Personal protective equipment (PPE) cost Fife's health board £6.3 million after the Covid outbreak presented a new challenge to safety.

Worldwide demand grew dramatically and prices doubled, with 1.1 billion items distributed by NHS National Services Scotland between March 2020 and April 2021.

In the last financial year more than £1.2m was also spent in Fife on testing kits with expenditure increasing significantly for the board.

A total of £53m was specifically spent on Covid measures such as staffing, equipment and vaccinations, while £20m of this was also transferred to Fife Health and Social Care Integration Joint Board.

Despite the financial challenges, NHS Fife finished the year with a small surplus but that was largely down to a £10m boost of additional funding from the Scottish Government.

Patricia Fraser, from Audit Scotland, presented an annual report to the NHS Fife board last week.

She said: "You will see throughout the report the theme of Covid is reflected.

"We have noted that NHS Fife has a plan for one year going forward and there is a budget gap identified of £22m.

"It's assumed that this will be met by the Scottish Government but we recommend that NHS Fife has a contingency plan in case it's not met."

Audit Scotland highlighted the increase in staff costs with a 19.4 per cent staff turnaround in 2021 – described as "quite significant".

Ms Fraser credited the health board's work on the their accounts during the audited process in an "exceptional year".

Margo McGurk, director of finance & strategy at NHS Fife, said: "We have seen the clear impact of Covid.

"I am pleased the board met all of its key finance targets.

"But we have seen a very significant increase in staffing costs."

In quarter one of 2021 NHS Fife received £11.6m of Covid funding from the Scottish Government which covered all of the board's costs.

The overall capital budget is anticipated to be £25.3m.

The majority of this, £18.1m, relates to the new elective orthopaedic centre at Victoria Hospital and the board is on track to spend the allocation in line with that funding level.

Ms McGurk added: "There have been a number of issues with supplies and the cost of materials which is not just a problem in Scotland.

"But we have put in some mitigation to try and avoid delays.

"Right now things are on track."