THERE has been a softening in NHS Shetland’s stance on its controversial travel policy, which might ultimately result in the health board ditching plans to make an overnight ferry trip the default option for patients.
Following a private board meeting at Montfield in Lerwick on Tuesday at which a potential improved deal with airline Loganair was discussed, chairman Ian Kinniburgh said it was now recognised that the initial £1 million-a-year savings target was overly optimistic.
With Loganair making an offer that could save NHS Shetland a considerable six-figure sum on airfares – it currently spends £2.7 million a year on patient travel – it now appears to be a question of whether the savings gap between the two options can be narrowed sufficiently.
It is understood the estimated savings have now been downgraded to around £600,000 and could yet drop further, while Loganair’s offer could save the health board a guaranteed £250,000 annually.
In March the board voted 6-4 to make NorthLink ferry journeys the preferred option for most patients attending appointments and treatment in Aberdeen.
But following a considerable public outcry in recent weeks, Kinniburgh told reporters after Tuesday’s meeting that there “could be an alternative solution”.
Further talks with Loganair are planned on Wednesday, though the chairman said he had “no regrets” that the board voted the way it did last month. He also insisted the decision to press ahead with the policy – prior to conducting detailed research into the implications – had not been a negotiating ploy.
“It’s fair to say that we have been in discussions with Loganair and they have put an offer on the table for us,” Kinniburgh said. “It clearly falls significantly short of the amount that we’d hope to release by transferring patients to boat travel, but nevertheless it is a significant offer and I’m really pleased that they’ve done that.
“Hopefully we can give a degree of reassurance that they aren’t wasting their time trying to do a deal with NHS Shetland.
“We fully acknowledge that removing a significant number of people from their regular business will potentially have a destabilising effect and that that could have a knock-on impact for the whole of Shetland.”
The commercially sensitive nature of the deal was the reason why the board debated the travel policy update behind closed doors. Board members Malcolm Bell and Andy Glen had unsuccessfully urged Kinniburgh to hold at least part of the discussion in public.
The policy, Kinniburgh said, had initially been based on an assumption that 80 per cent of patients would travel by boat and 20 per cent by plane.
Now the matter has been looked into in more detail, it has become apparent that the savings will be some way shy of £1 million – primarily because a higher proportion of patients would still need to travel by plane.
“Several things have shifted,” Kinniburgh said. “Grampian have shifted their stance [on looking at the volume of appointments given to Shetland patients], Loganair have shifted their stance, clinicians have helped us clarify what some of the clinical things are. The public have quite rightly raised a number of other things around potential social exemptions.”
He continued: “It’s likely the savings would still be considerable. I’d be surprised if Loganair could match that, but if the gap isn’t as substantial… then it is possible that the board would reconsider its decision.”
Kinniburgh accepted it was a “money-saving initiative” rather than one that was best for patients but, with costs having been regularly trimmed amid public spending cutbacks, the alternative would be some major cuts to clinical services within the islands.
Bell said after the meeting that he was encouraged by the shift in thinking among board members.
“It would appear that the initial target, as I always suspected, has now been revised downwards,” he said. “I just don’t see it, in practice, making the savings that have been proposed, but in any event I do not believe it is appropriate to remove choice from patients.
“Clearly the board does have to save money, and I’m encouraged by how the meeting went today – and I look forward to it coming back to another board meeting soon.”
NHS Shetland faces making the biggest percentage cut of any health board in Scotland in the 2016/17 financial year and Kinniburgh added it was “not one where we have obvious answers”.
He said more would be done to encourage Grampian to minimise clinical appointments for patients where the option of a phone call or videoconference might suffice, but that process “will still take several years”.
It was planned that the board would meet again to discuss the travel policy issue on 23 May, but after Theresa May on Tuesday called a UK general election for 8 June, Kinniburgh suggested it might be too politically sensitive to discuss during the campaign.
That means it is likely to be a further two months before further discussions, meaning a quarter of the financial year will have elapsed before implementation of the policy can be considered further.