NHS Lothian needs ‘clearer’ financial plans

Warning in Audit Scotland report that also reveals board paid an extra £11m to children’s hospital contractor

Thursday 8th August 2019

NHS Lothian needs a ‘clearer plan’ on how and where savings will be delivered, Scotland’s public spending watchdog has warned.

A new Audit Scotland report has highlighted a financial gap identified by the health board of £26m for 2019-20, after taking account of recovery plans.

Significant risks that have been identified as potentially impacting on progress include winter costs, integration, delayed discharge, waiting times and Brexit.

The report says the projections highlight ‘the ever-increasing challenges the board faces in achieving financial sustainability, while maintaining an appropriate level of performance.’

It notes targets for care have also deteriorated in a number of areas since 2017-18, including the rate of MRSA-type infections, treatment for cancer within 62 days, inpatient and day cases seen within 12 weeks and outpatients being treated within 12 weeks.

The report also highlights a ‘number of challenges and delays’ around the building of the new Royal Hospital for Children and Young People in Edinburgh.

A detailed assessment has been ordered by the Scottish Government after the move to the new site was delayed at the last minute in July, when final safety checks revealed a ventilation system had failed to meet national standards.

The Audit Scotland report reveals NHS Lothian agreed to pay an additional £11.6m to contractor Integrated Health Solutions Lothian (IHSL) Ltd towards the end of the build to resolve matters relating to drainage and other issues.

It said: ‘NHS Lothian had identified a number of issues that it believed were not compliant with the original contractual requirements and raised concerns over what it felt would be a significant adverse impact on patients, staff and visitors.’

The negotiation of the payment to complete the project, which was approved by the Scottish Government, was made after legal advice did not give ‘sufficient confidence’ that pursuing the matter through the courts would be beneficial.

Before the opening of the hospital was delayed, the Audit Scotland report had recommended a thorough evaluation of the project be carried out, with key outcomes shared with NHS and other public bodies.