The NHS hospital trust sector is predicting a deficit at the end of this financial year, HSJ can reveal.

Slashed income and a reduction in bailouts have led to a spike in the number of individual trusts predicting deficits at the end of the year.

Data from the NHS Trust Development Authority shows nearly half of the hospital trusts it regulates are predicting a deficit at the end of 2013-14.

Twenty-five of the 62 acute non-foundation trusts started the financial year with a deficit plan, the data shows, but five more have since had to adjust their forecasts from a breakeven or surplus position to deficit.

The 30 trusts predict a total shortfall between spending and income of £232m, dragging the sector as a whole into a deficit of £87m.

If the predictions are accurate it would mark the first time the acute non-foundation trust sector has ended a financial year in deficit, although in previous years the underlying shortfalls were masked by “transitional funding” from strategic health authorities, primary care trusts or the Department of Health.

The TDA’s report, published this morning, said: “There [has] been a £282m reduction in non-recurring income planned to be paid to NHS trusts in 2013-14 compared to the previous year, and [there is] variation in approach across England with trusts in the Midlands and East seeing a reduction of just over £122m while NHS trusts in London see a reduction of just over £25m.”

The report said there was a 2 per cent difference between trusts’ 2012-13 income and their planned 2013-14 income. This difference amounted to £616m.

It said: “This is due to a combination of a net price deflator, a reduction in education and training funding and a commissioner rules-based approach resulting in a decrease in nonrecurring income from 2012-13.”

The figures do not cover foundation trusts, which are overseen by Monitor.

The five trusts who have slipped from a break-even position this year

Barts Health Trust in east London was predicting a surplus of £1.1m on its £1bn turnover this year. It is now forecasting a £51m deficit.

East Cheshire Trust was predicting a £1.7m surplus on its £187m turnover but is now looking at a year-end deficit of £8.4m.

Ealing Hospital Trust has seen its planned £48,000 surplus dwindle to a £8.9m deficit.

Kingston Hospital Trust and Western Sussex Hospitals Trust both became foundation trusts this financial year but the TDA document said they “Leave the NHS trust sector with a combined deficit of £1.95m having been authorised as a foundation trust part way through 2013-14”..


TrustPredicted % deficit as of TDA summer report 
Princess Alexandra Hospital NHS Trust9
Mid Essex Hospital Services NHS Trust7.1
University Hospital of North Staffordshire NHS Trust6.7
George Eliot Hospital NHS Trust6.5
Wye valley5.5
North West London Hospitals NHS Trust 5.3
South London Healthcare NHS Trust5.1
East Sussex Hospital5
Barnet and Chase Farm Hospitals NHS Trust 4.7
Mid Yorkshire Hospitals NHS Trust (
Barts and the London NHS Trust 4
Croydon Health Services NHS Trust4
United Lincolnshire Hospitals NHS Trust3.9
Barking, Havering and Redbridge Hospitals NHS Trust3.9
Ealing Hospital NHS Trust 3.8
Bedford Hospital NHS Trust2.2
Epsom and St Helier University Hospitals NHS Trust 2.1
Northampton General Hospital NHS Trust1.8
Worcestershire Acute Hospitals NHS Trust1.4
Lewisham Hospital NHS Trust 1.2
The Shrewsbury and Telford Hospital NHS Trust0.8
West Sussex0.4
Kingston Hospital NHS Trust 0.2