• Julian Kelly says “vast majority” of systems have submitted balanced financial plans
  • Acknowledges inflation is still “clear cause of financial pressure”
  • Follows month of pressure from NHSE after warnings of £3bn deficit

A total of 14 integrated care systems are forecasting a combined deficit of £650m in 2023-24, NHS England’s chief finance officer said on Thursday.

Julian Kelly said the “vast majority” of integrated care systems – which include commissioning boards and local trusts – had submitted balanced financial plans, though he admitted these would be challenging to deliver.

The number of areas warning of financial difficulties is far higher than the equivalent stage last year, when just five systems failed to set breakeven plans.

Speaking at a meeting of the NHS England board on Thursday, Mr Kelly said overspending ICSs would face “financial control regimes” and “oversight, management and regulatory action”. Similar warnings have been made in previous years.

The deficit represents a significant improvement from the start of last month when the combined ICS deficit stood at roughly £3bn.

ICSs identified by HSJ which have submitted deficits this year include Black Country, on £69m; Mid and South Essex, on nearly £50m; and Devon, on more than £40m.

During the meeting, chair Richard Meddings said the health service faced the “difficult challenges of an inflationary environment”, while a report to the board said inflation was a “clear cause of financial pressure for all systems”.

Mr Kelly added: “We will be already talking with those [deficit] systems in particular, but with the NHS more generally, about actually how are we planning for 2024-25, in some of those cases having those conversations at end of the first quarter, so that we are really making sure that everyone is returning to a financially sustainable position.”

HSJ reported earlier this week that NHS bodies face an average efficiency rate of 6 per cent in the coming year, well above levels demanded before the pandemic.

ICSs reported a £534m overspend during 2022-23, a report to NHSE’s board revealed.

There had been predictions earlier in the year that it could top £1bn. It followed NHSE releasing extra funding and providers using cash reserves to improve the final position.

A report by Mr Kelly said 16 systems had reported year-end deficits, most of which were less than 1 per cent of total allocations.

The paper said: “This variance is largely caused by operational pressures, in particular higher levels of covid and sickness absence, and also the ongoing impact of inflation.”

The local overspends appear to have been covered from underspends in NHSE central costs and commissioning budgets.

HSJ Patient Safety Congress 2023

The 16th HSJ Patient Safety Congress 2023 will be held on 18 – 19 September in Manchester.

Join 1000+ NHS and independent healthcare leaders, managers, clinicians, and patient representatives from across the country and worldwide. We will challenge the status quo on safety and engage in honest and practical discussions with 120+ speakers across 6 streams of content.

Acknowledging the current healthcare environment in the UK, the 2023 theme is: Facing reality: Honest conversations around safety. Attending will allow you to gain fresh insights and practical, tangible solutions that you can take back to your organisation.

Book your tickets now to secure them at the best price.

Source

NHSE board meeting

Source Date

18 May 2023

Topics