NHS England has reported that the NHS ended 2025/26 with a £70 million national underspend.

The figure was published in NHS England’s Month 12 Financial Position 2025/26 paper, included in the public Board papers for the 4 June 2026 meeting.

Key Developments

NHS England reported an unaudited non-ringfenced Revenue Departmental Expenditure Limit position of a £70 million underspend.

The paper states that this represented 0.035% of the national position.

NHS England said the position was delivered without drawing on a reserve claim from HM Treasury.

The report states that final financial plans for 2025/26 were submitted at break-even, following a financial reset and a series of interventions after draft plans submitted in February 2025 had shown a £4.4 billion deficit.

Within the national position, systems delivered a £563 million deficit. NHS England said this figure reflected the impact of held-back deficit support funding and delegated specialised commissioning.

The broader system deficit including deficit support funding was reported at £813 million.

Fifteen systems reported deficits including deficit support funding, compared with 17 in 2024/25.

NHS England said the five systems with the largest deficits were responsible for 88% of the total system deficit. These were Kent and Medway, Cheshire and Merseyside, Nottingham and Nottinghamshire, Humber and North Yorkshire, and Hampshire and Isle of Wight.

The report also states that systems delivered £10.2 billion of efficiencies, equivalent to 92% of the planned level. This was £842 million below the planned £11.2 billion efficiency requirement, but £1.6 billion higher than 2024/25.

Agency spend was reported to have almost halved, falling from £2.1 billion to £1.2 billion.

Why It Matters

The Month 12 position is a significant financial update for NHS providers, integrated care boards and system leaders.

The reported national underspend indicates improved financial grip at system level during 2025/26. NHS England linked the outturn to stronger financial discipline, visible leadership focus and a more consistent emphasis on living within available resources.

However, the paper also shows that financial pressure remains unevenly distributed. Although the NHS reported a national underspend, systems still recorded a £563 million deficit within the overall position.

The concentration of deficit across five systems is relevant for provider and system leaders because it indicates that financial recovery remains a major local challenge in some areas.

The paper also identifies slippage against efficiency plans, including workforce costs above planned levels, as a driver of system overspends. Industrial action in July 2025 was also cited as having adversely affected system positions because of increased staff cover costs.

The financial position provides important context for 2026/27 planning, including productivity expectations, workforce cost control, elective recovery and provider-level operational grip.

Source Reference

• NHS England: Month 12 Financial Position 2025/26, 4 June 2026.