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Health / Remote out of hours mental health consultant cover being explored

An image from the Healthy Shetland website.

A NEW out of hours model for mental health support in Shetland involving remote consultants is being explored.

Members of Shetland’s integration joint board (IJB) heard at a meeting on Thursday that the idea relates to having staff remotely on call across Shetland, Orkney and the Western Isles.

Finance officer Karl Williamson said at the moment NHS Shetland is paying its own locum mental health consultants to be on call out of hours, which comes at a cost.

He said the new proposal could involve six consultants spread across the three health boards on a rota.

“At the moment we’re paying locums to be on call on their hourly rate through the night, so that’s very, very expensive,” Williamson said.

While he said he believed the Scottish Government had given the go-ahead for exploring the remote, regional plan, IJB chief officer Brian Chittick said the process to scope it out was still in the early stages.

“There are hopefully some regional solutions…because I think a lot of the IJBs and health boards are experiencing the same kind of financial pressures in similar areas that we are as well,” he said. 

Meanwhile the meeting heard that the projected overspend on health and social care services in 2022/23 has increased to nearly £5.5 million.

And Williamson warned that saving targets are likely to be placed on the board in the future.

This is because NHS Shetland is expected to need brokerage from the Scottish Government – or a loan – to balance the books at the end of the financial year. At the moment it is projecting a £4 million overspend.

Williamson said brokerage would need to be repaid and as such could filter through to saving targets for the IJB.

The projected IJB overspend comprises of around £2.7 million in the NHS Shetland arm of the budget, with the rest coming from the council side.

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The main factors are the extra costs of temporary and agency staffing, increased demand in option one and two self directed support packages and pay awards.

The meeting heard that the budget for the pay award was two per cent but on average it is coming in at eight per cent.

Meanwhile the board agreed that proposals be brought forward for the establishment of a substantive depute chief officer post for the integration joint board.

An interim depute chief officer post was introduced during the Covid pandemic due to additional workload, and the meeting heard that the pressures remain.

Making the post substantive is expected to cost around £110,000 a year.

Some questions were raised about the cost pressures, but there was a feeling that a substantive post was needed.

A business justification case for the role is now due to be prepared.

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