NHS Ayrshire & Arran has been admonished by the Scottish government for a ‘misleading’ financial report, as it faces ending this financial year with the largest deficit in 15 years.

By the end of 2024/25, Scotland’s NHS boards are predicted to have accumulated more than £380.6m in brokerage loans that they must eventually pay back to the government.

Government NHS finance director Richard McCallum, in letters released by the Scottish government, has told boards this is “now at a level which is unsustainable for Scottish government to continue to support”.

Five territorial boards received brokerage in 2022/23, at a total cost of £72.1m.

This amount will be capped from 2024/25, with a total of £133.5m to be made available to NHS Borders, NHS Dumfries & Galloway, NHS Fife, NHS Grampian, NHS Highland, NHS Orkney and NHS Tayside according to the letters.

NHS Ayrshire & Arran will also likely to require brokerage to break even in 2024/25.

The board is on track to end 2023/24 needing £54.1m to plug its gap, the highest level of brokerage of any board in the last 15 years according to the letters.

In a letter addressed to chief executive Claire Burden, Mr McCallum said he is also ‘extremely concerned’ about the way the board is presenting its financial position after misrepresenting extra sustainability funding previously provided as an improved position.

During the year, Scottish government provided NHS Ayrshire & Arran some £5.6m of sustainability funding as well as £18.2m of New Medicine Fund payments.

The NHS finance director wrote:

‘The level of brokerage currently forecast at month 7 is £54.1m – a small improvement from the original plan. The £56.4m in the original plan however did not take account of the £5.6m additional funding that was provided by the Scottish government earlier in the year for sustainability funding.

‘To suggest the board is slightly ahead of trajectory is misleading and not in line with my expectation.

‘I am still not assured that the system is gripping the materiality of the deficit that has been set out.’

NHS Ayrshire & Arran has since published an updated financial plan, with an expected deficit of £50.8m, but has been asked to get closer to £43.4m by the end of this financial year.

The board has been approached for comment.

More than half of NHS Scotland’s 14 territorial boards will require brokerage on current projections for next year, according to the letters.

By 2024/25, the total amount boards owe to the Scottish government will be in excess of £380m.

If better performing boards, like NHS Lothian and NHS Forth Valley, cannot balance their book, the money needed to plug the gaps may climb even higher.

These boards are predicting they will end this year with deficits of £22m and £10.3m respectively.