NHS Highland told to save £100 million

THE NHS Highland board was told on Tuesday that it has to make ‘unprecedented’ reduction in costs of around £100 million over the next three years.

During the board meeting, finance director Nick Kenton said that a ‘more of the same approach’ is not going to be sustainable and, therefore, that the current model of care that NHS Highland delivers needs to be changed, and it needs to change urgently.

Both NHS Highland chief executive Elaine Mead and employee director Adam Palmer said that NHS Highland staff and management will have to work hand-in-hand together to help transform healthcare delivery to ensure it is ‘fit for purpose’ in the future.

Aside from financial challenges some of the current models cannot be staffed without significant locum costs and there is an over-reliance on costly hospital and institutional care.

Previously Mr Kenton had outlined that the board needed to reduce costs of around £20 million in 2017/2018.

However, this target has now been revised to £ 50 million. And over the next three financial years from 2017 to 2018 the requirement outlined by the Scottish Government’s draft budget is likely to be in the region of £100 million.

He said: ‘This is an unprecedented scale of change and it is clear that a “more of the same” approach is not going to deliver a balanced plan and, therefore, the model of care needs to be changed.

‘There needs to be a mindset that focuses on delivering maximum value within our total £ 800 million resources rather than focusing on the margins.

‘Although the scale of the challenge is daunting, the changes required across NHS Highland are consistent with the Scottish Government’s recently published Health and Social Care Delivery Plan, which builds on the National Clinical Strategy (February 2016) and the move towards realistic medicine as set out in the chief medical officer’s annual report for 2014/15.’

NHS Highland chief executive Elaine Mead sent an email to staff recently about the need to fundamentally change the models of care.

She said: ‘More of the same is no longer an option. While it is true that we have had uplift in our funding in this and previous years, our increasing costs and demands mean that we will need to significantly reshape the way that we deliver services.

‘ We have already started this, and I do believe we are well placed to now radically transform our services.

‘Our current complex, expensive and often institutional-based models of care can no longer deliver the timely high quality of care that we all rightly aspire to provide. Therefore, it is clear that we will need to change, and change quickly to meet the needs of our aging population.’

NHS Highland employee director and Unison representative, Adam Palmer, said while the challenges from these efficiency targets appear formidable, they are not insurmountable. He said current employment frameworks are in place and a willingness to co- operate on both sides should help enable the necessary changes required.

He said: ‘We are all becoming aware of the fact that the future is increasingly challenging for NHS Highland. Not only is there is a financial gap to bridge – both as this financial year closes and for next year – but the board also has to deal with the pressing problem of changing demographics in our area and an ageing workforce.’

Meanwhile, Mr Kenton told the board that the baseline uplift in resources for 2017/18 is 1.5 per cent, which represents an increase of £ 8.7 million on the board’s baseline allocation.

He said: ‘This excludes a wide range of other allocations such as primary care funding which are allocated separately. This is £1.7 million lower than we had originally planned on; across Scotland, boards had been planning on a 1.8 per cent uplift.’

A spokesperson for NHS Highland added: ‘While NHS Highland has taken significant strides in recent years to implement new models of care to address the increasing demand and a changing workforce, such as redesigns in Badenoch and Strathspey, Skye, Lochalsh and South West Ross, the north coast of Sutherland and the board’s out-of-hours service, the pace of change has been slow. The board has set a clear direction of travel but the real challenge now is how quickly can changes be made in partnership with all stakeholders.’