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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