The trust’s original financial plan for 2018/19 was to maintain financial performance in line with 2017/18 performance and deliver a deficit of £1.9m supported by an efficiency programme of £3.9m. The actual deficit delivered was £12.6m, a deterioration from plan of £10.7m. These figures include an asset impairment of £5.2m following a revaluation of the trust’s land and buildings, by independent valuers Montagu Evans, as at 31 March 2019.
This deterioration is also due to an on going review by HMRC into the recovery of VAT on services the trust outsources to third party providers. NCH&C continues to robustly defend its position that it was appropriate to recover the VAT on these contracts based on the VAT guidance, advice from VAT specialists and in line with how other NHS providers have treated VAT under similar circumstances. However, following receipt of an initial assessment from HMRC in April, the trust was required to make a provision for the potential cost going back four years, plus associated costs, which totals £6.1m. Making this provision has also meant the trust was no longer eligible to an element of Provider Sustainability Funding (PSF) that is linked to financial performance of £0.3m. Excluding both the asset devaluation and the VAT, provision the trust would have been slightly ahead of the £1.9m deficit financial plan, achieving an underlying deficit of £1.7m.
One way to measure efficiency and benchmark performance with other trusts is by using the outputs from a national reference cost data collection which is refreshed annually in arrears.
The outputs for the 2017/18 data collection shows the trust as the second most efficient community trust nationally.
NCH&C's efficiency programme of £3.9m consisted of £1.6m of recurrent savings and £2.3m of non-recurrent savings. The main elements of recurrent savings are from the trust’s continued redesign of services and implementation of new roles within services as part of our workforce plan. 27 different projects generated recurrent savings during the year.
During the year, NCH&C invested £3.7m in capital schemes. One key area of investment was the continued redevelopment of Norwich Community Hospital, including the demolition of disused buildings, which totalled £1.0m. In addition, the trust has invested £0.6m in enhancing its cyber security systems. Although NCH&C was not directly impacted by the 2017 WannaCry attack it is important that we continue to develop these systems. We also invested £0.4m in mobile working to maximise the time staff spend with patients. NCH&C's cash position remains strong with a year-end balance of £17.4m - a small reduction from the 2017/18 balance of £18.2m.
The trust is required to pay its non-NHS and NHS trade payables in accordance with the Confederation of British Industry (CBI) Better Payments Practice Code. This requires us to aim to pay all valid invoices by the due date or within 30 days of receipt of a valid invoice, whichever is later and where possible undisputed invoices within 15 days for small and medium businesses.
The trust has a duty to ensure it breaks even cumulatively with 2009/10 being the starting position for this calculation. 2017/18 was the first year NCH&C had not achieved a surplus and this continued in 2018/19. The trust had built up reserves of £7.3m since 2009/10 to be within the break-even duty.
Over the coming year NCH&C will continue to work collaboratively with commissioners and other providers to secure the future of community services and ongoing financial sustainability within the Norfolk & Waveney Sustainability and Transformation Partnership (STP). During 2019/20 the STP will be producing a revised five-year financial strategy that NCH&C will be part of and will help shape the future strategy for the delivery of community services in Norfolk and Waveney. The longer term STP strategic approach will continue in parallel with the trust’s internal plans to explore opportunities for improvements and developments in our services alongside delivering financial efficiencies, mitigating cost pressures, strengthening core business and developing new service opportunities.
Full details of our finances can be found in our Annual Report and Annual Accounts.
Expenditure over £25,000
HM Treasury requires all NHS organisations to publish their expenditure over £25,000 on a monthly basis.
In support of the government’s Transparency Agenda, NCH&C publishes reports detailing agencies used and staff groups they relate to:
Facility Time Publication
As part of the Trade Union (Facility Time Publication Requirements) Regulations 2017 we are required to publish information in respect of employees who were relevant Trade Union officials during the period 1st April 2017 to 31st March 2018.