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Health / Health and social care partnership plans for the future

The integration joint board's chief officer Simon Bokor-Ingram.

SHETLAND’s health and social care partnership has approved its first medium term financial plan – with a funding shortfall of £7.7 million expected over the next five years.

The integration joint board, which brings together Shetland Islands Council and NHS Shetland, agreed to implement the plan at its latest meeting on Wednesday afternoon.

External auditors Deloitte had previously stressed to the board its need for clearer longer term financial planning.

A report from chief financial officer Karl Williamson said the integration joint board will need to revise the plan annually to reflect changing circumstances, such as decisions from the Scottish and UK governments and scenarios like Brexit.

The medium term financial plan shows that the cost of services to the board is expected to rise from £48.18 million in 2019/20 to £56.37 million in 2023/24.

Vice-chairman councillor Allison Duncan reiterated his calls to press for more money from the Scottish Government.

He said it could make “quite a difference if [NHS Shetland chairman] Gary Robinson can pull the rabbit out of a hat when it comes to finances”.

With much of the financial worries coming from the cost of employing locum staff to temporarily fill vacancies, Robinson replied that tackling the “root problem” of recruitment was the key priority.

The NHS chairman said the Scottish Government would not be interested in merely funding the cost of locums to plaster over the problem.

Health board member Natasha Cornick reminded the meeting that the five-year funding gap figure was if the board were to “do nothing” in terms of finding savings.

“We are doing something, we are not doing nothing,” she said.

Chief officer Simon Bokor-Ingram, however, said after the meeting that the £7.7 million funding gap was “really challenging”.

“We know it’s been challenging already – we’ve found savings year on year, and we’ve found more some years, less in others,” he said.

“But the whole efficiency and redesign agenda is here to stay. Change is constant, but managers are really, really up for the change.

“We’ve been doing transformational change for years, and I think that the main thing is we understand what that challenge is through the medium term financial plan which has been presented at the IJB today. We understand what that challenge is and we now need to work towards meeting that.”

The integration joint board, meanwhile, also approved its budget for 2019/20, with a funding shortfall of £2.53 million predicted.

There are savings of nearly £2 million proposed – although £1.2 million of this comes from an assumption that there will be another Scottish Government pay-out for the additional costs of funding primary care in Shetland, which ministers approved recently for the current financial year.

The remaining £544,000 funding gap will be “closed by additional non recurrent actions”.

“The NHS has a good track record of achieving non-recurrent savings and it is expected that this will continue into 2019/20,” Williamson added.