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NHS Highland faces £42m shortfall


By Scott Maclennan

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Budget pressures at NHS Highland will be outlined at a meeting on Tuesday.
Budget pressures at NHS Highland will be outlined at a meeting on Tuesday.

NHS Highland has projected a financial black hole of more than £42 million despite its budget increasing by almost £100 million since 2019.

The news will be seen as a major blow because the health board is still operating under special measures, at stage three of the board escalation framework.

Now papers going to the health board on Tuesday show the dire financial situation facing the health board.

Deputy director of finance Elaine Ward outlined the position, including pressures from previous years totalling £49.2 million; a pay uplift £16.8 million; and inflation £23.8 million.

Covid continues to cause problems with an anticipated spend of £31.5 million while the cost of remobilisation is put at £11.9 million.

And anticipated allocations reach £133.9 million; additional adult social care investment £20.5 million and other pressures come to £869,000.

However, it is hoped that a Cost Improvement Programme (CIP) worth £26 million can be worked out from the Scottish Government, leaving an unfunded gap of £16 million.

But dealing with that will be tricky because the Scottish Government’s director of health finance and governance, Richard McCallum, told all health boards “that further funding will not be forthcoming”.

That means that bosses will have to find the money themselves out of their own budgets to plug the gap and the government may argue that it has already given the board enough cash.

NHS Highland’s budget has increased every year for the last three years, starting at £627.5 million in 2019/20 reaching a peak this year and next of £725 million – yet the board is still plagued by its finances.

Last summer there was considerable optimism that financial issues were beginning to be overcome as the board was moved from stage four to three on the special measures framework.

That was in part due to strengthened financial processes and improvements in governance, leadership and culture.


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