Finance
During the financial year 2022/23 the Trust spent just over £420m, an increase of £10m over the previous year 2021/22. This was in balance with income received and the Trust achieved a break-even position for finance for the year.
The original financial plan for 2022/23 was to deliver a deficit of £1m, so to report an improvement at break-even was an exceptional achievement as the NHS and the Trust continued to face challenging financial circumstances.
Recovery from the COVID-19 pandemic continued to affect the Trust during the year. Income was reduced as activities across the NHS transitioned back to ‘normal.’
However, recovery across the NHS had required additional activity to process the backlog created during the pandemic and this continued to affect the Trust, especially across its patient transport services. The Trust received and spent £14.6m on activity and purchases for the continued COVID-19 pandemic response.
Across 2022/23 the Trust invested £10.4m in capital assets:
- £2.9m on IT towards the electronic patient care record (ePCR), data lake, malware protection and frontline digitisation projects.
- £5.5m invested in building projects. This was for the development of existing sites, for station refurbishments and for our electric vehicle charging infrastructure.
- £1.6m was invested in new vehicles including double staffed ambulance (DSA) chassis, welfare vehicles and resilience vehicles.
- £0.4m was invested in training equipment.
- The Trust received capital investment of £1.4m to support both digital projects and the ambulance replacement programme.
- We disposed of one aged station site, Corringham, relocating the provision of this locally. This generated capital receipts of £0.1m.
The usual financial contractual arrangements for the emergency services contract with clinical commissioning group commissioners continued to be suspended nationally, as it has been during the previous two financial years, and the ‘block’ income arrangement remained in place. These arrangements included allocations for ‘normal’ activity.
The provision of income towards the response to COVID-19 was significantly reduced, but there was additional income provided nationally for winter capacity as activity levels continued to increase. Ambulance activity, whilst at times lower than pre-pandemic levels, continued to recover and therefore our increased costs. were reflective of this.
The Trust faced challenging operational pressures due to hospital handover delays which continued at unprecedented levels with some vehicles spending whole shifts waiting outside emergency departments. This led to additional costs being incurred as the Trust tried to supplement front line resources to meet activity and performance demands.
The break-even achievement for the financial year 2022/23 included deficits to budgets for operational areas with these being mitigated by underspends to budgets across support areas. The underspends were mainly due to vacancies that were slow to fill with recruitment proving challenging due to a lack of candidates applying for roles. The risk, as these vacancies fill, is that financial balance may be compromised, but the Trust focus on its finances would identify forecast risks to allow mitigating actions should they be required.
We continued to focus on cost efficiency targets across 2022/23. Our initial target was agreed at £13.2m. This was a major increase from our 2021/22 target but in line with the ambition to return to normal financial control and efficiencies following the pandemic.
The target was reviewed in year as operational pressures remained high for the Trust and the target was adjusted to £5.1m. This adjusted target was achieved. The cost efficiency target for 2023/24 is planned at £13.6m and plans are well underway as we commence the new year and are at a developed stage.
The Board will continue to monitor our financial position and key risks. The most significant financial change for 2023/24 is the achievement of investment of £27m from the national urgent and emergency care (UEC) funding. This allows for the transformation of services that is required to improve performance to our patients. An accumulated deficit arose last year and the Trust has an agreed 5-year recovery plan.
Break even for 2022/23 has not increased the deficit amount, but efficiencies have taken on increased importance as the Trust continues on its financial recovery journey through 2023/24. The NHS continues to work to the return to pre-pandemic contractual income arrangements and the Trust will be required to return to a balanced budget.
The full financial statements for the year ending 31 March 2023, are presented within the annual accounts.