Fife Health and Social Care Partnership chief warns of £34m budget gap

A report to members of the Fife Health and Social Care Partnership’s IJB board said the predicted deficit for the next three years had been driven by continued growth in demand, rising complexity of need and national pressures affecting health and social care systems across Scotland.

Transformation of services is planned to help balance the books with a redesign of models of care and a shift in provision from hospital and bed-based care to prevention and community pathways.

Workforce models are to be modernised while digital and technology-enabled care will also be introduced.

Along with this, targeted efficiencies will aim to reduce cost, increase productivity and modernise service delivery.

Chief Finance Officer Tracy Hogg said financial pressures continued despite previous savings.

“The cost of continuing to deliver services, even with anticipated funding uplifts, does not keep pace with these pressures,” she stated.

“The main cost drivers include pay inflation, rises in provider costs, pharmaceutical pressures, and demographic change, all of which continue to escalate year-on-year. Funding contributions from NHS Fife, Fife Council and national allocations contribute, but are insufficient to fully offset these pressures.

“The choices ahead are not easy, but by working together and maintaining a clear focus on what matters most, we can create a more resilient and person-centred system for the future.”

NHS Fife’s Medical Director, Chris McKenna, acknowledged it had been an “extremely difficult budget” to bring together and voiced his fears to fellow board members.

“I am concerned about quality and safety and the impact that the additional savings target place across the top of this could bring because we have not detailed where that is going to come from,” he said.

“I would hope we monitor extremely carefully against the harms that could come as a result of focusing too heavily on requirements to save money and not on the requirements to keep people safe and ensure their needs are met.

“Up until now, we have been able to do that. This budget pushes this a little further than we have previously done and the IJB needs to be really content with that as we move forward and monitor very, very carefully the impact of the budget that we agree today.

“It is just a word of quiet caution that we keep a very close eye on quality and safety and the impacts for people.”

Councillor David Alexander was more hopeful.

“We are where we are,” he said. “I think it is going to take us two or three years to balance where we are but I think we are going to do it.”

Councillor Rosemary Liewald said she had been assured that they will get to where they need to.

“Some of the proposed savings are going to be difficult. We know that,” she said. “We cannot deny it would be better to bring us back in line and to balance the books.

“We were given the confidence and assurance that this is exactly what we are working towards. My hope is things will get better.”

Board member John Kemp was another with concerns.

“I would support this budget – I am not sure there is a huge number of alternatives anyway but I am not sure I share the optimism of others,” he said.

“This is a really tricky budget. While we are developing a good track record in implementing savings, this year includes management actions or savings of £3m before we start.

“I think it is going to need extremely careful monitoring. The quicker that we in the IJB and partner bodies are aware of what is happening with implementation of the budget, the better It is easier to fix these things if you do them earlier rather than later.”