From financial performance reports published by Monitor, NHS Improvement and NHS England, 2015-16 to 2020-21. As methods for reporting and calculating savings against efficiency targets have changed substantially during that time (including the reporting of additional income as a "cost improvement") figures shown here are estimates and for illustrative purposes only. Trust income and expenditure reporting during the period was also subject to manipulation through the use of one-off accountancy adjustments. Planned spending increases in 2018-19 and 2019-20 include funding the cost of the Agenda for Change pay deal in both years, and the impact of £1bn extra commissioner spending on emergency care in 2019-20. 2020-21 figures are net of extra spending on Covid-19.