NHS Orkney has been moved to level three of the recently published NHS Scotland Support and Intervention Framework due to its “deteriorating financial performance” .
What does this mean and why is it happening?
NHS Scotland’s support and intervention framework has 5 stages.
- steady state
- enhanced monitoring
- enhanced monitoring and support
- senior external support and monitoring
- statutory intervention
Out of Scotland’s 14 Regional Health Boards 6 have been escalated to stage 3 or above within the framework. This is the stage at which boards are considered to require a higher level of support and oversight from Scottish Government and other senior external support.
The six territorial NHS boards currently escalated to at least stage 3 are:
- NHS Ayrshire and Arran
- NHS Borders
- NHS Forth Valley
- NHS Highland
- NHS Orkney
- NHS Tayside
| NHS Ayrshire and Arran | 3 | Financial management and position |
| NHS Borders | 3 | Financial management and position |
| NHS Forth Valley | 4 | Governance, leadership and culture |
| NHS Highland | 3 | Financial management and position |
| NHS Highland | 3 | Mental health performance |
| NHS Orkney | 3 | Financial management and position |
| NHS Tayside | 3 | Mental health performance |
NHS Orkney Financial Position
Laura Skaife-Knight, Chief Executive at NHS Orkney, said:
“We have this week received confirmation from the Scottish Government that we have been moved to the first stage of formal escalation due to our deteriorating financial performance, which we have updated our local community on in recent months.
“The Board has been moved to level three of the recently published NHS Scotland Support and Intervention Framework, which is the first stage of formal escalation as a result of the deviation from our agreed financial plan for the year.
“This is not where we would wish to be, however, we see escalation as a much-needed intervention and an opportunity to ensure we see the improvements that are necessary so that our financial position can be recovered and so that we move to more sustainable solutions and ways of working. We will fully embrace this process and welcome the additional national support NHS Orkney will receive, the details of which remain under discussion and are being worked through.”
In NHS Orkney’s Annual Review 2023 it stated the challenges it is facing in delivering a health service to Orkney.
- Fragile services & unacceptably long waits – outpatients and planned care (including ophthalmology, dentistry, pain services, rheumatology, children’s services, speech and language therapy)
- Consistently timely treatment for cancer patients
- Inadequate care home and system capacity – resulting in delayed transfers of care from The Balfour
- Sustainability: workforce, financial and clinical services
- Housing availability – impacting on recruitment and retention
The expensive need to use locums is a considerable drain on NHS Orkney’s finances.
NHS Orkney has to publish records of payments to suppliers which are over £25,000. In the month of October 2023 the payments to agency locums where each payment came to over £25,000 totalled £334,588.68
For September 2023 payments to agency locums where each payment came to over £25,000 totalled £303,158.59
Payments like this are being paid out every month.
Fiona Grahame
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