The foundation trust sector finished last calendar year with a deficit five times higher than planned, in the latest sign of the ‘exceptional pressure’ the NHS is under.
According to new figures from Monitor, the sector reported a deficit of £321m over the nine months to 31 December, with 78 of the 149 FTs in England in deficit (53 per cent).
The FT regulator is now forecasting an end of year deficit of £375m for the sector – £104m worse than its prediction in November – and against a planned deficit of £16m.
But Monitor conceded that its revised deficit forecast may actually be “understated given operational pressures and the fact that previous in year forecasts by [FTs] have been optimistic”.
The current £321m deficit is comprised of a gross deficit of £530m balanced against 71 trusts with a combined surplus of £209m.
The financial deterioration of the FT sector is blamed on an unplanned increase in costs outstripping revenue growth, with stress concentrated in the acute sector, where 60 trusts – 73 per cent of all acute FTs – are in deficit.
According to Monitor “a large majority” of financially challenged acute trusts are medium or small in size, which is says raises “the question about their long term financial sustainability”.
As well as struggling financially, FTs have now failed to meet national waiting time targets for accident and emergency, routine and cancer care for three successive quarters in the 2014-15 financial year.
The sector failed to achieve the A&E waiting time target of seeing 95 per cent of patients within four hours for the 2014 calendar year.
For the first time, ambulance FTs breached the three response time targets relating to life threatening “category A” calls.
Patients waiting on a trolley for more than four hours in A&E increased by 134 per cent to 42,600 due to reduced bed availability between October and December.
Monitor said trusts were experiencing “exceptional pressure” because of a large increase in patient demand, with attendances at FTs’ A&E departments between October and December up 8 per cent on the same period in2013.
FTs also treated 7 per cent more non-emergency patients in the quarter compared to the previous year.
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The combined waiting list for elective care stood at 1.64 million at the end of the quarter – 2.5 per cent higher than the year before – although there had been a reduction of 40,000 waiters since the previous quarter.
Monitor said the pressure on trusts had been increased by the need to make cost savings and the use of expensive agency staff.
The use of agency workers contributed to providers spending £419m more on staff than planned in the nine months through to December, but the £810m in cost savings made by the FT sector was £210m less than planned.
Monitor chief executive David Bennett said while trusts were working “harder than ever”, the NHS needed “to move rapidly towards more joined up, efficient models of care if it is to deal with this continuing growth in demand for services”.