NHS Grampian will slash staff overtime, cut agency workers and even slice sandwich spending as bosses battle to save £35 million.
The drastic proposals were made as the health board faces a staggering £82.5m overspend for the year.
Finance chief Alex Stephen presented an update to the NHS Grampian board this morning, describing how debt has mounted since Covid.
The report outlined a number of cost cutting measures that were later agreed in a bid to help NHS Grampian balance its books.
But, health chiefs have promised that the changes will not impact patients and their care – or staff and their jobs.
How did NHS Grampian get here?
The finance boss said a number of reasons are to blame for the cash challenges.
This includes caring for an increasing number of elderly people and other patients being diagnosed with multiple health issues.
New technologies, expensive medicines and the introduction of new services, such as the Covid vaccination programme, have also played a part.
While ongoing recruitment challenges have led to the health board relying on drafting in “expensive” agency staff to cover shifts.
Mr Stephen also revealed that NHS Grampian is still working through a backlog of services that were delayed due to the pandemic.
What will be cut to save cash?
A major savings plan was drawn up with a number of proposals that should enable the health board to claw back around £35m.
NHS Grampian is aiming to reduce medicine waste which could save a whopping £2.3m.
While £3.6m could be saved by cutting back on the use of temporary agency staff.
But, medical chiefs admit this will be “challenging” in specific areas such as the neonatal unit, cardiac cath labs, endoscopy and intensive therapy unit.
Interim chief executive Adam Coldwells confirmed that “safety caveats” will be in place to ensure additional staff can still be taken on if required.
The health board will also stop recruiting any non-patient facing posts until the end of its financial year.
If one of these jobs is deemed to be essential, the NHS will look to cover the post internally.
Staff overtime training cuts
Nursing staff will no longer be paid for overtime used to carry out essential training in a move that will save £300,000.
Mr Coldwells stressed that this particular cut would not impact patients or their crucial treatments.
“We are really keen that we have a well-trained workforce,” he stated.
“The Agenda for Change has included additional time as part of that for people to have protected time for learning and training.
“Some of that will now be in place going forward that we didn’t have before.”
Mr Stephen explained: “If you are an A&E doctor working 12 hours a day, you probably don’t have time to do your mandatory training which might take four to five hours.
“You have to fit that in outside your working hours when you aren’t caring for patients.”
But despite all of these staff changes, the medical bosses are adamant that their employees are still vitally important.
NHS Grampian Board chairwoman Alison Evison said: “We are focused on looking at the financial challenge in front of us but also will ensure we are looking at our staff.
“They are the ones providing services and they are crucial to everything.”
Catering cash woes
Meanwhile, hospital meals could be hit too in a bid to save £800,000.
The report revealed that the number of meals being ordered everyday exceeds its current bed levels.
And patients ordering sandwiches as well as a main meal will soon be told the snacks are off limits.
Others were found to be ordering from an alternative menu which should only be available to those with a specific clinical or nutritional need.
But, the sandwich saga is a historical problem that has been changed in a bid to improve the system.
In previous years, hospital wards would order excess food in case someone was admitted in the middle of the night.
Now, if someone is admitted and is in need of a bite to eat, the ward can get one sandwich sent up instead.
Taxis and printers also face the axe
Taxis to transport dialysis patients has left the health board with a £656,000 overspend.
This figure is expected to remain the same over the next year.
But, the NHS is hoping to save £500,000 by rolling out home renal dialysis machines.
A final bid to save cash will result in desktop printers being removed and staff being banned from buying toner.
What can be done?
NHS Grampian says change is “essential” to ensure it can continue to deliver vital services to patients across the region.
Mr Stephen bluntly warned the board: “The stark options we are faced with are either to resist change and see services deteriorate to the point of collapse over time…
“Or to embrace transformation, work to create a modern, sustainable health and care service that is properly equipped to help people stay as healthy as possible.”
He added that “radical” transformation was needed but stressed that simply throwing money and resources at the issues wasn’t enough.
Mr Stephen said: “The seriousness of this financial position cannot be underestimated.
“We need to make decisions which seek to recover the financial position quickly, seeking to mitigate implications and deliver the most efficient services wherever we can.”
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