Quarter 3 data released by NHS Improvement yesterday showed that providers coped well with the extra pressures and maintained A&E performance levels, after four years of decline.
However, it has left providers with a total deficit of £1.28bn over the financial year to date, £365m higher that the £916m forecast for that point in the year.
For the end of 2017-18, the acute sector is now predicting an overall deficit of £931m, which is £435m worse than planned.
This financial decline against plan is concentrated in a minority of providers, NHS Improvement said.
During the quarter, one trust was put into special measures for finance reasons to protect services and drive improvement.
NHS Improvement chief executive Ian Dalton said: “Some providers appear to have managed the financial pressures better than others.
“We are working closely with those providers whose financial position has deteriorated seriously to ensure that they grip their problems while delivering the best possible care for their patients.”
Dalton added that it would be “unrealistic” to assume demand on the NHS would start to reverse and urged local health systems to work together.
Richard Murray, director of policy at the King’s Fund, said: “It is alarming that NHS providers now forecast a £931m deficit for this financial year, a deterioration of over £300m in three months.
“This reflects the dramatic decline in the finances of a number of individual trusts, and raises serious questions about how reasonable the financial targets were in the first place.”
He added that there was a risk the Department for Health and Social Care could breach its own budget, despite additional funds from the Treasury.
Anita Charlesworth, director of research and economics at the Health Foundation, commented: “The serious pressures on emergency care have not only affected patients and increased costs, but also made it harder to deliver planned long-term efficiency savings.”
The figures showed there were 5.6 million A&E visits over the quarter, a quarter of a million more than over the same period lat year.
Performance held up, with 89.5% of patients being seen within four hours, virtually unchanged on the rate recorded in 2016.
NHS Improvement said this showed operational planning for winter had been better and paid tribute to the hard work of NHS staff.
Agency costs continued to fall substantially, despite an increase in bank staff to handle the additional demand. The sector spent £108m less than planned on agency staff and £441m less that the same period last year, a 20% drop.
There were 1.1 million whole time equivalent staff in the NHS but also 100,000 vacancies.
The Q3 figures also show there were 470,000 bed days across acute, community and mental health settings occupied by delayed discharge patients, equivalent to 4.6% of all beds.
