Survey of London ICBs: an insight into managing financial crisis

A Lowdown snapshot survey of the board papers and plans of London’s ICBs reveals the depth of financial pressures and some of the impact upon services

North Central London ICB (NCL) has published May Board papers, which nonetheless go back to a Month 9 Financial Report, with grim news that the system as a whole was £53.6m in deficit, £32m adverse to plan – all of this down to providers.  There was no mystery as to why:

“The primary causes remain consistent, including system expenditure on agency staff being higher than plan and target, [inadequate] delivery of planned efficiency savings, persistent excess inflationary challenges over and above those that the system was allowed to plan for …” (p14)

There is clear evidence here of denial and delay in reporting the bad news to minimise the consequences:

“Although the system forecast position will remain as break-even at Month 10, there will be movement among providers’ positions as part of this. Providers whose positions move adverse to plan will trigger the NHSE Forecast Outturn protocol but as the overall system is still forecasting break-even, the consequences of this will be limited.” (p14)

Somehow despite the scale of the deficits, and the red-rated risk to long term financial stability, the ICB reports “It is likely that NCL will be able to deliver a breakeven financial position for the 2022/23 financial year. It is though crucial to note that this is underpinned by a significant level of non-recurrent benefit which will not be available in 2023/24 and that continued improvement to the underlying position of the system as whole is required.” (p95)

Full article in The Lowdown, 15 May 2023