Row over charges set to impact HSCP deficit

Health chiefs in Argyll and Bute are facing an overspend of more than £5 million if they cannot reach agreement with a neighbouring board for the provision of services.

The Argyll and Bute Health and Social Care Partnership (HSCP) has reported that nearly £500,000 of further savings have been identified as it looks to bridge its budget gap.

A forecast overspend of just under £4m has been quoted in papers for a meeting of the partnership’s integration joint board (IJB) on Wednesday March 27.

A report by interim chief financial officer Kirsty Flanagan warns that the figure is set to rise by £1.2m due to failure to secure a service level agreement (SLA) with NHS Greater Glasgow and Clyde (GGC), where many patients from Argyll and Bute receive treatment. In a report to the IJB, the partnership’s interim chief financial officer Ms Flanagan says: ‘The forecast out-turn position for 2018/19 is an overspend of £3.929m. I am pleased to report that this is an improvement of £0.469m on the position reported at the end of December 2018.

‘The most significant issue affecting the forecast out turn position for health is the SLA for Greater Glasgow and Clyde.

‘Due to the short time between now and the financial year end to resolve this issue, it is more than likely that the estimated overspend will increase by £1.2m.

‘Within health-delivered services, the forecast overspend is £1.156m.

‘The overspend is mainly in relation to savings not being achieved in addition to increased costs for oncology drugs, pharmacy costs, patient referrals, and agency/ locum staff.

‘Within social work, the forecast overspend is £2.773m. There has been higher demand than budgeted for supporting living and care home services within learning and physical disability and children’s external placements, as well as planned savings options within these services not being delivered in full.

‘There are underspends within older people care home placements, investment fund, foster care services and supporting young people leaving care that help to reduce the overspend.’

But while the partnership’s parent health board, NHS Highland, has stated that their share of the overspend will not require to be repaid, Argyll and Bute Council will look for its money to be returned.

Ms Flanagan continued: ‘NHS Highland has confirmed that the brokerage from the Scottish Government will cover the 2018/19 health overspend and this will not require to be repaid.

‘The 2018/19 social work overspend will require to be repaid to Argyll and Bute Council and following the final out-turn position, negotiation will require to take place with Argyll and Bute Council as to the pay-back arrangements.’

The impasse with NHS GGC is being predicted after a decision taken at the IJB’s meeting in November.

Board members decided to reject a proposed charge by GGC for the SLA, and with the end of the financial year approaching, the position looks increasingly unlikely to be accepted.

Ms Flanagan’s report says that, following guidance on outstanding balances with NHS Scotland bodies, NHS Greater Glasgow and Clyde could show the full amount of any disputed charge.

But this would not be interpreted as acceptance of the charge by the HSCP, or agreement to pay it.

‘The most significant issue affecting the forecast for health is the SLA for Greater Glasgow and Clyde’