Four NHS Foundation Trusts based in the North of England are to have their books scrutinised by health regulator Monitor after getting into financial difficulties.

Monitor has opened investigations at City Hospitals Sunderland NHS FT, Gateshead Health NHS FT, Lancashire Teaching Hospitals NHS FT and Wirral University Teaching Hospital NHS FT to “find out more about the financial situation at each trust and to establish what can be done to improve things,” said Paul Chandler, Regional Director at Monitor.

Whether regulatory action will be undertaken at any of the Trusts is not yet clear, but the move is yet another signal that the sector is struggling to cope with surging patient demands and financial independence.

Monitor's latest quarterly report revealed that, in the nine months to December 2014, FT deficit rocketed to £321 million, five times more than planned, while a massive 78% are currently in the red.