ICSs told to prepare ‘nuclear’ service cuts as NHSE plays ‘hardball’

Health systems are still struggling to meet their financial plans, despite hundreds of millions being raided from investment budgets to help balance the books.

Senior leaders in most regions said the cash falls short of their existing financial gaps.

Earlier this month, NHS England announced that £800m would be made available to integrated care systems (ICSs) to offset the additional cost of strikes. 

HSJ understands ICSs reported a combined deficit that was £1.5bn worse than planned in the six months to October, which implies a gap of several hundred million pounds unless systems can report substantial surpluses for the second half of the year.

HSJ spoke to senior sources in all seven regions, with more than half saying their systems would still fail to deliver breakeven, despite the funding transfers.

A source in the South East said their system’s share of the funding “won’t touch the sides”, adding that NHSE was playing “hardball”.

Another local source said they had identified a set of “nuclear options” to balance the books, but these would be “catastrophic for quality of care and/or nigh-on impossible to deliver”.

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Source: HSJ, 22 November 2023