Member Info for Radium1

Totally states in its RNS of last week, dated 25th January 23, that the services were inspected by the CQC in August 2022 and rated as GOOD overall. However, what about the later inspections? Why was nothing said about the outcome of the CQC’s comprehensive inspection of Queen Elizabeth Hospital Urgent Care Centre on 6, 7, 8 and 9 December 2022 when the, ‘Are services Safe’, category, was rated as ‘Requires Improvement’ and Notice was given that the areas where the provider must make improvement, as they are in breach of regulations are:

• Ensure that care and treatment is provided in a safe way to patients. The areas where the provider should make improvements:

• Improve throughput times such that it meets targets for discharging patients in four hours.

• Review systems for monitoring prescription stationery.

Queen Elizabeth Hospital Urgent Care Centre is a registered location that consists of four urgent treatment centres (UTC) at Queen Elizabeth Hospital, Kings College Hospital, Princess Royal University Hospital and Beckenham Beacon community health centre. The service is delivered by Greenbrook Healthcare (Hounslow) Ltd (Greenbrook). Greenbrook is a wholly owned subsidiary of Totally PLC.

We rated the service as requires improvement for providing safe services. At the time of the inspection visit between 6 and 9 December 2022, we identified the following breach of regulations:

• The service was not meeting the target of initially clinically assessing all patients within 15 minutes ‘’at any of the four sites’’.

Urgent - 1-2214107009 Queen Elizabeth Hospital Urgent Care Centre (27/01/2023) INS2-13701815141 (cqc.org.uk)

Would appreciate it if someone would post my addendum remarks onto advfm.

This courtesy 1gw.......CQC report published 27th Jan for Queen Elizabeth UCC (4 UTCs in S/SE London).
Good overall, but requires improvement in the "safe" category.

In breach.....Bit of a pattern developing?

"At the time of the inspection visit between 6 and 9 December 2022, we identified the following breach of regulations:

o The service was not meeting the target of initially clinically assessing all patients within 15 minutes at any of the four sites."

hTtps://www.cqc.org.uk/location/1-2214107009

hTtps://api.cqc.org.uk/public/v1/reports/41f8d439-6994-4c9d-a6cf-41506c09ad27?20230127080047
.............................
Extracts taken from the report. My addendum.
Are Services Safe…Requires Improvement.
. Staff told us that at Princess Royal University Hospital, at busy times there were insufficient rooms to host the number of clinicians required to meet the demands of the service. The organisation had tried to address this, but rooms could not be divided, and no further rooms were available.
. We were told that this had particularly been the case at Kings College UTC, where having taken over the service in October 2021, a number of nursing staff had left the service, which had impacted on the time to clinically assess patients. The provider told us that this had largely been addressed, but that there were still rota gaps at all four of the UTC services.
Requirement Notice issued under Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment.
How the regulation was not being met:
• The service was not meeting the target of initially clinically assessing all patients within 15 minutes at any of the four sites. This was in breach of regulation 12(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Extract from…. regulation 12(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
This regulation is one of the fundamental standards.
12(1) Care and treatment must be provided in a safe way for service users.
• Providers must provide care and treatment in a safe way. In particular, this includes the areas listed in 12(2) (a) – (i). However, 12(2) is not exhaustive and providers must demonstrate that they have done everything reasonably practicable to provide safe care and treatment.

surprised ....Jeez what on earth has any of that (link) got to do with senior management selling a large quantity of their share holding one day before releasing a damaging RNS?
I guess your handle is appropriate for you. 'Surprised'...its meaning ...somethings are always happening that you did not expect:
Think about it.

surprise re....do management buy shares on any or every drop of an sp...
Funny that. Juxtaposition = Is it considered ok for management to sell shares the day before an announcement that gonna cause a major drop in the sp?
The unsavvy answer.....Of course it is. It was just coincidental!

Totally....walking a tightrope.

The following from 1gw...
I listened back to the interims presentation (IMC) last night to remind myself what the company said about the 1H cash move. In it, Lisa went into some detail, listing essentially 3 factors that had contributed to the big drop in cash:

1. Some Covid services ended in 1H and so the up-front cash (negative working capital) associated with them reversed;

2. A large 111 contract ended and again the up-front cash reversed;

3. Pioneer has a traditional working capital model (invoice after work completed) and debt at end-1H was higher (i.e. cashflow in 1H worse) than anticipated because of the amount of growth in the business (more working capital needed), a backlog of invoices upon acquisition (delay in invoicing) and then further delay in invoicing caused by integration with Totally.

