The ICB, which has a budget of around £5.5bn in 2025/26, said it ‘must take immediate action to reduce our spending'.

Lancashire and South Cumbria ICS reported a £129.8m deficit in 2024/25 after receiving £175m for deficit support and £50m of winter surge funding. Excluding these items, the system deficit for 2024/25 would have been £354.8m, or £179.8m worse than the £175m control total set by NHS England.

ICB chief executive, Sam Proffitt, said: ‘We recognise we will have to make some difficult decisions over the next few months which may not always be popular, however, these will be clinically led with detailed impact reviews and in collaboration with local partners.

‘This includes reviewing services which are not providing value for money, are not efficient or which increase variation across Lancashire and South Cumbria. There are opportunities to reduce waste and duplication, and reconfigure services which will improve outcomes for our population whilst being more sustainable in the future.'

NHS England chief executive Sir Jim Mackey set out plans for ICBs to cut costs by 50% in a letter on 1 April. ICBs have been asked to submit transition plans by 30 May 2025.

Proffitt added: ‘We are going into 2025/26 with a robust set of commissioning intentions and waste reduction programmes which aim to ensure we remain within our budget whilst meeting all nationally-mandated requirements. Delivering these is a key part of our recovery support programme with NHS England.

‘Priorities include delivering in-year impact for intermediate care, managing long-term conditions in primary care, improving end-of-life care and frailty in addition to delivering transformation in the way we provide cancer, mental health, children and young people's services, acute and elective care.'