Trusts in deficit

This content relates to the following topics:

Part of The NHS in a nutshell

Article information

  • Posted:Thursday 12 November 2020

Made with Flourish

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, 2018/19).

In 2010/11, just 5 per cent of NHS trusts and foundation trusts in England overspent their annual budgets. By 2015/16, two-thirds of trusts (66 per cent) were in deficit as a slowdown in NHS funding took its toll.

The 2015 Spending Review provided additional ‘sustainability and transformation’ funding for the NHS. This contributed to a fall in deficits over following years – though 46 per cent of trusts still overspent their budgets in 2018/19. 

As part of the new five-year funding deal announced for the NHS in 2018, national NHS bodies have said that no trusts should be in deficit by 2023/24 and the number of trusts in deficit in 2019/20 should reduce by more than half the number in deficit in 2018/19 . The 2019/20 NHS annual accounts have not been published yet, but the Chief Executive of NHS England and Improvement has said that in 2019/20 three-quarters of trusts ended the year in surplus.   

For an in-depth analysis of NHS finances, see our Quarterly monitoring reports

Get the latest news from The King's Fund

Subscribe to our newsletters to keep up-to-date with the world of health and social care and hear the latest news and views from The King's Fund.

Learn more