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Winter A&E demand surge led to doubling of acute provider deficits

Are trusts making plans to meet demand during 2018/19?


NHS Improvement figures for 2017/18 showing trusts ran up deficits totalling £960m have sparked controversy, with some commentators claiming the true figure should be higher.


NHS Improvement reported that although 156 out of 234 provider trusts finished the year meeting or bettering their financial plans, a surge in patient demand during the winter months led to deficits rising to a total of £960m, or £464m more than planned.


NHS Confederation chief executive Chris Hopson warned that the full underlying deficit is much higher and that the NHS has relied on one-off savings.


Nuffield Trust policy analyst Sally Gainsbury said the figures were subject to window dressing, and that the reported deficit followed around £850m of one-off savings as well as injections of funding from the £1.8bn sustainability and transformation fund.


‘Taking these into account, along with other short-term fixes, the true underlying deficit is likely to be in the region of £4bn,’ she said.


‘As we have previously warned, there is a widening gap between what we are asking the NHS to do and what we are funding it to do. This hand-to-mouth existence is not a sustainable way to run complex and vital institutions.’


The NHS Improvement figures show that the deficits arose in acute hospitals, and is mainly due to an increase in A&E demand during the winter months.


Other providers, including ambulance, mental health and community healthcare trusts, collectively underspent during 2017/18.


Further information

NHS Confederation: Trusts deliver creditable performance in difficult circumstances

NHS Improvement: NHS met unprecedented patient demand last year

NHS Improvement: Quarterly performance of the NHS provider sector: quarter 4 2017/18

Nuffield Trust: Response to NHS financial figures