Scottish NHS faces 'unprecedented pressures'

The budget for the NHS in Scotland is forecast to contract for six consecutive years, says the auditor in a report published on 16 December. Accounting for inflation, by the end of 2015-16 it will have fallen by £4.8bn below its 2009-10 level. In addition to this cumulative fall of 16.1%, the NHS will continue to face growing demand for its services. Robert Black, the auditor general for Scotland, said that NHS bodies have already had to find significant savings to balance their budgets and will need to find even more to continue to do so in future. The document outlines measures taken by NHS organisations to realise savings. They include delivering services in new ways, such as providing improved facilities in a single location; better management of resources and monitoring of unit costs; and improving procurement by using standardised products and central contracts. Over recent years the NHS in Scotland received substantial budget increases: between 2001-02 and 2009-10 its funding rose by 38% in real terms. In 2009-10 it spent £10.8bn, about a third of total public sector spending in Scotland. But in the current financial year NHS organisations are forecasting that they will need to achieve £274m of savings, 36% more than they delivered in the previous year. "The health service is taking action to meet the longer term financial challenges," said Black. "But for these to be successful, it needs good workforce planning, better information on costs, quality and activity, close partnership working and sound leadership." Victor Almeida, senior analyst at Kable, said: "The situation represent a near insurmountable challenge to the NHS in Scotland, where sickness rates are generally higher than in England. "Modernisation through ICT is still very limited in Scotland – for example, little progress has been made on electronic patient records, except for emergency data. And unfortunately, this means that efficiency savings and increased productivity could be even more difficult to achieve."