Moorfields Eye Hospital NHS Foundation Trust

Population 8,700,000
Income £125,670k
Comprehensive Surplus £8,901k
Operating Surplus £7,857k
PPI Cap 14.5%
PPI £18,682k
Public Members 8,067

Moorfields has its main site at City Road in London, but it also operates four district hubs, four local surgical centres, five community-based outpatient clinics and has partnerships delivering services with six other organisations. The Annual Report [1] says that Moorfields opened several new locations in 2011/12:

These new locations include three in south-west London alongside our centre at St George’s hospital in Tooting: a local surgical centre at Queen Mary’s hospital in Roehampton, providing more complex outpatient and diagnostic services alongside day-case surgery for the local area; and two community-based outpatient clinics in the Bridge Lane health centre in Battersea and Teddington Memorial hospital to focus predominantly on outpatient and diagnostic services. We also opened for business in a second location in Bedford, again providing mostly outpatient and diagnostic services to the local community in a more central location and relieving the pressure on our very busy unit in Bedford hospital.

Moorfields was awarded a contract by NHS Barking and Dagenham in 2011/12 to provide community-based ophthalmology services at Barking hospital with close links to our City Road hospital site. We subsequently relocated existing activity from the Upney Lane health centre to the new Barking community hospital and started to provide additional services in the same location as part of this contract.

The trust has a separate website for private patients [2] which says:

Moorfields Private is the exclusive division of Moorfields Eye Hospital, the largest specialist eye hospital in the world founded in 1805. Moorfields Private is governed by the NHS. Our patients are fee-paying and any profits are used to fund the treatment of NHS patients at Moorfields Eye Hospital NHS Foundation Trust. Moorfields Private has the capacity and expertise for more than 100 opthalmic procedures in its eye hospital

Private patients are treated at the trust’s locations at Upper Wimpole Street and there are also three private patient wings at Moorfields’ City site: John Saunders Suite, Arthur Steele Unit and Cumberlege Wing. In addition, the Richard Desmond Children’s Eye Centre [3] also treats private patients.

In its Annual Report the trust says that there was a “significant increase in new private patients” in 2011/12:

Moorfields Private is located on and adjacent to the main City Road hospital and also has facilities in Wimpole Street. The division had another successful year, with several new consultants joining our team. Coupled with some targeted marketing, these new appointments resulted in a significant increase in new patient referrals. For 2011/12, Moorfields Private recorded a Comprehensive Surplus of £2.6 million.

In spite of this increase, the Forward Plan [4] says that the trust had expected more:

Our commercial trading units, Moorfields Private, Moorfields Pharmaceuticals and Moorfields Dubai generated total income of £26.1 million, which was below expectations by £1.5 million.

Moorfields has a business selling pharmaceuticals to other organisations, and it has a clinic in Dubai for private patients. The Annual Report says that in the coming year it intends to increase private patients:

Maximise our returns from Moorfields Private by commencing the implementation of our private patient strategy

The trust says that it wants to increase the numbers of private patients:

The strategy for growth continues to focus on the creation of additional surgical capacity at the main City Road hospital to meet the requirements of the new consultant cohort, on providing a more comprehensive range of outpatient diagnostic services and, in time, on introducing Moorfields Private services in our NHS satellite locations.

This statement has two interesting admissions. First, the consultants are dictating the location of the hospital facilities. Second, the trust expresses a plan to expand over the country. This is reflected in the Forward Plan that says:

The strategy for growth is being implemented with a focus on the creation of additional surgical capacity at City Road and introducing Moorfields Private services at our satellite sites.

The financial plan in the Forward Plan gives the following figures for Moorfields Commercial Trading Unit (the trust’s commercial arm) and the NHS clinical income:

Table 1 Planned income for Moorfields

  2011/12 Actual 2012/13 2013/14 2014/15
NHS Clinical 106.6 108.9 107.8 107.1
Commercial Unit 26.1 28.4 29.0 30.2

This table shows that private income is expected to increase by 14% over three years, whereas the trust plans for NHS clinical income to increase by under 0.5% over the same period.

The trust says in the Annual Report that Moorfields Eye Hospital Dubai

had another successful year in 2011/12, making a Comprehensive Surplus of £0.3 million after absorbing the initial costs of appointing two new consultants

And the Forward Plan reports:

Patient activity has increased, a new service has been opened in Al Ain providing eye care in the Imperial College London Diabetes Centre, and two new consultants have been appointed. The coming year will see management change and the business challenge centres on the need to continue the steady growth of the unit whilst consolidating services prior to the opening of the Cleveland Clinic in Abu Dhabi in 2013. We will be negotiating a new contract for the Dubai hospital in 2012.

In general, for the entire trust, the Annual report says that in 2011/12

All categories of income grew (other than Moorfields Pharmaceuticals), with the largest increase being recorded for our private patient activity, which rose by £1.7 million.

The trust provides segmented accounts and selected values are given in Table 2

Table 2 Income, expenditure and Comprehensive Surplus for the divisions of Moorfields Eye Hospital in 2011/12

  NHS Moorfields Private Moorfields Dubai
Income from activities 108,903 11,911 4,856
Other operating income 15,996 1,180
Total income 124,899 13,091 4856
Operating expenses (122,968) (10,453) (4,594)
Comprehensive Surplus 1,931 2,638 262

This table shows that Moorfields Private (the London business) returns a large profit on income (of 20%), four times that of MoorFields Dubai.

The Forward Plan says:

We delivered a £5.8 million Comprehensive Surplus against a minimum target of £5 million, principally due to higher NHS activity on a well-controlled cost base.

Whereas the Annual Report shows that the Comprehensive Surplus from private patients was greater than the Comprehensive Surplus from NHS patients.

The trust has recently restructured its charities to give a single charity Moorfields Eye Charity:

For the year to 31st March, it is anticipated that charitable donations received will amount to approximately £4.4m in total.

The Forward Plan says that the charity donations will play “a crucial role in creating the new hospital”.

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