Several of NHS’ biggest trusts set to miss financial plans

Oxford University Hospitals Foundation Trust has admitted it will miss its 2019-20 plan by a large margin, while Barts Health Trust, London North West University Healthcare Trust and University Hospital Southampton FT suggested their plans will need to be reviewed.

The failure of large trusts to meet their financial plans can put significant pressure on the aggregated national position, which is a crucial indicator of NHS performance for government officials.

The expected reviews will concern national officials, as 2019-20 is the first year of an improved funding settlement for the NHS and an improved position is expected.

OUHFT has signalled it will miss its control total by £17m. It has had to drop its year-end plan for £7.7m surplus, and is now forecasting a £10m deficit. This underlying deterioration excludes the impact of missing direct payments from central budgets, such as “provider sustainability funding”.

The trust has blamed the deterioration on short staffing, issues with theatre capacity, and elective activity being lower than planned.

Most of these trusts maintained they will meet their control total, but several said they planned to review their forecast.

Barts Health Trust, the fourth largest in the country, was already £71m in deficit after the first six months of the year, against its full-year control total of £116m. It told HSJ its official forecast would be subject to a “refresh” process.

In the three full years since control totals were introduced, OUHFT and Barts have both missed their plans in two of those years.

LNWUH also said it was considering revising its year-end position, while the latest board papers for UHSFT suggested its best case year-end outturn would be a £6m surplus, compared to its control total surplus of £17m.

Other trusts have cited difficulties in meeting their control totals, without going so far as saying they would review their forecasts.

Manchester University FT, the largest trust in the country, reported a deficit of £16m after the first six months, against its year-end control total deficit of £13m. Its latest finance report warned that “current progress with delivery is still inconsistent with the financial plans put into place”.

The regulator published national level performance figures earlier this month, which showed a £1bn overall deficit for the provider sector. The official forecast suggested this would reduce to £320m by the end of the year, compared to a deficit of £827m last year (excluding the benefit of a technical accounting measure relating to Carillion).

Jason Dorsett, chief finance officer at OUHFT, said: “The main factor behind our reforecast of our control total was that the trust carried out fewer elective operations than originally anticipated in Q1 and Q2.

“This was for a number of reasons including the impact of a planned refresh of operating theatres at the John Radcliffe Hospital in Oxford, which — while essential — did temporarily shrink our theatre capacity. The overall impact was greater than expected. We also experienced some anaesthetic staffing capacity issues.”

Trusts that miss their control total will lose access to central funding including PSF.

NHSE/I were approached for comment.

This story was updated at 10:19 on December 17 to reflect the fact that NHS England and Improvement had published their trust-by-trust mid-year financial performance.