIP targets.

Operational Divisions

Operational divisions are, at month 3, overspent by £1,909k (£1,181k at month 2). Operational divisions continue to experience levels of temporary staffing and, more significantly, PICU/Private Placements which are causing significant distress the budgetary position.

It is clear that that the most significant aspect of the adverse financial performance in Operational Services are the costs associated with PICU/Private Placements. During the first quarter the Trust procured outplaced beds totalling £2,315k, which is ahead of budget by £1,702k year to date (£1,071k at month 2).

The Trust recognised costs of £5,934k for PICU/Private Placements in 2014/15. Although usage did fluctuate during the year, this equates to an average monthly cost of £494k. The average monthly cost during 2015/16 currently stands at £771k, which equates to approximately £831k more spend year to date.

During the early part of 2015/16, Coral ward was closed for health and safety related works, and the Trust experienced higher than average bed day costs as a result. Coral is now re-open and Tredgold beds are now available for acute usage, however month 3 has again experienced high costs for PICU/private patient beds. The Trust has, from July, commissioned 16 beds from East London NHS FT on a block basis, which has a lower average bed day cost than is currently being borne, and is revising its discharge processes in order to control usage. It is important that these actions lead to reduced levels of expenditure, as the financial position cannot accommodate ongoing expenditure at this level.

The following charts show the trend of expenditure on PICU/Private Placements. The average bed day figures is based on all private placement actuals where invoices are received and estimates from the bed team, and include all block bed contracts for inpatients:

£0k

£100k

£200k

£300k

£400k

£500k

£600k

£700k

£800k

£900k

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

Expenditure on External Placements Including Block Funded Beds (GL Figures)

Note: The average beds day figures are based on all private placement actuals based on invoices received and estimates from the bed team, and include all block bed contracts for inpatients.

It can be seen that there are indications that the increase in costs incurred are resulting from both a slight increase in bed numbers as well as a more noticeable increase in average price.

Due to the seriousness of the financial position reported at month 2, a series of meetings were held in late June and early July, with the Chief Operating Officer and each division, with Finance also in attendance. These meetings arrived at a series of actions designed at identifying outstanding CIP and reducing run rates over the remainder of the financial year. The meetings also agreed that specific budgets would be moved from divisional positions and held centrally within Operational Services Management, with divisions expected to manage expenditure levels within the revised budgetary envelope.

These budget changes were actioned during month 3, and while the timing of the agreed actions was too late to materially impact on month 3 expenditure rates, it is important that the position from month 4 onwards starts to reflect these actions.

Within Operational Services it is also noticeable that Acute Services, the Community Mental Health division and Rehabilitation & Recovery are all showing overspends.

The Acute division is overspent by £326k (£128k at month 2), and within this position, Acute Inpatient services are overspent by £173k (£72k at month 2), with temporary staffing pressures prevalent. However it is noticeable that the division is struggling to adjust their run rates to accommodate new 2015/16 CIP targets, and it is important that this adjustment happens as soon as possible.

The Community Mental Health division is overspent by £172k (£136k at month 2), with, once again pressures being experienced due to temporary staffing levels and run rates falling short of reduced budgetary levels.

0

10

20

30

40

50

60

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

Average No. Bed days

£0

£100

£200

£300

£400

£500

£600

£700

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

Average Bed day price (based on GL expenditure)

Rehabilitation & Recovery stands at £245k overspent year to date (£43k at month 2), the biggest factor being pay costs still being held in Tredgold pending confirmation of where the pay costs need to be reallocated to, while reduced budgetary levels are once again a pertinent factor in the worsening budgetary position.

Services for Ageing & Mental Health is showing a small overspend at £21k (£9k underspent at month 2) while SMS is underspent year to date by £6k (£21k at month 2).

Medical

Medical staff budgets are £202k overspent year to date (£171k at month 2). While CIP is again an issue in this area, pay costs are also a pressure. A review of Medical budgets with the Medical directorate has taken place and action plans agreed, while confirmation of training monies has led to an increase in budget.

Local Authority Lines

LBC is £50k overspent (£16k at month 2), with both income and expenditure budgets being rebased during month 3 upon confirmation of LBCs 2015/16 income reductions. LBI budgets are underspent by £26k (£1k overspent at month 2). The positions continue to be monitored.

