Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether Integrated Care Systems (ICS) will be allowed to run deficits when placed on a statutory footing; what discussions he has had with the Chancellor of the Exchequer on that matter; whether NHS Trusts will be allowed to run deficits after the financial year 2023-24; and what assessment he has made of the potential effect of the combined impact of the inability of ICSs to run deficits and the removal of the ability of NHS Trusts to run deficits on the delivery of NHS services.

We are proposing to establish statutory Integrated Care Systems, made up of an Integrated Care Board and Integrated Care Partnership (together referred to as the ICS). We are also proposing that Integrated Care Board working with their partner Foundation Trusts and National Health Service Trusts will need to balance spending across the system.

ICSs will be key bodies for financial accountability and financial governance arrangements will need to reflect that with updated guidance to reflect these changes. It is possible in principle for an NHS Trust within a system to run a deficit, but for the system as a whole to be in financial balance. However, there will continue to be consideration of how efficiently a provider uses its resources and how financially sustainable it will be over the longer term.

The NHS Long Term Plan and the additional associated funding being provided has been set with the ambition that all organisations are in financial balance by 2023/24. NHS Funding beyond 2023/24 is for a future Spending Review.

The Department has published its legislative proposals including for system accountabilities. These were agreed across Government including with HMT and did not involve a direct discussion with the Chancellor.