NHS Improvement: Trust finances hit by A&E pressures

In a letter to trust leaders last week, NHS Improvement said many providers have found ways to address the financial pressures, often with support from commissioners.

However, it warned that other trusts have “more work to do”.

Many providers will have been forced to deploy additional agency and bank staff in recent weeks in order to cope with increased activity levels in non-elective services.

It is therefore likely that for many trusts, unplanned expenditure has made their year-end financial targets even harder to meet.

The sector has been told it must meet its combined deficit “control total” of £580m in 2016-17, and NHS Improvement has previously expressed confidence that the plans are broadly on track.

It is not yet clear how much unplanned expenditure there has been.

Some of the additional pressure will translate into adverse financial performance in December, which would impact NHS Improvement’s next quarterly report in February. The quarter three report is seen as crucial in terms of providing assurance to the Treasury that trusts are recovering their finances.

However, much of the extra pressure has been in January, so would only translate through to trusts accounts at the end of the financial year.

The letter to trusts, shared with HSJ, said: “It has been a very tough few weeks for the NHS…

“It is also now evident that this operational pressure has caused significant additional and unplanned financial pressure.

“Again, many providers have found ways of addressing this, often with support from commissioning colleagues. Others have more work to do and our organisation is working actively with them this week to agree how this is best done.”

The letter added that trusts have reduced their planned capital spending by £600m, after they were told that their plans were still unaffordable.

The latest letter, sent by NHS Improvement chief executive Jim Mackey and chair Ed Smith, added: “Finally, thanks for your leadership in these difficult times.

“Your staff are making humbling and heroic efforts every day. In many ways, in clinical and leadership terms, the NHS is doing things that we all thought previously were impossible.

“We have to recognise that working this way over a short period is different to it being the new baseline, but equally, capturing some of those improvements and new ways of working will help us all.”