Annual Report Summary Accounts 2006-07 · 2015. 12. 16. · under the Energy Efficiency...

Annual Report & Summary Accounts

2006-07

2 United Lincolnshire Hospitals | Annual Report 2006-07

3United Lincolnshire Hospitals | Annual Report 2006-07

Contents

This document has been prepared in accordance with the 2006/2007NHS Trust Manual for Accounts issued by the Department of Health

Foreword by Chairman and Chief Executive 4

Service developments and new appointments 6

Our patients 10

National inpatient survey 10

Equal opportunities 10

Complaints 11

Goals and objectives 12

Values and behaviours 12

Operating and financial review 13

Independent auditor’s statement to the directorsof the board of United Lincolnshire Hospitals NHS Trust 18

Remuneration report 18

Summary of the statement oninternal control 2006/07 22


The year was the most challenging and turbulentour organisation has seen. For many years weexperienced significant financial problems (seechart below) and struggled to deliver consistentperformance against many national targets.At the beginning of the financial year we wereforecasting a deficit of £24.6 million. Historicalperformance and the forecast of an even greaterfinancial loss than previous years led to ourorganisation being one of several requiringturnaround support from the Department ofHealth. The turnaround programme that followedplanned for significant cost reductions andpotential job losses. In August the Trust alsoreported several hundred patients who had theirwaiting times inappropriately adjusted.

We joined the Trust in the Autumn of 2006.By the end of 2006/2007 the Trust Boardhad changed significantly with five newnon-executive directors, two new executivedirectors and a new style of clinically drivenmanagement being implemented. The new TrustBoard set about ensuring delivery of the existingturnaround plan and developing a future plan toensure long-term performance improvement andfinancial stability.

The year ended with a deficit of £13.76 millionwhich was within the agreement reached withNHS East Midlands and was the 54th mostoverspent organisation nationally. All thosepatients affected by the failure of the waiting listsystems were treated by the end of February2007. Job losses were kept to a minimum andonly a handful of staff out of a total of over7,000 were made compulsorily redundantcompared to the approximately 200 planned joblosses at the beginning of the turnaround process.

We owe a great deal of thanks to our staff,patients and their carers, and a wide range oforganisations including the Patient and PublicInvolvement Forum for improving the way weworked over the year that helped us to deliverimprovements in a very uncertain climate.

As we look to the future we now have a fiveyear plan that provides much more certaintyabout the direction of the Trust. We havecontinued to see the improvements madetowards the end of last year carry through tothis year and have for example delivered thenational target for A&E waiting time for the firstthree months of 2007/2008.

Foreword byChairman and Chief ExecutiveAs the Trust’s new Chairman and Chief Executive we are pleased to introduce the AnnualReport for the year ending 31 March 2007.

David BowlesChairman

Gary WalkerChief Executive

Financial Performance

£m

Break even2004/05

-4.9

-15 -13.8

1.5

2005/06 2006/07 2007/08


Parkinson’s Disease Nurse Specialist A specialised service was launched in Louth.Marion Smith, Parkinson’s Disease NurseSpecialist, is available to patients on a full timebasis. The specialist nurse is an invaluable sourceof help and support to people with the condition,their families and carers working both within thecommunity and at the hospital. Marion assistspeople living with Parkinson’s to improve theirquality of life by identifying and linking toappropriate care service and therapies. Marionworks alongside Consultant, Dr Christopher Cookwho has a special interest in Parkinson’s Diseaseand runs a Parkinson’s Clinic at the hospital –one of very few specialised clinics in the country.

Nurse Cadet Scheme The Trust launched a scheme for young people inthe Grantham area who have an interest innursing. The nurse cadet scheme which hadalready been run successfully at Lincoln CountyHospital and Pilgrim Hospital at Boston wasexpanded to Grantham. The Trust offered theopportunity for 5 cadet placements on the 2 yearscheme which offers 16-17 year olds the chanceto gain an insight into health care as well as asound academic qualification in preparation for a3 year nurse training programme. The initiative isdelivered in partnership with Grantham College.

Service developments and new appointmentsThere have been many clinical achievements for the Trust during the year.

These developments include:


Clinical and patient information officerThanks to a 2 year funding project from whatwas previously the Trent Workforce DevelopmentConfederation, the Trust appointed a clinical andpatient information officer. The role involvesensuring information is available for patientsabout their care, to enable them to makedecisions, in a way that is accessible for them.

