The House of Commons Public Accounts Committee has issued a critical report on the state of the finances of Acute Hospital trusts. Extraordinary evidence from a Trust Finance Director talks of the pressure from the NHS regulators to use "wheezes" and questionable adjustments to make the Trust's revenue accounts conform to NHS England's targets The report concludes, "The Department of Health, NHS England and NHS Improvement have not taken action soon enough to keep trusts in financial balance. The target for trusts to make 4% efficiency savings across the board is unrealistic and better data is needed for more informed savings and efficiency targets. Failings in the system for paying providers need to be addressed as a matter of urgency, with NHS Improvement and NHS England acknowledging that the current system is not fit-for-purpose as it does not incentivise the right behaviours needed for joined-up healthcare services. Spending on agency staff has contributed to trusts financial distress, and action to tackle this problem is welcome, albeit late. The NHS will not solve the problem of reliance on agency staff until it solves its wider workforce planning issues.