Primary care trusts across the country are falling behind on their targets for efficiency savings and plunging into the red, Pulse can reveal.

A series of trusts that broke even or recorded surpluses last year are now forecasting multimillion pound shortfalls, as managers struggle to implement reconfigurations or find they are saving far less than they hoped.

Half of the 40 trusts surveyed by Pulse are implementing 'plan B' emergency measures designed to wipe millions from budgets as they find their initial efficiency drive will not be enough to prevent black holes in budgets.

Pulse's investigation lays bare the growing financial crisis in the NHS, even before the severe tightening of PCT budgets planned for 2011/12.

It comes as NHS chief executive Sir David Nicholson admitted in a letter to PCTs: 'A number of primary care organisations are behind on cost-improvement programmes. These issues need urgent attention.'

Six months into the financial year, six of 40 trusts replying to requests for information predicted they would be in the red by the end of 2010/11. Only one was in the red at the start of the year.

A further 14 PCTs are implementing emergency packages to avoid slipping into deficit by the end of the year, with two of those already in the red.

Trusts plan to raid reserves, borrow money from neighbours and implement swingeing extra cuts - to GP referrals, drug budgets, mental health services and public health programmes.

NHS Hampshire, which last year recorded a surplus of nearly £500,000, needs to make £91.2m savings to break even this year and said it was at risk of an £8.3m deficit.

NHS Warrington said it had cut savings forecasts from 'disinvesting' in services from £4m to £0.5m and was predicting a £1.9m deficit, while NHS Halton and St Helens said its 'best estimate' was a £5m overspend.

NHS South Birmingham said it had a 'significant risk' of falling into the red, forecasting a £14m shortfall against a contingency of £9m. It is planning 'urgent steps' to stay within budget, including 'rigorous contract management' and tackling overspending in mental health and GP prescribing.

NHS North Lancashire said: 'In line with plan B, reserves set aside for investment have been frozen.'

NHS Peterborough is forecasting it will be £3m in the red, after failing to achieve £20.2m of planned savings.

Its chief executive, Dr Paul Zollinger-Read, said: 'We have not made as much progress in some areas as the plan visualised and will ensure we take all actions necessary. It's crucial we provide a firm foundation for developing GP consortia.'

Richard Hoey, editor of Pulse, said: 'It's alarming that PCTs are already slipping into debt, because this is supposed to be the calm before the storm - the real squeeze on NHS budgets doesn't happen until next financial year.

'Our findings suggest the last government and the current one have over-estimated the potential for efficiency savings to bail out the NHS from financial trouble. They also explode the myth that the NHS has somehow got away scot-free from the programme of public service cuts.'

Source:
Pulse