High score in study by Saga Healthcare A study by Saga Healthcare revealed thatGrantham and District Hospital was one ofEngland’s top hospitals for the treatment of theover 50s, closely followed by Pilgrim Hospital,Boston and Lincoln County Hospital. The studyalso showed that mortality rates and waiting listtimes were down.

Successful scheme supports patientswith lung problemsA scheme to support patients with ChronicObstructive Pulmonary Disorder (COPD) washailed a success. The scheme, run by twospecialist nurses at Grantham and DistrictHospital, involves assessing patients during theirstay in hospital. The scheme has enabled patientsto continue to be supported in their own homesfor approximately 2 weeks following dischargefrom hospital. The scheme also allows for thosepatients who have been on it before, to referthemselves back to the scheme for furthersupport if they become ill again. This enables oneof the COPD nurse specialists to identify andobtain the most appropriate treatment for them,from either their own GP or from the hospital.

Specialist care for last days of lifeA special designated team was established atLincoln County Hospital to enhance care forpatients who have a life expectancy in terms ofweeks, days or hours. The discharge end of lifeteam (DELTa) comprises of discharge liaisonnurses, an occupational therapist, Macmillannurses, Social Services community care officers,a Marie-Curie palliative care community linknurse and physiotherapist. Two key workers areidentified for each patient who assess and planthe care required during the end stages of life.These members of staff are extremely sensitive tothe needs and requests of the patient and theircarers and will try and achieve the patient’spreferred place of care.

Consultant Radiologist brings newexpertise to PilgrimPilgrim Hospital at Boston was delighted towelcome a new consultant radiologist on itsteam. Dr Amjad Iqbal joined the hospital fromDublin. Dr Iqbal used to visit the area to seefriends and decided he would like to make hishome in Lincolnshire. He works with variousimaging procedures including CT, MRI and

ultrasound and specialises in the areas ofvascular and non vascular intervention. Dr Iqbal’sappointment means that local people are able tohave certain procedures carried out locally ratherthan heading to Leicester University Hospital.

International recognition for work inbreast careMandy Holland, Senior Radiographer at PilgrimHospital won the best scientific paper ata congress held in Vienna. The paper, whichMandy presented at the ECR Congress in Vienna,highlighted the UK’s position as a world leader inthe radiographer role extension. The Congress isone of the largest medical meetings in Europeand the second-largest radiological meeting inthe world. The study compared radiographers’ultrasound reports to radiographers’ reports inbreast clinics for 78 females under the age of 35.As a result of the study, the breast serviceexpanded by 20%. This has enabled patients tobe seen sooner as now a radiographer hasbecome the radiology lead in breast clinics whichsees women under the age of 35.

Welcome improvements for Granthamand Sleaford Macmillan teamThe Macmillan service based at Grantham andDistrict Hospital moved into modern, spaciousoffices – a real improvement on the old officesthey occupied. The new accommodation providesa cubicle for each nurse to work in as well asa private interview/counselling room.

Leading the way in emergency care forbabies and childrenThe Trust ran the first European Paediatric LifeSupport Course (EPLS) in the Trent region.The course attracted candidates from as far afieldas London and Scotland. The Trust’s resuscitationteam forged links with other resuscitation teamswith an interest in emergency paediatrics acrossthe Trent region. The team has been teaching atGreat Ormond Street Hospital and building linkswith emergency paediatric staff there as well aswith their transfer and retrieval team.


Pilgrim beat national target fortreating heart attack victimsPilgrim Hospital, Boston dramatically exceededthe performance targets set by the governmentfor patients suffering a heart attack.The Department of Health stipulates thatthrombolytic drugs should be given to heartattack patients within 30 minutes of arriving athospital, following an attack. A report from theRoyal College of Physicians, Myocardial InfarctionNational Audit Project (MINAP) showed thatPilgrim achieved giving the clot bustingtreatment to 87% of patients within 30 minutescompared to the national target of 75%.A national award was won by the team in2004 for Best Practice in Integrated CardiacCare for the initiatives and team work in thisspecific area.

Water births available at PilgrimMidwives at Pilgrim Hospital were delighted tobe able to offer water births for local mums tobe. The inflatable pool allows the midwifery teamto offer a mostly unassisted and natural deliverywhich reduces stress, labour pain and the needfor drugs in childbirth.

21st century technology improvespatient carePicture Archiving and Communications System(PACS) went live across the Trust and communityhospitals. The system was implemented on targetacross 7 sites. This new technology is paving theway for different working practices andimprovements to patient care.

