Item 8 - Sheffield Health and Social Care

We have continued to build on our past successwith apprenticeships. Ten apprentices completedtheir training this year with four gaining substantiveposts at SHSC, two in other NHS Trusts and fourgoing on to non-NHS employment or highereducation. Twenty-five people have startedapprenticeships this year across pharmacy, businessadministration, health and social care and cleaningsupport services. These are a combination of newrecruits and existing staff updating their skills.In addition to the apprenticeships, forty-threemembers of staff have enrolled on vocationalcourses and qualifications this year.2.17 Our financial performance andother disclosures in the public interestWe have now been established as Sheffield Healthand Social Care NHS Foundation Trust for over fouryears. Through strong financial performance, wehave successfully maintained a Financial Risk Ratingof 4 with Monitor, our independent regulator.In respect of the year 2012/13, we exceeded ourplanned forecast of a £2,545,000 surplus andachieved a surplus of £3,512,000 with Earnings BeforeInterest, Tax, Depreciation and Amortisation (EBITDA)of £8,876,130 (against a plan of £6,888,688).As an NHS Foundation Trust, we are able to carryforward any financial surplus monies that we havegenerated. These surpluses will be used to maintainand, where appropriate, enhance the quality of theservices that we provide. The surpluses will also helpto secure our future financial stability, especially overthe next few years, in order to mitigate the adverseimpact of the current economic climate.We are pleased to report that the surplus has exceededthe target identified in the Annual Plan, and this hasbeen achieved through rigorous expenditure controland tight management of our efficiency programmes.We have maintained our surplus to enable us toachieve the minimum Financial Risk Rating of 4 whichprovides Monitor with assurance that a FoundationTrust is in good financial health.Our present Financial Risk Rating has come about dueto the effective delivery of our Annual Plan objectivesand focus on our Integrated Business Plan, which wesubmitted as part of our Foundation Trust application.Both the Annual Plan and the Integrated BusinessPlan objectives have been delivered.Whilst the targets of our Cost ImprovementPlans have been met for 2012/13, some of thisdelivery (approximately, £1.6 million) was throughnon-recurrent measures.The NHS Foundation Trust enablement to retaincash has allowed us to maintain a healthy bankbalance. This will remain so for the coming year,although our commitment to achieving ourNational Efficiency Savings targets over thenext two years will involve capital spending.The following sections provide our commentaryon the Trust’s financial performance and anoverview of our accounting processes, capitalplans, income and expenditure.The Accounts for the period commencing from1st April 2012 to 31st March 2013 are includedin full under Section 15 of this Annual Report.2.17.1. Financial risk ratingPart of the NHS Foundation Trust governanceframework requires NHS Foundation Trusts tosubmit to Monitor, an Annual Plan as well asquarterly and other ad hoc reports on their financialperformance, governance and mandatory services.On the basis of these submissions, Monitor assignsa quarterly or annual risk rating (as the case may be)to each NHS Foundation Trust.The risk ratings are designed to indicate the risk ofan NHS Foundation Trust’s failure to comply with itsterms of authorisation, which form the basis uponwhich they derive their mandate to operate.In its regulatory oversight in the area of finance,Monitor uses a risk rating scale of 1 to 5, where1 represents the highest risk and 5 representsthe lowest risk of failure to comply with an NHSFoundation Trust’s terms of authorisation.Sheffield Health and Social Care NHS FoundationTrust achieved a Financial Risk Rating of 4throughout the year 2012/2013.As a Trust, we have a rigorous performancemonitoring system in place through the structureof our operational committees, committees ofthe Board of Directors, right through to the Boardof Directors itself where performance reports aremonitored and reviewed on a monthly basis.2.17.2. Our income and expenditure positionIn the 12 months covered by this report, the Trust generated an income totalling £128,382,000.A summary of the position is provided below:Total1st April 2012 – 31stMarch 2013 (£ 000s)Total1st April 2011 – 31stMarch 2012 (£ 000s)Income from activities 93,276 86,961Other operating income 34,788 35,513Total income 128,064 122,474Operating expenses (122,994) (118,466)Profit on disposal of property, plant and equipment 318 73Interest received and other financial costs 130 101Movement in fair value of investment property (20) 0Public dividend payable (1,986) (2,191)Surplus for the year 3,512 1,9912.17.3. Disclosure in relation to other incomeThe composition of other operating income isdisclosed in note 3.1 to the Annual Accountscontained in Section 15 of this report.2.17.4. Cash flow managementWe continue to review our Treasury ManagementPolicy and cash and working capital management.Our aim is to ensure that cash managementcontinues to be in line with Foundation Trustrequirements, which are based on commercialcash management arrangements.Our cash balance at the end of March 2013 was£22.731 million and the Trust has a contractedworking capital facility of £2.5 million. During theyear, the Trust did not need to use its workingcapital facility.2.17.5. Capital expenditureThe Trust’s investment in capital expenditure for2012/13 was £2.901 million. The spending ofcapital has been minimal this year as we continueto review our existing estates strategy. A majorpart of this review relates to the Acute CareReconfiguration of mental health services.The planning and development of the PsychiatricIntensive Care Unit (PICU) commenced in 2012/13,although the majority of expenditure for this willoccur in 2013 – 14. The site has been identified,plans drawn up and building work is due tocommence in May 2013.The development of the Intensive Support ServiceUnit (ISSU), within the Learning Disabilities Servicecommenced in 2012/13, although some of theexpenditure will occur in 2013/14. The building isprogressing to the timescales agreed and will beoperational in 2013 – 14.With the exception of the PICU and ISSU, themajority of capital funds are being retained untilthe estate strategy review is complete.2.17.6. Long term borrowingMonitor, the independent regulator for NHSFoundation Trusts, sets the approved prudentiallong term borrowing limits for all NHS FoundationTrusts from the date of their authorisation. Theselimits are revised every year. Our approved longterm borrowing limit for 2012/13 was set at £24.9million. During the year, we have not borrowedagainst this limit.3334