Risk over-stretched Birmingham NHS finances won't balance out by end of year
NHS bosses in Birmingham have warned there is a risk they won’t be able to balance their books come the end of the year.
Members of the joint NHS Birmingham and Solihull and NHS Black Country Integrated Care Board were told increasing deficits mean they might not hit the forecast break even point by the end of March.
A report to the board showed that, by Month 8 (November) of the 2025/26 financial year, NHS Birmingham and Solihull (BSOL) recorded a deficit of £45.9 million.
This is more than £32 million where it was forecast to be at this point and a further deterioration of £7.2 million against the previous month’s distance from plan.
Pay is the main driver of the deficit with the overall wage bill being £37.2 million over budget, consisting of £23.8 million substantive and £18.8 million bank staff.
Although, savings of almost £5.5 million have been made in terms of cutting agency and other pay costs.
Efficiencies are also forecast to hit plan but currently are £19.8m behind their year to date plan. The report said the Financial Recovery Board continues to drive this forward.
University Hospitals Birmingham NHS Foundation Trust (UHB) is the biggest concern for BSOL with current finances showing it is £36,941,000 in deficit – almost £24 million adverse to the forecast position at this stage of the year.
UHB is currently working with NHS England attempting to tackle the issue and mitigate risks.
Paul Taylor, chair of finance and performance, said: “We’ve been forecasting a break even position across Birmingham and Solihull since the start of the year.
“We recognise that was a challenge and we’ve been looking at the spending that happens in all the trusts and the ICB over that period.
“There is a risk we won’t get to a break-even position by the end of the year.
“That doesn’t mean we’re not going to get to break-even it’s just that as we get closer to the end of the year, we get less time to forecast and more time to act and therefore there is very little wriggle room.”
Paul Athey, chief finance officer, added: “Month 9 is the key month. There is a reasonable expectation from NHS England that the number you put down at Month 9 is the number you will hit.
“What we are seeing is that some of our providers who have been flagging risks but have been positive about their ability to manage those risks are probably now in some cases taking a view that maybe that won’t be possible.
“That’s in the context of quite stretching efficiency targets in the last quarter of the year.”
