The clinicial commissioning group for an “advanced” health system is expected to post a significant unplanned deficit in 2017-18.

In its month 11 finance paper, Buckinghamshire CCG said it was forecasting an overspend of £19.2m against plan.

It is part of the Buckinghamshire “integrated care system” – one of eight shadow ICS created by NHS England. These areas are currently in discussions with NHSE and NHS Improvement about accepting a system-wide financial control total. It is not yet clear what effect this unplanned deficit will have on the development of the Buckinghamshire ICS.

The commissioner’s financial situation has deteriorated sharply since December. According to NHSE’s quarter three financial performance report, its finances were on track in the first nine months of 2017-18. It finished quarter three with no variance to plan and a year-end forecast that its spend would remain within its allocation.

However, its month 10 finance report said it was forecasting a year-end overspend of £11.7m.

The deficit increased further as NHSE instructed the CCG to include a £7.5m “community equipment stock risk” in its reported position.

The CCG’s April 2018 governing body papers said the financial deterioration was partly due to an over performance against hospital contracts of £21.9m, plus a 24 per cent under delivery the savings’ target submitted to NHSE in late December.

After the third quarter, the CCG’s main acute provider, Buckinghamshire Healthcare Trust, was reported to be narrowly behind plan excluding the impact of missed sustainability and transformation fund payments.

The CCG, which was created through the merger of Aylesbury Vale and Chiltern CCGs last month, was approached for comment.