Eight in ten (81%) NHS trust leaders say that trusts and systems have insufficient funding to invest in digital transformation, according to a survey by NHS Providers.
With the NHS looking to recover a predicted shortfall that reached nearly £7bn for the 2025-2026 financial year, trusts have been asked to drastically reduce running costs while improving performance against key targets.
In a survey of trust leaders, published by NHS Providers on 9 May 2025, 47% of trust leaders said that they would have to scale back service provision to deliver their financial plan and a further 43% said that this is already under consideration.
Respondents named virtual wards as among the services at risk of being scaled back, along with rehabilitation centres, talking therapies and diabetes services for young people.
Saffron Cordery, interim chief executive of NHS Providers said that trust leaders are “acutely aware of pressures on the public purse, the scale of the challenge they’re facing and their duty to make the most of every pound that goes into the NHS”.
“They’re working hard every day to find efficiencies, cut costs and make savings without compromising safety.
“They’re at the forefront of efforts to shift care from hospitals to the community, from analogue to digital and from treating sickness to preventing ill-health.
“Trust leaders have also heard loud and clear that overspending will not be tolerated and have made major inroads in tackling the huge financial deficit facing the NHS.
“But let’s also be clear: cuts have consequences.
“NHS trusts face competing priorities of improving services for patients and boosting performance while trying to balance the books with ever-tighter budgets,” she said.
“It’s really worrying to hear trust leaders tell us highly valued staff and services including vital work to address health inequalities and prevention could be among the early casualties of budget cuts.
“These decisions are never taken lightly and will always be a last resort.
“They’re committed to working with the government to build a better health service but fear immediate financial pressures could undermine plans to transform the NHS,” Cordery added.
The survey, carried out in April 2025, received 160 responses from chief executives, chairs and other board executive directors from 114 trusts, including acute, acute specialist, ambulance, community and mental health trusts.
More than a third (37%) said their organisation is cutting clinical posts, with a further 40% considering this.
With trusts told to halve corporate cost growth, 86% of trust leaders said their organisation is going to have to cut posts in non-clinical teams, including digital – potentially risking efforts to deliver services, innovate, and improve productivity.
The survey found that several trusts are aiming to take out 500 posts or more and one organisation is planning to cut around 1,000 jobs.
More than nine in ten (94%) said the steps needed to deliver financial plans would have a negative impact on staff wellbeing and culture.
