In a letter to local NHS leaders on their financial plans for 2025/26, chief executive, Amanda Pritchard, and incoming transition chief executive, Sir James Mackey, said it was time to ‘get a grip' after revealing a ‘very significant financial deficit' of £6.6bn and ‘limited confidence of delivery of operational expectations'.

The letter said the NHS leadership event on 13 March will now re-purposed to discuss how the reset will work.  

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Saffron Cordery, interim chief executive, NHS Providers, said NHS trusts had been ‘stretched to the limit' during their ‘toughest ever financial year' and warned the request could mean ‘scaling back or stopping services and shedding staff'.

‘With the new financial year just weeks away, trusts need certainty and realistic plans confirmed as soon as possible,' Cordery added. ‘They are working extremely hard already to improve productivity and on track to find more savings in the year ahead but times are tough after years of underfunding and severe staff shortages right across hospital, mental health, community and ambulance services.

‘Government and NHS England will need to back any trade-offs needed to be made locally if these extra savings are to be found.'

NHS Confederation chief executive Matthew Taylor, warned of the danger of members ‘operating at the outer limits of what is achievable', adding the NHS needed to be ‘realistic about what it can provide'.

Taylor urged the Government to consider a number of options ahead of the Spending Review, including ‘raising more private capital investment in the NHS, protecting investment in proven preventative actions which are known to generate savings for the NHS and wider public services and supporting local NHS leaders when they need to make difficult decisions about which services to cut'.