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Auditors have warned that one Scottish health board is facing significant financial challenges, while another must revamp its health and social care system to achieve financial stability. Auditor General Stephen Boyle expressed concerns about NHS Ayrshire and Arran’s ability to achieve financial sustainability, as the board required a £51.4m loan in 2024/25 to break even. With a projected deficit of £33.1m for the current year, the health board lacks a clear strategy for attaining financial sustainability. Likewise, a separate report on NHS Grampian emphasized the need for a major overhaul of its health and social care system to restore financial balance.
NHS Ayrshire and Arran has accumulated loans amounting to £129.9m, the highest in Scotland’s NHS. Additionally, the health board overspent by £14m on temporary staff, exacerbating its financial woes. The severity of the financial challenges facing the board was described as unprecedented by Mr. Boyle, who cautioned against overly optimistic savings plans that may not be feasible. The reliance on non-recurring savings in 2024/25 has only increased future financial pressures, with performance falling behind the current delivery plan targets.
The Scottish government rejected NHS Ayrshire & Arran’s proposed savings plan, citing insufficient improvement in the board’s financial position for 2025/26. Despite a directive to submit an updated plan in June, the external auditor did not receive it. The report highlighted issues such as high costs associated with temporary staffing and mixed performance against national waiting time standards, including A&E attendees being admitted, transferred, or discharged within four hours, falling well below the national 95% standard.
As the reports underscored the financial pressures faced by NHS Grampian, the health board was urged to develop a financial recovery plan promptly. The move to stage four of the NHS Scotland framework underscored the urgency of addressing the board’s financial challenges and bridging the financial gap over the medium term. Laura Skaife-Knight, the newly-appointed chief executive of NHS Grampian, acknowledged the challenges outlined in the report while expressing a commitment to collaboratively develop an improvement plan. Scottish Conservatives health spokesman Dr. Sandesh Gulhane raised concerns about the broader crisis affecting health boards in Scotland, calling on the government to streamline operations and allocate resources more effectively towards frontline medical services
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