The NHS Providers survey ahead of the Darzi review of the NHS on Thursday found 45% of trusts expected to breakeven in 2024/25 and just 11% forecast a surplus.

The chief executive of NHS Providers, Sir Julian Hartley, said: ‘There are real deep-seated worries about NHS funding and how those pressures are intensifying. Budgets and services are stretched to the limit in the face of mounting demand and pressure. It's never felt tougher.

‘Time and again, trust leaders tell us they want to see long-term, multi-year investment in the health service which allows them to plan for the future instead of this stop-start approach to NHS funding which leaves them constantly worrying about budget cuts followed by quick-fix, short-term funding announcements.'

Over half (51%) of respondents were extremely concerned about delivering operational priorities within their organisation's 2024/25 financial budget.

Over nine in ten respondents (92%) felt the scale of the efficiency challenge in 2024/25 is more challenging than 2023/24.

Almost a third of respondents (32%) were confident their system will deliver its recovery targets to reduce waits for physical health services in 2024/25 while only 8% said they were confident about recovery targets to reduce long waits in mental health services.

Of the respondents who deliver A&E services, nearly half (46%) said it was likely their trust will meet the new target of seeing 78% of A&E attendees within four hours by March 2025. 

A Department of Health and Social Care spokesperson said: ‘The NHS is broken. We recognise that local NHS systems are facing some severe financial challenges, and it's encouraging that they are working to deliver on the plans they agreed at the beginning of the year despite this.

‘The health and social care secretary has ordered a full and independent investigation into the state of the NHS, which will inform a 10-year plan to radically reform it and ensure it has the funding it needs as a health service fit for the future.'