NHS Fife is facing the highest level of financial challenge since devolution according to its chief.
Margo McGurk outlined the heath authority's position at a recent board meeting.
Since March, a £55m shortfall has been predicted however the board has also overspent its budget by around £9 million from March to July 2024.
NHS Fife is also on the line for a further £8 million worth of overspends from the Health and Social Care Partnership.
“The financial position of NHS Scotland and NHS Fife for 2024/25 represents the highest level of challenge since devolution,” said Ms McGurk.
“The whole system is faced with challenges. And I want to recognise the context when we’re talking about financial performance.”
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The overspends and pressures are in part due to continuing cost pressures and unachieved savings brought forward from previous budgets. However, the IJB budget is the biggest problem for NHS Fife finances."
NHS Fife chairperson Pat Kilpatrick said the most significant risk to the heath board's financial outcome was the Integrated Joint Board (IJB).
"We need to be really clear and the timescales need to be put around this to make sure we can work with the IJB to understand what it’s going to do and how it’s unlikely we’re going to be able to fund these [gaps]," they said.
"It just puts us further into overspend."
Ms McGurk added: “The IJB recovery plan is going for consideration and discussion on Friday, but even with the plan there would still be a financial gap.”
“This is a significant concern. It’s been raised as NHS Fife’s biggest financial risk.”
However, it’s not all bad news. In July, the health board received an unexpected, one-off £3.4 million cash boost from Holyrood, which brought Fife’s projected end of the year budget gap down to £51.3 million.
Ms McGurk said that the rate of overspend is “slowing and now flat-lining” now as well.
“In July the in-month position flat-lined with that of June which is positive,” her report stated. “However, it is essential that we increase the pace of savings delivery and do not fall behind in planned trajectories.”
NHS Fife will continue to work towards its savings goals and the IJB recovery plan will be discussed by HSCP members on Friday morning.
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