• North Staffordshire and Stoke on Trent CCGs set to miss control total by £34m
  • Local acute trust claims the level of contractual challenges from commissioners have become “unsustainable”

Commissioning leaders in northern Staffordshire have admitted they will miss their financial plans by more than £30m in 2018-19.

The shared leadership team for North Staffordshire and Stoke on Trent clinical commissioning groups expect to fall short of their NHS England “control total” by £34m in 2018-19, according to their latest finance report.

Papers published for the 6 November governing body meeting said the adverse variance had been agreed by national chiefs, following a recent “capacity and capability review” by Deloitte.

Around £18m of the forecast overspend relates to North Staffordshire CCG and £16m to Stoke on Trent. The CCGs originally planned for a combined in-year surplus of £7m, but are now forecasting a deficit of £27m.

A spokesman for the Staffordshire CCGs said: “The variance was not discovered by Deloitte; the CCGs have been forecasting this level of risk against their financial plans.”

The two CCGs have a combined allocation of around £690m.

Meanwhile, the three CCGs in the south of Staffordshire (Cannock Chase, South East Staffordshire and Seisdon Peninsula, and Stafford and Surrounds) are forecasting a combined deficit of £29m, which is around £3m worse than planned.

This means all commissioners in the Staffordshire and Stoke on Trent sustainability and transformation partnership, including East Staffs CCG which has a small surplus, are now forecasting a combined deficit of around £55m.

It comes amid multiple contractual disputes between the commissioners and their financially challenged acute provider University Hospitals of North Midlands Trust, which is currently forecasting a deficit of £40m.

In board minutes, published 12 November, UHNM’s chief finance officer, Helen Ashley, said the contractual challenges had become “unsustainable” and it “was building a significant issue for the trust if these were not settled”.

According to UHNM’s November board papers, commissioners have challenged £30m in activity for June and are currently “challenging the entire non-elective bill.”

The board papers added: “A significant risk to the delivery of the plan remains the trust’s assumption around income from commissioners and the impact of any actions they take to address their affordability issues. The trust has received notification from CCGs that they are disputing all emergency activity for months one to four.”

In 2017-18, the CCGs attempted to levy £9.3m in fines which the trust is currently disputing.

In May this year, Labour Stoke on Trent Central MP Gareth Snell asked former health secretary Jeremy Hunt to “intervene” and “waive” the fines, claiming they would be “the difference between the hospital getting through the next 12 months and [the] hospital crawling over the next 12 months on its knees”.