NHS High­land told to save £100 mil­lion

The Oban Times - - NEWS -

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.’

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