"Any attempt to mislead the public about the true state of a commissioner’s accounts is totally irresponsible," said RCN Northern regional director Glenn Turp.
"If this is true and the CCG has run up a deficit of £41m in total then this runs contrary to a legal direction whereby a CCG must ensure it doesn’t run over a £5 million deficit each year."
"This is an unacceptable situation with worrying implications for the future of patient care and public trust in NHS England."
"Like many organisations, the CCG has been a victim of cuts in public health spending and has tried to cope with increasing demand within an ever-decreasing budget."
"We call on the chief executive of NHS England Simon Stevens to provide the public with a clear explanation of why the CCG was forced into this position in the first place."