• Forecasts of 42 trusts worsened by £364m over the last three months
  • NHS Improvement was forecasting £623m sector deficit for 2017-18
  • Official figures for quarter three due to be published

The year-end financial forecasts of around 40 NHS trusts have worsened by £364m over the last three months, analysis by HSJ reveals.

The revisions will put significant pressure on the position of the overall trust sector in 2017-18, which NHS Improvement previously said was forecasting a year-end deficit of £623m.

The deterioration would take the combined forecast deficit close to £1bn, although improvements reported elsewhere in the sector are likely to reduce it to around £950m.

NHSI was due to publish its report for the first three quarters of the year on Monday but the publication has been delayed.

HSJ examined 50 trusts that appeared to pose the most risk to the financial position this year.

These trusts had reported the biggest differences between their actual monthly run rate in the first six months of the year, compared to what would be required to meet their mid-year forecast.

Of the 50 trusts, HSJ obtained figures for 42 from published finance reports. This included quarter three figures for 34 trusts and month eight figures for the remaining providers. For these eight, the analysis assumed any variance to plan at this stage in the year would be maintained until the end of the year.

Our analysis found the forecasts of the 42 trusts will worsen by £364m compared to quarter two. This excluded the impact of missed payments from the sustainability and transformation fund.

Trusts reporting the worst deteriorations include Portsmouth Hospitals Trust (£34m), Mid Essex Hospital Services Trust (£23m) and East Sussex Healthcare Trust (£21m).

These pressures are likely to be offset by trusts outside the 50 reporting improvements, though HSJ is also aware of several providers not in the 50 that have made large downward revisions to their forecast. These include Norfolk and Norwich University Hospitals FT, where the forecast has worsened by £22m.

The figures collected by HSJ are those reported to trust boards, so do not include any subsequent revisions following submission to NHSI.

In 2016-17, the official forecast for the whole trust sector worsened from a £669m at quarter two and to £873m at quarter three. The final outturn improved to £791, following delivery of back loaded savings and various one off transactions, including land sales and accountancy adjustments.