Struggling NHS Scotland boards still facing 'significant' challenges, warns spending watchdog

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Two struggling NHS boards are still facing "significant" challenges, Scotland's public spending watchdog has warned.

NHS Tayside had to be bailed out with £17.6 million of Scottish Government cash in 2018-19, the seventh year in a row it has required such help.

NHS Tayside's financial position has been "unsustainable" since 2013-14, Audit Scotland found, Picture: JPIMedia

NHS Tayside's financial position has been "unsustainable" since 2013-14, Audit Scotland found, Picture: JPIMedia

Meanwhile NHS Highland, which is also the subject of bullying allegations, required £18 million of brokerage funding.

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Audit Scotland said while NHS Tayside has plans in place to break even by 2021-22 it still faces "significant financial challenges".

The public spending watchdog further raised concerns about NHS Highland - which also aims to break even by 2021-22 - with Auditor General for Scotland Caroline Gardner saying this "appears unrealistic".

A new report noted while the health board had identified £50.5 million of savings as being required in 2018-19, it had only achieved planned savings of £26.6 million.

Labour health spokeswoman Monica Lennon said the "scathing reports" from the public spending watchdog "hold up a mirror to the SNP's reckless management of the NHS".

She said: "Health boards have become dysfunctional and the Audit Scotland assessment of Tayside and Highland is extremely worrying."

NHS Tayside's financial position has been "unsustainable" since 2013-14, Audit Scotland found, with the report highlighting its higher operating costs compared with other Scottish health boards.

Staffing levels in the area have historically been higher per head of population, with in-patient costs also greater than other boards, as well as higher prescribing costs.

Last year, the board overspent by £6.9 million on acute services - with £2 million relating to increased nursing and agency costs and £1.7 million linked to prescription costs, the report said.

Audit Scotland noted NHS Tayside had "failed to meet the majority of its national service targets in 2018-19".

It said "effective leadership" would be critical in making the changes required, with the report noting "concerns that several key vacancies are still to be filled".

While a transformation plan has been put in place by the health board, Ms Gardner said "moving away from the current ways of working will be difficult without well-developed and detailed implementation plans".

She concluded: "The future is challenging for NHS Tayside. Effective and stable leadership will be critical in bringing about long-term service transformation."

In NHS Highland, Audit Scotland reported overspends on drugs and adult social care had contributed to the board's failure to meet its financial targets.

The report also told how "high levels of unfilled vacancies in key clinical posts in primary and secondary care resulted in a reliance on locum staff" - with the bill for this rising from £14.9 million in 2017-18 to £15.6 million in 2018-19.

Ms Gardner said: "NHS Highland urgently needs a clear and achievable plan to redesign services.

"This must go beyond the series of short-term fixes we have seen in the past.

"Longer-term planning is critical in ensuring it can continue to deliver the services needed by people living across the NHS Highland area."

She added: "The scale of changes needed are such that the board is unlikely to become financially stable in the next two years.

"Given the board's past record in addressing problems and the current leadership and organisational difficulties it faces, I am concerned about its capacity to bring about the necessary changes."