10 English NHS hospital trusts overspend by £850mMegan Orito
10 English NHS hospital trusts overspend by £850m.
Experts say hospitals cannot keep to budgets because of underfunding and demand.
Ten English hospital trusts clocked up combined overspending of £850m last year, as the NHS’s finances stayed perilously in the red amid prolonged austerity funding, official figures reveal.
The worst deficit was at King’s College healthcare trust in London, which was set to end 2018-19 with a deficit of £182m, according to the data from NHS Improvement (NHSI), which oversees the health service’s finances.
The deficits incurred by Barts Health (£85m) in London and the Worcestershire acute (£73m) trust meant that the five biggest overspenders incurred a collective deficit of £523m.
However, trusts should not be blamed for racking up such huge deficits, NHS experts said. Hospitals could not keep to their budget because of government underfunding of the NHS, staff shortages and the fast-rising demand for care rather than profligacy or mismanagement, they stressed.
“The reason hospitals are reporting deficits is very simple: every year since 2010 the amount they have been funded to care for each patient they treat has been cut,” said Sally Gainsbury, a senior policy analyst at the Nuffield Trust health thinktank.
Ministers created the colossal overspends by giving the NHS too little money to discharge its role properly, Labour claimed.
“Whatever Theresa May claims about NHS funding, the reality is many hospitals remain seriously in the red. Years of financial squeeze and staffing troubles have left hospitals struggling,” said Jonathan Ashworth, the shadow health secretary.
“NHS bosses are now even telling hospitals to scale back maintenance plans despite facing multibillion backlogs in repairs because the cash simply isn’t available. Whatever the spin, our NHS continues to suffer from Tory austerity.”
Only creative use of NHS funding had disguised that England’s 240 NHS trusts of all types – including mental health, community and ambulance trusts – last year had a £4bn “gap between their ongoing costs and their reliable income”, Gainsbury said.
“The financial hole has been patched up with emergency funding, loans and one-off cost cuts, but it has left trusts under financial siege, with no regular funding to cover their running costs for, on average, 18 days a year.”
Morecambe Bay trust’s £70m deficit in 2018-19 was equivalent to 19% of its income the year before. More than 10 trusts had overspends that equated to at least 15% of their 2017-18 budget, Gainsbury said.
NHSI’s predicted year-end deficits are contained in its report covering NHS performance in the first nine months of last year, which contains estimates of the financial health of every trust.
The regulator will publish final year-end actual figures on 30 May. But the deficits it will detail then will be lower at some trusts because they received bailout money from the NHS’s provider sustainability fund.
NHS bosses have promised to get the service’s disastrous finances back on track over the next five years, using the extra money which the prime minister pledged last year to mark the service’s 70th birthday. That will increase the NHS’s budget by £20.5bn by 2023-24.
The NHSI report contained other worrying evidence that finances were worsening rather than improving:
- 60 trusts had already run up bigger deficits than planned after nine months of 2018-19, up from 44 in the previous quarter.
- 73 trusts were expected to end 2018-19 in the red.
- Chronic understaffing had forced trusts to spend £1.795bn on agency staff – £139m more than planned.
- Trusts had made £244m less of efficiency savings than hoped.
King’s said it had made changes that would improve its productivity and eventually stabilise its finances. “Despite the financial challenges, the trust continues to deliver excellent, high-quality care and services to patients,” a trust spokesperson said.
An NHS spokesperson pledged that all trusts’ deficits would have been erased by 2023-24. “The NHS successfully balanced its books in 2018-19 and productivity has been growing three times faster than in the rest of the economy,” the spokesperson said.
“Trusts in deficit are getting extra funding as part of the new NHS financial settlement so that trust deficits are progressively eliminated over the next five years.”
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