Stalemate in Argyll & Bute/ Glasgow health boards payment row

Health chiefs in Glasgow have insisted they won’t back down in a row with their Argyll and Bute counterparts over service charges.

The Greater Glasgow and Clyde board treats patients living in Argyll and Bute at its hospitals in Glasgow, Paisley, Greenock and Alexandria – and charges the Argyll and Bute health and social care partnership (HSCP) accordingly, under a ‘service level agreement’ (SLA).

But HSCP officials in Argyll and Bute have insisted they will not pay more than the minimum under that agreement unless activity in Greater Glasgow and Clyde (NHSGGC) increases.

Kirsty Flanagan, the HSCP’s interim chief financial officer, told members of the partnership’s joint board  that the dispute over payment of more than £1 million to NHSGGC remains a “significant financial risk” to the HSCP.

But NHSGGC insists its charges are “fair, equitable and consistent”. A spokesperson said: “We treat patients from a number of different geographical board areas including the board that covers the Argyll and Clyde area. We therefore need to recoup the costs of treating patients from other areas.

“We do this proportionately and consistently, to ensure that each board pays its fair share of the costs for the services that it accesses and that there is no cross-subsidisation of costs amongst boards.

“Argyll and Bute HSCP’s proposal is to pay £1.1m less than the cost of providing the services.  This would leave a shortfall to be picked up by NHS Greater Glasgow and Clyde.

“NHSGGC’s allocation from the Scottish Government’s health and social care directorates is not designed to subsidise shortfalls in payments from other board areas. Therefore, it is not acceptable for the service level agreement value to be less than the associated costs.

“We feel that the charges we have proposed are fair, equitable and consistent.  They simply cover the cost of services provided.

“We appreciate that boards are under financial pressure, but it is not appropriate to underpay service level agreement charges as a way of addressing that pressure.

“NHS Greater Glasgow and Clyde is not able to agree to a service level agreement value which does not cover the costs of providing services to Argyll and Bute HSCP’s residents.”

Ms Flanagan said in a report for the HSCP’s integrated joint board: “The most significant risk for the 2019/20 position is the contract with NHSGGC that is currently in dispute. With intervention from the Scottish Government, it was agreed that the brokerage given to NHS Highland would cover the disputed costs for 2018/19, and that there would be collaborative work with other health boards who have an SLA with NHSGGC on a new funding model for 2019/20 onwards.

“We have been clear that if activity levels for 2019/20 do not increase from the 2018/19 levels, then we will not pay more than our 2018/19 SLA offer plus inflation.

“Further information on the ongoing negotiations will be brought back to the board for approval. This remains a significant financial risk for the IJB.”