Special measures for financial reasons

Placing a provider in special measures for financial reasons is a regulatory measure to bring about swift improvement in challenged NHS providers finances.

Each NHS provider will undergo a rapid review, and agree a financial recovery plan. Specialist teams, led by an improvement director, will oversee intensive, accelerated action to bring about financial improvement including support from peer providers where appropriate. 

Which trusts are in special measures for financial reasons?

The NHS providers currently in special measures for financial reasons are:

  • Barking, Havering and Redbridge University Hospitals NHS Trust 
  • Barts Health NHS Trust
  • Brighton and Sussex University Hospitals NHS Trust
  • East Sussex Healthcare NHS Trust
  • East Kent Hospitals University NHS Foundation Trust
  • Gloucestershire Hospitals
  • Maidstone and Tunbridge Wells NHS Trust
  • St George’s University Hospital NHS Foundation Trust
  • North Lincolnshire and Goole NHS Foundation Trust
  • University Hospitals of North Midlands NHS Trust
  • United Lincolnshire Hospitals NHS Trust
  • King's College Hospital NHS Foundation Trust

Entry criteria

To be eligible for special measures for financial reasons providers must meet one of the following objective criteria: 

  • the provider has not agreed a control total and is planning a deficit for the year
  • the provider has agreed a control total and has a significant negative variance against the control total plan, and is forecasting a significant deficit
  • the provider has an exceptional financial governance failure (eg significant fraud or irregularity)

Any providers meeting any of the objective criteria will be considered for financial special measures, but may be excluded in light of other relevant considerations such as:

  • exceptional mitigating circumstances
  • the provider is already subject to a significant package of regulatory action
  • the provider already has a robust recovery plan approved by their board and NHS Improvement
  • there is a recent track record of full year delivery of plan and/or of agreed recovery actions

Exit Criteria

In order to leave special measures for financial reasons providers will need to demonstrate rapidly that they are returning to financial discipline, which will include developing a robust financial recovery plan.

Once out of  special measures for financial reasons, we will continue to work extremely closely with each provider to ensure that improvements are lasting and that recovery plans are carried out properly.

Providers in  special measures for financial reasons will be expected to maintain, and where necessary, improve standards of quality during and after their financial recovery.

Criteria for exit from financial special measures PDF, 207.9 KB

Sets out the financial special measures exit criteria.

Jim Mackey, Chief Executive at NHS Improvement said:

“This suite of measures will help ensure that the providers facing the greatest financial challenges are supported to bring about rapid financial recovery, while maintaining or improving quality where necessary. This plan will help restore financial discipline and ensure ongoing financial sustainability in the NHS.”

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