The NHS trust sector’s financial position has deteriorated to an overall deficit of £414.2m, providing new evidence of the pressure trusts are under.

Papers presented at the NHS Trust Development Authority’s board meeting last week show that for the eight months to November last year the trust sector is £38m further into the red, compared to the £376.2m deficit it reported in the six months to September.

The TDA is forecasting the sector will finish the year with a deficit of £308m – £25.7m worse than the £282.3m it predicted previously.

Bob Alexander

Some mental health trusts are also in deficit, Bob Alexander said

However, the underlying financial performance is worse than these numbers suggest, as figures for the trust sector have been improved by the inclusion of “provider deficit funding” bailouts distributed to 15 trusts by the Department of Health.

The TDA said trusts were under pressure because of “unplanned growth” in hospital care, an increase in contract and agency staff, and failure to deliver savings planned at the start of the year, with a “larger proportion of cost improvement scheme being delivered non-recurrently”.

Thirty trusts are forecasting a combined deficit of £452.1m, but with 69 trusts forecasting a surplus of £144m between them, the aggregate position for the sector improves to the £308m deficit.  

Most of the trusts in deficit are acute providers, but at the board meeting TDA finance director Bob Alexander said: “We have a community trust and a couple of mental health trusts that are desperate to join the pack.”

Solent Trust and Manchester Health and Social Care Trust, which are both community and mental health providers, are forecasting unplanned deficits for the year.

The overall end of year figures forecast for the sector are flattered by “provider deficit funding” made available for 15 trusts.

Mr Alexander said the TDA had already “played a portion of that [funding] into the £308m position”.

The authority said this non-recurrent funding is being directed towards trusts with “exceptional” financial challenges that threaten their overall sustainability.

It said the funding comes with conditions, and that those receiving it have to be on track to deliver an agreed financial plan for the year.

However, it is not yet clear exactly how much will be distributed to each trust under the scheme, and it appears unlikely that this will be known before the general election in May.

A spokesman for the TDA said the body was “working through the final details and figures”, which would be “published in due course”.

The deficit funding is set to appear in trusts’ annual accounts published in May, but these will be subject to the “purdah” rule that prevents the publication by public bodies of politically sensitive information in the run-up to elections.

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