Scottish Government Has No Clear Plan To Deliver NHS Vision Says Audit Scotland

6th December 2024

Audit Scotland published its latest look at NHS Scotland on 3 December 2024 before he budget announcements by Shona Robison, Finance Minister in her budget for 2025/26. The government's budget is only in draft and it remains to be agreed in February 2025. The SNP government cannot pass the budget on its own as it is a minority government and will require backing from other parties who may demand changes.

More money being spent on more staff but less patients being seen - something needs sorted.

The Scottish Government needs a delivery plan that clearly explains to the public how it will reform the NHS and address the pressures on services.

Despite increasing funding and staffing, the NHS in Scotland is still seeing fewer patients than before the Covid-19 pandemic. Auditors found that:

• commitments to reducing waiting lists and times have not been met.

• the number of people remaining in hospital because their discharge has been delayed is the highest on record.

• and NHS initiatives to improve productivity and patient outcomes have yet to have an impact and lack clear progress reporting.

Health accounts for about 40 per cent of the Scottish budget. Funding grew again in 2023/24 but has mostly been used to cover pay commitments and inflation. Costs are forecast to continue rising and making savings remains challenging. Work to build new healthcare facilities also remains paused.

The Scottish Government's restated vision for health and social care is not clear on how these operational pressures on the NHS will be addressed or how reform will be prioritised. It needs to
work with NHS staff, partners and the public to set out a clear delivery plan and make tough decisions about how it may change or potentially even stop some services.

Stephen Boyle, Auditor General for Scotland, said, "To safeguard the NHS, a fundamental change in how services are provided remains urgent.

The Scottish Government needs to set out clearly to the public and the health service how it will deliver reform, including how progress will be measured and monitored.

"Difficult decisions are needed about making services more efficient or, potentially, withdrawing those services with more limited clinical value to allow funding to be re-directed.

Taking those steps will require greater leadership from Scottish Government and NHS leaders than we've seen to date."

Note
The Scottish Finance minister Shona Robison has in her budget announced some changes to spend.

Read the Audit Scotland report HERE

On 6 December 2024 - Scottish Government announced Record funding will transform engagement with health services. What remains unclear is how the changes will happen and exactly when. Every year an increase is a record amount but may still not be enough to cover full inflation rising costs.

People will get appointments quicker and receive treatment sooner in Scotland's health service, as a result of the Scottish Government's Budget.

The record £21 billion funding allocated to Health and Social Care will help ensure the journey from diagnosis to treatment to aftercare is as straightforward and stress-free as possible.

If approved by the Scottish Parliament, the Scottish Budget 2025-26 aims to:

enable patients to get treated faster by increasing appointment capacity and cutting waiting times help people to live healthier lifestyles by supporting GPs to deliver more services aimed at preventing illness transfer patients from hospital into more appropriate settings quicker with an additional 600 Hospital at Home beds improve the availability of procedures where backlogs exist such as hip replacements allow more people to be treated closer to home with more resources in the community.

Visiting the Linlithgow Medical Practice in West Lothian Health Secretary Neil Gray emphasised the difference the funding would make to patients:

"Most of the stories I hear about people's experience of the NHS are positive, thanks to the dedication and empathy of health and social care staff across the country.

"But I know some people are waiting too long and finding appointments hard to come by. We want everyone to have a positive experience of the NHS, so we have listened and are taking action.

"By March 2026, no-one will wait longer than 12 months for a new outpatient appointment, inpatient treatment or day case treatment with more than 150,000 extra patients treated as a result.

"This Budget will also deliver an additional 600 Hospital at Home Beds, helping people to get out of hospital when they are ready and supporting them with the care they need at home whilst freeing up capacity.

"I am determined that every penny of the record £21 billion allocated to health and social care helps make each patient's experience as smooth as possible at what can be a worrying time.

"We want to improve our NHS, but to do that Parliament must approve our Budget Bill to unlock investment to drive long-term and lasting improvements - and the healthier population that we all want to see."

Previously Scottish government had announced a pause on all capital funding. This has built in more delays to many projects across Scotland but may now be started again following the budget3