Three out of the 13 cost-reduction schemes implemented by NHS Fife face "significant risk" of not meeting their goals by March 2025, according to a new report.

At the beginning of the year, the Scottish Government required NHS Fife to find £25 million in savings across its budget.

The health board is currently £1.7 million behind their savings target, currently on course to save £23 million. 

Ben Hannan, director of reform and transformation said in his report: "Delivery of the [savings] framework is critical to the sustainability and strategic development of NHS Fife, particularly in meeting the current fiscal challenges."

In his report, Mr Hannan noted that five savings schemes have significant assurance, five have moderate assurance, and three have limited assurance.

These changes comprised ongoing medicines optimisation, a major review of a private finance initiative contract for phase three developments at Kirkcaldy’s Victoria Hospital, and reintegrating aspects of Fife’s unscheduled care bundle back into NHS Fife’s Acute Services Division.

Other measures included reducing Covid-19 legacy costs and rationalising NHS Fife estate and infrastructure.

Mr Hannan's report highlighted the challenge of generating savings from supplementary staffing as having the greatest impact.

While the expenditure on agency and bank staff continues to decrease, it has not yet reached the planned savings.

NHS Fife has had to continue using agency staff in certain areas due to a national skill shortage.

This dependence on supplementary staff is costly, and it has been challenging for NHS Fife to make savings in this area.

Surge capacity, the NHS’s ability to respond to a sudden increase in patient care demands, is another area at "significant risk."

Plans to cut costs and reduce surge capacity have been impacted by "high continuing levels of emergency admissions," according to Mr Hannan.

Acute services are operating under more pressure than during the previous two winters.

However, plans are progressing to improve system flow and discharge planning, supporting Fife’s national below-average length of stay.

The health board also intended to make £1.4 million worth of savings through "business transformation."

This plan involved capitalising on digital opportunities and automating certain admin functions.

However, these plans have faced delays due to the complexity of planning required to date and the time needed to agree on principles.

External contracts and complicated service level agreements with other health boards and organisations have also proved difficult to deliver in full.

Mr Hannan acknowledges that " a priority focus will be to review the moderate and limited assurance schemes to identify opportunities to accelerate performance for the remainder of the year.”