In board papers published yesterday, the ICB said £49.3m of the deficit related to lost deficit support funding and £148.7m related to adverse performance against plan.

An NHS Kent and Medway spokesperson said: ‘The current forecast deficit reflects the most up‑to‑date assessment across all partners. This position has been shared with NHS England, and we continue to discuss with them. The forecast includes the deficit support funding already received earlier in the year; however, with no further support in quarters three and four, this impacts the overall position.'

The ICB said it had been ‘clear for some time there were significant risks to delivery of a breakeven position', acknowledging efforts to offset the deficit had not been delivered ‘at the pace and impact required'.

Alongside an independent review, the ICB said it had brought in additional support ‘to ensure we have a credible, deliverable and sustainable financial plan for 2026/27'.

The spokesperson added: ‘A deficit of this size is clearly very serious, and we are working closely with NHS England to understand the implications and agree the next steps. No decisions have been made about repayment profiles or timescales. Our priority is to ensure services for the people of Kent and Medway remain safe, sustainable and focused on the needs of patients.'