NHS Borders embarks on £28m of savings

Chief Executive NHS Borders, Ralph Roberts.Chief Executive NHS Borders, Ralph Roberts.
Chief Executive NHS Borders, Ralph Roberts.
Health boss speaks out.

NHS Borders needs to embark on a series of cost savings as it looks to plug a £28m gap in its coffers, it has emerged.

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In a frank admission, the organisation’s chief executive, Ralph Roberts, admitted there was a “significant financial challenge facing NHS Borders in the next financial year and beyond”.

There is expected to be an opening financial position in April 2024 of a £30m deficit.

And without any cost savings being made this overspend would rise to around £45m at the end of March 2025 because of inflation, responding to increased demand and the cost of investments needed to deliver new health technologies and services.

“This is clearly unsustainable”, Mr Roberts has admitted.

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Given that backdrop, NHS Borders has agreed with Scottish Government that the first step is to reduce the deficit to £17 million by the end of March 2025 – that equates to achieving savings of £28 million within the coming financial year.

Mr Roberts said: “Although this situation is not unique to the Borders with most other health boards in Scotland facing a similar position, we have a responsibility to deliver a balanced financial budget so it is vitally important that we inform the public about the scale of the challenge that we face.

“Following the pandemic it has been difficult to return to previous levels of activity and performance in some areas. However we now need to balance our financial challenge against the performance and access we can deliver, while ensuring our services are of an acceptable quality.

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“It is important to be honest that with the level of savings required (more than of 10% of our total budget), this will have an impact on the services we provide and we will need to make some significant and radical decisions.

“Although we will do everything we can to mitigate the impact, we recognise that our services will feel different for our staff, patients and communities.

“We cannot speculate on any detail at this stage and are currently working closely with our teams to come up with options to present to the Board, after which we will set out the choices that we face and engage with our staff and communities. We will need to be in a position to do this over the course of the next eight weeks with the intention of agreeing an updated financial plan at our board meeting in April 2024.

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People who engaged with our ‘Time for Change’ conversations across the Borders between October and December last year heard us talk about finance and the challenges that we face providing services with limited resources.

“However the draft Scottish Government budget, announced on 18 December 2023, set out an even more challenging budget position than we described when we were having those conversations with the community. We are therefore reviewing all the feedback we received and will use this to help inform the work we are currently doing on the future of our services.

“We are also considering what the changed situation will mean for the way in which we progress the next stage of discussions with our communities and stakeholders.”