Three quarters of integrated care systems (ICSs) have submitted deficit plans for the 2024/25 financial year, according to NHS England.
In a report to the July NHS England board meeting, chief financial officer (CFO) Julian Kelly said 31 out of 42 ICSs have a deficit plan for this financial year, with a total planned overspend of £2.2bn.
NHS England said it would cover this overspend, but it would ‘leave no room to cover any further pressures’.
Rewards will be provided for those systems that break even, and consequences will be put in place for those with the largest deficits. It added that there would be stronger oversight and reporting.
It said: ‘Systems have agreed revenue spending targets for the year which in aggregate are affordable in the context of the overall NHS position. These targets take into account the historic financial position of each system.
‘Alongside the targets, we have also revised the financial framework to provide rewards for systems that deliver breakeven, and consequences for those with the largest deficits.’
The report also said that the actual spending by systems for the first two months of the financial year was already over budget by £237m, or 1%, which was ‘driven by overspends in systems with much of this driven by slippage against efficiency plans’.
‘This is in part due to the delayed completion of the planning process,’ it added. ‘It is expected that year-to-date overspends will be recovered in the latter part of the year resulting in a forecast position in line with plan.’
It comes after a National Audit Office (NAO) report last week found that 15 out of 19 ICB CFOs said their integrated care board’s (ICB) underlying financial position had deteriorated in 2023/24, with seven saying it had done so ‘significantly’.
The NAO NHS financial management and sustainability report 2024, which included case studies, interviews, and financial analysis alongside the survey, estimated there was £1.4bn aggregated deficit in 2023/24 across the 42 ICSs, with three ICBs in NHS England’s Recovery Support Programme alongside 21 trusts.
