NHS trusts and foundation trusts have booked a combined deficit of £991 million for 2017/18, according to the National Audit Office's latest report on NHS financial sustainability.
NHS England is reported to have achieved an underspend of £1,183 million, 4.1% of the £28,572 million available for its national functions and centrally commissioned services; whereas clinical commissioning groups (CCGs) together reported an overspend of £213 million, 0.3% of the £80,964 million available for locally commissioned services.
The report notes that the NHS long-term plan "sets out a prudent approach to achieving the priorities and tests set by the government," but also warns that "a number of risks remain”, including staff shortages.
It also found the number of CCGs in deficit grew from 57 in 2016/17 to 75 in 2017/18, and commented on the increasing waiting lists and waiting times, which are ‘continu[ing] to slip’.
BMA council chair Dr Chaand Naipaul told the media that “It is deeply worrying that this assessment has found the NHS is not in a financially sustainable position, with parts of the system mired in deficits and overwhelmed by rising waiting lists that together are combining to damage patient care.”
“We do need the Government to urgently ensure the NHS long-term plan is built into a strategy that not only provides stability, but also gives the NHS the resources to meet the growing needs of its patients and to fund a proper workforce,” he added.
To be sustainable, the NHS needs to manage patient demand, including how long patients wait, the quality and safety of services, and remain within the resources given to it.
Also commenting on the report, Niall Dickson, chief executive of the NHS Confederation, said it is a "sober assessment" and "a reminder of the huge challenges facing the NHS in England."
"In spite of promised extra funding, the finances of our health system are in a precarious state," he stressed.
"Hospital and community services are reporting an underlying deficit of £1.85 billion and this, together with rising demand and a workforce crisis, means it will be incredibly difficult to make the service sustainable. The latest planning guidance is an attempt to support organisations to move back into balance, but this will take time.
He went on to say that while extra money from the government is welcome, "as the NAO highlights, it does not cover key areas of health spending such as education, public health and capital investment. As we have also repeatedly pointed out, the NAO says this could affect the NHS's ability to deliver the priorities of the NHS Long Term Plan. The same is true of social care funding."