Trust HQ

Trust HQ budgets are currently showing an overspend of £331k, which is a slight worsening of the £210k overspend at month 2. The overall position is predominantly a reflection of material overspends in Director of Nursing & People budgets (£235k) and ICT budgets (£161k). Other areas are operating broadly in line with budget.

This position is of significant concern and is the result of (as is the case with Operational Services) a failure of run rates to accommodate 2015/16 CIP targets as well as continued high usage of temporary agency staffing, and in particular temporary staffing costs significantly in excess of the budget for the posts being covered.

Finance has met with all corporate budget holders to go through the respective positions and to start to formalise actions to reduce run rates and address CIP. THQ CIP targets are currently being held within corporate team budgets pending the development of schemes to deliver outstanding amounts, and it is important that delivery of these targets is now addressed.

Temporary Staffing

The graphs below show levels of temporary staffing against vacancy levels.

The graphs shows levels of temporary staffing against vacancy levels, however, the costs are shown both against the period where the costs were incurred and restated to reflect the period when the shift was actually worked.

During month 3, the Trust used £1,049k of temporary staffing (i.e. spend relating to June work, excluding spend relating to prior months) which is an increase on the month 2 level of spend. At month 3, Operational Services temporary staffing usage was £686k in month (which equated to approximately 5% of budget), with THQ being the other major area of usage with £220k (approximately 7% of budget).

£0k

£200k

£400k

£600k

£800k

£1,000k

£1,200k

£1,400k

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

Total Temporary Staffing

Finance Ledger Position Figures after smoothing retrospective shifts

In month 3, the Trust was carrying a budgetary level of vacancies of 267 FTE, which (at an average cost) equates to a £1,029k monthly vacancy saving. While this approach is indicative in nature, it is pertinent that the cost of temporary staffing has now risen above the vacancy factor. Of particular concern is that month 3 has seen, overall, temporary staffing costs increasing despite a small reduction in vacancy levels.

Recent correspondence has set out NHS wide expectations that temporary staffing will be managed more closely, and the Trust will be looking closely to see how its temporary staffing usage compares to the national directives.

It should be noted that the above graph shows total levels of temporary staffing usage. It is not the intention that this analysis is a definitive, detailed assessment of the reasons behind usage of temporary staffing, which is considered by the Workforce Committee. It is important that trends are assessed within operational services in order that the Trust can assure itself that temporary staffing usage remains under control, within budgetary constraints and that value for money is obtained.

5. CIP

The Trust’s CIP programme for 2015/16 does not contain any major transformational schemes. All CIP targets have been applied to budgets, therefore, the main risk to the financial position becomes maintaining run rates against the reduced budgetary level, rather than the identification of savings schemes.

As has been previously discussed, run rates are showing signs of distress due to the allocation of 2015/16 CIP targets. CIP is being continually monitored and assessed, and it is essential that the current adverse run rates are promptly addressed.

6. RISK RATING

Monitor rates foundation trust financial performance against a Continuity of Service rating, which includes 2 metrics, which are the Liquidity ratio and the Capital Service Cover ratio. The rating is from ‘1’ (high risk) to ‘4’ (low risk). The Trust’s annual plan for 2015/16 was consistent with a rating of ‘4’.

The following table shows the Trust’s Continuity of Service ratings for month 3:

100

150

200

250

300

350

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

Vacancy Factor

Vacancies (FTE)

CONTINUITY OF SERVICE RISK RATING

MetricQ4 14/15 Jun Weighting Rating

Lower

Threshold

Higher

Threshold

Actual

Liquidity ratio (days) 94 87 50% 4 -2.0 n/a

Capital service cover ratio

(times)2.6 1.70 50% 2 1.3 1.8

Continuity of Service Risk Rating 3

As discussed previously in this report, the Trust has experienced an extremely challenging beginning to 2015/16, which has resulted in a sharp fall in financial performance. This has been reflected in a fall in the Trust’s Capital Service Cover ratio from 2.6 (year end 2014/15) to 1.7 at month 3. This equated to a fall in rating on this metric from ‘4’ to ‘2’, resulting in the Trust’s overall rating falling, for the first time since Monitor introduced this rating system, to a ‘3’.

Monitor has begun a consultation exercise to expand the format of the Continuity of Service rating to include measures of overall I&E performance as well as accuracy of both I&E and Capital Programme planning.