So looking at the implications for 2H cashflow, there should be some cash inflow relative to 1H if they have been able to reduce the backlog of Pioneer invoices, but potentially further cash outflow if Pioneer has grown further. If they have lost big urgent care contracts (NW London UTCs) or more Covid contracts have ended then they will suffer the reverse of the up-front cash on those, but offset by any net new contracts starting in 2H with similar up-front terms. Given they appear to have spent the £7m that was on the balance sheet at end-1H on the contingent consideration and the 2 dividends, they don’t appear to have a lot of room for disappointment, although they do have a £5m revolving credit facility to bail them out to some extent.

As it seems it has been ever since I first started looking at it, IMO Totally remains a bet that something will turn up before the company gets caught out by its balance sheet. Pioneer looks good, for now, assuming it can sort out its invoicing problems but it needs working capital to continue growing. The apparent loss of the big urgent care contract, allied to Lisa’s interims presentation, is a reminder that to some extent cash on Totally’s balance sheet is there through the kindness of its main customer. If it falls out with that customer through repeated failure to perform, or indeed if that customer moves to a more “standard?1; B2B invoicing model then Totally’s balance sheet could be a problem for it. I think investors also have to ask themselves how sustainable the goodwill on the balance sheet is, if Greenbrook and/or Vocare start to lose business, or indeed if the cost of capital used in impairment tests needs to be increased – no impact on cashflow perhaps, but potentially a big hit on profit.

gdog, re, 'several investors I know wonder if you guys ever considered a marriage between TRMR and PERI'.
Well, if there was any, I guess you know already that there is no way that Peri could part with that inside info. Nice try though.

Canute not looking so smart anymore, is he?

This from 1gw...

Just trying to get my head round the cash position here. As far as I can see:

£7m cash at 30th September
£5m paid out in contingent consideration/adjustments to Pioneer sellers
£1m paid out in dividend (final)
£1m to be paid out in dividend (interim)

Net cash flow from operating activities in 1H was an outflow of £6m, driven by working capital outflows, in particular due to growth and high debtor days at Pioneer.

But management expects the Pioneer working capital position to "normalise" over the coming quarters.

They appear to be counting on a big turnaround in operating cashflow between 1H and 2H, and yet look to have just lost the big NW London UTC contract and whatever working capital benefit that involved.

gdog….yeah, was down the same path and I’d tossed all that stuff around in my head for quite a while before I posted that clip asking people for their views.
The same extracts you quoted from Peri’s cc, re, “In terms of the acquisition, yes, we identified 2 areas where we want – “the CTV is definitely high…” and, ”this needs to be a company that definitely represents a leadership position in the domain, not less than that. It's not going to be a technology acquisition. It's definitely a business acquisition, which have prominent first tier agencies and customers”… this triggered my curiosity as to who/what Peri might be looking for. Who, and how many of them are out there with that degree of prominence, and capable of fulfilling these requirements? Tremor International stood out bold for me.
Howeve, rather than an outright acquisition, I had visions of a possible share swap merger of unequal’s, with Tremor backing into Peri. Tremor gets its name change, Peri gets all its holes plugged, and both end up with an ad tech platform that offers massive scale and capacity.
But really, in the real world, I think the disparity between these two platforms is just too big at the moment and thus I doubt that it's the right time for this to happen.
But if it ever was to come about, wouldn’t this marriage be one very attractive combo?

"The ICB will be working with Greenbrook on a mobilisation plan between now and the contract commencement date to ensure the contractual requirements are met. "

hTtps://www.investegate.co.uk/totally-plc--tly-/rns/totally-secures-new-contract-worth-up-to-c.--66m/202212120700032957J/

In the light of the Health Service Journal article citing "performance concerns" I had a look back at previous new contract awards for UTCs and was struck by the above wording on mobilisation for the 12th December 2022 RNS. This was for a "new" contract covering 2 UTCs, but was to replace an existing contract that Totally already had for those two UTCs.

Why would anyone feel the need to add the phrase "to ensure the contractual requirements are met" if there were no concerns that this might be an issue?

Although other new contract award RNS's do sometimes have references to mobilisation, this wording appears unusual. I found it difficult to find awards of other new UTC contracts in recent times (just lots of extensions), but an RNS on 2nd August 2021 simply stated "Plans to mobilise the new service are already underway in preparation for commencement of the Contract" and before that an RNS on 11th October 2019 for a new UTC contract didn't mention mobilisation at all afaics.

I won't see it but I bet your resident Canute does his usual and attacks the poster.

1gw....."The areas where the provider must make improvements as they are in breach of regulations are:

o Ensure that care and treatment is provided in a safe way to patients."

(link to CQC report in post 19491)

The problem IMO with the Health Service Journal piece drawing attention to “performance concerns” is that it is likely to make those awarding future contracts more aware of the detail of the CQC Northwick Park report on Totally’s performance, rather than just the headline “good” rating. So I think it is difficult to argue that it won’t have a reputation impact, pending a more comprehensive rebuttal by Totally.

