NHS finances: Why we are being kept in the dark

It's coming up to six months since the start of the financial year. A year that many believe - financially at least - will make or break the NHS.

Yet we still don't know how hospital, mental health, ambulance and community services are shaping up.

Yes there have been predictions and forecasts. But - as yet - no concrete figures.

There are two economic regulators for the sector: Monitor, which keeps an eye on the books of foundation trusts (the leading trusts), and the Trust Development Authority, which looks after those that have not attained the status

Neither has released the figures for the first quarter of April to June. Finance directors on the ground have submitted data, but the figures need more work apparently. Hence, we approach the half-year mark in the dark.

So when will we get an idea of what is happening? I have heard whispers that the two regulators are planning a joint publication after the party conferences.

But this - it seems - is only likely to delay the bad news. Last year was the first that foundation trusts finished the whole year in deficit, recording a £249m loss.

When the non-foundation trusts were included, the deficit topped £800m. And the NHS as a whole only broke even after an extra £250m cash injection from the Treasury and by raiding the capital budget, which is meant to be spent on buildings.

'Challenging year'

This year, the budget has been increased by 1.6% above inflation, bringing it to just over £116bn. But even that looks like it will not be enough.

While the accounts are being kept under wraps, a survey of 100 finance directors by the King's Fund think tank over the summer found two-thirds were predicting deficits.

The outlook was particularly bleak in the hospital sector, where nine in 10 thought they would finish the year in the red.

It has also been suggested that the business plans, submitted by trusts at the start of the year but not published en masse, forecast a £2bn deficit.

It's no wonder then that King's Fund chief economist Prof John Appleby has called 2015-16 "the most challenging year this century".

This is not the first time that the NHS has had problems with its finances though. A decade ago, it was struggling to make the sums add up.

But the difference then was that the health service was enjoying record rises in its budget and was able to find the reserves and savings to cover the overspend.

But Chris Hopson, chief executive of NHS Providers, which represents trusts, says such slack is simply not in the system this time round.

"Trusts are doing everything they can - but a lot of the easier savings have been done, so it is going to be difficult to do any better than a £2bn deficit," he said.

It raises the prospect of NHS bosses having to curb spending in the coming months or the Department of Health going cap in hand to Chancellor George Osborne to ask for more money while much of the rest of the public sector is being squeezed. Neither seems palatable.

So is a tough year about to get tougher? When the figures do finally come out, we should have the answer to that.

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