An approximation of this is included in Appendix G. The Trust’s month 2 performance is consistent with a score of 2.5, which would normally be rounded up to an overall score of ‘3’. However, Monitor have included an underlying rule stating that any foundation trust gaining a ‘1’ in any metric other than capital planning will have the overall score capped at ‘2’, and may be subject to potential investigation. As the Trust’s I&E position in month 3 of £897k behind plan equates to a variance of -2.7% (and a metric rating of ‘1’), the overall rating allocated under the proposed regime would be ‘2’.

7. BALANCE SHEET AND CASH FLOW

At the end of month 3, the Trust maintained a strong balance sheet. In particular, cash balances were held totalling £46,504k, which includes £39,000k held on deposit with the National Loans Fund. Liquidity levels are slightly behind plan as a result of the additional costs associated with PICU/Private Placements. The Trust has received interest of £40k YTD, which despite the continuation of low interest rates, is ahead of budget.

Working capital balances continue to be positive and the Trust continues to actively address its debtor and creditor balances, and remains confident that the Trust’s overall liquidity is strong.

The month 3 balance sheet shows increases in both receivables and payables from the year end position. These are predominantly caused by the requirement by the LETBs for trusts to raise Quarter 2 training and education invoices in advance, with the intention that cash settlement does not happen until Quarter 2. For the Trust, this has led to a presentational increase in receivables of circa £4,300k, with a corresponding increase in payables as the income is deferred into a future period.

8. CAPITAL PROGRAMME

The Trust’s annual plan, as submitted to Monitor in April, had a commitment to spend £9,521k on its capital asset base in 2015/16.

As at month 3, the Trust has spent £2,351k against its capital programme, which is ahead of the year to date plan, by £38k (2%). Estates schemes account for £1,587k of this spend, and are broadly in line with plan.

The majority of the year to date spend (46%) relates to Highgate backlog and compliance works, and in particular the anti ligature works, and as at month 3, these works are again progressing in line with plan.

The other most significant item in the 2015/16 capital programme is the EPR Replacement project, which is showing spend of £669k which is in excess of plan by £319k. This is currently offset by underspends against other IT schemes of £373k, however, it should be recognised that the budgets for the smaller IT projects aren’t fully finalised at the time of writing, but are expected to be shortly. Once this has happened, there is scope for costs currently allocated to the EPR project to be moved against these projects. The EPR project team are currently reviewing the costs of the scheme to provide a revised forecast.

9. SUMMARY

The month 3 financial position shows a year to date deficit of £397k, which is behind plan by £897k.

The overall financial position, as at month 3, is the result of significant pressures within PICU/Private Placements costs, as well as, to a lesser degree, run rates being insufficient in certain areas to accommodate the 2015/16 CIP targets and reduced budgetary levels. This position is obviously of significant concern and requires immediate remedial action. The re-opening of Coral ward, the additional beds in Tredgold and in East London and management action regarding run rates and CIP targets will all be required to deliver financial gains, however it remains that the Trust now faces significant challenges to meet its financial targets for 2015/16.

The Trust is required to make a declaration to Monitor, in its’ Quarter 1 return, concerning its future Continuity of Service ratings.

While performance against the Capital Service Cover rating at month 3 has shown a marked and worrying deterioration, the Trust’s Liquidity ratio remains strong, and as the overall weighting is an average of the 2 metrics, this should give the Trust considerable assurance that a score of ‘3’ or above will be maintained. Trust therefore intends to declare to Monitor that it expects to retain a rating of ‘3’ or above (the Trust is currently a ‘3’) for the subsequent 12 months (the declaration proforma is attached at Appendix H for information).

RECOMMENDATION: The Board is asked to approve an In Year Governance Declaration, for finance, that it anticipates the retention of a continuity of service rating of ‘3’ or above.

Appendix A

Business UnitAnnual

BudgetBudget Actual

Variance

(favourable)

