Report of the Business and Finance Committee to the Board of Directors

CONFIDENTIAL

BOD5/2012

Report of the Business and Finance Committee to the Board of Directors

Introduction

The Board is asked to note this report which highlights issues that the Committee feels should be drawn to its attention. Details of other considerations are contained in the minutes of the meeting attached to this report.

Decision required by Board / Decision made by Committee

There are no decisions required by the Board from this meeting nor were there any notable decisions taken by the Committee.

Contracts / CQUIN / Annual Plan

The Committee held a lengthy discussion regarding the current contracting position and were informed that the Trust had given notice on the Harrow CAMHS Tier 4 service as part of the contract reduction with NHS Harrow. It was noted that the annual plan would potentially be reprioritised following further consideration of the discussions that were held at the Board away day.

In relation to CQUIN, the Committee were also informed that the new CPA Care Plan and crisis cards had been released to improve performance against those two indicators. Funding had also been approved for a year for a CQUIN support post.

Finance / CIPs

The Committee received and commended the Finance report to the Board. The Committee were informed that the Trust was unlikely to hit its Q3 debtor and creditor targets, due to continuing issues with external bodies. The Committee has requested a review of the position to inform how likely it is that it will be hit by year end.

The Committee have requested that the CIP Group timetable be reviewed to check it is still on track.

Community Service performance / Camden Provider Services cross-subsidisation

The Committee received a report detailing the financial performance of CPS and HCH against that of ‘old CNWL’ and noted that it indicated the acquisition had been a successful and beneficial one for the Trust. In relation to CPS cross-subsidisation the Committee has requested additional work to be brought to the next meeting.

New Business bid

The Committee were informed of a request at short notice to tender for 1-year funding for the provision of additional services across the Trust, including a particular bid of £5.8m for a service within psychological medicine. Due to the timing of the request it had not been possible to present this to the Committee.

A particular concern was raised regarding the feasibility of the setup of a team for such a short contract and the Committee has requested that this be reviewed and brought back.

Bhavana Desai, Chair

Non-Executive Director

B&F /2011

Central and North WestLondon

NHS Foundation Trust

Business and Finance Committee – 23 December 2011

DRAFT RECORD OF MEETING

Record of a meeting of the Business & Finance Committee held on 23 December 2011, 9.00 a.m. at Stephenson House, London, NW1.

1.Welcome

Members present:

Ms. Bhavana Desai(Chair)Non-Executive Director, Chair

Mr. Laks Khangura(LK)Non-Executive Director

Mr. Ian McIntyre(IM)Director of Commercial Development

Mr. Trevor Shipman(TS)Director of Finance

In Attendance:

Mr. Nick Bell(NB)Deputy Trust Secretary

Ms. Robyn Doran(RD)Director of Operations and Partnerships

Ms. Jenny Greenshields(JG)Deputy Director of Finance

Ms. Caroline Leveaux(CL)Interim Associate Director of Strategic Planning and Information

Apologies for Absence

aThere were apologies for absence from John Vaughan.

Minutes of Meeting 25 November 2011

aThe minutes were considered for matters of accuracy and agreed as an accurate record.

Matters Arising

aIt was requested that the contracting update include a schedule of contract income

bTS to confirm that the CIP Group timetable is being followed

cItem 7, K&C Section 75, RD advised that the project was going to plan so far.

dItem 9b, statement of comprehensive income, report to be attached with the monthly finance report.

eItem 12a, Bank Facility Review, TS advised this has now been signed off with the Chair and Chief Executive and taken forward.

fIn relation to the benchmarking paper provided, the Committee welcomed the timetable. It was queried what the overall objective of the benchmarking was, and clarified that as much as possible, it was for the Trust to be assured that service pricing and performance is competitive, and to identify areas which are less so. TS added that there were moves to form a national benchmarking group which would potentially inform the next stage of the project. It was agreed a set of criteria should be developed to ensure the project follows this objective. It was also requested that feedback from management be included against each of the benchmarking items.

Contracting Update

aCL introduced the item and advised that the key issue remains non-payment by North Central London, which currently sits at circa £8m. However dialogue is moving forward to try to resolve the issues.

bIn relation to the commissioning intentions 2012/13, the Committee considered the appendix to the report and CL advised of the main headlines. Of particular note was that to form part of the savings for NHS Harrow the Trust has given notice on the CAMHS Tier 4 service. Also notice has been given on the Ealing Addictions contract and the Trust will be bidding for the revised contract. It was requested that a summary table detailing the overall contracting picture be provided.

cIt was clarified that these were not the only funding savings the Trust was facing, as on top of this CIP savings will need to be made.

dIt was requested that the annual plan update should be included as part of the review of the commissioning intentions for the future as they link closely together.

eThe Committee considered the annual plan update. CL discussed the main headlines and advised that the Board had agreed to remove the cap on expansion, while maintaining mindfulness of the need to consolidate business and not overextend. The Trust would also start to consider options outside of the Greater London area where it was identified as sustainable.

fIM noted that there had been detailed discussions at away days around the corporate strategies, and one of the key corporate areas was around the Organisational Development programme which was not reflected in the report. It was noted that the away day discussions would be considered further at the January Board and that may change part of the content of the annual plan priorities.

gLK advised that he had requested the Medical Director review loss-making services and the way forward with these, and it was agreed this would be useful to consider at the Business and Finance Committee.

