Trust Board papers - University Hospital Southampton NHS ...

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Worked wtes rose by 105 in November to 7,654. Within this, agency usage rose by24 wte and overtime / excess hours increased by 14 wte. The hospital has beenunder significant capacity pressures for much of November and in addition to theimpact on performance targets, the agency spend was £2.0m in month, up £0.3m onthe year to date average and a cause for concern.Division ADivision A over spent by £0.2m in November which is also £0.2m greater thanforecast (£9.9m total expenditure for the month). Mid-month concerns with meetingthe Emergency Department (ED) access targets, led to Critical Care Unit nursingshifts being fully filled for the weekend with high cost agency, to ensure that patientswere not held up in ED. This meant the Critical Care Care Group missed its financialforecast by £120k. Agency spend in Critical Care doubled from last month to £0.3mfor November and because extra capacity was open clinical supplies expenditurewas also greater than forecast.Spend for the Division as a whole is £211k more than last month. An increase in runrate was not forecast for November and is largely attributable to the change inapproach in Critical Care.At the end of November Division A was £2.4m over spent largely due to the CancerCare Care Group (£2.2m) and specifically Drugs (£1.7m). Year to date slippageagainst the CIP target is £0.7m. On a positive note, debtors, which were £2.3m inMay and as such have been subject to much control action, have this month fallenbelow the £1m threshold for the first time.Division A has generated £60m of clinical income after the first 7 months of thisfinancial year (latest data available) and is above plan. Whilst Cancer Care isoverspending it is also over performing, in income terms, against its production plantarget (£1.5m over ytd).At the end of November the Division has identified 91% of its £4.1m CIP target. TheDivision has actioned 128 schemes so far this financial year with a total value of£2.7m, this represents 66% of the total CIP Target.The Division is currently forecasting to spend £115m in FY2012/13; this will bereviewed in light of the change in Critical Care capacity provision.Division BIn November Division B spent £6.9m which is £0.2m more than October and £0.1mmore than that forecast. The main reason for the adverse position is MSSEexpenditure within the respiratory centre on high cost ventilators, endoscopyconsumables and medical equipment maintenance.There is an in month overspend of £0.5m against the Divisional budget due to CIPshortfall of £0.1m, £0.2m agency nursing net of vacancies, £0.1m MSSE and £0.1mdrugs. The main concerns going forward are the agency use both in nursing anddoctors required to close the vacancy gap and cover winter pressures, plus theability to keep pace with the expected CIP delivery which increases to £0.7m permonth in Q4.At present the Division is continuing to focus on overseas recruitment and limiting itsturnover rate. Achievement against CIP depends on the length of stay scheme inEmergency Care which to month 7 is reporting activity over plan of £1.3m (4.5%). Intotal the Division is over-performing against production plan by some £2.1m (3.5%)which includes high cost drugs.3
Division CDivision C was favourable in November by £97k (the cumulative position is £379kadverse) and spent £8.5m in month which was the same as October and as perforecast levels.CIP shortfalls, staffing pressures in Women & Newborn and pressures on staffing, xray film & clinical supplies within Neonates and Theatres were offset by supportservices underspends and lower non pay & higher income on car parking.The Divisional pay bill has increased since last month by £108k. This is due tovacancies being filled in Clinical Support and Non Clinical Support and higherDietetics agency covering vacancies. The total actual wte has increased by 41wte,30wte within Support Services on Therapies & Non Clinical support and the balancein Child Health.The main financial problem facing the Division is slippage against identified schemesplus unidentified CIPs with 10% (£571k) of the Divisional target still to identify.The latest activity figures show an over-performance of approx £1.2m (2.02%).Division DDivision D is £2.7m adverse at month 8, which is an adverse movement of £512k inthe month.The main issues in the month were unfound CIP in Cardiac, Medical staff spend inT&O, Nursing spend in T&O due to “specialing” of a patient , Stroke Unituncommissioned beds, Sub Contracting in T&O & Cardiac, high non pay costs forInterventional Radiology & CSI and low PP Income. This has in part been offset by ablood rebate.The Division spent £10,608k in November with agency expenditure at £447k.Headcount was 1,657 wte. (up 25 on the previous month). Latest activity figuresindicate the Division is £2m behind Plan, mostly in T&O due to combined Traumaand Winter related pressures.THQTHQ budgets overspent by £99k in November and are cumulatively £9k overspent.Clinical Governance (including training & development) overspent by £143k as theresult of returning budget for flexible SpRs to reserves following a reduction in NESCfunding in line with falling expenditure. CEO overspent by £101k including £73k inthe PSC. Estates overspent by £69k due to slippage on CIP delivery andengineering maintenance.Other Services underspent by £159k thanks to favourable movements on Thornburyagency bills, the EU emissions scheme and finance leases.Other THQ Directorates were close to break-even.4
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Board Paper Cover SheetTitleChief E
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4. Signing & Sealing4.1 The Seal of
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performance target and C-Diff targe
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University Hospital Southampton NHS
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Appendix 2Exception Reports - Novem
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Monthly MeasuresPatient ExperienceH
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IM&T Report - Nov 20121. Purpose1.1
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2.2. Information to support patient
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