King’s College trust set to make record-breaking budget overspend of nearly £200m

King’s College Hospital NHS FT could be set to record the biggest overspend in NHS history as the special measures trust expects an annual deficit of between £180m and £191m.

The hospital trust believes it has exceeded its 2018-19 budget by a further £34m to £45m after another series of setbacks, according to documents seen by the Guardian.

King’s College has struggled with financial difficulties for years now, first reporting a deficit of £38.8m, but over the course of 2017-18 this rose to £70.6m and then to £92m.

The trust ended 2017 with a deficit of £130m and was placed into special measures by NHS Improvement with a financial improvement director put in place, with most of King’s College’s leadership departing, including chair Lord Kerslake.

Struggles financing a large number of agency workers to cover a chronic shortage of staff, fines for missing the four-hour A&E waiting time target, and a takeover of another trust in 2013 have all exacerbated the trust’s situation.

The new projected figures of £180m to £191m surpass the highest overspend ever recorded in the NHS, which was already held by the King’s College trust.

Papers given to the senior managers at the trust said that it started the 2018-19 financial year with a deficit of £146m, but states that this has risen by at least £34m due to a number of factors.

The trust fell £8m below its savings target, delays to its new critical care unit cost it £4m, and “poor operational performance” also cost the trust expected income.

The papers say: “We have experienced further one-offs not foreseen in the original budget of £17m, taking the expected in-year deficit to £180m. We have submitted business cases which, if not approved by NHS Improvement, would increase the in-year deficit to £191m.”

A spokesperson for King’s College Hospital Trust said: “Our current financial forecast is higher than that planned this time last year.

“However, over the past year, a number of changes have been implemented that will enable the trust to improve its productivity and stabilise its longer-term stability.

“Despite the financial challenges, the trust continues to deliver excellent, high-quality care and services to patients.”

The trust has struggled with severe staff shortages, along with most UK trusts, but the spokesperson said a number of recent successful recruitment drives has seen King’s cut its nursing vacancy in half to 7.3%.

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