The main hospital trust serving Barnet reported a £30.3 million deficit in the 2023-24 financial year reports Sonja Tutty, Data Reporter

The entrance sign at Barnet Hospital — Barnet Hospital

The Royal Free London reported a £30.3m deficit last year, new figures show, amidst concerns about the “fragile” financial health of the NHS.

Analysis by the Nuffield Trust think tank suggests NHS finances are as unstable as they were before the pandemic with deficits across England’s trusts more than doubling.

The figures show Royal Free London NHS Foundation Trust reported a £30.3 million deficit in the 2023-24 financial year, meaning the trust’s spending exceeded its income.

However, it was an improvement on the deficit the year before, when it reported a £35.5 million overspend.

Overall, the deficit last year accounted for 2% of the trust’s revenue.

Across England, NHS provider trusts reported a £1.2 billion overspend in the 2023-24 financial year – 0.9% of revenue.

Collectively, they reported a £448 million overspend the year before or about 0.4% of revenue.

The Nuffield Trust said it puts the sector in a similar overall position to 2019-20, when “financial instability left it poorly equipped to deal with the pandemic”.

Sally Gainsbury, senior policy analyst at the think tank, said: “These findings reveal just how fragile the financial health of the NHS is, which should sound alarm bells over the government’s promise of extensive reforms but with no new money to pay for them.”

She added the government’s aim to shift care out of hospitals and reduce waiting lists requires community and mental health care to be “adequately resourced.”

She said: “With over 6 million people on an NHS waiting list – many of them needing treatment in a hospital – it is not realistic to assume expenditure on acute hospitals can just be switched to expand other services such as community and mental health care.

The figures also show the deepest overspends are in the North West and the Midlands which, along with the North East and Yorkshire, have also seen the steepest declines in financial health since 2022-23.

Meanwhile, the steepest declines were recorded among acute hospital trusts in the most deprived areas, while modest improvements were seen in more affluent areas.

Gainsbury warned this is “particularly concerning”.

“It is well known that people living in poverty have poorer health, more complex conditions and die younger. A strategy that targets investment in these areas, rather than allowing it to flow away from them, is needed to reverse these worrying trends,” she said.

The think tank added widespread strikes among medical staff, increased temporary staffing, and an increase in expenditure on outsourcing care to the independent sector had a significant impact on the sector last year.

A Department for Health and Social Care spokesperson said the government “inherited a broken NHS with trusts facing severe financial challenges, which is why we announced a £26 billion increase in health and social care funding at the Budget.

“But investment must go hand in hand with a strong grip on any money spent, and proper reform alongside it.”

They added an “extremely tough” productivity and efficiency target has been set for the NHS next year, adding the Government is giving the health service “tools to hit it”.

“Through our Plan for Change, we will get the health service back on its feet and fit for patients long into the future,” they said.

A spokesperson for NHS England said: “It is essential NHS organisations operate within their budgets, and we are giving them greater flexibility to focus funding where it’s needed the most – while continuing to take action to address any financial issues.”

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