The overall deficit forecast across trusts and foundation trusts has hit £823m, in the latest sign of the ‘continuing deterioration’ in the health service’s finances.

According to board papers from the NHS Trust Development Authority, based on figures to the end of last December, the trust sector is forecast to end 2014-15 with an overall deficit of £448m.

When combined with Monitor’s forecast that FTs would finish the year with a net deficit of £375m, also based on figures to the end of December, the total deficit for the provider sector exceeds £800m.

The £448m trust sector shortfall is £140m worse than the £308m deficit the TDA was forecasting two months ago.

The papers note that the “continuing deterioration in the financial position of NHS trusts” is a “consequence of the many pressures on providers and an issue of overriding concern”.

They also say the early evidence is that “forecasts for 2015-16 will be more difficult still”.

According to the TDA, the projected deficit is in spite of £1.3bn of efficiencies it forecasts trusts to deliver for 2014-15.

The forecast deficit figure is also flattered by a significant but undisclosed amount of “provider deficit funding” that has been given to trusts which are in particular financial stress.

The authority blamed the deterioration on unplanned growth in hospital demand, a significant increase in the use of agency staff, and the failure to deliver cost improvement savings planned at the start of the year.

Within the TDA’s £448m net deficit forecast, 64 trusts forecast a break even or surplus figure, coming to a combined total of £123m.

However, 35 trusts are forecasting a combined deficit of £572m between them, dragging the sector into a net deficit.

The financial stress is concentrated in the acute sector, where 52 per cent of trusts are forecasting a deficit, while only four of the 39 non-acute trusts are predicting deficits.

Nation-wide, London and the Midlands and East regions have 52 and 39 per cent of trusts forecasting a deficit respectively, compared to 26 per cent in the North and 22 per cent in the South.

Commenting on the figures, Chris Ham, chief executive of the King’s Fund, said the next government would “inherit a health service under huge financial pressure, with deficits among hospitals and other providers likely to continue rising in 2015-16”.

He added: “While there is still scope to improve efficiency to close some of the gap, this will leave new ministers facing an unpalatable choice between increasing NHS funding to restore financial stability, or allowing patient care to deteriorate as staff [numbers] are cut and waiting times rise.”