NHS Lothian needs £31 million to address funding shortfall

STRUGGLING NHS Lothian would need up to £31 million to return services to the levels provided in 2017, MSPs have been told.

NHS Lothian records worst A&E waiting times since records began.

The funding shortfall facing the health board was revealed in evidence to Holyrood’s Health Committee.

Deputy chief executive Jim Crombie said the board had “characterised a gap in our ability and our capacity to deliver against the access targets”.

He said: “We’ve been clear to the board, we’ve been clear to government that there is a significant element of funding that would be required to allow us to recover.

Jim Crombie, Deputy Chief Executive NHS Lothian appears before the Health and Sport Committee to give evidence on the Scrutiny of NHS Boards - NHS Lothian. 24 April 2018. Pic - Andrew Cowan/Scottish Parliament

“Part of the request from the Scottish Government was to present what they characterise as an operational plan for 2018/19 and in that we’ve characterised all of our intelligence around demand, all of our intelligence around efficiency, productivity and maximising the use of our resource.

“But even doing all that we’ve characterised a gap and we’ve characterised the quantum of funding that would be required to allow NHS Lothian to return to the levels of performance in terms of patients waiting over 12 weeks at March 2017.”

Pressed by committee convener Lewis Macdonald on the figure, he added: “To return NHS Lothian to the position of March 2017 is £31 million, circa.”

Jacquie Campbell, chief officer of acute services at the health board, added: “Even if we had the funding to return to March 2017 we don’t have the overarching capacity either internally or with the external providers in relation to that and there’s often a lead in time in starting up capacity.”

Jacquie Campbell, Chief Officer, Acute Services NHS Lothian appears before the Health and Sport Committee to give evidence on the Scrutiny of NHS Boards - NHS Lothian. 24 April 2018. Pic - Andrew Cowan/Scottish Parliament

Ms Campbell was also questioned by Green MSP Alison Johnstone about progress on recruitment to paediatrics at St John’s Hospital in Livingston, where staff shortages have led to a reduction in services.

She said: “We have an ongoing commitment to maintaining and delivering a 24/7 service at St John’s, that hasn’t changed at all.

“In terms of recruitment, despite what is a national backdrop of shortages of paediatricians, we’ve actually successfully recruited seven additional consultant paediatricians into NHS Lothian.”

Ms Campbell said five of these were already working in the department, with one on maternity leave and another due to start in August.

Jim Crombie, Deputy Chief Executive NHS Lothian appears before the Health and Sport Committee to give evidence on the Scrutiny of NHS Boards - NHS Lothian. 24 April 2018. Pic - Andrew Cowan/Scottish Parliament

In addition the health board was training two advanced paediatric nurse practitioners who would be able to participate in an out-of-hours rota towards the end of the year, and was recruiting again for more.

She said: “This is not about money, this has been an active and proactive and continuing recruitment drive but despite all of that we require 39 out of hours shifts to be covered every month and at the moment, based on our substantive staff, we could provide about 21.

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“So we still have a way to go around having a sustainable out-of-hours rota.”

Jacquie Campbell, Chief Officer, Acute Services NHS Lothian appears before the Health and Sport Committee to give evidence on the Scrutiny of NHS Boards - NHS Lothian. 24 April 2018. Pic - Andrew Cowan/Scottish Parliament

It comes amid an external review of financial governance at NHS Tayside after claims emerged the health board used cash from an endowment fund to cover planned expenses including new computer systems in 2014.

Scottish Labour’s shadow health secretary Anas Sarwar described the funding gap as “shameful,” adding: “Every day we hear stories of NHS staff who are overworked and undervalued and under resourced. Figures show that over the last eight years of this SNP government that early retirements of NHS staff have doubled.

“And that mismanagement was further highlighted this morning at health committee where it was revealed that NHS Lothian alone needs £31m just to existing levels of service.”

He continued: “Scotland needs a credible NHS workforce plan from a credible Health Secretary. It’s time for Shona Robison to step up or step down.”

Scottish Liberal Democrat health spokesman Alex Cole-Hamilton MSP added the government needed to “step up” and meet the challenges the service is currently facing.

He said: “The troubles with NHS Tayside, and now with NHS Lothian, show the clear strains on the system.”

“Staff are working around the clock but they aren’t getting anywhere near the support and resources they need.”

“In other health boards the Scottish Government has ignored warnings and seen things go from bad to worse. Here’s the early warning that NHS Lothian needs help. The government must step in and properly resource the struggling service so it has what it needs to meet demand.”

“Yet again inaction and under-resourcing are hurting staff, patients and services. The health secretary ought to do the right thing and resign, if not it will fall to parliament to make clear that this is not good enough for our NHS.”

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