New radiographic images, such as xrays andscans, are available to all clinical staff as digitalimages. This means that radiological images canbe accessed quickly within minutes of the imagebeing taken without the need for films to beproduced. Being film-less also enables the Trustto make cost savings each month ofapproximately £90,000.

Midwives gain national success at RoyalCollege of Midwives AwardsJane Kania and Alison Brodick, midwives atLincoln County Hospital gained second place –Highly Commended at the Royal College ofMidwives Awards. The Awards are an annualnational event organised by the Royal College ofMidwives and Jane and Alison won their awardin the “Promoting Normality” category.

Pulling the plug on energy wasteThe Trust achieved its second re-accreditationunder the Energy Efficiency Accreditation Scheme,the UK’s independent benchmark for energy use.This national recognition for achievements inenergy efficiency was initially awarded to theTrust in December 2000. The Trust wasparticularly praised by the assessors for the clearcommitment staff and management made tooptimise energy practices.

New Consultant Maxillofacial SurgeonMr Martin Clark joined the Trust from Scotland asa maxillo facial consultant specialising in headand neck cancers. He works at Lincoln andGrantham seeing patients with large andaggressive skin cancers which cannot be treatedby a dermatologist. His special interest is inmouth cancers. With skin cancer rates doublingevery ten years Martin’s addition to the teammeans patients can be seen more quickly andwill help the Trust achieve more efficient waitingtimes for cancer.

New nurse led service means quickerdiagnosis for patientsA new nurse led service commenced at the Trustthanks to the successful training of two staffnurses in endoscopy at Lincoln County Hospital.The procedure uses specialist equipment,an endoscope, to examine the bowel to identifyproblems including bowel cancer and the two

nurses undertake flexible sigmoidoscopies tofree up consultants’ time and help reducewaiting lists.

Doctors at the heart of Trust’sdecision makingStrong clinical leadership is at the heart of theTrust’s clinical direction and six senior doctors atthe Trust were appointed to be clinical directorsto ensure the Trust provides high quality, patientcentred services.

£2m breast unit at Boston gets go aheadBreast services at Pilgrim Hospital Boston are setto benefit from the approval of a £2millioninvestment in a new purpose built unit when thescheme was given the go ahead. Patients andtheir families were consulted over the design ofthe new unit and involved in decisions about theservices it provides to further enhance the qualityof patient care.

Improvements to the currentservice include:

• Purpose built unit

• Ultrasound and mammography will beavailable at review clinics to ensure patientsonly need to attend hospital once for eachfollow up appointment

• In some cases, same day diagnostic tests willbe undertaken, such as liver ultrasound andchest x-ray

• Benign test results will be given overthe telephone to the patient to reducepatient anxiety and the need for a followup appointment

• An increase in the range of nurse led clinics

• An increase in patient and familycounselling sessions.

New Consultant PhysicianDr Rashaad Gossiel, Consultant Physician inAcute Medicine and Infectious Diseases joinedthe Trust from Leeds. He is the dedicatedconsultant for the Emergency Admissions Unit atLincoln County Hospital. The Trust was one ofthe first to have a dedicated consultant inEAU giving continuity of patient care andrelieving pressure elsewhere in the hospital foron-call consultants.

Service developments and new appointments


During the 12 months ending March 2007, the Trust has seenan overall reduction in staff of 100 headcount(120.92 full time equivalent).

Against this trend nursing and midwifery registered staff numbers continuedto show a year on year increase, with a rise of 41 headcount (13.18 FTE).Allied health professionals and professional and technical staff also againsaw a slight increase in the number of full time equivalent employees.

The overall Trust sickness absence rate for the 12 months was 5.37%, thesame as at the previous month-end but an increase from 5.24% on theprevious year.

2005/2006 2006/2007

Planned inpatients 14,656 14,217

Day cases 51,180 54,043

Emergency inpatients 92,609 91,883

New/first outpatients 125,333 139,303

Follow up/subsequent outpatients 335,305 333,889

A national independent patient surveyshowed that 88% of patients whoresponded rated their care as good toexcellent, with 78% reporting thatthey were always treated with dignityand respect.

The survey, undertaken in the autumn of 2006,asked patients across the Trust’s hospitals for theirviews on their care as inpatients.

Over 500 patients responded from 850 who weresent a form asking for their views.

The areas highlighted in the survey for the Trustto address in their future plans were consistentwith the national trend and included improvingcommunication and having greater involvementto give patients more information about theircare and procedures.

