Trust Board Febuary 2010 - Sandwell & West Birmingham Hospitals

SWBFC (1/10) 010
The Committee was pleased to note that the Trust remains classified as a
‘performing’ organisation, despite the amber rating.
Mr Harding advised that the Department of Health had revised a number of the
thresholds within this framework, including those associated with cancer waiting
times and stroke care. Data for Quarter 3 was noted to be based on the revised
targets and performance was highlighted to meet or achieve the targets for the
majority.
6 Financial planning update
SWBFC (1/10) 007
SWBFC (1/10) 007 (a)
SWBFC (1/10) 007 (b)
Mr White reported that in terms of financial planning for 2010/11, a number of
measures had been put in place, including the ‘road test’ tariff. The Operating
Framework had also been issued, which clarified expectations around efficiencies
to be delivered. Cost Improvement Plan targets had been developed with the
efficiency expectations in mind.
There was however, considerable work to be done to prepare for and settle the
current LDP negotiations. Outline plans for the health economy in 10/11 are due to
be submitted at the end of January. A surplus of c. £2m is expected of the Trust in
2010/11 on the basis of the controls issued by the SHA. There is an expectation that
the contracts with commissioners should be signed by the end of February 2010,
with the budget being brought to the Board for approval subsequently.
Mr White advised that by 2015/16, the ‘Right Care, Right Here’ planning assumptions
would see acute activity fall with a significant proportion linked to procedures of
limited clinical value, therefore the services will need to be adjusted over the years
leading up to this. Access to the strategic transitional reserve will be required to
assist with this requirement.
Tariffs for four best practice pathways will be introduced and plans to align to the
Trust to this development are already underway through the divisional annual
planning process.
In terms of CQUIN, a further 1% of tariff will be added for 2010/11, although the list of
targets is as yet, unclear.
Payment will not be made for any ‘Never Events’ that occur.
To deliver the surplus and CIP, the Committee was advised that a target income of
£372m income is required. Mr Trotman noted that expenditure on pay is a significant
issue and asked how robust the plans were to address bank and agency costs as
part of the overall financial programme as he was very concerned that pay was
over budget this year and was conscious that that this should be avoided in
2010/11. Mrs Davis added her concern that the presentation of overall pay costs in
2009/10 with those planned for 2010/11 did not show a clear reduction in pay
spend. Mr Kirby advised that additional capacity had been necessary to handle
the operational pressures recently. An increasingly smaller group of areas did rely on
agency and bank staff, including theatres, Accident and Emergency departments
and assessment units. He gave assurances that the use of bank and agency staff
would be addressed in the coming year, alongside the implementation of a
number of operational efficiencies that would assist. The current level of overspend
in Medicine and Surgery was reported to be necessary to ensure unimpeded
patient flow. Mr Kirby continued that a benchmarking exercise on pay costs had
been undertaken by Dr Foster, where the Trust was compared with eleven similar
trusts, the results from which will be built into future capacity planning
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