THE CHAIRMAN of NHS Shetland says there were no real surprises in a new Audit Scotland report which said the national health service is no longer in a financially sustainable position and needs to move away from short-term fire-fighting to long-term change.
The grave warning came from the auditor general for Scotland Caroline Gardner in her latest annual health check of the NHS, which was published last week.
In her 40-page report she wrote that pressure is building in several areas including major workforce challenges, rising drug costs and a significant maintenance backlog.
Her findings confirm and reiterate what has repeatedly been voiced by the local health board, which is faced with an overspend of £1.8 million half way through the current financial year.
Officials have admitted that NHS Shetland may have to seek brokerage loan funding from the Scottish Government to make ends meet.
NHS Shetland chairman Gary Robinson said it is “fair to say there was really nothing in the Audit Scotland that came as a surprise”.
“I think everyone has known the pressure that health has been under in recent times and also the real need to turn that around,” he added.
Robinson also reiterated that recent measures announced by the Scottish Government to help ailing health boards were welcomed locally.
Health secretary Jeane Freeman confirmed earlier this month that heath boards would be given a three-year financial framework to work in, instead of trying to break even every year, while the government would also write off brokerage loans outstanding from the last five years.
“The indication that all Scottish health boards would enter the new financial year with a clean state was recognition I think that we needed to clear our feet to be able to move forward,” Robinson said.
The chairman added that there are “still big opportunities in working closer and better with partners locally”, such as Shetland Islands Council and the voluntary sector.
“I think the cabinet secretary again has clearly signalled that she wants to see the pace of health and social care integration speeded up, and I think that still has potential to deliver benefits to individuals who require health care, but also savings as well, through working smarter.”
The Audit Scotland report, meanwhile, showed that when taking into account inflation, the Scottish health budget for 2017/18 was a 0.2 per cent decrease from the previous year.
It said that health boards struggled to find “unprecedented” savings targets, with a heavy reliance on one-off efficiencies, and that no NHS boards were able to meet all eight national performance targets.
NHS Shetland did meet a handful of targets in 2017/18, including waiting times for child and adolescent mental health services, drug and alcohol patients and cancer treatment.
The health board was also the only one in Scotland to meet the national target for sickness absence.
Gardner said: “The performance of the NHS continues to decline, while demands on the service from Scotland’s ageing population are growing. The solutions lie in changing how healthcare is accessed and delivered, but progress is too slow.
“The scale of the challenges facing the NHS means that decisive action is needed now to deliver the fundamental change that will secure the future of this vital and valued service.
“Alongside longer term financial planning, this must include effective leadership, and much more engagement with communities about new forms of care and the difference they make to people’s lives. This will help to build support among the public and politicians for the changes required.”