Over a Third of NHS Trusts Say Savings Targets Are Out of Reach

More than one in three NHS trusts do not expect to meet their efficiency targets for the current financial year. The findings highlight growing concern about financial pressures across the health service as trusts continue to grapple with inflation, workforce costs, and rising demand.

Mounting Financial Pressures

Approximately 35 per cent of trusts believe their savings targets are unachievable, raising fears that financial gaps could widen further by the end of the year. NHS leaders have warned that higher-than-expected pay settlements, energy costs, and ongoing use of agency staff have placed significant strain on budgets.

Efficiency savings are a central component of NHS England’s financial planning framework, intended to reduce expenditure while maintaining service standards. However, many organisations report that the targets set for 2025–26 are no longer realistic given the continuing pressures on operational performance and staffing.

Balancing Recovery and Cost Control

Trust finance directors say they are being asked to deliver savings at the same time as recovering elective care backlogs and sustaining urgent and emergency services. This has created what several leaders describe as a ‘double bind’, where meeting financial targets risks undermining service quality or delaying planned improvements.

Some trusts have introduced cost control measures, including limits on recruitment and restrictions on non-essential spending. Yet leaders warn that these actions can only go so far without affecting patient care or staff morale. One finance director reported that 'the space for genuine efficiency has narrowed to the point where cuts and savings are becoming the same thing.'

Calls for Realistic Planning and Support

Sector representatives are calling for NHS England and the Department of Health and Social Care to take a more flexible approach to financial oversight. They argue that savings targets should be linked to achievable productivity improvements rather than headline percentage reductions.

Health analysts suggest that without additional investment or realistic planning assumptions, more trusts could end the year in deficit. They also warn that continued shortfalls could slow down digital and capital investment, limiting long-term efficiency gains.

The Wider Outlook

While NHS England maintains that its efficiency plans remain essential to restoring financial balance, trust leaders have urged policymakers to recognise the operational realities on the ground. The current environment, they say, requires pragmatic financial planning that protects frontline care while supporting innovation and workforce stability.

As winter approaches, the prospect of unachieved savings targets underscores a broader challenge: how to sustain quality and access under conditions of persistent financial pressure.