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News / Health board struggles to find savings

NHS Shetland chief executive Ralph Roberts. Photo: Shetland News

NHS SHETLAND is facing a projected financial deficit of at least £1.6m for this year and is danger of not achieving a required balanced budget.

Chief executive Ralph Roberts admitted at Tuesday’s board meeting that the figure was a “best case at the moment” as the health board continues to overspend on locum staff while being faced with rising costs.

It is projected that the board has to find savings of around £10 million over the next five years.

Chairman Ian Kinniburgh warned of the dangers of making “knee jerk reactions” to find savings that may have long term implications.

The board will give an update at its next meeting in June where the prospect of asking for last resort brokerage funding from the Scottish Government may have to be raised.

Members of NHS Shetland’s management team met with the government in March to discuss the board’s draft operational plan for 2018/19.

Roberts said at Tuesday’s meeting that the required cost savings for the financial year have not yet been found.

A report from Roberts presented to board members said efforts are ongoing to identify where short term efficiency savings and service changes could be found.

There will also be an emphasis for services to find opportunities for new income generation.

NHS Shetland has also asked the government to review its primary care allocation associated with GP practices after its finance team reported that the heath board invests “significantly more” to subsidise primary care compared to other health boards.

This extra investment is estimated at £843,000 above the Scottish average in 2016/17.

It said this means that its GP allocation is lower than expected or that there is a service model that is “significantly more expensive than elsewhere”.

Kinniburgh said it was a “significant issue” and added there was a “real argument to make” to the government.

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Chair of Area Partnership Forum Ian Sandilands also questioned if the government could also help with contributing to the costs associated with travel and accommodation for locums.

Roberts said it was an issue – previously raised by integration joint board vice-chairman Allison Duncan – which has already been discussed with the government.

A third scenario planning workshop, meanwhile, will be held by NHS Shetland on Wednesday as the health board continues to explore future service models.

Roberts’ report warned that service transformation is likely to be “challenging and result in the need for extensive leadership input and most importantly, community and staff engagement.”

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