Of course, if Totally can’t meet performance standards at acceptable margin then it could just try to move away from urgent care contracts towards other types of contract which it can make work both financially and operationally. But it may be constrained by its balance sheet (net current liability position) if this means replacing urgent care contracts (which appear to provide early cash) with insourcing/outsourcing contracts with more traditional working capital models. Note the reference to “the impact of changes in our working capital model” in the interim results.

https://www.msn.com/en-us/money/other/future-today-doubles-revenue-working-with-unruly-ad-platform/ar-AA16X0DM

Moniman….As previously stated, I have stt1 filtered so I don’t see or read any of his clap anymore. You are correct though in stating that this man has spent 10 years+ on the Tremor International, advfm and lse bulletin boards placing content that is designed to damage the investment case for those invested there and followed it through with his version of pleasure posting, detailing how correct his forecasts have been and implying how silly we all were and if only everyone had listened to him, we wouldn’t be where we are, we wouldn’t have lost our money, would we, type innuendo.
It’s quite incredible that I can state here that stt has posted a total of thirty four thousand and fifty two posts on the Tremor International advfm bulletin board alone, to date, all of it with a negative slant and (I’m not prepared to waste time checking for correctness) but it’s somewhere in the region of another 11,000+ similar posts on Tremor's lse bulletin board as well. And recent reports indicate that this guy has now migrated to bulletin boards where those same Tremor investors have other interests.

It's a well-deserved irony then, for those same investors, knowing that stt is so heavily invested here in Totally PLC at prices dating back to 95p+ days, (I mean, seriously invested). Filled his ISA with Totally on one occasion that I know of; is now suffering the same fate that he tried so hard to bring upon others. He’s not looking so bright right now, is he?
What Totally Plc investors are receiving here at this time is, quite simply, Schadenfreude, from those long-suffering Tremor guys.

Irrespective of all this, I personally, have never been able to make an investment case for Totally Plc. and right now, without doubt, it is a worrying time for Totally Plc investors. As I see it, the situation is precarious. There is nothing personnel, on my part, to the ordinary Joe here but as I see it, one more RNS carrying bad news and this one is going down hard. On top of that you’ll likely suffer further collateral damage from angry Tremor investors because of the above. For me, I’ll try to restrain myself but there is a debt yet to be paid to Tremor investors (and others) for a decade of misery from this man.

Would appreciate it if someone would post this onto the Totally advfm bulletin board.

justdeezerts re your....perhaps you and moniman are the same person?

Your postings indicate to me that you are an absolute lightweight.

justdeezerts.....I've never heard of THG and my posting total on LSE for all time is less than one tenth of what you have stated. You have a propensity to post utter nonsense.

Investors bailing. Not prepared to wait for that miniscule 0.5p interim dividend pay out on 24 February 2023.

This guy thinks like myself.

Terribly thin project margins just look at EBITDA £3.4m and now committed to paying 0.5p a share dividend nearly 100% payout ratio, unsustainable, no cash flow left over, cash reserves reduced from £15m to just £7m..There's no finance for growth just a £5m RCF facility for day to day payments and just like Carillion it wouldn't surprise me the least if they had been undercutting competition to win government contracts with loss making bids which are now magnified due to high wage inflation as revenues although up 14% but more or less so are costs in particular labour and overhead costs and against general inflation of 9.2% doesn't look good...NHS also under extreme pressure to cut costs but somehow increase nurses salaries...private sector firms involved in non essential services who have failed to deliver easy target's...expect more of the same!...margin pressure, rising costs, contracts cancelled or not being renewed

Thanks guys, much appreciated.

Dartron, I don't do 'short', period! And, for the life of me, I can not think why Totally, using up its rather miniscule £1million Profit before Tax on paying out an equally miniscule dividend to its shareholders, should fill you with such confidence? If there is a tax liability here, then, after tax its made a loss. Yes/no??

I have no

gdog, thanks. I just wanted to put the idea out there. All considered your thoughts are pretty much in line with my own assessment in the end.
Incidentally, aside that Peri’s market cap is 2.5 times that of Tremors, I was thinking more along the lines of a stock/stock merge rather than a takeover/acquisition and although I think the combo would be great, there are real differences in that these two platforms, built with similar bricks and mortar, have internals, design and architecture that differ greatly. Like two different personalities, each has been built to standalone and thus, perhaps, remain apart.

In regard to Perion. What’s your thoughts on the 45% handcuff to Microsoft? The relationship’s been strong and ongoing for a long time, a decade plus, but it relies on continuous contract renewal and the current one runs out in just over a year (I think). Any concerns there? Also, Peri has had an exceptional run over the last 4 years, mostly on the back of the Microsoft tie, but what’s your thoughts on Perion ability to scales up from here? It was these questions that started my thought processes on the Perion/Tremor merger path, in the first place.