£4m overspend could all but wipe out Fife healthcare reserves, board warns

The organisation, also known as the Integrated Joint Board (IJB), expects to be £4.1 million in the red by the end of the financial year in March. Last week, board members decided the partnership would use its reserves of £5m to cover the gap, but that will leave them nearly empty - significantly less than the IJB’s 3% policy minimum.

“We’re obviously concerned about the reserves position - and quite rightly,” Alistair Grant, chair of the finance, performance and scrutiny committee said. “Initially the board had a very comfortable position with reserves. That has changed beyond all recognition and that needs to be accepted. It is quite a challenging position.”

Arlene Wood, chair, added: “I think it’s positive that we are going to have a balanced budget this year, but need to really recognise how that’s been done.”

Looking ahead, she warned that the IJB “cannot be complacent in any way” about the upcoming 2024-25 budget.

“We don’t know at this moment what our funding will be. However, we all probably know what's coming. I think this [use of funds] has stored up significant problems for us over the next year with little to no reserves,” she said. “The reserves will be under 1% based on current information. What we do this year impacts next year – and these transformation programmes are going to be absolutely critical.”

Like other boards and governing bodies across the UK, the IJB is under a lot of pressure. Hospital and long term care, GP prescribing, family health services, older people residential and day care, homecare and adult placements are all areas that have contributed to its budget deficit.

Audrey Valente, chief finance officer, explained in her report: “The overspend on prescribing (at November) is projected at £6 million, which reflects the increased price and also increased volume.”

Another major area of overspend has been £700,000 on locums at NHS run GP surgeries, but some areas have underspent, which has helped to partially offset deficits elsewhere. If, for any reason, the IJB can't find a way to fill its budget gap, NHS Fife and Fife Council will be on the hook to help out.