NHS Fife said their finances have “probably never been under more strain” after the board admitted they expect to be overspent by £23 million by the end of the financial year. 

By September 30 they were already £16m in the red, an increase of £5m in just two months, with a warning it's set to get worse by next March and that it's "highly likely" they'll need a bail-out from the Scottish Government. 

Health chiefs blamed the ongoing costs of supplementary staffing and surge capacity - the NHS’ ability to handle patient/care influx - as well as inflation and cost of living pressures, while there are still Covid 'legacy' costs. 

They also failed to meet their savings targets.  

The dire financial situation was outlined at Tuesday's board meeting with a report from Maxine Michie, deputy director of finance, stating: “Despite ongoing attempts to reduce costs and a commitment to avoid any additional investment in our services, it is highly likely that the board will require significant financial brokerage to break-even."

Dunfermline Press: Additional staffing costs are one of the reasons NHS Fife's overspend has soared. Additional staffing costs are one of the reasons NHS Fife's overspend has soared.

She said the current financial position had “materially deteriorated” this quarter and added: "Given the position reported at the end of September, it is clear that the organisation will require a level of brokerage to deliver a balanced financial position, we maintain close contact with the Scottish Government in this regard."

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At the meeting Margo McGurk, the director of finance, said NHS Fife had agreed the current financial plan based on a “number of savings assumptions”.

They had planned to make savings of £15m but this wasn't achieved and she admitted it was increasingly unlikely that they will come to fruition within the current financial year. 

“We’re seeing some [savings] but nothing at the scale we need to deliver our original financial assumptions,” Ms McGurk told the board. 

Some members suggested that the financial plan had over-promised on savings and had been overly ambitious.

However, Ms McGurk explained that NHS Fife had no choice and explained: “The government advised all NHS boards that they needed to meet 3 per cent savings priorities.

"There was a need to be ambitious. At the end of the day, we make these decisions and we have to stand behind them when you’re in the moment."   

Acting board chair Alistair Morris encouraged board members and services to continue to look for cost-cutting opportunities – no matter how big or small. 

“Lots of little savings could add up to £4m or £5m which will make the government feel a lot happier and it will make us feel a lot happier that we’re moving in the right direction,” he said. 

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“It’s important to get our timescales right, and perhaps our original timescales were over ambitious. 

“Looking at the time I’ve been on this board, we’ve gone from a stage where money was everywhere due to Covid to the opposite practically overnight. 

“That requires a culture change. We’re moving from having resources and thinking expansively to having nothing behind us and feeling exposed.

"It’s going to take time to make that culture change. In reality, that’s not going to happen in one financial year. We need to be realistic about these things and work through them.”