The NHS in Stoke-on-Trent and Staffordshire has been placed in a form of financial 'special measures' – after recording a £91 million deficit last year.

Staffordshire and Stoke-on-Trent Integrated Care Board (ICB) is now formally in 'undertakings' with NHS England, as it 'is failing or has failed to discharge one or more of its functions, or that there is a significant risk that it will fail to do so'.

NHS England says that last year's deficit shows that the health and care system in Staffordshire is not demonstrating financial sustainability. According to the document setting out the undertakings, the deficit reflects  'overspends in commissioned services including continuing healthcare services and prescribing and the distribution of risk across the system'.

The ICB is also showing 'significant risk' in relation to meeting expenditure limits and ensuring controls are in place on resource use.

The document states: "These issues pose ongoing concerns regarding the sustainability of Staffordshire and Stoke-on-Trent ICS's financial position and how quickly this can be resolved, and this is reflective of concerns regarding the extent to which the ICB is having regard to efficiency and sustainability when making decisions."

According to a new document the deficit reflects 'overspends in commissioned services' (SWNS).

The ICB, which is in charge of the area's integrated care system, has now agreed to carry out a series of actions aimed at ensuring that a balanced underlying financial position can be achieved by the end of March 2026.

These steps include the development of a recovery plan for the whole system and the implementation of financial controls. The ICB will have to provide NHS England with regular updates on its progress, and any failure to comply with the undertakings could result in 'further formal action'.

ICB chief executive Peter Axon told July's board meeting that they had a 'significant' mountain to climb, but noted that similar challenges were being seen across the entire NHS. He said: "We do have a significant financial challenge, which we are tackling. I am confident that the work we are doing is addressing it directly.

"But what I would say is that equal challenges, if not greater challenges, are being posed to every single system across the country, all 42 integrated care systems. Our national financial position is not good at all. So we aren't alone in this regard.

"But we absolutely should not be defeatist in any way. The mountain we have to climb is quite significant, but what we're doing is the right thing.

The Staffordshire and Stoke-on-Trent Integrated Care System has been given a target of £90 million deficit in 2024/25 (SWNS).

"I'd also say that I'd hate to think that financial challenge overshadows the great work we're doing in Staffordshire. Things like elective recovery – the amount of work we've done to break down that elective backlog is mammoth. Or the vaccination programme – we're really good at vaccination management in Staffordshire."

The Staffordshire and Stoke-on-Trent Integrated Care System has been given a target of £90 million deficit in 2024/25. After two months, it has an adverse position of £4.5 million against this plan.

Chief finance officer Paul Brown said this challenging start to the year was not unexpected. He said: "It's early days, too early to be sure about trends. But we do see signs of some financial tension, and we expected that, to be honest. We agreed a budget with a significant amount of stretch, so we knew it would be tricky at the start. We are seeing some overspends of £4.5 million."

University Hospitals of North Midlands accounts for £4 million of the adverse position, while the ICB accounts for £500,000, mainly due to 'slippage in efficiency'.

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