Financial confidence within the NHS is ebbing away, with a financial crisis looming in 2015-2016, according to the latest Quarterly Monitoring Report published by The King's Fund.

One in eight trusts and clinical commissioning groups (CCGs) will overspend their budgets for the financial year just ended, based on a survey of NHS finance directors carried out for the report. Although this is an improvement on the findings from the previous quarter, it reinforces concerns that the NHS provider sector will end the year in deficit for the first time since 2006-2007.

Looking ahead, only 40% of finance directors in hospitals and other providers are confident their organization will achieve financial balance in 2014-2015. This figure plunges to just 16% in 2015-2016. CCG finance leads are more optimistic, although only a third are confident of balancing the books in 2015-2016.

This lack of confidence reflects concerns about the implementation of the $6.4 billion Better Care Fund, which will see an additional $3.2 billion transferred from the NHS to support joint working between health and social care from April 2015. To compensate for this, NHS England has estimated that hospitals will need to reduce emergency admissions by 15%—a prospect rated as very unlikely by nearly 70% of hospital finance directors responding to this part of the survey.

Meanwhile, pressures on hospital waiting lists are growing, with more than 360,000 additional people waiting for treatment in January 2014, compared to the same month last year.

Richard Murray, director of policy at The King's Fund, said, “The NHS has coped well during the winter. However, as the implications for hospitals of implementing the Better Care Fund sink in, there is a growing recognition that the NHS will face a financial crisis in 2015-2016, if not before. It is now certain that the next government will need to find more funding for the NHS or accept significant cuts to services.”