A new report claims that a failure to engage doctors and other health staff in managing their budgets is behind the financial problems in the NHS.
And the study, which was carried out by the Audit Commission, calls on staff to work more closely in order to help improve services for patients.
The report found that some "strongly held" negative stereotypes between clinical staff and those working in NHS finances has contributed to the problem.
It said that staff who deal directly with patients need to become more involved in how the money is spent.
The Commission recommended that clinical staff are trained in financial management and that finance staff increase their knowledge of what happens on the frontline.
The NHS is projecting a surplus of £1.8bn in 2007-08, which is more than treble the £510m surplus in 2006-07 and comes after a deficit of £547m in 2005-06.
Chief executive of the Audit Commission Steve Bundred said: "This is about giving power and responsibility to those in the very frontline.
"Most NHS money is spent by doctors and other clinical staff. It is they, rather than finance managers, who are best placed to identify how funds can best be used to improve the quality and efficiency of services.
"Where there is an ongoing lack of trust, respect and mutual understanding between clinical and finance staff, decision-making can be poor and progress very slow. But where they do come together, it can transform services."
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"Hearing about a £1.8bn surplus for the current financial year is of little comfort to those managers whose practices are located within a PCT that is still facing a financial deficit. There are still many examples around. I do not expect a nonclinical member of staff to make a clinical decision. Similarily, medical staff should not be involved in making financial decisions if they are not happy to do so or feel that there is an assumption that they will be expected to. Let's face it, PCTs have full-time, professionally qualified staff who still seem to struggle year on year. Many managers have good financial acumen, and the key to making things work is to actually devolve responsibility down to local levels. Budgets should not be indicative. They should be actual, which will create a true sense of 'accountability'. The answer is that whoever is responsible for the actual financial budget is the one that should be held accountable whether they are medical staff or not" – Steve Williams, London