/ adverse

A B C D=C-B

£'000 £'000 £'000 £'000

Income

1 Service Level Agreements (93,084) (23,531) (23,531) (0)

2 Local Authority (14,930) (3,769) (3,769) (0)

3 Education and Training (15,441) (3,940) (3,940) 0

4 Research and Development (2,476) (619) (619) 0

5 SUBTOTAL CENTRAL INCOME (125,931) (31,859) (31,859) (0)

Expenditure

6 Operational Divisions 55,499 14,565 16,474 1,909

7 Camden Social Services 4,079 1,020 1,070 50

8 Islington Social Services 3,108 739 713 (26)

9 Medical Directorate 10,867 2,737 2,939 202

10 PWLD 1,564 391 391 0

11 Psychology SLAs 12,939 3,235 3,266 31

12 Subtotal Direct Services 88,056 22,686 24,853 2,166

13 Trust Headquarters 11,612 2,952 3,282 331

14 Central Services, SLA's & reserves 15,677 3,570 1,980 (1,590)

15 Subtotal Central Services 27,289 6,522 5,263 (1,259)

16 SUBTOTAL EXPENDITURE 115,345 29,208 30,115 907

17 NORMALISED EBITDA (10,586) (2,651) (1,744) 907

18 Depreciation 4,501 1,125 1,125 (0)

19 Dividend Payment 4,219 1,055 1,055 0

20 Interest Received (140) (35) (46) (11)

21 Interest - unwinding of discount on provisions 6 6 6 0

22 NORMALISED (SURPLUS) / DEFICIT (2,000) (500) 397 897

23 Normalised Costs - Impairments 1,100 0 0 0

24 RETAINED (SURPLUS) / DEFICIT (900) (500) 397 897

FINANCIAL POSITION AS AT MONTH 3

* Earnings Before Interest, Tax, Depreciation and Amortisation [calculated as line 6 less line 17]

**Normalised surplus excludes technical adjustment relating to profits/losses on sale of fixed assets, impairments of the Trust's Estate and any

restructuring costs in order to show the underlying position of the Trust

Appendix B

Line Ref Operational Service Annual Budget Budget Actual

Variance

(favourable) /

adverse

A B C D=C-B

£'000 £'000 £'000 £'000

1 Acute Services 15,294 3,903 4,229 326

2 Private Placements/PICU 1,948 614 2,315 1,702

3 Community Mental Health 10,146 2,581 2,753 172

4 Rehabilitation & Recovery / Outreach 13,154 3,304 3,549 245

5 Services for Ageing & Mental Health 6,475 1,514 1,535 21

6 Substance Misuse & Forensic 4,850 1,212 1,207 (6)

7 Operational Services Management 3,633 1,437 886 (552)

8 TOTAL OPERATIONAL SERVICES 55,499 14,565 16,474 1,909

OPERATIONAL DIVISIONS EXPENDITURE POSITION AS AT MONTH 3

Appendix C

Current as at 31.03.14 Movement

A B C=A-B

£'000 £'000 £'000

NON CURRENT ASSETS

1 Property, plant and equipment 128,931 127,706 1,225

2 TOTAL NON CURRENT ASSETS 128,931 127,706 1,225

CURRENT ASSETS

3 Stocks 0 0 0

4 Receivables - NHS 13,924 7,698 6,226

5 Receivables - Non NHS 2,984 2,375 609

6 Non current assets held for sale 0 0 0

7 Cash at bank and in hand 46,504 50,987 (4,483)

8 TOTAL CURRENT ASSETS 63,412 61,060 2,352

CURRENT LIABILITIES

9 Payables - NHS (1,536) (2,271) 735

10 Payables - Non NHS (28,468) (23,759) (4,709)

11 Provisions for liabilities and charges (795) (795) 0

12 TOTAL CURRENT LIABILITIES (30,799) (26,825) (3,974)

NON CURRENT LIABILITIES

13 Provisions for liabilities and charges (60) (60) 0

14 TOTAL NON CURRENT LIABILITIES (60) (60) 0

15 TOTAL ASSETS EMPLOYED 161,484 161,881 (397)

TAXPAYERS EQUITY

16 Public dividend capital 59,533 59,533 0

17 Revaluation reserve 59,621 59,621 0

18 Income and expenditure reserve 42,330 42,727 (397)

19 TOTAL TAXPAYERS EQUITY 161,484 161,881 (397)

BALANCE SHEET AS AT MONTH 3

Appendix D

£'000

1 TOTAL OPERATING SURPLUS / (DEFICIT) 618

2 Depreciation 1,125

3 (Increase)/decrease in stocks 0

4 (Increase)/decrease in receivables (6,835)

5 Increase/(decrease) in payables 3,157

6 Increase/(decrease) in provisions 0

7 NET CASH INFLOW / (OUTFLOW) FROM OPERATING ACTIVITIES (1,934)

RETURNS ON INVESTMENTS AND SERVICING OF FINANCE:

8 Interest received 46

9 Interest paid 0

NET CASH INFLOW/(OUTFLOW) FROM RETURNS ON

10 INVESTMENTS AND SERVICING OF FINANCE 46

CAPITAL EXPENDITURE:

