Major acute trusts already forecasting to miss control totals

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Some of the largest hospital trusts in England are already struggling to meet their financial target for 2016-17, according to analysis by HSJ.

Most acute providers are forecasting to meet their “control totals” set by NHS Improvement, albeit with significant risks acknowledged in many of the plans.

Among the trusts forecasting to miss their control totals are Barts Health Trust, which was already £13m behind plan at the end of May.

The trust was forecasting a deficit of £113m at that point, against its £83m control total. It has not responded to enquiries about its performance in June.

Barts’ most recent finance reports said the shortfall was due to not recovering enough patient treatment income, under-delivery of cost improvement plans and the junior doctors’ strike in April.

The trusts forecasting to miss their 2016-17 control total by the biggest amount

Trust	Control total including STF where accepted (£m)	Forecast deficit assuming full receipt of STF (£m)
Barts Health Trust*	-82.70	-112.70
East Kent Hospitals University FT	0.61	-10.87
Torbay and South Devon FT	2.28	-3.56
Heart of England FT	-13.48	-19.00
Derby Teaching Hospitals FT*	-11.22	-16.60
_{*Data from month two rather than month three}

Torbay and South Devon Foundation Trust said its final contract settlement with commissioners was lower than expected, and it expects to lose three-quarters of its STF allocation, which would result in a deficit of £8.6m. HSJ has included the full STF in its forecast to enable comparison to the plan.

Heart of England FT said its previous planning assumptions included the full suspension of fines and penalties for 2016-17. It said in a board report: “It has subsequently been determined that emergency readmissions penalties (£5.4m) can still be levied by commissioners and therefore the current forecast is a deficit of £19m for 2016-17, subject to full achievement of planned efficiency savings and full receipt of STF.”

Derby Teaching Hospitals FT said its £16.6m forecast deficit “reflects the inherent cost pressure” on the control total.

The forecast at Shrewsbury and Telford Hospital Trust is £4.6m worse than the control total, but the trust said “corrective actions” will be taken to meet the target. HSJ asked what this would involve but received no response.

A number of trusts have not revised their forecast despite being significantly off plan.

King’s College Hospital FT was almost £7m behind plan at the end of June, due to fewer elective cases than plans and “slippage on cost improvement plans”. The FT said its forecast is now under review.

St George’s University Hospitals FT and North Bristol Trust are both around £4m behind plan.

At least 20 trusts were behind their plan after the first three months of the year.