• 84 CCGs overspent their allocations but NHS England says majority expect to recover their positions
  • Year-end forecast for CCGs is a £190m overspend, compared to a £10m overspend forecast in July
  • Forecast for overall commissioning budgets has improved due to expected underspends and extra income within central budgets

Clinical commissioning groups have overspent their allocations by £236m in the first six months of 2016-17, increasing from a £57m overspend in the first quarter.

Eighty-four CCGs overspent, according to NHS England’s quarter two finance report. However, the national body says the majority expect to recover their positions.

Financial spreadsheets

Financial spreadsheets

Midlands and East CCGs accounted for half of local overspending in the first six months

The year-end forecast for CCGs is now a £190m overspend, compared to a forecast overspend of £10m in July.

CCGs in the Midlands and East accounted for more than half of local overspending in the first six months, at £120m, but forecast a major improvement by March to end the financial year with an overspend of £35m.

Commissioners in London were £16m overspent after six months, but forecast to end the year £44m in the red.

Despite the deterioration among CCGs, the forecast for overall commissioning budgets has improved due to expected underspends and extra income within central NHS England budgets.

This would include £45m of underspending in primary care and secondary dental budgets, the benefit of £91m “rates and fraud recovery income”, and up to £44m of contingency funding.

The national commissioner forecasts a year-end overspend of just £10m, compared to £83m in July.

The report warns of £280m worth of “risk” to this position, however, due to the challenge of delivering efficiency plans.

The overall NHS England budget was overspent by £168m in the first half of the year.

However, the report says this “nets to an underspend of £231m” once half the “risk reserve” is accounted for. This refers to the £800m CCGs have been forced to withhold from their spending plans in case of overspending in the provider sector.

The document adds: “The creation of the risk reserve has placed significant pressure on the commissioning system, which is reflected in an increase in the level of savings that commissioners need to deliver, from an average of 2.2 per cent of allocations in 2015-16 to 3 per cent of allocations in 2016-17 plans.

“The challenge in delivering a higher level of savings has been reflected in commissioner risks from the start of the year and is now increasingly beginning to crystallise in individual CCG forecasts…

“Including this reserve, the current forecast and risk assessment show that CCGs and NHS England are on course to balance their combined budget for 2016-17 as a whole, while contributing a managed underspend to fully offset the planned £580m net deficit in the trust sector.”

Although the provider sector has planned for a deficit of £580m this year, trusts are currently forecasting a deficit of £669m. Experts have warned this position could worsen significantly by March.

In 2015-16, NHS England recorded an overall underspend of £599m, much of which was achieved through one-off measures. It helped the Department of Health avoid a formal parliamentary process to ask for more money. Within this, CCGs reported a combined overspend of £16m.