NMH

NMH | 2024 11 Governance T he financial results for the Hospital for 2024 reflected an overall deficit of €0.8m. Total income for the year at €111m was up €5.9m (5.7%). Income for the Hospital comes from two primary sources. Funding from the HSE amounted to €98.8m for the year which was 89% of overall income. HSE income is up €6.1m (6.6%) on prior year reflecting both cost inflation as well as an increasing volume of services and specialties that the Hospital delivers. This includes expanding activity in the genetics function and fertility service among other things. Overall the breadth and complexity of services provided by NMH continues to increase year on year. The balance of funding primarily comes from services provided to private and semi-private patients. This amounted to €11.9m for 2024 which was a marginal 2% decline on prior year. Considerable effort is being made in maintaining and enhancing this very important source of income. Total costs incurred were €111.5m which is an increase of €7.9m (7.6%) over 2023. Of this €89m related to Pay which saw an increase of €5.4m (6.4%) over the prior year. The main reason for this increase was government mandated pay awards, some of which related to backpay settlements for 2023 as well as continuing migration towards Slaintecare POCC23. In addition, there was a marginal level of headcount increase which related to the enhancement of new and existing services. Consistent with previous years the cost base of the Hospital remains largely fixed with staff costs accounting for 80% (prior year 81%) of Hospital spend. The major elements of non-pay costs relate to medicine, pathology costs, medical supplies, catering, energy and maintenance costs. Non-pay expenditure at €22.3m was an increase of €2.5m (12.7%) over last year. This, however, includes c. €1m of once off expenditure on a cybersecurity project and software Honorary Treasurer's Report upgrades, both of which were funded by the HSE. Excluding this it is €1.5m (7%) up on last year representing inflationary increases. Included in this are the ongoing increasing recruitment costs for foreign nurses and midwives reflecting a general shortage available qualified candidates. Staffing remains a challenge for the Hospital with a number of reasons attributable with the cost of accommodation high on the list. The Hospital continues to look at all possible avenues to try and support staff with this issue. Whilst the Hospital awaits its co-location to the St Vincent's University Campus at Elm Park, it continues to provide excellent care in an aging building. The move is still some years away. The current building does need continual maintenance but also investment in the intervening period. Discussions are ongoing with HSE in relation to funding of additional essential upgrade works. Approval for any new capital projects or essential upgrades is long and protracted. the year end. This is totally sub-optimal from a financial planning and cash management perspective. The upfront allocation and timely provision of funds would result in a much more efficient outcome both in terms of administration and value for money for all concerned. The Hospital is left managing the current delays by seeking advance drawdown of its revenue allocation from the HSE on an ongoing basis but that is a short term solution to a longer term issue. The HSE have sought to make changes to this process in 2025 which will aid cash flow planning through the year. Other areas of focus by the Finance Committee during 2024 included NMH@ ElmPark, governance, procurement, the impact of Slaintecare, policies and procedures, management of debtors, compliance, activity based budgeting, new services and SORP accounting. I would like to extend my appreciation to all the NMH Finance Team and my fellow members of the Finance Committee. The NMH Finance Team have successfully exercised strong financial control whilst concentrating on essential spend to ensure we can continue to deliver excellent care to the patients. In this my first year as Honorary Treasurer, I would like to thank my predecessor Michele Connolly whom, during an eight year period in the role, made an outstanding contribution to the NMH and has been very helpful in the handover. Tom Murphy, Honorary Treasurer. The NMH Finance Team have successfully exercised strong financial control whilst concentrating on essential spend to ensure we can continue to deliver excellent care to the patients." The funding model from the HSE has improved somewhat but remains a challenge. There are considerable delays in approval for any new funding – capital or revenue. The revenue allocation for a given year is never fully confirmed until several months post

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