A collective report from the pleasingly named SHIP primary care trust cluster – Southampton, Hampshire, Isle of Wight and Portsmouth – gives a snapshot of the South Coast’s state of affairs.

It reveals commissioners are already dipping into cash reserves to keep up with revenue surplus targets. Southampton and Hampshire all but maxed out their contingency budgets in the first quarter, releasing £5.1m and £3m respectively, to offset overspends on acute contracts.

Hampshire has an “underlying cash problem” and is in talks with NHS South Central to find a permanent solution. Southampton should mitigate underperformance by savings under the quality, innovation, productivity and prevention scheme, says the report.

Cluster QIPP performance was sluggish in quarter one, generating £15.8m of savings against a target of £18.2m – NHS Hampshire was again the major underachiever.

Although Portsmouth and the Isle of Wight reported modest QIPP shortfalls, Hampshire was £2m short of its £11m savings plan.

Meanwhile, the report awarded “performance under review” status to all four PCTs, highlighting across-the-board concerns with accident and emergency and stroke care.

Diagnostics waits were a particular area of concern for Hampshire and Portsmouth. The yearly target for the number of patients waiting more than six weeks for a test is 100 – but Hampshire had 300 in May alone.

There were pan-cluster concerns over activity levels too. Inspection of the demand for acute services reveals the cluster is struggling to meet targets on GP referrals. All four PCTs exceeded their plans in May, but in Southampton written referrals from GPs were a third over the planned level.