Areas where the Trust showed improvement fromthe previous year were:• the length of time patients waited to be admitted • changes to admission dates • the way in which doctors communicated

with patients.

Starters and leavers Our patients

National Inpatient Survey

89.32 0.62 1.68 0.06 0.19 0.14 0.13 3.22 1.16 0.06 0.74 0.09 0.82 0.21 0.40 1.03 0.14 6983

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During the year 2006/2007 the Trustreceived 786 formal complaints,a reduction from the previous year when823 formal complaints were received.The concerns raised covered such areas ascommunication, medical care and waitingtimes. The graph (right, top) providesa breakdown of the top ten reasons forcomplaint received by the Trust for theyear 2006/2007.

Complaint response times65% of complaints were responded to in thetimescale. The timescale changed from 20 days to25 days mid-year to provide organisations withflexibility and to assist and support organisationsachieving local resolution. The complaintsmanagement team relocated during the year andconsolidated all resources on to the same hospitalsite as Trust headquarters. The aim of this was toimprove the consistency of approach tocomplaints handling and for the system to comeunder one manager. This has been successful,however, staff vacancies in the department andchanges within the Trust management team hasled to a reduction in the timeliness of responseswhich is disappointing. Nevertheless, the Trust hasimportantly focused on achieving local resolution,also seeing complaints as an avenue for learningand service improvement.

Complaints are an excellent way for theTrust to learn and improve services forpatients and carers.

Some examples of improvement are:• GPs are notified when clinicians have changed

roles or sub-specialised• Midwives review patient records when taking

over care to improve communication• Guidance has been produced to ensure

records are filed consistently• Introduction of a consultant led

multi-disciplinary notes audit

• Additional training provided to help nursingstaff carry out patient monitoring followingan operation

• Matrons follow up audits on ward cleanliness• Review of drug stock levels and the availability

of drugs• Information is provided above beds for

patients and visitors on how they can accessthe medical team

• Additional training has been provided ontissue viability and the use of aids

• A trauma co-ordinator now provides anoutreach service to non-orthopaedic patients.

NHS Litigation Authority Standardsand Clinical Negligence Scheme forTrusts (CNST)The Trust currently meets level 2 of the standardsfor acute general care and maternity. Just underhalf of acute Trusts nationally achieve thisstandard. Importantly, this demonstrates that theTrust provides safe clinical care and takes patientsafety seriously. It also means the Trust savesmoney on the ‘insurance premiums’ paid as amember of the scheme. The Trust is preparing forre-assessment during 2007/2008.

ComplaintsTransport

2006-07

2005-06

2004-05

2003-04

2002-03

Reasons for complaints (Top 10)

Complaints analysis

Number of written complaints Number replied within timescale

Environment issues

Medication

Discharge

Attitude

Cancellation and charge

Communications

Waiting times

Medical care

Nursing or midwifery care

0

0

20 40 60 80 100

100 200 300 400 500 600 700 800 900

120 140 160 180 200


The Trust wishes to change the culture intoan organisation that performs at everylevel, is progressive about change andimproving health outcomes, is able toinfluence commissioning decisions, cancommunicate well with patients at everylevel and one that delivers on its promises.

To achieve this, the Trust has set out goals andobjectives, and also considered what is importantto how Trust staff work together.

ValuesEvery employee will uphold the following values:

• Put the patient and public at the centre ofour work

• Lead and take responsibility, not blame others• Work together, not undermine each other• Fully understand problems, their cause, and

find solutions and answers not excuses• Be responsive and flexible to enhance the

experience of all those who use our services.

BehavioursEvery employee will:• Treat patients, colleagues and visitors with

respect, dignity and empathy• Recognise that patient care is improved by

effective team work. We will recognise ourindividual responsibility to contribute to thesuccess of the team

• Involve team members as early as possible• Speak well of each other – inside and outside

of work• Give authority to team members to act, we let

them deliver• Raise concerns about safety, health or patient

care promptly and appropriately without fearof victimisation

• Respect the right of confidentiality.

To deliver the overall strategic directionthe Trust has established seven key goalswhich will be achieved over the next threeto five years. Each goal is supported by anumber of objectives which will form thebasis of the organisation’s business planfor subsequent years. In addition, thereare values and behaviours that our staffare expected to uphold.

