Comment How far into red can NHS sink?

And according to hospital trusts themselves, the NHS can’t carry on like this.

They are represented by a body called NHS Providers, which is run by the chairs and chief executives of hospitals across the country. For example, Paula Clark, Chief Executive of the Dudley Group NHS Foundation Trust, in on the board.

Chris Hopson, NHS Providers chief executive, said trusts had spent more than expected “largely because of winter pressures.”

This not only meant they had more patients to treat, but also meant they cancelled operations – freeing up beds to meet “record emergency winter demand” – and lost income as a result.

Hospitals have been told to save money – but there is a limit to what they can do, she said.

She said: “We shouldn’t kid ourselves.

“The NHS’s underlying financial position is not sustainable. Two thirds of finance directors we surveyed say a significant amount of the savings their trusts have made are one-offs that cannot be relied upon in future.

“The National Audit Office has recently warned of the dangers of such an unsustainable approach but the NHS continues to rely on it.”

Many hospital trusts were expected to overspend this year. But they’ve gone further into the red than predicted.

For example, Walsall Healthcare NHS Trust, which runs Walsall Manor Hospital, was expected to go £5.2 million over budget by the nine-month mark but actually ran up a £16.2 million deficit over nine months.

Staffordshire and Stoke-on-Trent Partnership NHS Trust, which runs a range of community health services and community hospitals, was expected to have a deficit of £5.6 million but recorded a deficit of £21.9 million.

The individual trust figures all contribute to the national overspend, but the national figure also includes trusts which had a surplus in the first nine months of the year.

Birmingham Children’s Hospital NHS Foundation Trust, for example, had a surplus of £4.9 million, reducing the national deficit a little.

And the national figure is lower because the Government provided £1.8 billion of emergency funding, known as sustainability and transformation funding, although not all of it has been paid out yet.

Hospitals have been told to cut costs, but health experts say they may already have done as much as they can.

Sally Gainsbury, senior policy analyst at health think tank the Nuffield Trust, said: “This massive deficit comes even though NHS trusts have delivered very high levels of cost cutting: £2.9bn in the first nine months of this financial year alone.”

She warned: “The NHS now appears to be locked into systematic overspending - a function of the simple fact that funding is rising significantly slower than patient numbers.

“If this continues, we have calculated that by next year all parts of the service will be in deficit.

“There is a widening gap between what we are asking the NHS to do and what we are funding it to do.”

The Government is under pressure to act, and some health experts say NHS hospitals will not be able to balance their books until problems in social care are addressed.

A charity called the Health Foundation has urged ministers to provide extra funding for social care in next month’s Budget.

Anita Charlesworth, director of research and economics at the Health Foundation, said: “Hospitals will find it very difficult to balance their books while social care remains under such intense pressure.”

Hospitals will find it very difficult to balance their books while social care remains under such intense pressure Anita Charlesworth