Into the Red? The State of the NHS' Finances

This report shows that the NHS’ finances are starting to come under severe financial pressure.


Published: 10/07/2014

ISBN: 978-1-905030-87-3

Download the report [PDF 1.9MB]

The unprecedented financial challenge facing the NHS, and the difficult decisions facing health and social care services in England, make it crucial to understand how the NHS spends money, and to identify areas of success and failure in financial performance. Drawing on the accounts data of English NHS organisations, this Nuffield Trust research report provides detailed annual analysis of expenditure and financial performance across the NHS.

Into the Red? The state of the NHS’ finances is an analysis of NHS expenditure between 2010 and 2014 examines current financial performance and labour productivity to update a previous Nuffield Trust study using data from 2012/13 and, where available, 2013/14. The report takes a comprehensive look at how the finances of the hospitals and commissioning groups that make up the NHS in England have held up under austerity.

Based on audited accounts, it finds that until last year the NHS was coping well with an unprecedented squeeze on funding due to increasing demand on the health service and the consequences of public sector austerity since 2010. But provisional data from the 2013/14 financial year shows that cracks are starting to show in a system under severe financial pressure.

“Demand for NHS services shows no signs of abating. With hospital finances increasingly weak, growing pressures on staffing, and the goal of moving care out of hospitals and into the community proving elusive, the NHS is heading for a funding crisis this year or next.”

At the same time, we have published the findings from our first survey of 100 health and social care leaders. We will be interviewing the panel members regularly in the run-up to the election. View the results of the first survey, which also focused on the key issue of finance.

Suggested citation

Lafond S, Arora S, Charlesworth A and McKeon A (2014) Into the Red? The State of the NHS' Finances. Research report. Nuffield Trust.