GoalsWe will:• Provide quality healthcare• Put education, training and evidence based

practice at the heart of patient care

• Meet the needs of patients more fully byinvolving them in the design of services andthe delivery of their care

• Build strategic alliances to identifyopportunities to improve patient outcomes

• Become a nationally recognisedmodel employer

• Develop our commercial expertise in orderto operate effectively in the newmarket-oriented environment

• Use new technology to improve patient care.

Values and behaviours

Goals and objectives


• 2006/07 Financial PositionThe Trust reported a deficit in the financial yearof £13.76 million which is in line with theagreed plan. This is an improvement from theposition reported in the last financial year and itis also the first time in five years that the Trusthas delivered its financial commitment unaided.

• Where our money comes fromTotal income received by the Trust was £294.2million, a 1.6% increase on the previous year.The majority of the Trust’s income comes fromthe provision of patient care services (£274.95million), the remainder of income comes fromsuch things as education, training and research,income generation (car parking, staff cateringand accommodation) and the provision ofnon-patient related services to other bodies.

• How we spent our moneyThe Trust spent £300.8 million in the financialyear, the largest component of this expenditurewas salaries and wages where we spent £205.4 million with the average number of staff

employed being 5,786 whole time equivalents.The average staff numbers included 861 doctors,3,285 nurses, healthcare assistants and othersupport staff and 691 scientific and technicalstaff. The overall pay bill increased by 1.6%,although the cost of agency staff reduced by23% due to an improved recruitment in keyareas of the workforce.

A further £48.3 million was spent on clinicalsupplies and services such as drugs andconsumables used in providing healthcareto patients.

The chart below shows a breakdown of themain categories of expenditure for 2006/07

• How is our financialperformance assessed?

The Department of Health measures NHS Trustfinancial performance against the followingfour targets:• Break even: to balance income and expenditure

after payment of a public dividend, taking oneyear with another

• Capital Cost Absorption Rate: to achieve a capitalcost absorption rate of between 3% and 4%

• External Financing Limit (EFL): to operatewithin the approved EFL

• Capital Resource Limit (CRL): to remain withinthe CRL as set by the Department of Health.

The Trust is committed to following the‘Better Payment Practice Code’ in dealingwith our suppliers. The code sets out thefollowing principles:• agree payment terms at the outset of a deal

and stick to them• pay bills in accordance with any contract

agreed with the supplier or as agreed by law• tell suppliers without delay when an invoice is

contested and settle disputes quickly.During 2006/07 the percentage of bills paidwithin target was:• number of bills : 99%• value of bills : 91%

• Capital investment The total capital expenditure in 2006/07 totalled£14.9 million. The main areas of investment were:

£’m

• Replacement medical equipment 3.1

• Picture Archiving and CommunicationsSystem (PACS) 5.2

• Maintenance of buildings and estate 2.6

• Cancer equipment 0.6

Operating and financial review

How we spent our money

Salaries and wages

Clinical supplies and services

General supplies and services

Establishment expenses

Premises and fixed plant

Capital charges

Other costs

69%

17%

2%1% 3% 4% 4%

Target Actual Target Met

Break Even - Surplus / (Deficit) £'m 0 (13.8) No

Capital Cost Absorption % 3 - 4 3.6 Yes

EFL £'m 3.778 3.327 Yes

CRL £'m 16.697 14.888 Yes

Table 1 – Our performance against the Department of Health finance targets


Operating and financial review• Financial Outlook – 2007/2008 to 2009/2010During the next three years the Trust will need to substantially improve itsperformance on delivering both national and local targets. In general, TheTrust’s performance in the past few years is about average against mostnational indicators. The Trust’s financial performance has been amongst theworst nationally.

The healthcare market is changing rapidly and with at least one choice infive providers expected to be from the private sector by 2008, the market isbecoming increasingly competitive.

During the next three years the Trust will need to improve efficiency andreduce operating costs by at least £44.6 million to ensure that it deliversthe national efficiency targets and repays historical debt.

The Trust will during the next three years, deliver a significant reduction inwaiting times to ensure that the maximum waiting time from referral totreatment is under 18 weeks.

A summary of the key financial indicators is given below:

2007/08 2008/09 2009/10£'m £'m £'m

Income 320.0 309.0 293.0

Expenditure -318.5 -304 -285.7

Surplus/(Deficit) 1.5 5.0 7.3

Savings required in order to achieve the forecast I & E performance are:

2007/08 2008/09 2009/10£'m £'m £'m

Tariff reduction (2.5% efficiency) 7.3 8.0 8.0

Loss of transitional support 1.0 1.0

Other cost savings 2.0 2.0 2.0

Repayment of historical debt 1.5 3.5 2.3

Reduced income at end of 18 weeks 6.0

Total savings 11.8 14.5 18.3

Savings over three years 44.6

A Service and Financial Plan has been developed for 2007/08 which deliversa planned surplus of £1.5 million. Monitoring financial performance andtaking corrective action has been given much greater management focusand the Trust is committed to the delivery of this challenging financial target.

