Responding to the new National Audit Office (NAO) report, NHS Financial Management and Sustainability, Saffron Cordery, deputy chief executive at NHS Providers said:

"This report highlights the significant strain on NHS trusts as they continue to grapple with compounding financial pressures, including the cost of industrial action, inflation, workforce pressures and a deteriorating estate.

"Despite trusts’ best efforts to deliver record levels of activity last year, NHS productivity has struggled to rebound to pre-pandemic levels. Ever-rising demand for healthcare will also mount further pressure on the health service.

"In the face of these unprecedented financial challenges facing the NHS, trust leaders want and need to see greater emphasis on long-term investment. This includes shifting more resources into the prevention of ill health and tackling health inequalities, along with greater investment in digital technologies and infrastructure and ensuring the delivery of the NHS Long Term Workforce Plan."