11 (Payments) to acquire fixed assets (2,595)

12 Receipts from sale of fixed assets 0

13 NET CASH INFLOW/(OUTFLOW) FROM CAPITAL EXPENDITURE (2,595)

14 DIVIDENDS PAID 0

15 NET CASH INFLOW/(OUTFLOW) BEFORE FINANCING (4,483)

FINANCING:

16 New public dividend capital received 0

17 Public dividend capital repaid 0

18 NET CASH INFLOW/(OUTFLOW) FROM FINANCING 0

19 INCREASE/(DECREASE) IN CASH (4,483)

CASH FLOW STATEMENT AS AT MONTH 3

Appendix E

CASH AND LIQUIDITY

£10.0m

£15.0m

£20.0m

£25.0m

£30.0m

£35.0m

£40.0m

£45.0m

£50.0m

£55.0m

Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16

Actual cash £50.6m £47.1m £46.5m

Planned

cash£48.0m £48.0m £48.0m £46.0m £46.0m £46.0m £47.0m £47.0m £47.0m £47.0m £47.0m £47.0m

In year cash balances (including deposits)

Appendix F

15/16 Plan15/16

Committed

15/16 YTD

Plan

15/16 YTD

Actual

YTD Var

v Plan

£'000 £'000 £'000 £'000 £'000

Estates Projects

1 SPH backlog and compliance works 1,035 783 80 114 34

Finalisation of anti ligature works and lift improvements at

SPH and initial works to facilitate the move away from

Kings Cross Rd

2 SPH Huntley Centre 75 0 30 0 -30 Works brought forward from 14/15

3 Highgate backlog and compliance works 4,130 2,050 1,150 1,087 -63Refurbishment , anti ligature and safety works at Highgate

commenced in late 14/15

4 Community properties & Other Projects 1,010 1,223 235 386 151Various schemes including anti ligature works in

community sites

IT Projects

5 EPR Replacement Project 783 783 350 669 319 Figures based on current anticipated spend

6 Nurse Technology Fund 521 0 130 25 -105

Money secured by the Trust from the Nurse Technology

Fund, to procure further hardware purchases. To be drawn

down as Public Dividend capital

7 Hardware Refresh schemes 350 350 88 39 -49 Rolling hardware refresh programme

8 Other projects 1,617 149 250 31 -219Includes previous years projects, Docman rollout, Royal

Free conectivity and Agresso upgrade

9 Total 9,521 5,338 2,313 2,351 38

CAPITAL PROGRAMME AS AT MONTH 3

Note – figures based on Monitor’s consultation document, and may vary before being adopted

Appendix G

MetricQ4 14/15 Jun Weighting Jun

Lower

Threshold

Higher

Threshold

Actual Rating

Liquidity ratio (days) 94 87 25% 4 -2.0 n/a

Capital service cover ratio

(times)2.6 1.7 25% 2 1.3 1.8

I&E Margin 1.4% -1.2% 25% 2 -1% 0%

Variance in I&E margin

from plan0.0% -2.7% 15% 1 n/a -2%

Varaince in Capital

Expenditure-4.7% 1.6% 10% 3 +/-20% +/-10%

Weighted Score 3

OVER RIDING RULE

Does any metric, except variance on capex, score '1'? Y(if so, overall rating capped at '2')

2

CONTINUITY OF SERVICE RISK RATING - New Monitor Proposal

Provisional New Continuity of Service Risk Rating

Appendix H

In Year Governance Statement from the Board of Camden and Islington NHS Foundation Trust

The board are required to respond "Confirmed" or "Not confiirmed" to the following statements (see notes below) Board Response

For finance, that:

For governance, that:

Otherwise:

Consolidated subsidiaries:

Signed on behalf of the board of directors

Signature Signature

Name Name

Capacity [job title here] Capacity [job title here]

Date Date

The board anticipates that the trust will continue to maintain a Continuity of Service risk rating of at least 3 over the next 12 months.

The board is satisfied that plans in place are sufficient to ensure: ongoing compliance with all existing targets (after the application of

thresholds) as set out in Appendix A of the Risk Assessment Framework; and a commitment to comply with all known targets going

forwards.

The board confirms that there are no matters arising in the quarter requiring an exception report to Monitor (per the Risk Assessment

Framework, Diagram 6) which have not already been reported.

Number of subsidiaries included in the finances of this return. This template should not include the results of your NHS charitable funds.