There are a number of sections within this part of the document. Using the links below, or to the side, you can skip to specific sections.
Jargon busting:
Despite our best efforts there may be a number of acronyms as well as NHS jargon in the our Operational Plan for 2024/25. To help, we have created this handy glossary of terms.
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DBTH May 2024 plan submission
DBTH June 2024 plan submission updated for ICB non recurrent Income Support.
The Trusts included a £24.2m deficit with CIPs of £21.2m (c4%) in its submission on the 12th June 2024. This compares to the March submission of a £38.2m deficit with CIPs of £15.9m (c3%) as presented previously. The Trusts deficit after ICB non-recurrent income support is £2.4m.
A high-level summary of the 24/25 financial plan is presented in the table below:
| 24/25 Financial Plan | |
|---|---|
| Income | 575.4 |
| ICB Non-Recurrent Income | 23.8 |
| Pay Expenditure | (377.3) |
| Non-Pay Expenditure | (236.9) |
| Financing Costs | (8.6) |
| Deficit before CIPs | (23.6) |
| CIPs | 21.2 |
| Deficit after CIPs | (2.4) |
The key assumptions within the plan include:
- 23/24 outturn has been used as the starting financial position, adjusted for:
- Non-recurrent items including CIPs and Industrial Action funding.
- Full year effect of committed expenditure including CIG cases approved in 23/24 and implementation of national cleaning standards
- Impact of efficiency deflator of 1.1% per national guidance and convergence adjustment for non-south Yorkshire contracts. Convergence has not been applied to South Yorkshire contracts.
- Impact of capital programme and cash borrowing
- No centrally held contingency/cost pressure reserve
- No workforce growth from 23/24 outturn is assumed in the plan unless for centrally funded schemes e.g. CDC or MEOC or approved business cases from 23/24.
- ERF target assumed to be fully delivered and no strike costs.
- Growth funding and capacity funding is included in the plan per that set out from our ICB commissioners.
| Growth/Capacity Funding | |
|---|---|
| Funding | £m |
| ICB Capacity Funding | 2.4 |
| ICB Targeted funding | 8.0 |
| Additional Growth | 5.0 |
| Total | 15.4 |
The clinical income included within the plan is based on contract offers where received (and where not received based on 23/24 outturn adjusted for national planning assumptions. Other income is based on forecast outturn adjusted for non-recurrent items.
2024/25 Capital plan
The total ICS capital budget (CDEL) for 24/25 is £111.2m. The current proposed share of this for DBTH is £26.9m.
| £m | |
|---|---|
| ICB | 2.4 |
| Providers | |
| Barnsley | 11.7 |
| DBTH | 26.9 |
| RDASH | 5.0 |
| SCH | 13.2 |
| SHSC | 3.7 |
| STH | 37.1 |
| Rotherham | 11.2 |
| 108.8 | |
| Total | 111.2 |
The following additional capital allocations have been included within the capital budget (CDEL).
- LIMS £1,711k
- UEC Performance £2,000k
- Revenue Performance £1,000k
The following additional sources of capital are expected for ringfenced schemes funded by PDC.
- Community Diagnostic Centre £6,314k
- Electronic Patient Record £2,142k
- BDGH 2nd CT Scanner £1,561k – Awaiting final approval
This gives the Trust a total expected capital budget of c£38.5m for the year.
The three capital working groups (Estates, Digital and Medical Equipment) have identified the requirements for 24/25, this equates to £31.9m which is significantly higher than the £22.2m available.
Within the requirements there is significant pre-commitments across the groups of £4,509k. The table below summarises the current allocation proposals taking into account the pre-commitments and also allocating a contingency reserve of £3.7m to support in year pressures / re-prioritisation.
| Total £’000s | Pre-Commitments £’000s | Balance £’000s | |
|---|---|---|---|
| Estates | 10,138 | 3,593 | 6,545 |
| MEG | 4,000 | 132 | 3,868 |
| Digital | 4,377 | 784 | 3,593 |
| Contingency | 3,694 | 3,694 | |
| LIMS | 1,711 | 1,711 | |
| UEC Performance Funding | 2,000 | 2,000 | |
| 23/24 Revenue Performance | 1,000 | 1,000 | |
| Total CDEL | 26,920 | 4,509 | 22,411 |
| CDC | 6,314 | 6,314 | |
| EPR | 2,142 | 2,142 | |
| CT Scanner | 1,561 | 1,561 | |
| Total PDC | 10,017 | 10,017 | |
| IFRS16 Leases | 1,594 | 1,594 | |
| Total IFRS16 | 1,594 | 1,594 | |
| Total Capital Plan 24/25 | 38,531 | 16,120 | 22,411 |
Since capital expenditure will be above available cash resources, the Trust will need to ask for capital support of c£9m in 24/25 (for context in 23/24 the Trust requested c£7m).
| Project | Funding Source Amount £’000s |
|---|---|
| PDC | 10,017 |
| System Cash Support | 8,998 |
| Internally Funded | 19,516 |
| Total Capital | 38,531 |
Efficiency
The trust has completed significant work in identifying and quantifying efficiency opportunities for 2024/25 against the CIP target of £21.2m. The table below summarise the schemes against the stages of development and their current delivery “risk rating”:
Work to fully finalise the documentation for schemes has been delayed by the wider workforce plan development issue and sign off of control totals. Now this has been resolved a number of these schemes will rapidly move into black.
Key risks There are a number of key risks to the plan including:
- Industrial action impacting elective recovery and incurring additional costs not budgeted for
- Any benefits that come up in year will be taken to the bottom line by the ICB (rather than being available for Trusts)
- ICB currently still has a financial gap to breakeven so more pressure likely to come to reduce the deficit further
- No contingency in the plan
- ERF double count in system and local organisation plans and concerns about costs being covered in the budget for plans due to lack of clarity.
- Workforce plans better but still more work to do.
- Delivery of elective activity targets and thereby earning ERF.
- Delivery of 4% CIPs. Delivery of CIPs is always a challenge however there are clear opportunities identified through the work undertaken in year.
- Organisational capacity to support transformation and efficiency specifically if further periods of industrial action occur.
- Inflation pressures. In the current economic context it is difficult to predict the level of inflationary pressures the Trust will see in 24/25. Coupled with this if there is a difference in the pay award from the national assumption this may cause the Trust a cost pressure as historically funding has not always matched the cost pressure.
- Winter – The trust has set aside £0.75m for winter in line with this year however this is always a potential area of pressures depending on clinical/operational demands.
- The Trust will need to continue to borrow revenue cash support from NHSE at least up to the value of its deficit.
- Next section: System working and strategic development
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