Business confidence in the North West declined sharply in this quarter, according to new research.
The Business Confidence Monitor from Grant Thornton and the ICAEW suggests economic challenges and the looming EU referendum have drained optimism on the back of three quarters of gradual declines.
The business confidence score for this quarter was 3.3 - down from a peak of 28.3 in Q3 2015.
Domestic sales growth had slowed from 5.7 per cent year-on-year in Q2 2015 to 2.3 per cent in Q2 2016.
Meanwhile, 40 per cent of businesses said completion is more fierce than a year ago.
Almost a quarter (24 per cent) said that the availability of management skills is more of a concern than 12 months ago, while 26 per cent said non-management skills are a worry.
Melanie Christie, ICAEW regional director for the North West, said: "Business confidence in the North West has taken a plunge for the third successive quarter. It is likely that worsening of financial performance, which has been apparent over the last year across the region is impacting business sentiment.
"Furthermore, wider uncertainties are likely to stem from the upcoming EU referendum. Business confidence in the region is fragile and the next quarter could be decisive in terms of a return to a trend for growth and the economy going forward."
Carl Williams, North West managing partner at Grant Thornton, added: "At first glance, the ICAEW/Grant Thornton Business Confidence Monitor does not make for happy reading, but given the proximity of the EU referendum and the uncertainty it has caused in national and regional markets, it should not be a huge surprise.
"Aside from the referendum, I believe the fundamentals of the region's economy are robust. In the next month, the North West is going to be hosting the second International Festival for Business in Liverpool, which is an outstanding opportunity for all of us to exploit to grow our networks.
"Another massive boost is the launch of the first direct flights to Beijing from Manchester in June, which says a lot about how highly the North West is regarded internationally.
"The road to sustained economic growth is never a smooth one and there will always be bumps in the road. In the long term I am confident in the prospects for the North West, particularly given the political agenda, which recognises that significant investment is needed in infrastructure and transport."