News / Tough challenges await Scottish health boards

According to the auditor’s annual report, although services had improved, funding was not keeping pace with demand. The total health budget in 2015/16 was £12bn, a real-terms increase of 2.7% on the previous year, yet many boards had to use short-term measures to break even.

Costs were rising – drug costs increased by 10% between 2012/13 and 2014/15, for example. The boards delivered savings of £291m in 2015/16 and plan to save £492m in the current financial year – an average of 4.8% compared with 3% in 2014/15.

The report also highlighted staff issues. It said the NHS had an ageing workforce and experienced difficulties in recruiting and retaining staff in some areas. Boards were spending more on agency staff – agency nursing and midwifery spending increased by 47% compared with 2014/15. Agency doctor spending rose by a third.

The auditor recommended the Scottish government consider giving NHS boards greater financial flexibility. For example, three-year rolling budgets rather than annual financial targets would facilitate longer-term planning.

It added that the government should model the cost of its clinical strategy and how it will be funded, including the capital investment that will be needed.

It should share best practice on health and social care integration, including governance and budget-setting.

Auditor general Caroline Gardner (pictured above) said major challenges lay ahead for the NHS in Scotland.

‘The Scottish government has had a policy to shift the balance of care for over a decade, but despite multiple strategies for reform, NHS funding has not changed course,’ she said.

‘Before that shift can occur, there needs to be a clear and detailed plan for change, setting out what the future of the NHS looks like, what it will cost to deliver and the workforce numbers and skills needed to make it a reality.’