NHS reports surplus despite CCG and provider deficits

The overall NHS position was revealed at an NHS England and NHS Improvement meeting in common at the end of June. This showed that the commissioning sector had a year-end surplus of £916m – an aggregate underspend of £651m against plan.

Although CCGs reported a £155m overspend at year end – £203m more than plan – this was offset by underspends in other areas, including direct commissioning (£315.4m), NHS England running and central programme costs (£713.2m) and technical adjustments (£42.6m).

The provider sector ended the year with a £571m deficit, which was £177m more than planned. The figure was reached after including the benefit of the provider sustainability fund (PSF) and an exceptional adjustment of £256m following the liquidation of Carillion.

Two hospitals under construction were brought onto the NHS books after the collapse of the firm, which are treated as part-donated assets. Before these and other adjustments, providers had an aggregate deficit of £867m.

The total combined position of the commissioning and provider sectors was a surplus of £345m. However, part-donated assets are not recognised for RDEL reporting purposes (the key measure of departmental reporting), so the final overall year-end figure is an £89m surplus – £218m more than plan.

The year-end finance report tabled at the meeting said 33 CCGs overspent against plan (totalling £219m), while 27 CCGs underspent against plan (£27m).

As a result, CCGs overspent against plan by £264m but this was partially offset by £61m in quality premium that was not earned by commissioners. This produced the final figure of a £203m overspend against plan.

Savings in NHS England central budgets included vacancy controls, income from GP rates rebates and counter fraud receipts.

The report added: ‘During the year, NHS England acted to ensure delivery of the overall financial position by holding back investment that would otherwise have been used to fund transformation and service improvement.’

NHS chief financial officer Julian Kelly congratulated the service on achieving the overall financial position. He added: ‘The £89m underspend is quite a feat on £113bn of spend. In aggregate, providers underspent against their capital plans to the tune of about £300m. Relative to previous years, the slippage of what they spent compared with what they said they would spend is much lower.

‘It probably indicates both that they are getting better at doing what they said they were going to do and indeed some of the pent-up demand in the system to address maintenance issues, which we will need to keep an eye on.’

• Julian Kelly will address the HFMA summer conference on 5 July. Conference coverage at www.hfma.org.uk/news