40% of acute trusts, 20% of ambulance trusts, 11% of specialist trusts and 7% of mental health trusts are in deficit

This article is more than 6 years old

This article is more than 6 years old

The number of NHS foundation trusts in England in financial difficulty has almost doubled in a year from 21 to 39, a study by their watchdog has found.

The study from Monitor, which regulates England's 147 trusts, found that their combined deficit was £180m, £12m higher than anticipated. Five trusts account for 60% of the deficit.

The regulator had predicted that only 24 trusts would be in financial trouble.

The Midlands is the most financially troubled region, with 14 of its 38 trusts being, including Peterborough, Mid Staffordshire, Sherwood Forest and Milton Keynes in deficit, the report said.

Overall, 40% of acute trusts (33), 20% of ambulance trusts (one), 11% of specialist trusts (two) and 7% of mental health trusts (three) are in deficit.

Mid Staffordshire, which runs the scandal-hit Stafford hospital, became the first trust to be put into administration in April.

The foundation trust sector as a whole remains in financial surplus, but "the size of the surplus has more than halved since this time last year, reflecting the tough financial climate and foundation trusts' response," Monitor said.

The surplus stands at £135m so far this year, down on the planned £173m.

The research also showed that foundation trusts' performance against a key target for urgent cancer referrals had fallen to its lowest level in two years.

The number of trusts breaching the target for 85% of patients with suspected cancer to start treatment within 62 days of being urgently referred has more than quadrupled in a year.

Quarterly figures for October to December 2013 show that 18 trusts breached the target, up from 12 the previous quarter and compared with just four in the same period the previous year.

Monitor said the reasons given for breaches vary between trusts, but an increase in the number of referrals "is a possible common factor". Late referrals and consultant cover were also mentioned as troubling issues.

Trusts did perform well, however, against a target to see the most urgent cases within two weeks.

Overall, they achieved three other waiting time targets, but more trusts breached all three during the quarter compared with the previous one.

One key target for inpatient treatment showed that 90.7% of patients in November started treatment within 18 weeks of referral. This was down from 92.1% in the previous November, although the overall target was met.

Seventeen trusts failed the target during the quarter, with general surgery and trauma and orthopaedics generating the longest waits.

Overall waiting lists have also risen significantly, the report said, with 1.6 million patients waiting for treatment in December, 14% more than in December 2012.

Of 80 trusts where waiting lists have grown, 75% said a significant increase in referrals was the main reason. A fifth blamed reduced capacity to cope with the numbers and other issues such as data quality.

Monitor said the A&E sector has "so far managed to cope with winter pressures", though 28 trusts failed the four-hour A&E waiting time target during the quarter.

Two-thirds of England's NHS hospitals are now foundation trusts.

Of the 147, 26 are currently in breach of their licence, including eight that are in special measures.

Monitor is also investigating a further eight trusts for potential licence breaches over issues including performance failures and financial problems.

The report also showed that trusts have delivered "efficiency savings" of £867m so far in this financial year, 18% less than planned.

Monitor said the overall picture was that foundation trusts were "performing well in providing quality services to patients in challenging economic times".

Jason Dorsett, the watchdog's financial reporting director, said: "The financial trust sector is doing remarkably well in tough circumstances but is looking a little frayed at the edges."

The shadow health secretary, Andy Burnham, said: "After a decade of improvements in cancer waiting times, progress has been derailed by David Cameron's NHS reorganisation.

"We warned that focus would be lost and that is exactly what has happened. Patients with a life-threatening illness should not face these unnecessary delays."