NHS funding is not keeping pace with the ageing population and the increase in demand, which means health boards are facing an “extremely challenging financial position”, says a new Audit Scotland report, NHS in Scotland 2016.
The consequences are that boards have failed to meet the majority of key national standards, with only one out of 8 NHS Scotland key performance targets met.
The total health budget in Scotland is £12.2 billion, and while health boards made savings of £291 million in 2015/16, savings of £492 million are planned for 2016/17.
The report recommends that the Scottish Government should:
- Provide a clear written plan for implementing the 2020 Vision and National Clinical Strategy, including:
- Immediate and longer-term priorities, including a public health strategy to help NHS boards focus on preventing ill-health and tackle health inequalities.
- Support for new ways of working and learning at a national level.
- Long-term funding plans for implementing the policies.
- A workforce plan outlining the workforce required, and how it will be developed.
- Ongoing discussion with the public about the way services will be provided in the future to manage.
- Set measures of success by which progress in delivering its national strategies can be monitored, including its overall aim to shift from hospital to more community-based care. These should link with the review of national targets and align with the outcomes and indicators for health and social care integration.
- Consider providing NHS boards with more financial flexibility, such as three-year rolling budgets rather than annual financial targets, to allow better longer-term planning.
A spokesman for Community Pharmacy Scotland said: “Today’s report by Audit Scotland faces the serious challenges the NHS faces as it meets the twin pressures of ever-increasing demand and squeezed funding.
“Community Pharmacy Scotland maintains that Scotland’s network of 1,250 community pharmacies, scattered throughout the country and accessed by more than 600,000 NHS patients every day, can play a pivotal role in making changes to the way some services are delivered.
“For example, the Scottish Government is considering a Community Pharmacy Scotland proposal to enhance the successful Minor Ailments Service, which has seen hundreds of thousands of patients take advantage of the current restricted service to have their local pharmacist help treat minor conditions, such as colds, rather than visit their hard-pressed GPs.
“Community Pharmacy Scotland believes this service should be open to all, and both the Labour Party and the Conservative Party adopted this as part of their Holyrood election manifestos, so Parliamentary support for this does exist.
“In addition, pharmacists are the qualified experts on the management of medicines and drugs, and we believe greater use could be made of the expertise of community pharmacists to ensure that the use of medicines is at all times cost-effective, safe and appropriate.
“We note that Audit Scotland maintain that the current pressure on the NHS ‘strengthens the case for changing the way services are delivered.’ Community pharmacists – and other qualified NHS professionals – must be allowed to make full use of their training, skills and expertise to bring about the changes that are needed.”