NHS Fife's finance chief has admitted the health board is struggling to make ends meet. 

The health board was forced to ask the Scottish Government for an £11 million loan to break even in March, but the troubles keep coming as its finance director is already forecasting a £29.8m overspend for the coming year. 

“This is a really challenging financial position,” Margo McGurk, NHS Fife’s director of finance and strategy, explained to the board.

“It’s our job to respond to situations as effectively as we can, but it’s absolutely clear that some difficult decisions and choices face us if we are to be successful.” 

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Despite receiving £10.2m in additional money from the UK’s HM Treasury, the board couldn’t balance its books and, with an £11m blackhole, it had to ask the Scottish Government for a loan. 

“For the second consecutive year, we were required to request Scottish Government repayable brokerage to balance our position which will be £11m to deliver the target of breakeven,” a report from Ms McGurk stated. 

“Without this repayable brokerage the target would not have been achieved.”

Finance was a critical point of discussion for the board and members were given an in depth look at the situation. 

Over the past year, it failed to fully deliver its ambitious £15m saving programme, and costs for acute services and external agency staff spiralled.

Looking to the future, the picture is not much improved.  NHS Fife will be required to deliver approximately £25m – three per cent of its budget – of recurring efficiency savings in the coming year.  

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That expectation has come directly from Holyrood. 

The government has also capped future brokerage loans at £5m – a figure that will reduce further in future years.  Even if the £25m cost cuts are achieved, NHS Fife is predicting a £30m deficit by next March.

To avoid that scenario, it will have to make an additional four per cent of savings. 

With NHS Fife’s financial situation as it currently stands, the Scottish Government has said it cannot approve the current 2024/25 financial plan – leaving the board in a state of limbo. 

“There are two specific things we absolutely have to do as an organisation,” Ms McGurk explained. 

“The first is to deliver in full three per cent recurring savings and the second is to work through the details of the additional [steps] necessary to deliver four per cent savings as far as possible.” 

She continued: “Notwithstanding that, we have to deliver our financial targets, and we have to do all of this safely and at pace.” 

The health board says it will deliver its financial improvement plan through what it calls a “Reform, Transform and Perform” framework. 

This will include immediate changes across the organisation; evolving NHS services, structures; and driving sustainable improvements throughout the organisation.