This report examines in detail the 2004-05 revenue situation of NHS organisations and considers key financial management and reporting issues facing the NHS both currently and in the future. Jointly prepared by the National Audit Office and the Audit Commission, the report incorporates the findings of their audit work on the NHS summarised accounts, the consolidated account of NHS foundation trusts, the Department of Health's resource account and the accounts of individual NHS organisations, as well as the unaudited NHS revenue out-turn for 2005-06 as reported by the Department of Health and Monitor. Findings include that in 2004-05, the Department reported a deficit across the NHS as a whole for the first time since 1999-2000, with an aggregate overspend for all NHS bodies of £251.2 million, with 171 out of 615 bodies recording a deficit or overspend, with 68 out of 259 NHS trusts failing to break even, and with 90 out of 303 primary care trusts exceeding their revenue resource limits.