Sustainability

Our organisation must remain sustainable (living within our means) to ensure that we continue to provide safe, high-quality mental health care across our five boroughs now and in the future.

We know that improved quality of care – for example safely reducing length of stay by providing more active treatment days, providing care closer to home, joined up services across providers (GPs, local authorities and the voluntary sector), reducing repetition and reducing the number of times a patient tells their story – not only results in improved patient experience, but also increases financial sustainability and reduces costs. We also know that reducing vacancies, improving retention, and relying less on agency or temporary employees results in improved patient and staff experience, as well as reduced costs.

Financial targets  

Our target was to achieve a £0.7m surplus before impairments. This target was achieved. While we are reporting a surplus of £1.8m, this includes upward revaluation of assets (positive impairments). However, these are technical in nature and are exceptional items against which we are not performance managed. The position excluding impairments is a £0.7m surplus. This position is representative of strong clinical and operational success in delivering challenging cost improvements, alongside high levels of inpatient demand.  

In addition, we delivered against the Department of Health and Social Care (DHSC) targets set out below:  

·        Operate within a Capital Resource Limit of £31.8m  

·        Maintain a Capital Cost Absorption rate of 3.5%.  

We will continue to have a strategic approach to financial sustainability such that it can achieve its financial targets in financially and operationally very challenging year ahead.

Cost Improvement Programme  

We set an ambitious target to implement cost improvement schemes of £17.9m, which we achieved. Nevertheless, due to the reliance on non-recurrent savings, the Trust has an opening underlying deficit for 2025/26 of £8m. The drivers for this underlying position are well documented and are linked to our continued use of beds outside of our own Trust bed base, as well as the premium costs associated with agency staffing.  The Trust reduced its reliance on agency costs during the year and was below the national target of agency costs, at below 2.9% of the pay bill.

Looking ahead to 2025/26, we recognise the need to further improve our delivery of recurrent savings. The 2025/26 plan has a challenging 7% savings target, which equates to £24.9m, of which a minimum of 76% is planned to be achieved on a recurrent basis.    

Better Payment Practice Code  

We are committed to paying our creditors promptly and have signed up to the Better Payment Practice Code. The code requires us to pay undisputed invoices by the due date or within 30 days of receipt of goods or a valid invoice, whichever is later. We paid 94.6% (in terms of value) of non-NHS invoices within this period (94.4% in terms of number) and 98.7% of NHS invoices (in terms of value) within this period, 88.4% in terms of number. Recognising our position as an anchor institution for the SWL population and the businesses within it, we are looking to improve our performance in this area moving forward and aim to specifically develop ways of monitoring our payment performance for small and medium sized enterprises; we understand the often very tight cash position that many smaller businesses operate within.  

Further information about our finances is available in the Financial Performance section.  

Performance against objectives

The table below describes how we have performed against our objectives, in terms of outcomes and metrics. We reviewed our delivery of this at the May 2025 Board.

 

Performance against objectives

Annual delivery plan 4: Sustainability Key outcome:  To continue to work towards financial and operational sustainability, supporting best value and efficiency in health and care in SWL	Year-end delivery rating
Outcomes/Metrics: ·       Proportion of agency spend in line with NHSE target – 2.9% Q1 – 4.1%, Q2 – 3.7%; Q3 – 2.47%; Q4 – 1.87%  ·        Activity per WTE – increase of 2% (23/24 baseline 24.5%) Q1 – 21.9%, Q2 – 22.9%; Q3 – 20.3%; Q4 – 20.3%  DNA rate – (23/24 baseline 6.6%) Q1 – 6.8%, Q2 – 6.7%; Q3 – 6.4%; Q4 – 6.2%	The key outcome will remain an objective for 25/26, while completion of job plans will continue until 25/26 for service lines. Productivity and efficiency work will continue