• Majority of trusts already had large deficit plans at the start of the year, but are now even deeper in the red than expected
  • HSJ has examined the finance reports for 136 acute trusts to reveal their latest recorded positions
  • Of trusts reporting against original plans, Heart of England Foundation Trust furthest from target
  • See the 20 trusts furthest behind their plans
  • Explore the data trust by trust

More than a quarter of acute trusts reported a financial position which was more than £5m worse than planned for the first nine months of 2015-16.

Doncaster and Bassetlaw Hospitals Foundation Trust

Doncaster and Bassetlaw Hospitals is expected to deliver at £38m deficit

Doncaster and Bassetlaw Hospitals Foundation Trust

The majority of these trusts had already planned for large deficits at the start of the year, but are now even deeper in the red than expected.

Last week, regulators said the NHS provider sector had reported a combined deficit of £2.3bn for the nine months to December, which was £622m worse than planned. The deterioration came almost entirely from the acute sector.

A breakdown for each trust was not provided by Monitor and the NHS Trust Development Authority, but HSJ has examined the finance reports for 136 acute trusts to reveal their positions as of December. Reports for November were used for a handful of trusts that had still to publish a report for December.

About half the acute sector reported their performance against revised plans or “stretch targets” issued by Monitor or the TDA last summer, while the rest reported against their original plans.

Of those reporting against original plans, Heart of England Foundation Trust was furthest from target with a year to date deficit of £46m. This was £38.5m worse than planned, and left the trust forecasting a year-end deficit of £59m.

Doncaster and Bassetlaw Hospitals FT, whose finance director resigned in October, reported a year to date deficit of £27m, which was £26m worse than planned. The trust had a £2m surplus plan at the start of the year, but is now expected to deliver at £38m deficit.

Barts Health, United Lincolnshire Hospitals and Epsom and St Helier University Hospitals were also more than £20m behind plan.

A further 22 trusts were at least £5m behind their original plan.

There were smaller variances among those reporting against stretch targets, with North Bristol Trust furthest behind plan. Its year to date deficit was £38m, which was £16m worse than expected.

Buckinghamshire Healthcare, Portsmouth Hospitals, Brighton and Sussex University Hospitals, and West Hertfordshire Hospitals were all more than £10m behind their revised plans. Six more trusts’ positions were more than £5m worse than planned.

Concerns have been raised in recent weeks that providers are under pressure to set unrealistic financial targets, as regulators aim to limit this year’s combined deficit to £1.8bn and achieve financial balance in 2016-17.

One finance director, who asked not to be named, told HSJ: “Some boards probably underplayed the downside risks in their 2015-16 plans and have never been able to make up the lost ground.

“We have always been put under pressure to pull something out of the back pocket, and an unsupported finance director might just get overly creative, but the truth will emerge in the end.”

Heart of England FT did not respond to questions about its deterioration, but its board papers said the trust has commissioned consultants EY to develop a recovery plan.

A spokesman for Doncaster and Bassetlaw Hospitals said its financial performance had been misreported for “a considerable period of time”, and its latest position was caused by agency spend on medical staff, shortfalls against efficiency targets and increased clinical negligence claims costs.

He added: “The trust is receiving cash support from the Department of Health to cover the forecast deficit. There are some realistic conditions attached to this.”

North Bristol said its deterioration was due to underperformance on elective income, fines from commissioners, the impact of the marginal tariff for specialised services, and agency spending. The trust has received a revenue support loan of £28m from the DH.

Other reasons cited by trusts included unfunded winter costs, delayed discharges and pressures on emergency care pathways, reducing the expected number of planned procedures.

Out of 136 acute trusts, 101 reported positions that were worse than planned in their latest finance report.

Revealed: The trusts most behind on their financial targets