An NHS board finance report is warning that the level of local savings expected by the Scottish government this year will adversely affect patients, staff, and the sustainability of services in the future.

NHS Tayside has been told by the government that it must find ways to reduce its spending in 2024/25 by £58m – savings equivalent to 9% of its total budget.

While the board has already identified a series of ways to cut spending by £38.1m, it is now looking at more extreme ‘level 3 options’ to deliver the rest.

Breast screening services across Tayside could be scrapped under the new proposals, which the board’s financial plan says will result in a significant number of breast cancer cases going undetected.

Even with this, a further £17m in loan payments from the government will still be needed this year.

Over the next three years, NHS Tayside predicts its total deficit will total more than £115m.

 

Unfunded expectations

The cost of delivering Scottish government policy demands and performance targets is unaffordable, the board has now stated in its medium-term financial plan.

These include expectations around operational performance, length of stay and the use of theatres which NHS Tayside says are not possible within the current funding envelope.

The board says all national initiatives must now be reviewed, and investment paused or stopped, so the affordability of projects can be considered.

NHS Tayside is far from the only health board in Scotland voicing concerns about facing financial situation.

All of Scotland’s chief executives came together last year to agree a 15-point plan to achieve at least 3% savings across the NHS, and most boards are expected to find millions more in local savings elsewhere.

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.

A national Financial Improvement Group and Financial Improvement Network have now been setup by the Scottish government to oversee and aid in savings efforts.

 

Tayside’s original financial plans unacceptable to government

NHS Tayside identified £37.6m of level 1 and 2 savings in its draft financial plan submitted to the Scottish government in March.

Since then, the government’s Director of Health Finance Richard McCallum told the board it can only request £17.2m in brokerage loans this year, meaning the Tayside financial chiefs will need to find an additional £20.4m in savings – significantly more than the 3% requirement set out by the government previously.

The government has rejected the board’s original financial plan as a result, instructing leaders to work alongside the government to find more ways to reduce spending.

NHS Tayside says it is now considering savings proposals that could cause harm to patients.

These include the withdrawal of transport services for patients in need of help to get to dialysis or radiotherapy appointments, the updated financial plan reveals.

The removal of a high-cost breast agency locum, which would end the current breast screening and symptomatic service, is also being explored.

NHS Tayside has also outlined a scenario where theatre capacity is realigned to NHS Grampian, which it says would result in 897 patients no longer receiving their planned operations in 2024/25.

Up to three theatres and one ward could also be withdrawn under the proposal, leading to a further 2,212 patients not receiving their planned operations this financial year.

The papers note the ‘very significant consequences’ of these proposals, which it says would likely lead to more demand for primary care and unscheduled care.

The NHS Tayside Chief Executive and Director of Finance is set to meet with Mr McCallum and NHS Chief Operating Officer John Burns to discuss options for the board.

In a letter to NHS Tayside chief executive, Mr McCallum has confirmed that the Scottish government understands the need for more certainty and flexibility around health board funding.

He said the Scottish government will review all budget allocations to assess whether some can be baselined or bundled into a bigger allocation.

 

Read more: NHS chief execs agree 15-point plan to cut costs; Health boards to soon accrue £380m in lifeline loans; Health secretary promises reform for NHS; Urgent workforce reforms needed for Scotland's NHS; Government to launch ‘conversation’ on future NHS

Sign up to our bulletin for key health & social care updates straight to your inbox and you can follow healthandcare.scot on Google News.