The challenges for Year 2 and Year 3 are great. In order to reduce costsfurther the Trust will adopt a strategy that reduces fixed costs (such asestates) but the Trust will still need to plan to:• Through a process of turnover and transfer of staff to other providers,

reduce headcount by around 500 – 700 whole time equivalents,• Become even more efficient in the use of resources,• Reduce our Trusts reliance on overheads such as land and buildings,• Reduce the time patients stay in hospital and close or transfer

approximately 200 beds.



Summary financial statements 2006/07These financial statements are summaries of theinformation contained in the annual accounts ofUnited Lincolnshire Hospitals NHS Trust. TheTrust’s auditors have issued an unqualified reporton the annual accounts. A full set of accounts isattached to this report and is also availablefrom the Trust website www.ulh.nhs.uk or onrequest from:

Mr Colin HillsAssistant Director of Finance – Financial ManagementFinance DepartmentUnited Lincolnshire Hospitals NHS TrustLincoln County HospitalGreetwell RoadLincolnLincolnshireLN2 5QY

The Annual Accounts Audit hasbeen carried out by the AuditCommission. Costs associatedwith the Audit were £217,000

The summary financial statements were approved by the Board on 31 July2007 and signed on its behalf by:

Gary Walker Bernard G ChalkChief Executive Director of Finance

• Income and expenditure account for the year ended31 March 2007

• Balance sheet at 31 March 2007

2006/07 2005/06£'000 £'000

Income from activities 274,945 264,362

Other operating income 19,209 25,067

Operating expenses (300,799) (296,776)

OPERATING DEFICIT (6,645) (7,347)

Profit/(Loss) on disposal of asset (104) 2

DEFICIT BEFORE INTEREST (6,749) (7,345)

Interest receivable 1,102 509

Interest payable 0 (2)

Other finance costs – unwinding of discount (58) (49)

Other finance costs – change in discount rateon provisions 0 (282)

DEFICIT FOR THE FINANCIAL YEAR (5,705) (7,169)

Public Dividend Capital Dividend Payable (8,056) (7,874)

RETAINED DEFICIT FOR THE YEAR (13,761) (15,043)

Financial support included in retained surplus 0/(deficit) for the year - NHS Bank

Financial support included in retained surplus 6,600/(deficit) for the year - Internally Generated

RETAINED SURPLUS/(DEFICIT) FOR THE (13,761) (21,643)YEAR EXCLUDING FINANCIAL SUPPORT

All income and expenditure is derived from continuing operations.

2006/07 2005/06£'000 £'000

FIXED ASSETS

Intangible assets 1,646 664

Tangible assets 247,889 231,328

249,535 231,992

CURRENT ASSETS

Stock and work in progress 4,479 4,558

Debtors 7,412 14,445

Investments 11 471

Cash at bank and in hand 604 662

12,506 20,136

CREDITORS: Amounts falling due within one year (24,816) (21,639)

NET CURRENT ASSETS/(LIABILITIES) (12,310) (1,503)

TOTAL ASSETS LESS CURRENT LIABILITIES 237,225 230,489

CREDITORS: Amounts falling due after more 0 0 than one year

PROVISIONS FOR LIABILITIES AND CHARGES (5,910) (4,237)

TOTAL ASSETS LESS CURRENT LIABILITIES 231,315 226,252 FINANCED BY:

Public dividend capital 176,684 173,014

Revaluation reserve 74,676 60,765

Donated asset reserve 3,547 3,655

Government grant reserve 7 338

Other reserves 190 190

Income and expenditure reserve (23,789) (11,710)

TOTAL CAPITAL AND RESERVES 231,315 226,252

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• Statement of total recognised gains and losses for the yearended 31 March 2007

2006/07 2005/06£'000 £'000

Surplus/(deficit) for the financial year beforedividend payments (5,705) (7,169)

Fixed asset impairment losses 0 0

Unrealised surplus on fixed asset revaluation/indexation 15,328 5,273

Increase in the donated assets reserve due 526 975 to receipt of donated assets

TOTAL GAINS AND LOSSES RECOGNISED IN THE FINANCIAL YEAR 10,149 (921)

