News / Focus on longer term, Scottish boards told

By Seamus Ward

NHS Scotland’s financial performance was good in 2012/13, but health boards must put greater emphasis on long-term financial planning, according to Audit Scotland.

A report from the auditors, NHS financial performance 2012/13, said the service had managed its finances well. All NHS boards had met their annual financial targets – for the fifth consecutive year – and the service overall reported a small surplus of almost £17m, it said.

However, pressures on NHS capacity became more apparent during the financial year. Some boards missed waiting time targets, and doctor, nurse and midwife vacancies increased. The service spent more on short-term measures to manage rising demand – spending on temporary staff and private healthcare rose.

Audit Scotland warned that boards’ main focus could be on breaking even each year, but longer-term financial planning was needed if they were to meet the challenges posed by population changes, advances in technology and cuts in budgets.

And it said that while the 3% efficiency target was achieved, boards found it more difficult to find savings and relied more heavily on one-off savings than planned – 22% of savings came from this source.

They will need to find at least the same savings again this financial year (2013/14), and this will be increasingly difficult, it added.

Scotland auditor general Caroline Gardner said NHS Scotland had made good progress in improving health outcomes, with fewer people dying from heart disease, cancer and stroke. It had a coordinated approach to improving patient safety.

She said: ‘The NHS in Scotland's financial performance was good in 2012/13, with all boards meeting their targets to break even and the service finishing the year with a small surplus. However, the health service needs to increase its focus on longer-term financial planning so that it is prepared for the challenges it faces.’

The NHS also had to change how it delivers services to meet growing demand, particularly from the ageing population.

‘The move to integrated health and social care services from 2015 will be a significant change for the NHS and its partners. Strong longer-term financial planning and analysis are central to meeting these challenges,’ she said.