Scottish Government control of NHS Tayside has been ‘de-escalated’ today after more than two years, following issues with finances, governance and mental health provision.
Holyrood placed the health board into its highest level of escalation in April 2018, which only occurs if ministers feel any functions are not being exercised adequately.
Thursday’s decision relates to the board’s financial position, governance and leadership, along with mental health performance.
Cabinet Secretary for Health and Social Care Humza Yousaf confirmed the change.
Government loans since 2012
NHS Tayside had to rely on loans from the Scottish Government – known as brokerage – to balance its books each year since 2012.
Dundee City East MSP Shona Robison, who was health secretary at the time, previously announced the drastic steps following reports that bosses at the health board plundered more than £2.7 million from donated funds to plug their ailing finances in April 2018.
A huge chunk of the cash, typically used to fund patient comforts or furnish day suites for families, bankrolled “digital healthcare” after a financial deficit was discovered in NHS Tayside’s 2013-14 balance sheet.
Professor John Connell and Lesely McLay resigned as chairman and chief executive after the revelations, with Ms Robison demanding the change in leadership.
In December 2020’s Audit Scotland report, it was noted that it was the sixth consecutive report that has been provided to the Scottish Parliament, and that
“previous reports have highlighted a series of significant concerns, covering financial, performance and governance issues”.
It read: “In April 2018, due to continued concerns over financial sustainability and
weaknesses in governance arrangements, the Scottish Government moved NHS
Tayside to level 5 of its NHS performance escalation framework – the highest level.
“NHS Tayside’s financial position has been challenging since 2013/14. Additional
financial support has been required in each of the last eight financial years from the
Scottish Government to achieve in-year financial balance.”
‘A major milestone’
A spokeswoman said today: “Today marks a major milestone for NHS Tayside and its staff with the announcement by the Scottish Government that the board is being de-escalated in the NHS Scotland performance escalation framework.
“This is in recognition of the significant progress and achievements made over the past two-and-a-half years and means that NHS Tayside has moved from level 5 in February 2019 to level 2/3 today.”
Today’s announcement means there is no longer any “formal escalation status” for the board, aside from additional support from the Scottish Government mental health policy team in delivering a formal recovery plan for mental health performance.
In relation to finances, governance and leadership, locally-led plans will be implemented.
‘Renewed confidence in services we deliver’
The existing Scottish Government oversight board will also now be wound up.
Chairwoman of NHS Tayside, Lorna Birse-Stewart, said: “NHS Tayside Board and staff at all levels have worked tirelessly to write a new chapter of recent history for NHS Tayside; one in which upper-end performance is the norm, compassionate care is delivered day in, day out, and people have renewed confidence in the services we deliver.
Emergency department targets
“It is very important that everyone knows that these successes are not a one-year, one-off achievement. The board has now moved to financial balance and is operating within the level of funding available to it but, even more importantly, service delivery has also improved in key areas such as cancer waiting times and Child and Adolescent Mental Health Services (CAMHS).
“We have also maintained our top spot in the UK for four-hour emergency department targets.
“It really is significant to look back and see what our teams have delivered over the past two to three years – notwithstanding the extraordinary efforts in the local response across Tayside to the pandemic and the ongoing vaccination programme.
“Our teams are now stepping up again as we remobilise more services to ensure we continue to deliver excellent care and treatment to the people of Tayside and we are extremely proud of them and continue to be grateful for all the work they do.”
Grant Archibald, chief executive, added: “Today marks a significant milestone for NHS Tayside, one which would not be possible without the hard work and commitment of our workforce and I would like to thank them for their unrelenting efforts.
“As well as the progress which has been recognised in leadership, governance and financial performance, I am very pleased that the efforts of our mental health workforce as they deliver care in hospital and out in our communities have also received recognition from Scottish Government.
“Mental health and learning disability services remain a priority for the board – and there is much work still to do – but we move forward knowing we are heading in the right direction for our patients and their families and carers and we stand alongside our staff.”