hLK considered the appendix detailing business priorities for the coming year and queried whether the business development team had enough resource built in to take forward this key area of work. IM advised that he had increased the capacity recently to cope with the numerous workstreams currently but this would always be subject to review depending on new opportunities as they arise. IM advised he would bring the breakdown and prioritization of workstreams to the next meeting under the Business Tracker.

iIt was requested that the Council of Members Annual Planning sub-group dates be circulated to the Committee.

jIt was requested that a one-page summary be developed which gives a very high level view of income vs cost and capital for the current year and future year plans as they stand so far, recognizing that this will be a shifting picture.

kThe Chair noted that the Business and Finance Committee had been tasked with having a more detailed review of CIPs, and part of this would be to review the quality impact. It was requested that the annual plan update also build this into its consideration of CIP work.

lThe Committee considered the CQUIN Update, and CL discussed the main headlines. CL advised that funding for a CQUIN support post had been approved for the coming year. CL advised that the new CPA care plan had now been released, and 25000 crisis cards had also been sent out, which would help improve performance in this area.

mIn relation to the repatriation project, RD advised there are some concerns over Harrow which she is taking forward. RD advised the main financial risk was around Brent but there was cautious optimism over performance there. It was noted there was a seeming discrepancy between the figures quoted and the project graph. It was requested that this be clarified at the next meeting.

Finance Report

aTS introduced the item and advised that the Trust is unlikely to hit the creditors / debtors target for Q3, the debt due to the continuing issues for NCL, although the Trust did receive a further £1.5m payment for invoices. Creditor performance was due to contract disputes with a number of PCTs. It was noted that in both cases the Trust was relying on external bodies to move this forward and this was the reason for the continued underperformance. It was requested that further clarity be provided on how this can be taken forward to achieve the proposed ‘green’ rating for Q4 so that the Board can be fully appraised of the risk in this area.

bIt was queried whether the change in law to agency staff employment had been built in to the Trust business planning. It was noted that this was part of the thinking.

CIPs Update Report

aThe Committee considered the CIPs update. TS advised that the year-to-date and full year effect of CIPs realized so far had increased since the last month. TS advised that focus was also now being brought on the next year CIP plans to firm up and finalise them.

bIt was requested that the CIP Group milestones be re-circulated to the Committee and that TS provide an update against this to the next meeting.

Community services EBITDA and CIP review

aTS introduced the item and advised it provided a comparison of current income and expenditure performance across the community services and in old CNWL. The Chair commented that this represented a successful acquisition in terms of the financial performance. The Chair noted that when the acquisition was initially made a list of potential benefits of the acquisition, and it was requested that this be updated. This could also then look at areas of further integration, to reflect the work taking forward the ‘adapt’ and ‘transform’ element of the acquisition. It was suggested that the way forward be further discussed outside of the meeting.

TS / JV

bIt was queried what the margins would be for next year. TS suggested it would likely be between 5.5-6%.

Income Analysis

aThe Committee received and noted the report.

Benchmarking

aJG introduced the item and advised this continued on from the inpatient review last month, to look at community teams – CRT, Assertive Outreach, and CMHTs. JG warned that a caveat was that the teams were in flux due to the move to service lines. It was noted that Brent costs were by and large lower than other boroughs; this was because they had already restructured their services. JG advised that the information would be discussed with local senior management teams, and the inpatient report was already enabling good debate. The Committee welcomed the report and noted this was also very useful information to have to hand in discussions with external partners.

Cross-subsidization in Camden Provider Services

aTS introduced the item and advised that the three tables provided a breakdown by service line of surplus / deficit, income, and contribution. TS noted that this provided the breakdown within CPS to show how different services within the service lines contributed to profit / loss.

bIt was requested that this be brought back to the next meeting with a cover sheet providing a narrative on the report and the areas for development.

TS / JV

Assurance Framework extract

aThe Committee received and considered the Assurance Framework extract. NB clarified that this was essentially brought to ensure the Committee has specific oversight of the areas for which it is identified as a principal monitoring group. It was noted that this would be useful to bring back every quarter and raise any issues by exception.

bThe Committee indicated their general satisfaction with the entries and were requested to pass on any specific comments to Exec leads.

Annual Plan update

aThis item was covered under item 5, Contracting.

SFIs

aThe Chair introduced the item and advised that the Audit Committee had requested the Business and Finance Committee regularly review the limits to ensure that the Committee receives an appropriate number and level of proposals. The Chair advised that this could be reviewed through the regular business tracker, and requested that out of meeting it be agreed how this would be reported.

TS / LK / IM

Private Patient services

bIt was requested that updates on the progress with the private patient service pilot be included in the business tracker.

TS / IM

New bid

cRD introduced the item and advised that they had been invited to tender for additional services across a range of Trust services, including community, inpatient, liaison, addictions. In particular there had been one bid of £5.8m which had had to be submitted at very short notice, in relation to psychological medicine.

dAt this stage this is funding for one year only. It was queried whether the Trust could effectively set up a £5.8m service within a year’s contract, for example with staff recruitment and subsequent accommodation (it was noted accommodation was excluded from the bid). The Committee requested that the risks and mitigation be identified and reported back and review the bid in light of these.

eThe Committee noted a number of other bids have also been submitted, however these fall within the Executive Board’s remit.

Meeting finished 12.05pm.

Chair