Fife health funding crisis: social care’s deficit set to soar to £24m report warns

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Four months into the current year, and Fife’s Health and Social Care Partnership is already reporting a £3.6million deficit - and it is projected to grow to £24million by March 2025.

Most of the overspend is down to non-delivery of savings. That’s an issue that has plagued NHS Fife more generally throughout the past year as well.

“It’s a difficult position,” Audrey Valente, the partnership’s chief finance officer, said at a meeting on Friday. “The combined Health & Social Care Partnership delegated and managed services are currently reporting a projected outturn of £24.353m overspend.”

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She continued: “It’s a very challenging year. We will continue to ensure delivery of savings and to reduce the risk of utilising the risk share agreement with our partners NHS Fife and Fife Council.”

Fife’s Health and Social Care Partnership's deficit is projected to grow to £24m gap by March 2025. (Pic: TSPL)Fife’s Health and Social Care Partnership's deficit is projected to grow to £24m gap by March 2025. (Pic: TSPL)
Fife’s Health and Social Care Partnership's deficit is projected to grow to £24m gap by March 2025. (Pic: TSPL)

Complex and critical care services were slated to make £15 million in savings, but the current project overspend includes non-achievement of savings of £9 million.

However, even if the goals were delivered instantaneously, which is impossible, the partnership would still need to find a further £6 million of savings to balance its books by the end of the year.

The cost of locums - temporary substitutes to fill vacancies - and agency staff are listed again and again as areas of overspend as well.Primary medical services is projecting a £1.4 million overspend as a result of locum costs. Locum costs and recruitment difficulties are even higher for mental health services where there is a project overspend of £2.8 million.

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“Care of the elderly is projecting to overspend by £4.7 million due to continued use of agency staffing and surge beds,” the finance report continued.

Older people nursing and residential services are projecting a £3.7 million overspend due to a greater number of beds being utilised than budget.

Going forward, Ms Valente said there is increased scrutiny of the IJB from both NHS Fife and Fife Council.

“As a result of the financial challenges, we plan to increase the frequency of meetings with both partners and the chair and vice chai,” the report explained.

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Ms Valente added: “We will be presenting further savings proposals at the next IJB meeting in September, but given the challenge we’re presented with today there’s an increased risk of implementing the risk share agreement.”

That would see NHS Fife and Fife Council called upon to plug the gap. As it stands, IJB savings reserves are low, and Ms Valente has already told members that they will be required in their entirety to help fill the gap at the end of the current financial year.

“Although there are very little reserves remaining, there is recognition that they will be required to be utilised this year to ensure safe delivery of service for local residents,” she said.

Arlene Wood, IJB chairperson, called it “quite a concerning position” but Ian Dall, an IJB service user representative, was more critical – “year after year I sit and hear that we have reviews and catch up plans and we keep on failing to reach the targets,” Mr Dall said. “The senior leadership team should really look at a new system because we can’t keep going year after year failing to make the savings that we project.”

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However, Ms Valente pushed back. She believed the IJB has a “good proven track record”, and she believes that it can make the savings - it’s just a matter of timing.

“We will deliver these savings,” she said. “It’s the timing of delivery that’s crucial. We’re looking at how we can speed up delivery. We’re meeting weekly, our absolute focus is bringing that £18m savings down as far as possible during this financial year.”

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