The areas of the country where NHS cuts are likely to hit hardest because services are nearing their “overdraft” limits have been revealed, in a new analysis.
Following the worst financial crisis in the history of the NHS, every part of the service has been set stringent “control totals” which limit the amount of deficit that can be authorised.
Research by Health Service Journal shows Staffordshire, Bristol, North Somerset and Gloucestershire are the areas likely to fall furthest short of their targets, with warnings that services will now have to “confront difficult choices”.
NHS authorities are already drawing up plans for dramatic changes to services, with the closure of Accident & Emergency departments and maternity units under discussion across swathes of the country.
In Staffordshire, health officials are dicussing the loss of full A&E services from either Burton Queen's Hospital, Royal Stoke University Hospital or County Hospital in Stafford, while Somerset’s plans could see the downgrading of A&E at Weston General Hospital.
But the new analysis suggests that existing plans may not go far enough to ensure areas achieve financial targets set by NHS England and NHS Improvement.
Staffordshire is set to miss its control total by £68m - almost 4 per cent of its income, the research suggests.
Bristol, North Somerset and South Gloucestershire will fall £45m short - around 3 per cent of its income, the forecasts show, with Gloucestershire set to miss its target by £28m, also 3 per cent of its income.
Last month, health officials warned that areas that could not bring their deficits down would be forced to take “difficult choices” - and to cut back on the services they provide.
The strategy, launched by NHS chief executive Simon Stevens, said: “Some organisations and geographies have historically been substantially overspending their fair shares of NHS funding and their control totals…
“In effect they have been living off bail-outs arbitrarily taken from other parts of the country or from services such as mental health. This is no longer affordable or desirable.”
“Going into 2017/18 it is critical that those geographies that are significantly out of balance now confront the difficult choices they have to take,” the paper continued.
“Where necessary this may mean explicitly scaling back spending on locally unaffordable services, so that they go into the next two years with a viable and balanced income and expenditure plan.”
Last May the NHS provider sector declared an overall deficit of £2.45bn - the highest in its history.
Health chiefs have said the sector is likely to remain in the red for the financial year which has just ended, with a deficit of around £600m predicted by the end of 2017/18.
Health areas with furthest distance from financial targets (ranked by percentage of income)
Staffordshire - £68m (4 per cent)
Bristol, North Somerset and South Gloucestershire £45m (3 per cent)
Gloucestershire £28m (3 per cent)
Sussex and East Surrey - £67m (2.2 per cent)
South West London - £50m (2.1 per cent)