A clinical commissioning group in Surrey has reported a deterioration of £7.4m in the final three months of 2016-17.

CCGs were required to deliver a breakeven position last year, while also holding back 1 per cent of their allocation. In January, official forecasts published by NHS England said Guildford and Waverley CCG was on course to deliver this.

But the CCG ended the year £7.4m short of this requirement, by posting a £5m in-year deficit.

It had warned NHS England earlier in the year of significant “unmitigated risk” around meeting the plan.

The CCG’s main provider is Royal Surrey County Hospital Foundation Trust, which posted an £18m surplus for 2016-17. The trust triggered £23m of incentive funding from national bodies by significantly beating its control total.

There was a tariff based contract in place between the two organisations, with the trust drawing in more income than the CCG had planned for.

Both organisations told HSJ they had not struck a deal to boost the trust’s surplus to maximise sustainability and transformation fund income. NHS Improvement had suggested such deals were appropriate, but NHS England warned against them.

The CCG said its outturn position has resulted in an “underlying financial problem” in 2017-18.

Ross Dunworth, finance director at the trust, said the trust could legitimately have charged the CCG for more income than it did, but agreed to some reductions to help minimise the CCG overspend.

He said the trust’s income was in line with its plan, which was to draw in the same amount as 2015-16 plus growth of 1 per cent.

Mr Dunworth added the organisations will be working more collaboratively in 2017-18 to ensure both meet their financial targets.