The NHS competition enforcer David Bennett has told NHS Foundation Trusts that if they don’t bring down their deficits, they will lose their freedom to decide their own strategy and the way they run their services. This includes the power to retain their surpluses and borrow to invest in services for patients.

The 152 foundation trusts together face a £1bn deficit this year, but the government has decided this is “unaffordable”.

David Bennett, the Monitor boss, told NHS finance directors they have to bring this deficit down by speeding up productivity improvements and working in new ways.