FINANCE: Commissioners in north east London have calculated that the financial challenge the area faces comes to almost £950m over five years.
The commissioners predict the local health economy faces a collective deficit of £943m if nothing is done to address its financial situation.
Barts Health Trust, the largest trust in the country, was placed in special measures earlier this month because of a deficit approaching £100m and performance concerns identified by the Care Quality Commission.
Barking, Havering and Redbridge University Hospitals Trust is struggling with a £35.9m deficit.
Both trusts have had poor accident and emergency performance over the past two years.
A letter to NHS England regional director, Anne Rainsberry, from the chief officer of Waltham Forest Clinical Commissioning Group, Terry Huff, said: “The [challenged health economy] work has initially assessed the five year financial challenge facing north east London as £943m across commissioners and providers.”
The area is one of 11 challenged health economies identified by Monitor, NHS England and the NHS Trust Development Authority last year.
The North East London Advisory Group has been established with members from the clinical side, providers, commissioners and local authorities “to ensure there is strong alignment for the case for change”, the letter said.
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Barking, Havering and Redbridge has already agreed an improvement plan.
The advisory group is overseeing the development of a single financial plan for the whole of north east London.
Modelling by three of the CCGs has suggested that “any site closure” would be an “unrealistic proposal” in an attempt to sort out the finances of the local health economy.
The letter continued: “Therefore, financial sustainability will be driven by integrated health planning across acute and non-acute services.”
The CCGs are also using independent financial advisers to “better understand” the underlying financial position of Barts and the reasons for its “deteriorating” financial performance this year.
The north east London CCGs have already agreed to work with north central London CCGs as a group of 12 to look at issues relating to specialised commissioning.
A spokeswoman for Waltham Forest, Newham and Tower Hamlets CCGs said: “CCGs are working in partnership with health and social care providers to reduce the burden on the health service, to improve and monitor performance, and to integrate care.
“CCGs are also working on longer term strategies to address the expected population increase, take advantage of new developments in treatments and produce a range of realistic options to deliver care in a safe, high quality and financially sustainable way.”
Neil Kennett-Brown, the director of transformation for Waltham Forest, Tower Hamlets and Newham CCGs, said: “Waltham Forest, Tower Hamlets and Newham CCGs are producing a new joint updated clinical strategy and investment case around Barts, which is due for first draft completion in the summer.”