NHS Fife has overspent its annual budget by £10.9 million just four months into the current financial year.
And the health board was told on Tuesday that the deficit has continued to grow, up £3m from the last update in July.
Margo McGurk, NHS Fife’s director of finance and strategy, said that the overspend is “significantly beyond where we would have hoped to be at this point in the financial year.”
According to a board report, the financial position as of 31 July shows an overspend of £10.984 million.
Health chiefs pointed to the continuing level of spend on supplementary staffing, medicines, and surge capacity – the NHS’ ability to handle patient/care influx.
Other factors included legacy Covid costs which the government will not be reimbursing the authority for, and cost of living increases.
The overspend is also due to limited progress across NHS Fife’s cost improvement programme.
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At the start of the financial year, NHS Fife announced plans to make £15m worth of cost saving measures.
Those have taken longer than anticipated and that delay is reflected in part in the board’s overspend figures.
“I think it’s fair to say that the level of confidence is decreasing as we go through the year but having said that we do believe that over the next few months we should see something coming through by way of [cost savings],” Ms McGurk said.
“The changes we made and the improvements and additional controls that were put in place really only took effect from the first of June, so we’ve really only had a couple of months data coming through.”
She continued: “We do have to find a way to deliver those £15m savings.
"Everyone is focused on delivering the cost reduction where it’s safe to do so.”
Alistair Morris, acting chair of the board, said it was “absolutely critical” that the board got on top of the overspend.
“I’m still firmly of the view that we will be held to account for the delivery of the annual delivery plan so we really do have to continue all efforts to make sure we achieve the performance elements in the timescale that we said we would make them,” he said.
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“That is going to force us into having some difficult conversations, but I’m confident that the culture of the board will help stand us in good stead when we address those issues.
"It’s not an easy position, it’s not a happy position to be in but we’ve got to be realistic about what the task ahead is and roll our sleeves up to deliver that.”
He added: “We’re getting towards half way through the year which means we’ve only got six months to claw back. That’s quite an uphill task."
Both Ms McGurk and Mr Morris were clear that no additional financial support should be expected to come from the Scottish Government to fill the growing overspend.
“The messaging currently from the Scottish Government is that we shouldn’t expect anything significant beyond the resources that have already been distributed,” Ms McGurk explained.
Mr Morris added: “There just isn’t any funds in the pipeline to come.”
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