The Q4 net deficit for the sector is £2.45 billion, compared to £2.27 billion at Q3. This is £1.6 billion more than at the end of 2014/15 and £2.3 billion more than at the end of 2013/14. They are reflective of a year when yet again demand and costs have rapidly outstripped revenue to the detriment of provider financial performance. The number of providers overall in deficit has risen from 50% to 65% in the course of a year, and is spread across provider type, size and geography, telling us more clearly than ever that this is a systemic issue. As such it requires strong, clear and honest national leadership as well as a provider sector willing to do everything within its power to address it.