St Helens clinical commissioning group should move towards a shared financial model with the trust that runs Whiston Hospital, its chief accountable officer has said.

The CCG’s financial struggles were highlighted during its last meeting of the governing body, with the commissioning group almost £900,000 away from its break-even target just five months into the financial year.

This was a significant jump from month four, which ended on a deficit of £537,000.

The CCG has indicated a potential deficit of £7.5 million by the year’s end, although various Quality, Innovation, Productivity and Prevention (QIPP) schemes are in place to reduce the risk.

Julie Ashurst, deputy chief finance officer, told the governing body that this was the “worst case scenario”.

She said the increasing deficit is largely down to acute trust activity, particularly relating to St Helens and Knowsley Teaching Hospitals NHS Trust.

Prof Sarah O’Brien, the CCG’s chief accountable officer, said the borough needs to move towards a financial model that incorporates more of a shared budget, which would therefore enable the risk to be shared.

She said: “One of the tensions for us, even with all the integrated work we’re doing, is the fact we want to get to a position where we’re allowed, or we can work within a budget for St Helens and share the risk when it’s overspent.

“The reality is where there’s budget, the budget might not be enough. So, if demand’s higher, there’s a financial risk to whichever organisation.”

Prof O’Brien added: “My sense is, if you look across Cheshire and Mersey, most of the acute hospitals now have moved into that space,” she said.

“Given where we are, it would be useful for the governing body to understand that. How many acute hospitals across Cheshire and Mersey are working in some different way?

“I think it’s most of them now, I think it’s most of them in Cheshire and Mersey.”

Ms Ashurst said talks about a shared budget have taken place with Nikhil Khashu, the trust’s director of finance.

“We continue to engage with St Helens and Knowsley,” she said.

“We have regular discussions with the director of finance at St Helens and Knowsley and those are the type of conversations that we’re starting to have.

“We’re not at that point yet and we’re not in that space yet.

“But we’re very clear about where the risks are in the system and how we might move to mitigate those risks.”

While the majority of UK trusts have yet to move towards a shared financial system, Ms Ashurst said “bigger pressures” across Cheshire and Merseyside has sped process up within the region.

Prof O’Brien said she is coming under increasing criticism and questioning over the issue of a shared financial model.

She said: “Despite the good work and understanding on the ground what the issues are, we’re coming under increasing – ‘it’s great what you are doing in St Helens, but you haven’t moved into that space of a sharing of the financial problems’.

“And if everybody else hadn’t it would be fine, but I think now on Cheshire and Mersey, Whiston is an outlier for that.

“I think they are the only acute hospital that hasn’t done some kind of different financial agreement with their main commissioner.”

Ms Ashurst also revealed it has challenged the trust whether recent data it has submitted is accurate following a spike in a number of areas.

In June the trust went live with its new Medway patient administration system (PAS) within its two main acute sites, St Helens and Whiston, as well as Newton hospital.

“We’re having discussions with the trust whether that’s real activity or whether there may be an issue with the data provided,” Ms Ashurst said.

The governing body noted the report.