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Podcast Transcript – NHS Tayside S22 17/18

I’m here with one of our Senior Managers, Leigh Johnston, to talk about our latest report on NHS Tayside. Leigh, could you just explain what this report’s all about?
This is the fourth consecutive report the Auditor General has produced on NHS Tayside and that’s a sign of the challenges it continues to face.  Its purpose is to draw Parliament’s attention to Tayside’s poor financial position and the difficulty it’s having meeting financial and performance targets. 
You say in the report that real urgency is now required to tackle these issues and turn around the organisation?
Yes, since 2013 Tayside’s financial position has been unsustainable. It’s needed over £50m of government loans in the last five years, the vast majority of which has not been repaid. 
The Cabinet Secretary has announced that all outstanding loans will be written off at the end of 2018-19, which reduces the pressure on Tayside to make repayments. But it doesn’t address the board’s underlying financial problems.
There’s also been a lot of media coverage of the board’s mismanagement of eHealth and endowment fund cash. How much have those decisions contributed to the challenges its facing now?
It’s certainly compounded the financial challenges the board faces, increasing the amount the board has had to borrow this year.
So what needs to change?
Service redesign is critical to reducing Tayside’s expensive operating model and comparatively high staff costs. Historically, NHS Tayside has employed more staff, both clinical and non-clinical, than its proportional share across all boards in Scotland. And its average prescribing costs have been more expensive than other boards. 
Very significant efficiency savings have been made by the board as part of their transformation plan but few of those are the long-term, recurring savings that come with redesigning services and how the health board operates.
And you say there is also an issue with the effective leadership required to turn the situation around?
Yes, the board continues to face significant leadership challenges. A new Chief Executive has been appointed – which is positive, but they are also the third person to hold the top post in the space of a year. And, at the same time, a recruitment exercise is underway to appoint a new health board Chair before the end of 2018/19.
You also note that errors were made relating to the departure of Tayside’s former Chief Executive?
Yes, there were a number of errors which are covered in detail in the report. But overall, we found that the board paid its former Chief Executive for six months’ notice rather than the three in her contract. And it also mistakenly agreed a payment of over £19k in pension contributions to cover her notice period – a sum the board is now seeking to recover. 
Finally, then, what’s the overall message you are giving to NHS Tayside in this report?
The board urgently needs to set out its medium term financial plans and how it intends to achieve service reform and further reduce its operating costs. And the board needs effective and stable leadership to drive forward its plans for transformation. That will be vital to ensuring Tayside begins to turn a corner.
Leigh, thank you very much. And if you want to read our NHS Tayside report, or any of our other work on Scotland’s NHS, you can download it from our website - audit-scotland.gov.uk. 
ENDS