Trusts in deficit

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  • Posted:Tuesday 20 March 2018


Data: 2017/18 data refer to the forecast number of providers in surplus/deficit at the end of the year, based on data from the first nine months of the 2017/18 financial year. With the exception of 2017/18, data refer to number of trusts in existence on 31 March each year ie, changes to the number of trusts during the year due to mergers, separations, or dissolutions are not counted.

Source: The King's Fund analysis of data from Monitor, NHS Trust Development Authority and Department of Health (2009/10–2011/12), National Audit Office (2012/13–2015/16), NHS Improvement (2016/17, 2017/18).


The Q3 2017/18 performance report recorded 2341 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 just under 80 per cent of all providers in deficit in 2016/17.

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 £931 million this year.

For an in-depth analysis of NHS deficits, see our report on 2016/17 provider finances and our Quarterly monitoring reports.

  • 1. This figure includes providers who are no longer active, for example those who have merged with another organisation. The latest data from NHS Improvement records 232 active providers: https://improvement.nhs.uk/resources/single-oversight-framework-segmentation