NHS England’s Month 10 financial position for 2025/26 reported a £71 million revenue overspend to the end of January 2026. 

The paper said the NHS remained broadly in balance nationally, while also reporting system-level overspending and further assurance requirements for systems forecasting year-end overspends. 

Key Developments

NHS England reported that the NHS remained broadly in balance for the year to date at Month 10, with the revenue, non-ringfenced Resource Departmental Expenditure Limit position to the end of January 2026 showing a £71 million overspend. This represented 0.04% of year-to-date allocation.  

The paper reported that the Month 10 year-to-date position was driven by overspends in systems of £428 million. NHS England said this figure reflected the impact of held-back deficit support funding.  

NHS England also reported that 15 systems and 56% of providers had delivered in line with their plans up to Month 10. At the same point in the previous year, systems had overspent by £1.089 billion, with six systems delivering in line with plan.  

The finance paper stated that system overspends were largely driven by slippage against efficiency plans, including workforce costs above planned levels. It also noted that the financial impact of five days of industrial action in July had affected system positions because of increased staff cover costs during the strikes.  

At Month 10, 14 systems that had been behind their planned financial performance during the year were formally forecasting a year-end overspend. NHS England stated that, where applicable, these systems would not receive their share of quarter 4 deficit support funding.  

Systems and individual organisations forecasting an overspend were required to complete a board assurance statement, signed by the chair and chief executive. NHS England said these statements were required to confirm board oversight, the impact of the forecast change and commitment to delivery of recovery plans.  

Why It Matters

The Month 10 paper presents a nationally controlled financial position, with the overall revenue overspend reported as a small proportion of year-to-date allocation. However, the same paper shows that financial pressure remained uneven across systems and providers.  

The reported £428 million system-level overspend and the identification of 14 systems forecasting year-end overspends indicate that local financial recovery remained a live issue going into the final part of 2025/26.  

NHS England also set out further actions for systems forecasting overspends, including work with regional teams to identify further actions in-year and reduce the run-rate carried into 2026/27. The paper also reminded boards of 2026/27 Business Rules, including that NHS England may adjust trust plan limits, including associated deficit support funding, where an NHS trust does not deliver its agreed plan in 2025/26.  

The figures provide financial context for wider NHS delivery priorities, including access recovery, workforce cost management, productivity improvement and system-level accountability. 

Source References

• NHS England, Month 10 financial position 2025/26, March 2026. 
• NHS England, Meeting of the Board of NHS England – agenda, 26 March 2026.