NHS Scotland needs fundamental change to remain viable, says financial watchdog

A new report into the performance of NHS Scotland from Audit Scotland has warned that the pressures of increasing demand, growing staff vacancies and rising costs mean that ‘the NHS will not be able to continue to provide services in the way it currently does’.

The report warns that NHS boards are already struggling to meet HEAT targets as a result of increasing pressures on the NHS and that ‘fundamental changes and new ways to deliver healthcare in Scotland are required now’.

The report points out that rural health boards in particular are struggling to attract and retain employees.

As a result they have to pay inflated prices for temporary staff. Whilst it costs an average of £15.62 an hour for an internal ‘bank’ nurse, employing a similar nurse from an agency costs £42.97. In Shetland, the cost per hour is £84.05.

The report also says that the health budget as a whole has decreased slightly since 2008/9 by 0.7 per cent once inflation and capital spending is taken into account.

Health boards - which are responsible for most frontline services - received a slight increase of 1 per cent, but not enough to keep pace with cost pressures.

The cost of drugs alone rose by 4 per cent and is expected to rise by 5-16 per cent in future.

Auditor General for Scotland Caroline Gardner said: “We have highlighted concerns around targets and staffing in previous reports.

“These have intensified over the past year as has the urgency for fundamental changes such as introducing new ways to deliver healthcare and developing a national approach to workforce planning.

“It is important that the Scottish government and health boards work closely together to help alleviate these pressures and also increase the pace of change necessary to meet its longer-term ambitions.”

Responding to the report, Chair of BMA Scotland Dr Peter Bennie said: “The overriding message that must get through from this report is that substantive and realistic action is needed if our health service is to cope with the rapidly increasing pressures it is facing.

“As the report makes clear, increasing numbers of people are living longer lives however the amount of time that they will spend in need of support from the NHS is also growing. The NHS in Scotland is already coming under real strain as a result of these growing demands, continuing constraints on resources and increasing unfilled medical posts.

“These challenges must be tackled now if patients are to continue to receive the level of care that they need in years ahead.”