Chairman’s challenges

Professor John Connell, NHS Tayside chairman, offers his perspective on some of the issues contributing to the health board’s cash crisis.

We have already done much work to understand where we should focus our attention and we have now identified key areas that need to be addressed as we transform healthcare in Tayside, including:

Too many patients are in acute hospital or other NHS beds awaiting suitable community-based solutions for continuing care.

Aside from the distress this causes patients and their families, the added cost of this diverts resources from other key areas.

In the last two months, this has increased the expenditure in Tayside by approximately £500,000, and it is easy to see how this impacts on the health service budget over a year.

Another cost pressure relates to prescribing, but we need to recognise that in some instances spending today may save costs in the future.

For example, Tayside’s expenditure for treating viral hepatitis is higher than other comparable regions in Scotland, but the impact is fewer patients go on to need liver transplants, which is very good for patients, and will save resources in the long term.

I am certain that our clinical staff have made the correct choices in focusing on preventing and treating conditions that will ensure that patients from Tayside have good outcomes.

Finally, we undoubtedly spend too much on employing agency staff either to fill gaps that occur due to problems with recruiting to some posts or to cover short-term, unplanned absences.

We are working hard to improve recruitment and retention of all grades of staff.

I am clear that our staff are our most important asset and we must do everything we can to support them.

The board of NHS Tayside has some difficult decisions ahead – and I can assure you all that these will only be made after widespread consultation and discussion across our communities.

It is clear that we cannot meet every expectation, but a clear principle has been that we will seek, at all times, to protect important services, such as our emergency department waiting times.

Our clinicians are absolutely committed to sustaining high-quality service delivery; however, they are also very keen to ensure that Tayside receives its fair share of national resources to protect health services.

At present our budget allocation is some way short of what would be provided based on the formula that is agreed by the Scottish Government and, therefore, the board is pressing for this to be revised to ensure a fair allocation is available to support health and wellbeing in Tayside.