THE financial sustainability of the NHS has been called into question by Government watchdog the National Audit Office.

The spending body has analysed the accounts of all the NHS trusts and Clinical Commissioning Groups and found that the existence of substantial deficits in some parts of the system, offset by surpluses elsewhere coupled with growing waiting lists and year-on-year increases in waiting times, did not paint a picture that is sustainable.

In Bradford, the financial situation of the trust that runs Bradford Royal Infirmary and St Luke's Hospital will be on the surplus side of the calculation as it is predicting it will be in the black for the financial year. Airedale NHS Foundation Trust is also predicting it will be in surplus this year.

The NAO said that although the NHS nearly achieved overall financial balance in 2017-18, it continues to offset surpluses and deficits, which hides local disparities in financial health and patient experience.

While NHS England had an underspend of £1,183 million, clinical commissioning groups (CCGs) together reported an overspend of £213 million, and trusts reported a combined deficit of £991 million, leaving a combined deficit of £21 million. The provider sector has an underlying deficit of £1.85 billion.

A spokesperson for Bradford Teaching Hospitals NHS Foundation Trust said: “For the period ending December 2018, the trust reported a deficit of £3.6m against a planned deficit of £1.8m, which means we are £1.8m behind plan at the end of Quarter 3.

“Our planned surplus for the end of the financial year is £2.8m, but we are forecasting a surplus of £0.8m. This means we are forecasting a £2m shortfall against our plan for the 2018/19 financial year.

“These numbers reflect the position including the trust’s earned share of the Provider Sustainability Funding allocation which the regulator, NHS Improvement, provides to organisations that meet certain financial and performance targets.”

The Provider Sustainability Funding allocation is a Treasury-funded scheme totalling £2.45 billion which distributes money to trusts if they show an improvement in their financial position, either by reducing their deficit or increasing their surplus.

Airedale NHS Foundation Trust director of finance Andrew Copley said: “Currently we are forecasting to deliver our control total of £400,000 surplus. However there is some uncertainty in this forecast, as the continued pressure on our urgent care services will make delivering this position a challenge.”

The NAO reported that previous analysis highlighted that in the past funding boosts have been spent on dealing with immediate, short-term pressures with less devoted to the changes required for long-term sustainability.

There is also a risk that the extra funding will not be used effectively due to staff shortages as more money may be used to pay expensive agency staff or will go unspent as individual healthcare providers may not be able to recruit the staff to deliver additional activity.