Difficult decisions lie ahead for Fife’s health and social care service as it faces a £20 million black hole.
A warning was issued that cost-cutting measures previously ruled out would have to be revisited as Fife’s Health and Social Care Partnership attempts to bridge its budget gap.
Workforce and service redesign and medical and efficiency savings will be considered by the integrated joint board of NHS Fife and Fife Council as it attempts to balance the books.
Director Michael Kellet forecast “challenging territory” as he admitted that significant overspend this year had been partly to tread water as well as improve services for patients and clients.
Prediction of the £20m gap between the costs of providing care during 2017/18 and the funds provided by NHS Fife and Fife Council comes on the back of an expected £12m overspend for this financial year, which is to be plugged by both authorities.
Mr Kellet said divisional managers had been charged with producing proposals to cut costs and that difficult issues would need to be considered.
He said: “It is inevitable we are going to have to go into tricky and challenging territory and that some of the issues the integrated joint board has dealt with in the past it may have to look at again.”
A report by the board’s chief finance officer, Lesley Kenworthy, said the significant gap required a transformational plan to meet the challenge of delivering a sustainable service in the coming year.
Almost £7m of this year’s overspend was due to the cost of prescribing medicine.
Other significant contributing factors were the use of bank and agency nursing staff in hospitals and an increase in nursing and residential placements and home care.
Mr Kellet said the overspend was both down to investment in improving services and “firefighting” to stand still.
He said: “We have new models of care that just weren’t in place before that are improving outcomes and improving our ability to manage flow through the system.
“There is lots of good news about progress the partnership has made and we should recognise and celebrate that.
“On the other hand the pressures are such that keeping the show on the road and continuing to deliver the services people need is challenging and we know that demand is increasing and is going to continue to increase.
“Some of the overspend is down to trying to ensure we deliver core services.”
He said it was right that the partnership was “open and honest about the financial and social challenges that we face” but there were also “opportunities to look at new and progressive ways of working, developing the services we deliver and improving the experience of our service users”.
He said: “Our transformation plan is being developed to ensure that services are both sustainable and offer best value, whilst adhering to the fundamental principles set out in both the strategic plan and clinical strategy, namely person-centred and community-based services, and improved outcomes through prevention and early intervention.
“The public and staff should be reassured that they will be involved in conversations around new ways of working and development of services, and will play an important role in helping to shape improved and sustainable services.”