Managers are concerned services will be hit

NHS managers will be told that balancing the books in 2006-07 will not be good enough - the NHS overall will have to run a small surplus.

Last month the government admitted the NHS was on course for a deficit of about �620m for 2005-06.

Meanwhile, troubleshooters are to be sent into the 18 NHS organisations with the biggest financial problems.

'Most doing well'

Accountancy firm KPMG investigated the finances of 60 NHS organisations with significant financial problems before Christmas.

As a result of that investigation it has been decided to send turnaround directors into nine NHS acute trusts, and nine primary care trusts.

The turnaround directors, who will be based at the strategic health authorities who oversee local NHS trusts, will do their best to try to sort out each of the trust's financial problems.

They will be private sector accountants, financiers or management consultants.

A Department of Health spokesman stressed that only a small minority of NHS organisations had serious problems with deficits.

He said most trusts were managing to improve services while at the same time balancing the books.

Spending squeeze

Ms Hewitt is set to reveal more plans for controlling NHS spending on Wednesday.

Managers will be given new business rules for the coming financial year.

Treasury officials have made it clear that the NHS is set for a spending squeeze.

Treasury papers have suggested the NHS is likely to see real term growth of less than 4% after 2007-8 - this compares with the 7% increase it has enjoyed since 1999.

A survey by the Health Service Journal published last week found that three-quarters of NHS bosses believe patient care will suffer because of the current cash crisis.

The survey found two-thirds of acute trusts polled had already had to close wards.