Auditor General Reports On Financial Challenges NHS Boards Including Nhs Highland
3rd October 2018
The Auditor General has reported to the Scottish Parliament that NHS Highland and NHS Ayrshire and Arran face significant financial challenges, which are likely to continue in the years ahead.
The reports note that these boards are unable to deliver services within budget, savings targets have not been met and it will be difficult to achieve financial sustainability in future. A significant proportion of their savings to date have been one-off savings.
NHS Ayrshire and Arran required £23 million in loan funding, known as brokerage, from the Scottish Government to cover cost pressures. Additional loan funding from the Scottish Government will also be needed this year, with a projected shortfall of £22.4 million.
The report says that the board will not be able to balance its budget by 2020/21 and it has no plans to repay the loans to the Scottish Government. It needs to implement its Transformation Change Improvement Plan and act on the recommendations of an external review.
NHS Highland also required a loan of £15 million from the Scottish Government in 2017/18, with an expected funding gap of between £19 million and £23 million in 2018/19. The Board is producing a longer-term recovery plan, but the report expresses serious concerns about its ability to deliver planned savings and achieve a balanced budget by 2020/21.
Auditor General Caroline Gardner said:"Both NHS boards face significant financial challenges, and I have serious reservations about their ability to make the changes that are needed to achieve financial balance in future."
The Auditor General reports on the overall financial health and performance of the NHS in Scotland later this month.
Worrying conclusion to the report -
30. The board estimates it will require brokerage of between £19 million and £22 million in
2018/19, and it is increasingly likely that it will need further brokerage beyond 2018/19 to
support the board to achieve in-year financial balance over the next three financial years.
31. Given the factors outlined above, there is a significant risk that NHS Highland will not achieve
all planned savings in 2018/19. The board faces continuing challenges that the savings
identified and delivered will be one off in nature contributing to the long term difficulties in
ensuring financial sustainability.
32. The agreement of the financial recovery plan with the Scottish Government will be critical
given the scale of the pressures facing the board alongside longer term service redesign.
Recognising the board's current capacity, it is difficult to foresee the board achieving a breakeven financial position within the three years planned. In particular, service redesign and new models of care will be required which will take time to consult on, and then implement.
33. It is important that the board puts in place an action plan accompanied by the necessary capacity and resources to deliver it, in order to address the issues the board are facing, whilst
recognising that the necessary change will take time to implement.
34. Stability in the future leadership of the board will be required to deliver the financial plans and strengthen wider governance and it is anticipated the financial challenges the board faces will deteriorate before improvement can be achieved.
See the full reports at -