The document summarizes the financial context and challenges facing the NHS in England. It reports that in 2014/15 there was an overall deficit of £151 million across English provider trusts and a £822 million underspend by clinical commissioning groups (CCGs). Finance directors are pessimistic about achieving financial plans for 2015/16 and beyond due to risks like slippage in cost savings and increased demand. While most believe service quality will be maintained this year, less than 10% feel their local areas have sufficient resources for long-term financial plans. Suggested actions to help meet financial challenges include greater honesty about what services can be provided, payment system improvements, and more integration/collaboration.

1. July 2015
HFMA NHS FINANCIAL
TEMPERATURE CHECK

2. FINANCIAL CONTEXT
£822m
£151m
CCG UNDERSPEND
IN 2014/15
REPORTED DEFICIT
OF ENGLISH
PROVIDER
TRUST SECTOR
IN 2014/15
There is a deficit
overall in local NHS
organisations.

3. FINANCIAL CONTEXT
NHS
FOUNDATION
TRUSTS
NHS
TRUST
SECTOR
£349m
£10m
£473m
REPORTED
DEFICIT
PLANNED
DEFICIT
REPORTED
DEFICIT
£408m
PLANNED
DEFICIT
There is an
overall deficit
across NHS
organisations
in 2014/15.

4. DRIVERS FOR VARIANCE
The main drivers for the
variance from the planned
financial position were:
TRUSTS CCGs
72%increase in agency
staff costs
55%under-achievement
of planned savings
66%acute contract
programme cost
increases
53%slippage on
planned savings

5. FINANCIAL FORECASTING
DEFICIT SURPLUS
83%
There is a clear
distinction between
trusts & CCGs
63%
Trusts CCGs

6. FINANCIAL PLANS
A small percentage of finance directors feel
there is low risk to achieving their plans.
2015/16 plans 2016/17 plans
2%
Trusts
4%
CCGs
16%
10%
Trusts
CCGs
Finance directors are even less
confident about achieving their
financial plans in the near future.

7. RISKS TO
FINANCIAL
PLANS
The main risks finance
directors identified to
their financial plans are
slippage in cost savings,
increased demand for
services and increased
emergency activity.

8. SERVICE QUALITY
2015/16
66%
Maintained
26%
Improved
7%
Reduced
2%
Don’t know
Overall,
most finance
directors
believe service
quality within
the NHS will
be maintained
in 2015/16

9. LEVERS FOR CHANGE
73%
TRUST FINANCE DIRECTORS
However, when thinking about their local
area, finance directors felt they did not
have sufficient levers to effect change.
Respondents felt, within their
organisations, they probably have
sufficient levers to improve quality
and financial performance.
43%
CCG CFOs

10. RESOURCES
Less than 10%
of English finance
directors believe
the organisations
in their area have
sufficient resources
to support their
long-term financial
plans.
LONG-TERM
PLANS
RESOURCES

11. ACTIONS TO HELP
FINANCE DIRECTORS
MEET FINANCIAL
CHALLENGES
Honesty about
services that can be
provided within the
financial settlement
FINANCE
DIRECTORS
SUGGESTED
Changes and
improvements to the
national payment
system in England
Greater integration of
services specifically more
progress on the Better
Care Fund in England
Improved joint
working and
collaboration