Performance and Finance Committee Assurance Report
Meeting: Public Meeting
Date: 8 May 2024
Report Title: Performance and Finance Committee Assurance Report
Agenda Item: PUB24/05/3.4
Committee Date: 28 February 2024
Meeting Chair: Julie Thallon, Non-Executive Director and Committee Chair
Meeting Quorate: YES
Purpose: Assurance
Recommendation: The Board is asked to receive assurance from the business discussed at the meeting and to review the matters for escalation and referral.
Link to Strategic Objective:
- Provide outstanding quality of care and performance
- Be an environmentally and financially sustainable organisation
Summary of Items Considered at the Meeting
Finance report and year end forecast
Consideration: Underspend year to date on both main budget and against additional capacity funding continues. Still awaiting detailed guidance from NHSE but indicative timetable agreed for submission of budget.
Forecast breakeven at year end with expected 2-3m surplus. Forecast confirms continued overspend associated with PTS.
Detailed discussion about vacancies across the trust and the reliance on the underspend to balance the budget. The workforce requirements need to be more explicitly stress tested against the business plan.
Resolution/Outcome: Submission to commissioners will confirm break even for year end.
Finalised budget planning decision to go to Board in March.
Refer vacancies discussion to People Committee.
Assurance: Moderate
QCIP
Consideration: Slippage against target continues with 93% being non-recurrent.
Delivery against big transformation programmes hasn’t delivered this year – shortfall continues to be covered by vacancies.
Detailed discussion about reliance on vacancies and the minimal contribution that efficiencies and transformation are making to the overall cost saving.
Resolution/Outcome: Refer to ELT in the first instance for discussion re how to align efficiency and productivity to business planning and transformation programmes for explicitly. Then for a future wider Board discussion.
Assurance: Limited
Annual budget and plan
Consideration: Work continuing on agreeing budget – gap still exists with further ELT discussion planned in March.
Resolution/Outcome: Agreed that once budgets are agreed the focus needs to shift to lessons learned re the process for 2024-25 and how to better balance transformation with efficiency gains. Need to build confidence and capability across the organisation to build accountability and responsibility at a more devolved level.
Assurance: Moderate
Operational performance report
Consideration: Performance continues to be challenging and sustainability of any improvements remains a risk. But making steady and sustainable improvements. Staffing remains a challenge.
Resolution/Outcome: Acknowledged progress being made and the challenge of taking next steps.
Assurance: Moderate
Group escalation report and Operational support report
Consideration: Both verbal reports. Accountability meetings becoming better established. Fleet challenges continue with significant improvements required around processes and systems.
Resolution/Outcome: For further future reporting through to the new Performance and Safety Committee.
Assurance: Moderate
Patient Transport Service – performance and contract negotiation
Consideration: Update primarily around contract position and the extension of all contracts to March 2025. Noted the good progress made which provides a better platform for ongoing discussions about our provision of this service in the future. Tested confidence across Executive about the ongoing financial risk and ability to stabilise before contract extension end.
Resolution/Outcome: Forthcoming year to focus on improving data quality and stability and capability within management team to enable an informed judgement about how to proceed beyond 2025. Agreed review at Performance & Safety Committee on finance, data and infrastructure with a more detailed paper to Sept/Oct meeting outlining position and forecast to enable a wider Board discussion about direction of travel.
Assurance: Limited
2024-25 Contracting round – 999 service
Consideration: Confidential update on current status of contract negotiations for 2024-25.
Resolution/Outcome: -
Assurance: Substantial
Integrated Transformation Programme Group report
Consideration: Update received on Digital and Integration programmes.
Resolution/Outcome: Agreed that QCIP should no longer be viewed as a transformation programme in its own right but should be part of the business planning process. ELT to discuss how best to manage.
Plan in place for transitional various programmes into new Committee structure.
Assurance: Substantial
Board Assurance Framework
Consideration: Risks discussed as part of main agenda items.
SR4 needs a re-framing to better illustrate the efficiency and productivity focus of the risk – currently more based around breakeven.
Resolution/Outcome: Review of BAF and controls due in Q4. Need to reflect the changed position the trust is in now and identify new and different mitigations to reflect that. NEDs to be involved to ensure full sign up to any changes.
PAF members to reflect on risks and mitigations as they stand currently in preparation for Board Risk workshop on 13 March.
Assurance: Moderate
PAF Committee Annual Report
Consideration: Report received with all but one question providing good or very good responses. Limited narrative to support comments however so difficult to determine how and where to improve.
Resolution/Outcome: Report noted.
Assurance: Substantial
Matters for Escalation or Referral
Vacancy management
To: People Committee **Reason:**Discussion around the ambition and potential to fill all vacancies and how to ensure better alignment to business plan and transformation priorities.
QCIP
To: ELT and on to Board Reason: Need to review approach to efficiency and productivity across the trust and align savings plan to business planning and transformation rather than having a stand-alone QCIP process which is not delivery recurrent sustainable savings.
PTS
To: ELT and on to Board Reason: The need to use the contract extension period to further explore and determine the future provision of PTS.
