The Healthcare Financial Management Association welcomed the extra cash from the government's comprehensive spending review, but expressed concern about its distribution.

Chair Jaki Meekings said the government 'has tended to distribute cash in an earmarked fashion' which would not help trusts and HAs to deal with balance sheet problems.

And one trust finance director, who claimed August was the busiest month ever seen in accident and emergency, said that by the time wages were taken into account his trust would 'see no real money'.