Following the Money: Streeting ends deficits (HSJ, 1 July 2025)

Summary

At this point in the past few years, finance directors were still finalising their plans, three months into the financial year.

Yet Sir Jim Mackey’s decision to go public about the scale of the challenge, in sharp contrast to previous years, led to a forecast £6bn deficit falling to £2.2bn, which would be covered by national deficit support funding.

But the speed and scale of the improvement inevitably raises questions about just how robust those plans are.

The new leadership at NHS England is alive to this. A meeting earlier this month of finance directors was well received by attendees, but the presentation warned of a £1.5bn risk “that will have to be proactively managed”.

Could it be that some systems met their control totals by moving numbers from the “deficit” column into the “risk” column? If so, the £2.2bn is likely to get bigger.