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Report questions NHS Highland's capacity 'to bring about necessary changes'

By Scott Maclennan

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AUDIT Scotland has released a damning report calling into question NHS Highland’s capacity to make urgent and major changes it believes are required.

The report by the Auditor General for Scotland, Caroline Gardner, stated that balancing the budget by 2021/22 appears unrealistic based on the board’s past record in identifying and delivering savings targets.

In April, the board needed £18 million from the Scottish Government after it missed a target to cut more than £50 million.

Audit Scotland said the authority faces high levels of vacancies in key clinical posts that are driving up the costs of locums, which leapt by close to £1 million in the past two years.

Bullying was also considered an issue because responding to the Sturrock report into allegations of harassment of staff will demand “considerable time and resources” to bring about the change to improve engagement, openness and transparency throughout the organisation.

Ms Gardner said: “The scale of changes needed are such that the board is unlikely to become financially stable in the next two years. Given the board’s past record in addressing problems, and the current leadership and organisational difficulties it faces, I am concerned about its capacity to bring about the necessary changes.”

A spokeswoman for NHS Highland said it was aware of the significant challenge it faced in delivering financial balance over a three-year period and in continuing to deliver safe, quality services, adding it was taking steps to address the situation.

The scale of changes needed are such that the board is unlikely to become financially stable in the next two years.

Highlands and Islands Labour MSP David Stewart said it was worrying that "the board is not in a good position to address challenges in the timescales set out".

He said: “The health authority has a recurring problem with making the amount of savings demanded by the Scottish Government and now it has to find the extra resources to meet the Sturrock recommendations. This leaves it in a very exposed position for the future without more help from the Scottish Government."

Mr Stewart, who is also Scottish Labour’s shadow minister for public health, added: “The level of unfilled vacancies puts terrible stress on remaining frontline staff and the cost of locums continues to rise. Long-term solutions are required but those need extra government resources.”

Highlands and Islands Greens MSP John Finnie said: “I am concerned by the Auditor General’s comment that she does not believe NHS Highland has capacity to bring about the necessary changes.

“My constituents deserve a quality service but there is a real risk that, without change, they won’t receive this in the face of ‘complex and ongoing problems."

Raigmore Hospital in Inverness is the biggest hospital in the area covered by NHS Highland.
Raigmore Hospital in Inverness is the biggest hospital in the area covered by NHS Highland.

“The Scottish Government must commit to supporting the board as it engages in a process of redesigning services, ensuring that local communities and committed staff are at the heart of discussions on any proposed service changes.”

According to a spokeswoman, the health board is undertaking “an ambitious programme of sustainable financial improvement measures is well under way with savings of £22 million identified for 2019/20.

“Importantly, approximately 80 per cent of our savings are recurrent in nature which provides us with a very solid platform for 2020/21 when our financial improvement programme will continue to focus on recurrent, sustainable change aimed at reducing our overarching deficit. Renewed efforts to address long-standing cost pressures with adult social care, prescribing and locums.

“NHS Highland has recently commenced the development of its Clinical and Care Strategy which will identify opportunities for service redesign and transformational change across our services, responding to recommendations in the Sturrock report and providing an opportunity for further, sustainable financial improvement to add to the current change programme.

“At the same time as this programme of sustainable financial improvement is planned and implemented, NHS Highland continues to face very significant one-off cost pressures which it is working hard to contain.

“Improvements to our financial and budgetary controls and empowerment of our frontline staff to manage budgets are steps we intend to take to minimise these cost pressures in future.

“NHS Highland is hopeful of achieving its ambition of achieving financial balance in 2021/22 but again, acknowledges the very significant challenge this presents.​”

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