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NHS trusts post £822m deficit for the year

NHS trusts in England have racked up a combined deficit of £822m over the past year, more than seven times the £115m from 2014.

The figure combines the end-of-year financial positions for NHS trusts and foundation trusts published by the NHS Trust Development Authority and Monitor.

A massive bill for agency staff and record-breaking surge in demand, putting trusts under “sustained and exceptional pressure”, are said to be the key reasons for the overspend.

Analysis by Monitor found foundation trusts treated 10.7 million emergency in-patients between April 2014 and March 2015, a 574,000 increase on the previous year. There was also a significant increase in non-emergency patients.

Foundation trusts spent £1.8bn on agency staff –more than double what they had planned (£766m).

Richard Murray, director of policy at The King’s Fund, said: “These deficits have occurred despite substantial extra money having been provided by government, without which the position would have been much worse.

“The figures underline the huge pressures facing acute trusts, which have collectively overspent by £1bn. This is largely due to increasing demand for services and decisions by hospitals to recruit more nurses in order to maintain quality of care, but it also reflects the squeeze on their incomes as a result of cuts in the prices they are paid for treatment.”

Overall, the 152 foundation trusts (the majority of NHS trusts) missed a number of national waiting times targets for A&E, routine operations and some cancer treatments for the entire year. Other findings in the report include:

• 77 foundation trusts (51%) ended 2014-15 in deficit, of whom 70% were acute trusts.
• The foundation trust sector as a whole has missed the A&E waiting time target of seeing 95% patients within 4 hours since autumn 2013-14.
• The size of the waiting list for routine operations reached 1.76 million, an 8.3% increase on 2013-14.
• Between January and March 2015, 55,400 people waited on a trolley for more than four hours between the decision to admit them to A&E and their arrival on a ward due to reduced bed availability.
• Foundation trust ambulance services meet the national waiting time for responding to the most critical and life threating incidents between January and March 2015.
• Monitor intervened or agreed regulatory action at 32 trusts (21% of the sector) because of operational or financial concerns.

Dr David Bennett, chief executive at Monitor, said: “The last financial year was exceptionally challenging for the foundation trust sector, and it is clear the current one is following the same pattern. The sector can no longer afford to operate on a business-as-usual basis, and we all need to redouble our efforts to deliver substantial efficiency gains in order to ensure patients get the services they need.

“This will no doubt involve some significant changes to the way people work at some institutions, but as the regulator we believe there is scope for more to be done at a number of levels without compromising patient care. Monitor is therefore stepping up its efforts to provide practical help and support to foundation trusts that are struggling both financially and operationally.”

Rob Webster, chief executive of the NHS Confederation, believes the report gives a clear indication of the pressures faced by the NHS today.

“Sustainability in the NHS is a challenge that must be met by the whole system and we will need to see strong leadership over the next five years to meet it,” he said.

“The figures published today demonstrate that the NHS has a fragile settlement and that this will remain over the coming years. We will need to count on transformation funding delivered up-front and action to prevent social care from being cut, in order to prevent NHS organisations from being knocked off course.”

A Department of Health spokesperson said: “We know the NHS is busier than ever and trusts are facing challenges; however we expect them to show tight financial grip and live within their means. We have backed the NHS’s own plan for the future by investing the £8bn needed to deliver it.”

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