£180m debt-ridden NHS Greater Manchester is ‘failing’ and now faces ‘enforcement’

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NHS Greater Manchester is "failing"

Greater Manchester’s debt-laden top NHS body is ‘failing’ in several key areas and now faces ‘enforcement’ action.

It’s been placed under extra scrutiny by national NHS chiefs after it fell into £180 million of debt, and failed to provide sufficient ‘provision of emergency care’, meaning A&E waiting times were among the worst in the country.

On Wednesday (17 July), NHS Greater Manchester formally accepted ‘enforcement undertakings’ from national body NHS England. They come after NHS England found the regional organisation ‘is failing or has failed to discharge some of the integrated care board functions as set out in the National Health Service Act 2006’.

The failings have been identified in ‘leadership and governance’, ‘financial planning’, ‘performance’ and ‘quality of care’, according to a new report. NHS Greater Manchester chair, Sir Richard Leese, said ‘it’s self-evident this is not the place we would want to be’.

Specifically, NHS England has moved in after the regional body descended into £180 million of debt in the last financial year. Its objective was to break even.

The latest update on the accounts says the deficit stood at £218 million at the start of May, and in mid-June, local leaders submitted a plan to bring the deficit down to £175 million this financial year. After two months of the 2024/25 financial year, the organisation ‘is reporting a deficit position of £78.1 million, which is £19.2 million worse than the year-to-date plan of £58.9 million’.

In terms of care, the probe found that ‘elective recovery and [its] long wait position is in the lowest quartile of the NHS Oversight Framework (NOF) for 65 week waits and activity growth’. It’s also ‘in the lowest quartile for A&E four-hour performance’.

Furthermore, its ‘cancer backlog position and cancer recovery 62 day backlog is in the lower end of the interquartile range, but above the national position’ and ‘diagnostic activity waiting time is not meeting the six-week performance target of five percent with variation on delivery across the ICS area’.

The ‘enforcement undertakings’ agreed by NHS Greater Manchester means it now must develop a financial plan aiming to get it back to ‘an underlying break-even financial position’ by 2026/27.

They also mean NHS Greater Manchester must make ‘a significant improvement in performance and backlog reduction for elective care services’, and ‘a sustained and improving trajectory for urgent and emergency care in terms of four-hour, 12-hour and 14 days plus length of stay performance’, according to NHS England.

Despite the findings that the organisation is failing, chief executive Mark Fisher said he was confident improvements will be made. He told a board meeting: “The heartland of the improvement we need to make is around our financial [position] and the provision of emergency care.

“We have been working with an improvement plan for some months. We have been in active discussions with NHS England. We have had very positive feedback from them on the detail in the plan and the robustness of the plan. I think we are in good shape to undertake it.”

Ethan Davies, local democracy reporter