Full results from a survey of the financial status of ICSs in England in early 2022.

Population Allocation £bn Spend per head £ Financial position 2022/23
North East and Yorkshire
Humber & North Yorkshire  1.77m 2.778 1,563 £140m deficit: 

CIP target 4%

North East and North Cumbria 3.13m 5.488 1,742 £240m deficit
South Yorkshire and Bassetlaw Integrated Care System 1.48m 2.396 1,610 £76.5m deficit (reduced from £140m draft plan)
West Yorkshire and Harrogate Health and Care Partnership 2.6m 4.018 1,529 £121m financial gap in initial plan
North West
Cheshire and Merseyside Health and Care Partnership 2.7m 4.018 1,769 £219m deficit in initial draft plan
Greater Manchester Health and Social Care Partnership 3.13m 4.810 1,628 Not known.
Lancashire and South Cumbria 1.8m 3.191 1,758 £370m “system gap” reduced to £90-£100m – requires 5% CIPs from each organisation
Midlands
Coventry and Warwickshire 1.04m 1.530 1,449 £37.9m deficit
Herefordshire and Worcestershire 812,712 1.277 1,556 Deficit: CCG & both acute trusts in the red
Joined up care Derbyshire 1.05m 1.812 1,626 In-year planned deficit of £196.8m. After efficiencies £89.9m deficit.
Leicester, Leicestershire and Rutland 1.17m 1.620 1,363 System plan showing a deficit of £27m plus £77m of “risk that is not mitigated”
Lincolnshire 801,457 1.287 1,592 System in national recovery support programme, discussions with NHSE on deficit plan
Live Healthy Live Happy Birmingham and Solihull 1.57m 2.381 1,503 System deficit of £48m
Northamptonshire Health and Care Partnership 1.23m 1.173 1,436 £49.7m deficit, reduced from initial £118m and £75.7m
Nottingham and Nottinghamshire: 1.23 1.895 1,522 £96.7m system deficit forecast (£59.7m attributed to NUH)
Shropshire and Telford and Wrekin 0.827 1,582 £13m deficit
The Black Country 1.27m 2.051 1,600 £48m deficit
Together we’re better – Staffordshire and Stoke-on-Trent 516,452 1.876 1,596 System plan submitted with £48.2m deficit, reduced from £78.4m. Underlying deficit £133.4m
East of England
Bedfordshire, Luton and Milton Keynes 1.06m 1.492 1,390 Anticipated efficiency ask across BLMK system of £56m
Cambridgeshire and Peterborough 1.0m 1.424 1,408 System Partnership Board March 30 projected break-even (assuming 4.8% efficiencies, £52m from Elective Recovery Fund, and only 2.8% inflation) Total unmitigated risks £77m.
Hertfordshire and West Essex 1.61m 2.349 1,450 No clear information. West Herts and East & North Herts trusts have deficits of £15.3m and £54m.
Mid and South Essex Health and Care Partnership 1.25m 1.912 1,518 Initial expectations  of need for £65-£70m of efficiencies to balance books increased to £85m.
Norfolk & Waveney 1.08m 1.757 1,613 System draft plan shows £51.2m deficit
Suffolk and North East Essex 1.04m 1.614 1,536 No clear information
South West
Bath and North East Somerset, Swindon and Wiltshire 980,516 1.37 1,403 Plans submitted for £58.6m deficit
Healthier Together Bristol, North Somerset and South Gloucestershire 1.06m 1.54 1,408 No clear information with CCG and trusts all focused on last year’s performance.
Cornwall and the Isles of Scilly Health and Care Partnership 596,230 0.987 1,641 No system figure, but Royal Cornwall Hospital Trust forecasting £28.8m deficit (with CIPs of 6.2%) “within the context of a system deficit.
Devon 1.27m 2.06 1,622 “Deficit is second highest (proportional to allocation) in the region at 5.5%; it has reduced by £27m to £104m.”
Our Dorset 819,184 1.33 1,627 March CCG Board papers: “Work is ongoing to identify and reduce the underlying CCG and system gap for 2022/23.
One Gloucestershire 676,860 0.963 1,423 No figures published. Gloucestershire Hospitals FT in April expected its Operational Plan “would reflect a system deficit which was in line with most other systems in the South West”.
Somerset 596,836 0.956 1,603 System plans deficit of £20.3m for 2022/23.
South East
Buckinghamshire, Oxfordshire and Berkshire West 1.93m 2.5 1,291 No useful information on finances published by BOB ICS or CCG. Oxford University Hospitals FT reveals “The ICS has made a ‘flat cash’ proposal to its providers…”
Frimley Health and Care 808,083 1.11 1,380 ICB deficit £36m (Frimley Health FT May Board)
Hampshire and the Isle of Wight 1.92m 2.9 1,514 Deficit across provider and commissioner of £105.6m, improved by £60.8m from initial draft submission (HIOW CCG May)
Kent and Medway 1.95m 3 1,526 “System plan £85m deficit and South East region £693m” “…all acute trusts in Kent currently showing deficits,” (Dartford & Gravesham April Trust Board)
Surrey Heartlands Health and Care Partnership 1.22m 1.65 1,471 “The ICS submitted second iteration of financial plan for 2022/23 which predicted a deficit of £143.27m” (Ashford & St Peters May Trust Board)
Sussex Health and Care Partnership 1.82m 2.92 1,604 No ICS/CCG figures published but major Trust (Uni Hospitals Sussex) has core gap of £57m, and aiming for £44m CIPs. ICS document Sussex 2025 is 24 pages of uncosted aspirations despite admitting “we are currently spending more money than is available…”
London
North Central London Partners in health and care 1.73m 2.6 1,503 NCL position “currently showing very significant deficit”. Cumulative deficit of £359m (Camden & Islington FT, March). NCL “faces one of the biggest funding reductions” – deemed to be “over-funded”.
North East London Health and Care Partnership 2.32m 3.34 1,424 Initial draft financial plan indicated £100m deficit (Homerton Trust Boar April)
North West London 2.72m 3.71 1,363 Draft ICS financial plan showed a deficit of £94m (£69m London Ambulance Service,£25m Hillingdon Hospital). £94m figure an improvement on earlier reported figure of £300m. (West London Trust)
Our Healthier South East London 2.04m 3.28 1,600 No details on draft or other plans for 2022/23: system is in “financial recovery” requiring 3% efficiency savings (South London & Maudsley May Board) £46.5m “convergence” reduction to ICS budget (Oxleas March board)
South West London Health and Care Partnership 1.73m 2.41 1,395 SW London CCG meets only 3 times/year – last met in February. £256m “challenge” across SW London system in 22/23 (One Croydon H&C Board, May)
England Totals 61.5m 94.6 1,538
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