NHS Shetland faces “huge” financial challenge as it looks to next year’s budget

NHS Shetland faces a “huge” financial challenge as it looks to save around £4.7 million from its budget and continues to wrestle with costly patient travel fees.

Members of the health board were discussing the 2017/18 books this morning, with another meeting planned on Friday to see where money can be saved.

NHS Shetland chief executive Ralph Roberts said the organisation was due to break even this year, though next year the board would have to find efficiencies.

The meeting heard rising drug costs, patient travel, staff fees and receiving less money from the government had led to increasing financial pressures.

Finance chief Colin Marsland told members some savings had been identified, though to meet the £4.7 million saving, there remained around a £2 million shortfall.

Mr Roberts the £4.7 million figure equated to 10 per cent of the health board’s core funding. which was “a huge challenge” and meant it would have to look at redesigning services.

That, he said, was “a huge challenge” and meant it would have to look at redesigning services.

The health board spends about £2.9 million on patient travel, accounting for about six per cent of its core budget.

Talks are underway as health bosses continue to tackle transport costs, and the board was told more was being done to keep oncology and haematology appointments in Shetland.

Plans of how to cut patient travel costs are due to come before NHS Shetland members next month.

Among the ideas is to work more closely with Red Cross staff to escort patients, have better communication with staff at NHS Grampian when it came to appointments, and provide more care in Shetland.

The board discussed feedback it had received from patients and an instance where a patient travelled to Aberdeen for a blood test.

SIC convener Malcolm Bell welcomed a delay in the patient travel paper, as there was a chance to “add meat to the bones” and find out why costs had increased.

Medical director Roger Diggle said in the longer term introducing “more generalists into the medical fraternity” rather than having lots of specialists, would help the problem.

“The new junior doctor training, for consultants in particular, is being rolled out in 2018. But that’s going to take somewhere in the region of six to ten years to develop a new breed of generalists.

“I think that will help to reverse some of the trend,” he said.

Dr Diggle said systems had to be developed “which proactively address the problem”.

“We need to be doing this in real time, that’s the hardest part.”

Afterwards, Mr Roberts explained the board would have to look how much money went on staff.

“We’re going to end up spending less on staff and the workforce than we are at the moment,” he said.

With the financial squeeze, Mr Roberts said “it’s about changing the way services are delivered and that might be looking at a different skill mix and looking at a different distribution of skills across Shetland.”

Asked if savings would mean staff cuts, he replied: “The logical conclusion is there will be fewer staff at the end of the process than there are now.”

“There could be fewer in some places and there might be more in others,” he said.

“There might be a different range of staff and different types of staff.”