The Department of Health’s overall financial position appears to be tighter in 2013-14 than it has been for a number of years.

In recent years the DH has recorded significant surpluses, including an underspend of £2.2bn in 2012-13. However, the significant overspending by providers this year is believed to be putting significant pressure on the overall NHS and DH financial position. Non-specialist acute trusts and foundation trusts in England are forecasting a total net end of year deficit of £373m.

NHS England predicted in its board papers this month that, while it will overspend against its own direct commissioning budget by £36m, NHS England and clinical commissioning groups will record a £702m underspend overall.

The overall NHS and DH position will also depend on the DH’s own spending and that of other arm’s length bodies, such as Health Education England.

King’s Fund chief economist John Appleby told HSJ it was likely providers’ deficits would be “balanced out” by CCG underspends. However, he said it was possible that nationally NHS finances were becoming tighter earlier than had been expected. Professor Appleby said: “I’m guessing that up at the national level the DH don’t have an awful lot of extra cash just lying around. A lot of those things will have gone.

“We’re entering the fifth year of essentially no real extra money for the NHS.”

The DH said it was “on target to end this year within the financial limit agreed with the Treasury”.

Exclusive: More than a third of hospitals set to end year in the red