A report showing the number of NHS foundation trusts breaching an urgent cancer target has more than quadrupled in a year also showed trusts had delivered "efficiency savings" of £867 million so far in 2014 -18% (£185 million) behind what they had planned for this stage.
All trusts need to up their game in delivering efficiency savings this year in order to maintain and improve the quality of care for patients, and ensure the sustainability of services.
The financial trust sector is doing remarkably well in tough circumstances but is looking a little frayed at the edges.
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Cold, quiet and calm