NHS Birmingham is confronting a significant financial challenge, with increasing deficits threatening its ability to break even by the end of the fiscal year. The joint NHS Birmingham and Solihull and NHS Black Country Integrated Care Board has reported a mounting deficit, raising concerns over the year-end financial position.
A recent report revealed that by November (Month 8) of the 2025/26 financial year, NHS Birmingham and Solihull (BSOL) faced a deficit of £45.9 million. This figure is over £32 million worse than originally forecast for this stage and marks a £7.2 million decline compared to the previous month’s position.
The primary cause of the overspend is staffing costs. Pay-related expenses have exceeded the budget by £37.2 million, comprising £23.8 million on substantive staff and £18.8 million on bank staff. Despite this, nearly £5.5 million has been saved by reducing agency and other pay costs.
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While efficiency savings are expected to meet planned targets eventually, they are currently £19.8 million behind schedule. The Financial Recovery Board remains actively engaged in efforts to improve this situation.
University Hospitals Birmingham NHS Foundation Trust (UHB) is identified as the key concern within BSOL’s financial position. UHB’s deficit currently stands at £36.9 million, nearly £24 million worse than anticipated at this point in the year. The trust is working closely with NHS England to address these financial pressures and mitigate associated risks.
Paul Taylor, chair of finance and performance, acknowledged the challenge: “We anticipated breaking even but recognize this is becoming more challenging. As the year progresses, we have less time to adjust our forecasts and implement corrective actions, leaving minimal flexibility.”
Chief finance officer Paul Athey emphasized the critical nature of Month 9 forecasts: “NHS England expects Month 9 figures to be accurate reflections of the final year position. Some providers who previously felt confident about managing risks are now reconsidering due to demanding efficiency targets in the last quarter.”
The NHS in Birmingham continues to work on recovery strategies, but the financial landscape remains uncertain as the year draws to a close.