Royal Marsden Financial Performance and Expenditure Analysis 2020-21

The Royal Marsden Annual General Meeting 28 September 2021 Marcus Thorman Chief Financial Officer

The Royal Marsden The Royal Marsden Financial Performance RM has performed well in challenging circumstances The main drivers of the decrease in surplus year on year relate to the pandemic with a decrease of 30m in Private Patient income and the NHS recovering the Trust back to broadly break-even This resulted in a normalised surplus of 2.6m in 2020-21 (2019-20: 25.2m) The cash position was 150m at 31 March 2021 ( 121m at 31 March 2020)

The Royal Marsden Income analysis 2020-21 The diversity in RM income helps ensure sustainability despite continued financial pressures during the pandemic 2019-20 m 2020-21 m % Area movement Commissioned Services Top Up Income Private Care Research Charitable Services to other bodies Education and training Corporate and Other Total income 233 244 47 102 25 33 5% 0% 0 132 28 28 -23% -12% 19% -70% -8% 5% 5% 9 5 3 5 28 30 463 488 RM has maintained a circa 62%:38% ratio of income between NHS and non-NHS sources Income from Private Patients accounts for 21% (2019-20: 26%) of the overall income Overall income has increased by 15m despite the decrease in Private Care revenue Commissioned Services income has increased from 233m to 245m (block contract) in 2020-21. The Trust also received 47m of top up income to cover the costs of Covid and the loss of income

The Royal Marsden Operating expenditure analysis 2020-21 As with most NHS providers, staff costs represent more than half of RM s annual expenditure 2019-20 m 231.9 82.4 34.6 10.1 60.4 419.4 2020-21 m 253.5 89.0 38.6 30.4 70.5 482.0 % movement Staff Drugs Clinical Supplies Depreciation/ amortisation & impairments Other Total operating expenditure 9% 8% 12% 201% 17% 15% RM spend in 2020-21 is 482m, an increase of 15% from 2019-20 Staff costs account for 53% (2019-20: 55%) of the overall expenditure Depreciation/ amortisation and impairment has increased by 20m in the current year the main changes relating to a revaluation gain of 5m in the prior year versus a 12m impairment in the current year

The Royal Marsden Capital spend in 2020/21 RM with support from The Royal Marsden Cancer Charity invested 49.8m in capital projects in 2020/21 RM estate 34m Medical Equipment 9.7m Digital Services 6.2m GET PHOTO FOR DIGITAL Included: Oak Cancer Centre Cavendish Square Included: 4th MRI Sutton 3rd MRI Chelsea Cyberknife Endoscopy stack system Included: RIS replacement Stem Cell system development Bloodtracking system Included in the above is the asset transfer on the dissolution of Sphere

The Royal Marsden 2020-2021 Recovery of Services In 2020-21 RM started the recovery of services post the first wave of the pandemic this is continuing Chemotherapy activity vs BAU Radiotherapy activity vs BAU 25,000 35,000 30,000 20,000 25,000 15,000 20,000 15,000 10,000 10,000 5,000 5,000 0 0 2019/20 H1 2019/20 H2 2020/21 H1 2020/21 H2 2021/22 H1 2019/20 H1 2019/20 H2 2020/21 H1 2020/21 H2 2021/22 H1 NHS - Chemotherapy PP - Chemotherapy NHS BAU - Chemotherapy PP BAU - Chemotherapy NHS - Radiotherapy PP - Radiotherapy NHS BAU - Radiotherapy PP BAU - Radiotherapy Elective activity vs BAU Outpatient activity vs BAU 140,000 140,000 120,000 120,000 100,000 100,000 80,000 80,000 60,000 60,000 40,000 40,000 20,000 20,000 0 0 2019/20 H1 2019/20 H2 2020/21 H1 2020/21 H2 2021/22 H1 2019/20 H1 2019/20 H2 2020/21 H1 2020/21 H2 2021/22 H1 NHS - Outpatients PP - Outpatients NHS BAU - Outpatients PP BAU - Outpatients NHS - Outpatients PP - Outpatients NHS BAU - Outpatients PP BAU - Outpatients All services saw a reduction of activity in the first half of 2020/21 due to the pandemic All areas have recovered to at least the pre-Covid rates of activity For NHS services the block contract remains whereas for private patients income is back to pre-Covid levels