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NHS trusts’ finances are fitting ominously into the pattern that developed last year, despite official claims that the deficit is shrinking.

Although the forecasts suggest their plans are broadly on track, a closer look at the year-to-date info shows they are laden with risk. Even more so than in 2016-17.

No one should be surprised if the year-end deficit ends up being £200m to £300m worse than the planned £496m, which would be depressingly close to last year’s outturn.

Several large acute trusts have already fallen significantly short of their three-month financial target and have notified NHS Improvement of a formal revision to their year-end forecast.

One of these trusts, Lewisham and Greenwich, is now having its financial governance investigated by the regulator, while United Lincolnshire has been placed in financial special measures.

But dozens more providers are either saying they can still recover their position, or are only meeting their milestones thanks to heavily backloaded savings plans.

Although it overstates the situation – because there is still a significant chunk of providers that do look on course to deliver their targets – there is probably still some truth in this HSJ reader’s assessment: “So in essence we’ve two groups – one that claim they can meet a target but have a snowball’s chance in hell of actually doing it, and the second group that also have no chance of meeting the target but are being upfront about it and admitting it.”

CCG has ‘no plan’

A beleaguered CCG has openly conceded it has no plan to meet its control total this financial year, as the halfway point of 2017-18 approaches.

Kernow CCG, which is subject to both legal directions and the capped expenditure process, has reported that there is “no viable plan” to achieve the £19.9m deficit control total set by NHS England.

It is forecasting a £37.6m deficit – and has a net risk of another £5.4m that needs addressing in the second half of the year.

While the CCG told HSJ it continues to work to reduce spending in Cornwall, its message is clear – it can’t save more money without it adversely impacting on patients.

This can be deduced through committee minutes, which reveal the CCG submitted a financial plan in early June described by chief finance officer Simon Bell as “very high-risk”.

The plan, drawn up as part of the CEP, proposed a “significant” downsizing of elective capacity that “might impact on patient choice and waiting times”.

But after Jim Mackey’s letter to providers in CEP areas, in which he stated patients’ constitutional rights must not be breached, the plan unsurprisingly “stalled”.

Since then the CCG has tried to find other savings through discussions with the local NHS, but a spokeswoman told us “this did not prove to be possible”.

So, what happens next? Will NHS England take further regulatory action, or could the control total be amended, kept or scrapped?

NHS Professionals’ U-turn

The Department of Health has backtracked on selling off a subsidiary company that provides temporary staff to trusts.

The DH announced it was marketing NHS Professionals in November 2016 but on Thursday said it will remain in public hands.

The department said none of the bids it received reflected the increasing value of the organisation, which has more than 100,000 clinical and non-clinical staff on its books. Bidders for the company were reported to include temporary workforce firm Staffline, outsourcing firm Serco and a private equity company.

The DH said the costs it incurred with lawyers and management consultants in the sell off, which HSJ reported in July was roughly £2m, will be paid off by the increase in NHS Professionals’ profits.