LTFM - Mitigations & Sensitivities

Mitigations

Income

• Contractual arrangements to mitigate risk of income loss
• Limited additional income mitigations may be accepted e.g. increase non clinical income

Pay

Further review of staffing structures not already identified in CIPs including:

• Reduction in overtime payments 
• Structures / Flexible arrangements
• T+C review
• Manage sickness
• Pay freeze/suspend increments
• Vacancy freeze
• Medical locum/agency freeze
• Reduction in clincal PA's/new clinical excellence awards

General Expenditure 

• Achievement of base case CIPs/bring forward efficiency programs
• Deployment of contingency
• Restrict non-essential expenditure/low risk mandatory training
• Corporate Restructuring/outsourcing opportunities
• Significant service line changes
• Significant estates rationalisation
• Reduce non-core loss making services
• Restrict/postpone maintenance expenditure
• Review services provided under contracts that do not directly generate payments

Cashflow

• Restrict capital program
• Managing debtors/creditors more effectively
• Refinance of loans/utilise working capital facility/temporary bridging loans

Sensitivities

• Loss of an entire service
• Loss of part of a service
• Reduction in activity across a number of services
• X% reduction in income
• X% failure to achieve CIP's
• CIP slippage
• X% failure to meet CQUIN targets
• Requirement for additional capital investment
• X% increase in pay pressures
• Increase in agency/locum spend
• Failure to meet workforce changes/s.devs plans within current resources
• Equal pay claims