There are 233 NHS trusts and foundation trusts providing ambulance, hospital, community and mental health services in England. In 2010/11, just 5 per cent of these providers overspent their annual budgets. By 2015/16, two-thirds of trusts (66 per cent) were in deficit before the proportion fell back to 44 per cent in 2016/17. Acute hospitals accounted for the majority (nearly 80 per cent) of all providers in deficit in 2016/17 (over 60 per cent of acute hospitals ended 2016/17 in deficit).
As recently as 2012/13 NHS providers recorded a surplus of nearly £600 million in aggregate. Since then provider finances have deteriorated sharply with an overall deficit of £2.5 billion recorded in 2015/16. In 2016/17, the NHS provider sector ended the year with a deficit of £791 million. This position includes £1.8 billion of additional financial support provided through the NHS Sustainability and Transformation Fund, which helped reduce the level of financial deficits in the provider sector in 2016/17.
The shared planning guidance for the NHS in 2017/18 stated an ambition that ‘at national level, the provider sector needs to be in financial balance in each of 2017/18 and 2018/19’. However, in 2017/18 the provider sector is expected to remain in deficit, with provider financial plans suggesting a deficit of £623 million this year.