Trusts in deficit

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Part of The NHS in a nutshell

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  • Posted:Wednesday 06 June 2018


Data: Data refers 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).


NHS Improvement report quarterly financial data for 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 as the slowdown in NHS funding took its toll. 

The 2015 Spending Review provided additional funding for the NHS in the form of a £1.8 billion annual ‘Sustainability and Transformation Fund’. This funding contributed to a fall in deficits, but 44 per cent of trusts still overspent their budgets in 2017/18, with acute hospitals accounting for just under 90 per cent of all providers in deficit. The NHS provider sector as a whole ended 2017/18 with a deficit of £960 million.

The national planning guidance for the NHS states that £2.45 billion of funding support will be available to NHS trusts in 2018/19 through a ‘Provider Sustainability Fund’ which will replace the Sustainability and Transformation Fund. This guidance also states an ambition that the NHS provider sector will financially balance in 2018/19. However, this was also a national ambition in 2016/17 and 2017/18, when the provider sector reported deficits of close to £1 billion. 

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 This figure includes providers who are no longer active, for example those who have merged with another organisation.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