• Cash flow statement for the year ended 31 March 2007

2006/07 2005/06£'000 £'000

OPERATING ACTIVITIES

Net cash inflow from operating activities 16,754 5,219

RETURNS ON INVESTMENTS AND SERVICINGOF FINANCE

Interest received 1,102 501

Interest paid 0 (2)

Net cash inflow from returns on investments and servicing of finance 1,102 499

CAPITAL EXPENDITURE

(Payments) to acquire tangible fixed assets (13,030) (9,163)

Receipts from sale of tangible fixed assets 1,021 203

(Payments) to acquire intangible fixed assets (1,234) (80)

Receipts from sale of intangible fixed assets 0 30

Net cash (outflow) from capital expenditure (13,243) (9,010)

DIVIDENDS PAID (8,056) (7,874)

Net cash inflow/(outflow) before managementof liquid resources and financing (3,443) (11,166)

MANAGEMENT OF LIQUID RESOURCES

(Purchase) of other current asset investments (233,500) (143,500)

Sale of other current asset investments 233,595 143,500

Net cash inflow from management ofliquid resources 95 0

Net cash inflow/(outflow) before financing (3,348) (11,166)

FINANCING

Public dividend capital received 3,778 11,128

Public dividend capital repaid(not previously accrued) (108) 0

Public dividend capital repaid(accrued in prior period) (433) 0

Other capital receipts 116 46

Net cash (outflow) from financing 3,353 11,174

Increase in cash 5 8



The Better Payment Practice Code requires the Trust to aim to pay allundisputed invoices by the due date or within 30 days of receipt of goodsor a valid invoice, whichever is later.

A definition of those costs to be included as management costs areexplained in the website:http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_400793

• Notes to the summary financial statements

2006/07 2005/06£'000 £'000

Management costs 10,472 10,441

Income 294,151 288,929

Management costs as a percentage of income 3.6% 3.6%

• Notes to the summary financial statements

2006/07 2005/06£'000 £'000

Better payment practice code-measureof compliance

Total Non-NHS trade invoices paid in the year 98,023 73,115

Total Non-NHS trade invoices paid withinthe target 96,759 66,400

Percentage of Non-NHS trade invoices paid within the target 98.7% 90.8%

Total NHS trade invoices paid in the year 2,957 31,743

Total NHS trade invoices paid within the target 2,333 28,227

Percentage of NHS trade invoices paid within the target 78.9% 88.9%


Remuneration StatementThe membership of the Remunerations andTerms of Service Committee comprises theChairman and two of the non executivedirectors. The Committee’s policy on theremuneration of ‘very senior managers,’ that isthose not covered by Agenda for Change, hasbeen to ensure that the job roles are externallyevaluated using the HAY job evaluation systemand comparative pay data intelligence.The Committee does not operate a formalperformance related pay scheme. Any payuplifts awarded are consistent with guidanceissued by the Department of Health, mirroringthe awards made to all other Trust employees.

No termination or severance payments weremade to any ‘very senior managers’ during thecourse of the year. If it were necessary toconsider severance payments the Committeewould apply the relevant policy guidance issuedby the Department of Health. There were no payor severance awards made to any past ‘verysenior managers’. All ‘very senior managers’ areemployed on permanent contracts and have asix month employer to employee notice period,with the exception of the Chief Executive who ison a fixed term contract.

I have examined the summary financial statements which comprisethe income and expenditure account, balance sheet, statement oftotal recognised gains and losses, cash flow statement and noteswhich include management costs and the better paymentpractice code.

This report is made solely to the Board of United Lincolnshire Hospitals NHSTrust in accordance with Part II of the Audit Commission Act 1998 andfor no other purpose, as set out in paragraph 36 of the Statement ofResponsibilities of Auditors and of Audited Bodies prepared by theAudit Commission.

Respective responsibilities of directors and auditorsThe directors are responsible for preparing the Annual Report.

My responsibility is to report to you my opinion on the consistency of thesummary financial statement within the Annual Report with the statutoryfinancial statements.

I also read the other information contained in the Annual Report andconsider the implications for my report if I become aware of anymisstatements or material inconsistencies with the summaryfinancial statement.

Basis of opinionI conducted my work in accordance with Bulletin 1999/6 ‘The auditors’statement on the summary financial statement’ issued by the AuditingPractices Board. My report on the statutory financial statements describes thebasis of our audit opinion on those financial statements.

