Concerns about mental health services, staff and prescription overspends are among the ongoing challenges faced by the Tayside health board according to the latest Audit Scotland report.

Audit Scotland has said that while NHS Tayside has ‘begun to show improvements’ in handling its finances, ‘substantial long-term financial and operational challenges’ remain.

Caroline Gardner, auditor general for Scotland, said the board has been in an unsustainable financial position since 2013 and will need continued loans from the Scottish Government until 2021-22 to balance its budget.

‘Significant overspends in nursing and agency costs, prescriptions and referring patients out with Tayside, together with widespread concerns about the provision of mental health services’ also feature in the report.

In May of this year the Scottish Parliament’s public audit and post-legislative scrutiny committee published a report consolidating its findings after 18 months of scrutiny of financial and governance issues that had engulfed the health board in recent years.

“It is a positive forward step that NHS Tayside now has a transformation plan,” Ms Gardner said, “but moving away from the current ways of working will be difficult without well-developed and detailed implementation plans.

“So far there is little evidence of the sustainable service redesign and transformation that is critical to reducing costs while maintaining or improving services.

Dundee university’s vice principal, Professor Nic Beech, was recently appointed to head the NHS Tayside board after interim leadership from Lorna Birse-Stewart following chair John Brown’s departure in July 2019.

Ms Gardner added: “The future is challenging for NHS Tayside. Effective and stable leadership will be critical in bringing about long-term service transformation.”

Reacting to the assessment, Tayside health bosses said the situation was improving but there was no room for complacenct.

Grant Archibald, who has been chief executive since the start of 2019, said the organisation's three-year plan to balance the books was already delivering "good results".

The improvements made in our financial reporting and performance stand us in good stead as we move forwards and I am confident that we are making significant progress in the right areas," Mr Archibald said.

“Our current mid-year position also shows improvements in our waiting times performances, in particular with our cancer waiting times. In January 2019, NHS Tayside performance for the 62-day Cancer Waiting Times Standard was 85%. A new approach by the cancer teams in Tayside has brought significant benefits for patients and NHS Tayside has now exceeded the national waiting times 95% target for treating cancer patients every month since June 2019.

“Our most recent figures show that in September, 95.9% of cancer patients received treatment within 62 days of their referral and 97.6% of patients were being treated within 31 days of their cancer diagnosis. 

Tayside is also the best in Scotland when it comes to treating A&E patients in the four hour target, he added.

“These are all indicators of an improving position which is allowing us to increase the pace of our Transforming Tayside programme. Our clinical teams are leading the way with a move into a new phase of transforming services and transforming costs to ensure future sustainability.

Meanwhile £164m is being invested in new developments including a new neonatal intensive care unit and hcildren's threatre suite at Ninewells hospital in Dundee.

“We are not complacent about the work which still lies ahead and everyone is committed to keep making the difference in Tayside," the chief executive said.

"It is really important that our staff are recognised for their hard work in delivering these improvements. They deliver high-quality health and social care to patients, service users and their families across Tayside every day and we would like to thank them for their continued efforts as we press ahead with our ambitious redesign of services.”