Croydon Health Services (CHS) was one of 5 acute trusts across the country to be placed in Financial Special Measures in July 2016. The intervention by NHS Improvement meant that each Trust was given intense scrutiny and tougher targets in order to turnaround rising financial deficits.

NHS Improvement challenged CHS to reduce its deficit by £7m more than planned in 2016/17, whilst achieving over £14m of agreed efficiency savings throughout the year. At the same time, CHS was to maintain its quality of care and meet national standards for planned operations and cancer care, along with agreed trajectories for emergency care.

Balancing the cost of treatment with rising demand from a growing and ageing population is a challenge across the NHS, but is particularly difficult in Croydon where funding for health and care services has historically been very tight. Croydon Clinical Commissioning Group also faces significant financial challenges, and was itself placed in financial special measures last year.

CHS has focused improving the quality of its care, at the same time as taking control of its finances. However, many necessary quality improvements have not had sufficient cost efficiencies or funding. Despite some success, the Trust has found it difficult to recruit where there is limited availability of trained clinicians and greater competition, especially in London. As a result, the Trust spent £24m on temporary staff in 2015/16 in order to keep services running.