OpinionIn my opinion the summary financial statement is consistent with thestatutory financial statements of the Trust for the year ended 31 March 2007.I have not considered the effects of any events between the date on which Isigned my report on the statutory financial statements (21st June 2007) andthe date of this statement.

David BrumheadDistrict AuditorLittlemoor HouseLittlemoor LaneEckingtonSheffieldS21 4EF23 July 2007


Independent auditor’s statement to theDirectors of the Board of United LincolnshireHospitals NHS Trust

Remuneration Report


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Operating and financial reviewNotes:1. Mr R Paffard received a payment under an approved compensation scheme in 2005/06.

2. Mr E Morton was seconded from Chesterfield & North Derbyshire Royal Hospitals NHS Trust in July -September at a cost of £10,127

3. Mr G Walker was formally appointed as Chief Executive in February 2007 with costs as shown.Between October 2006 and January 2007 costs of £70,786 were paid via invoices.

4. Mrs J Froggatt has been seconded for the entire year from Lincolnshire PCT at a cost of £101,531.

5. Mr K Howells was seconded from Nottinghamshire Healthcare at a cost of £79,415.

6. Mr R Barton was invoiced from the Trust directly for his services at a cost of £32,316.

7. Mr K Hutchinson was appointed through an agency at a cost of £27,416.


A Cash Equivalent Transfer Value (CETV) isthe actuarially assessed value of the pensionscheme benefits accrued by a member at aparticular point in time. The benefits valued arethe member’s accrued benefits and anycontingent spouse’s pension payable fromthe scheme.

A CETV is a payment made by a pensionscheme, or arrangements to secure pensionbenefits in another scheme or arrangementwhen the member leaves a scheme and choosesto transfer the benefits accrued in their formerscheme. The pension figures shown relate to thebenefits that the individual has accrued as a

consequence of their total membership of thepension scheme, not just their service in a seniorcapacity to which the disclosure applies.

The CETV figures, and from 2004-05 the otherpension details, include the value of any pensionbenefits in another scheme or arrangementwhich the individual has transferred to the NHSpension scheme. They also include anyadditional pension benefits accrued to themember as a result of their purchasingadditional years of pension service in thescheme at their own cost. CETVs are calculatedwithin the guidelines and framework prescribedby the Institute and Faculty of Actuaries.

Real increase in CETV - This reflects the increasein CETV effectively funded by the employer. It takesaccount of the increase in accrued pension due toinflation, contributions paid by the employee(including the value of any benefits transferredfrom another pension scheme or arrangement) anduse common market valuation factors for the startand end of the period.

Openness and accountabilityMeetings of the Trust Board are open to themembers of the public. Full details of times andlocations, together with electronic copies ofagendas and minutes, are available via the Trustwebsite at www.ulh.nhs.uk.



The Board is accountable for internal control. As AccountableOfficer, and Chief Executive of this Board, I have responsibility formaintaining a sound system of internal control that supports theachievement of the organisation’s policies, aims and objectives.I also have responsibility for safeguarding the public funds andthe organisation’s assets, for which I am personally responsible asset out in the Accountable Officer Memorandum.

The system of internal control is designed to manage risk to a reasonablelevel rather than to eliminate all risk of failure to achieve aims andobjectives in line with policies; it can therefore only provide reasonable andnot absolute assurance of effectiveness. The system of internal control isbased on an ongoing process designed to:• identify and prioritise the risks to the achievement of the organisation’s

aims and objectives in line with policies • evaluate the likelihood of those risks being realised and the impact

should they be realised, and to manage them efficiently, effectively and economically.

The system of internal control has not been in place in UnitedLincolnshire Hospitals NHS Trust for the whole of the financialyear ended 31 March 2007 and up to the date of approval of theannual report and accounts.

Further copies of the Annual Report including Summary FinancialStatements are available on request to Colin Hills, Assistant Director ofFinance – Financial Management or through the Trust website,www.ulh.nhs.uk.

A fuller version is also available incorporating the full Statement of InternalControl and Annual Accounts as a separate appendix.

Gary WalkerChief Executive

Summary of thestatement onInternal Control2006/07

stephensk

Text Box

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Annual Report Summary Accounts 2006-07 · 2015. 12. 16. · under the Energy Efficiency...

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Transcript of Annual Report Summary Accounts 2006-07 · 2015. 12. 16. · under the Energy Efficiency...