Croydon Clinical Commissioning Group (CCG) is “urgently reviewing” its spending as it looks to slash its costs by more than £18.4m this year.

The group, comprised of all 58 GP practices in the borough, has been forced to find ways to reduce expenditure as struggles to rein in an expected annual deficit of £9.9m.

The forecast overspend is more than double the target set by NHS England, which placed the CCG in financial special measures in July.

NHS England wants the CCG to limit its in-year deficit for 2016/17 to £4.2m and its cumulative deficit to £47.9m.

RELATED: Croydon's NHS trust and CCG both placed into special measures to tackle financial troubles

The CCG has faced financial challenges since its establishment in April 2013 and is expected to have racked up a total overspend of £53.6m by April next year.

It says it was underfunded by £46m –10.4% of its budget - in its first year of existence alone.

Dr Tony Brzezicki, chair of Croydon CCG, said: “Croydon CCG is facing its toughest financial challenge yet.

“Over the last five years, Croydon clinicians have made savings of £72 million through service efficiencies and finding new ways of commissioning health services for local people.

“We now know even more needs to be done to meet our statutory duty to live within our means.”

The CCG has drawn up a shortlist of cost-cutting initiatives, but Edward Odoi, the group’s chief management accountant, warned in a report to the group's board there was “significant risk” these plans could fail to deliver the savings needed in the required time.

Dr Brzezicki said: “We need to focus our limited resources where we can have the biggest impact on people’s health and well-being.

“If we propose any significant service change, we will fully engage and consult with the public on what we should prioritise in order to get health services in the borough back into balance.”

RELATED: Croydon Health Services NHS Trust borrowing money to mitigate £36m deficit

The CCG will also need to borrow £5.7m to top up its annual budget, Mr Odoi's report to next week's CCG board meeting added.

In a separate report to Croydon Council’s health, social care and housing committee on Tuesday, the CCG said additional funding it had received in the past two years meant “future allocation growth will be modest,” putting further pressure on its finances.

The report added: “It is anticipated that the significant in-year savings requirement will require significant service changes. Potentially, some of these changes will require wide scale engagement or consultation with the CCG’s patients, public, residents, stakeholders and partners.

“The lack of future funding growth, the growing demand for services and the reducing opportunity for efficiency means that the NHS in Croydon, to live with within the resource allocated to it, must more rapidly work with its partners, across care settings, to transform the whole health and care system and make service provision prioritisation decisions.”

In July the CCG, along with Croydon Health Services NHS Trust, was placed into special measures designed to “restore financial discipline” to troubled parts of the NHS.

They were among five NHS trusts and nine CCG across the country forecasting “significant deficits” for 2016/17 chosen by NHS England and NHS Improvement to fall under the measures, which require them to agree an intensive recovery plan overseen by specialist teams.

NHS England said it had selected Croydon CCG to fall under special measures "in in the light of its deteriorating financial position in quarter 1 2016/17”.