NHS Shetland makes budget cut challenge

NHS Shetland managers have been asked to consider how they would slash their budgets by 10 per cent, as the organisation grapples with ongoing financial problems.

In a newsletter to staff, chief executive Ralph Roberts has issued the “10 per cent workforce challenge”, requiring managers to see how they could make a 10 per cent financial saving. This could mean fewer staff – although the board has a policy of no compulsory redundancies – or staff on a different pay grade within a department. Staff costs account for 70 of expenditure.

But in any case: “We will all need to recognise that we can’t afford to provide the same service in the same way for ever.”

It could also mean changes to the way in which services are delivered.

Mr Roberts said that although NHS Shetland would meet its financial targets this year, in the medium term it is not sustainable. The board’s five-year financial plan requires it to make around £6 million-worth of “recurrent”, or permanent, savings, but this is difficult in the face of “pressures” such as pay awards and increases in drug and energy costs.

The board, he said, has a “significant ongoing financial challenge”.

He continued: “With over 70 per cent of our local costs in staffing, it is inevitable that we have to look at our workforce if we are to achieve the level of savings required…

“We understand this is not easy to do and this is not about asking existing staff just to work harder. We are therefore looking for managers to identify what else would need to change to allow these workforce savings to be delivered, and what the risks [would be] to service areas where either no or only a smaller change is possible, but it is important we assess that in as fair and equitable a way as possible.

“We may also need to invest in some places, perhaps in training, equipment or numbers to allow a bigger change somewhere else.

“We also recognise that in Shetland, where we have many very small or single-handed services this can be harder than in a large service.

“This will then allow us to make sensible medium term decisions about the workforce. We will also need to take into account the ‘No Redundancy’ policy in place across NHS Scotland and therefore any proposed changes will need to take into account how quickly any departments will change through staff turnover and retirements.”

He stressed that if staff reductions meant a diminished service: “we will need to make an explicit decision that that is something it is appropriate to do for that service.”

Mr Roberts encouraged as many staff as possible to be involved in the “complicated” piece of work so that the “best possible” decisions could be made about the future workforce. Work carried out so far will be collated next month, and will be continued over the summer.