NHS Highland Faces Up To £10million Overspend

6th August 2013

NHS Highland faces a forecast overspend of £9.8 million though a report by the organisation's Director of Finance predicts financial break-even by the end of the financial year.

In a report to NHS Highland's board, which will meet on 13th August, Nick Kenton points out that his forecast of break-even depends on the delivery of savings targets and a range of management actions.

Although June is relatively early in the financial year, he will tell the board, a £9.8 million forecast overspend gives “some cause for concern”. However, it is in line with previous years – the forecast three months into the previous financial year was a £10.1 million overspend

The unit with the biggest forecast overspend – £7.7 million – is Raigmore Hospital. The director will tell the board that Raigmore's senior management team is seeking to identify measures to reduce costs. Work will also be required to improve the forecast within adult social care, where there is a current reported overspend forecast of £3.7 million.

Back in May Independent Highland councillors expressed concerns about the NHS Highland budget when they were asked to agree a bale-out from Highland council funds and it was reported in the Lochaber News as follows -

A FORMER social work chief has warned of a real financial risk to Highland Council after the region’s health board took over elderly care services.

Senior councillor Margaret Davidson has claimed NHS Highland is used to getting regular “feeds” from the Scottish Government so it can balance its multi-million pound budget.

The health board assumed responsibility of adult social care from the council last year, with responsibility for children services transferring the other way.

About 1,400 council staff are now employed by the NHS and 208 health workers went in the opposite direction.

In March, the council agreed to a one-off £1 million payment to the health board to go towards adult services, which came on top of a £575,000 payment in December.

NHS Highland had been facing a £2 million budget overspend.

It also secured £1 million in transitional funding from the government.

Councillor Davidson, the former chairman of the local authority’s housing and social work committee, said there were “two very different cultures” of financial management between the public sector organisations and claimed the NHS finances were “extremely opaque”.


Other NHS Highland Board matters to be discussed next week.-

Among other matters to be raised at next week's board meeting is progress with infection prevention and control.

NHS Highland has met all targets for Staphylococcus aureus bacteraemia (SAB) and Clostridium difficile in patients aged 65 and over as at March this year.

However, the board will be told there remain several key challenges, including influencing the prevention and reduction of C.diff infections acquired in the 15-64 age group in the community.

Board members will be given an update on progress with embedding the Highland Quality Approach, NHS Highland's new management system aimed at ensuring the provision of person-centred care while eliminating waste, reducing harm and managing variation, and will be told of proposals to take the system forward.

New director of quality improvement Linda Kirkland will propose that four Quality Improvement Fellowships be created. The Fellows would lead improvements and play a key role in another of the proposals the director will put to the board – the development of physician/staff compacts.

The director will explain that such compacts – agreements which state what doctors can expect of the organisation in which they work, and what expectation the organisation has of them – are common in high-performing healthcare organisations in the United States.

She will also tell the board of interest in what has been described as one of the most innovative healthcare systems in the United States.

Southcentral Foundation, which provides healthcare services to 60,000 Alaskan native and American Indian people, has developed the 'Nuka System of Care' – a whole healthcare system in which the foundation's 'customers' drive through all aspects of improving health and wellbeing.

Discussions are to be held with one of the foundation's top team when she visits the UK later this year.

The development of a replacement health centre in Tain, challenges in recruiting and retaining staff in remote and rural areas and steps taken to address health inequalities in the Highlands will also be raised at next week's board meeting.

The board meeting starts at 8.30am in the board room in Assynt House, Inverness and is open to the public. Anyone interested in attending should phone 01463 704830.