New survey findings from NHS Providers reveal the daunting financial pressures facing the NHS ahead of a landmark review of the health service by Lord Darzi.

The survey of NHS trust leaders found their finances had taken a series of hits – through industrial action, erosion due to inflation, eye-watering efficiency demands, and relentless operational pressure on the service.

The results reveal:

1. Over half (51%) of respondents were extremely concerned about delivering operational priorities within their organisation’s 2024/25 financial budget.
2. Over nine in ten respondents (92%) felt that the scale of the efficiency challenge in 2024/25 is more challenging than 2023/24.
3. 44% of respondents forecast their trust’s financial position for 2024/25 as a deficit, 45% forecast their position as breakeven and 11% forecast their position as a surplus.
4. Almost a third of respondents (32%) were confident that their system will deliver its recovery targets to reduce waits for physical health services in 2024/25 while only 8% said they were confident about recovery targets to reduce long waits in mental health services.
5. Of the respondents who deliver A&E services, nearly half (46%) said it is likely that their trust will meet the new target of seeing 78% of A&E attendees within four hours by March 2025. 

The chief executive of NHS Providers, Sir Julian Hartley said:

"The Prime Minister’s comments today echo what trust leaders have been telling us- the shockwaves of the longest and deepest squeeze in NHS financial history, a growing mismatch between capacity and demand, major workforce challenges and the after-effects of the Covid-19 pandemic are still being felt throughout the health service.

"The impact on children and young people is particularly worrying.  Our recent report found that we’re in danger of seeing a forgotten generation of young people. Too many young lives are being blighted by delays to accessing vital NHS care.

"There are real deep-seated worries about NHS funding and how those pressures are intensifying. Budgets and services are stretched to the limit in the face of mounting demand and pressure. It’s never felt tougher.

"Time and again, trust leaders tell us they want to see long-term, multi-year investment in the health service which allows them to plan for the future instead of this stop-start approach to NHS funding which leaves them constantly worrying about budget cuts followed by quick-fix, short-term funding announcements.

"Our survey also showed trust leaders are seeking – and finding - solutions for better care.

"It’s incredibly impressive how trust leaders and their teams are responding to the productivity challenge. You can see the benefits of collaboration, incentivising staff, using digital tools to help them work more efficiently. That’s all happening but it can only go so far without significant strategic investment in infrastructure and digital technologies.

"We need to recognise the value of investment in the NHS – its impact as a catalyst for economic growth, employment and research, and the importance of funding infrastructure, digital and other technology to drive productivity. We need to see a more strategic, long-term mindset that maps out a route to a sustainable, high quality, high value NHS."