Chief executives of Scotland’s health boards will look to cut the numbers of admin and support staff as part of their efforts to improve sustainability of the NHS.

A set of ‘tactical actions’ to help boards achieve 3% savings in 2024/25, agreed by health board chiefs in November last year, has been revealed in a freedom of information (FOI) response published by the Scottish government.

The 15 actions to improve operational and financial performance include commitments to reduce spend on procedures and medicines of ‘low clinical value’.

Cuts to the number of people employed in administrative and support service roles – such as clerical, catering assistants, porters and domestics – will also be explored by health boards.

This will all come as part of ‘wider work on business systems transformation’, according to the letters published last week.

Matt McLaughlin, head of health at UNISON Scotland – which represents staff across the NHS – said he is “disappointed” that these letters have not been shared with trade unions.

Mr McLaughlin told healthandcare.scot:

“There is a prevailing view in the NHS in Scotland that service staff and admin staff are not as important at frontline workers – this is nonsense.

“Everyone is part of the same team and is essential to providing high quality and safe public services. The Scottish government would be better placed to be getting on solving some of the issues in the NHS rather than cutting posts.

“We need to get beyond incalculable statements. There needs to be a genuine and legitimate discussion on how to deliver services. Cutting services to meet a deficit created by this government is not the way forward.”

It comes the same week financial and staffing dominated concerns of Scotland’s Auditor General in his annual assessment of the NHS.

New health secretary Neil Gray has since confirmed in response that the Scottish government has already begun formulating plans to reform the NHS, which will be detailed in the coming weeks.

 

Tactical improvements

All 14 of Scotland’s territorial health boards have been told by the government to achieve at least 3% recurring savings in 2024/25.

The released letters show board chief executives have collectively agreed to take forward 15 short-to-medium term ‘opportunities’ in prescribing, workforce and productivity to support this.

Rising costs of medicines have been raised as a key financial concern by most boards.

Now, health board leaders will look to establish targets for reviews for people who take multiple medications and complete further work on affordability of new medicines.

Digital prescribing is to be accelerated, while greater regionalisation of local lists of routinely available medicines – known as formularies – will also to be explored.

Spending on NHS temporary staff in Scotland recently reached a record high, with £169.7m spent on agency nurses and £119.6m spent on medical locums in the year ending March 2023.

A reduction of agency staff and medical locums are also a focus of the cost-cutting measures.

Boards have been told to consider medium to long term ‘transformational options’ alongside these tactics.

 

Read more: Health secretary promises reform for NHS; Urgent workforce reforms needed for Scotland's NHS; Economic change key to Scotland's health inequalities; Government to launch ‘conversation’ on future NHS; Who is Scotland’s new health and care secretary?

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