Commissioners report aggregate underspend

The Q2 figures, published at the NHS England November board meeting, showed clinical commissioning groups had a year-to-date overspend of £74m, largely driven by overspends on acute contracts. There were 36 CCGs with year-to-date overspends.

Interim chief financial officer Matthew Style (pictured) told the board meeting that, at month six, he expected all but 11 of the 36 CCGs to bring their position into line with their plan at year-end.

However, the year-to-date position was balanced by underspends in direct commissioning (£28.5m) and NHS England central budgets (almost £94m). Central budget underspends were largely due to vacancies and unexpected income from GP rates rebates. Technical and other adjustments (-£11m) reduced the final year-to-date commissioning sector figure to a £37.5m underspend.

In September, NHS England and NHS Improvement agreed an action plan to recover planned provider year-end deficits of £519m. They wanted the provider sector to reach a balanced position at year-end to give them a springboard going into the five-year funding settlement and implementing the long-term plan.

The report said commissioners were on track to deliver the planned underspend of £265m at year-end – the sector’s contribution to getting providers back in overall balance.

Mr Style said a greater year-end underspend could be delivered. NHS England had conducted its regular deep dive into central budgets half way through the year to see if further funding could be released. Likely underspends in central budgets, together with the management of risk, the conclusion of the Pharmaceutical Price Regulation Scheme deal and the successful procurement of biosimilar medicines would also contribute.

He added: ‘We think for month 7 we will be able to release further reserves and contingencies into the reported position. Taking those together with the position on direct commissioning and updated forecasts of performance against the quality premium in our next report, we expect to forecast a year-end underspend of at least £450m.’