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Health board criticised for underspending millions on primary and community care

Health board criticised for underspending millions on primary and community care

A Scottish health board has been criticised after reporting an underspend in primary and community care, at a time when GPs are struggling to recruit and provide services.

Falkirk’s Integration Joint Board reported an underspend of £400,000 on primary care and £3.5 million on community health care services, linked to staffing and vacancies across services as recruitment continues to prove difficult.

A finance report published ahead of a meeting of the board mentioned ‘GMS and Out of Hours (OOH) underspends.’

As reported by local paper The Daily Record, Dr David Herron, a local GP and Falkirk Health and Social Care Partnership clinical lead, told the board this was ‘disappointing’ at a time when GPs are struggling from a lack of investment to provide their patients with the care they need.

He said: ‘I think it’s really important to the people of Falkirk that they have access to primary care services.

‘We’re struggling from a lack of investment and we can’t provide the staff and services that the people of Falkirk need – then we see a budget that shows an underspend.

‘We know there will be an underspend, so let’s recruit far higher and if we’re failing to recruit let’s look at diverting that money to other services that can provide services to patients in a quicker way to deliver as many services as we can, rather than sitting on an underspend.’

Steven Kirkwood, chief finance officer at Falkirk Health and Social Care Partnership told Pulse the board will ‘always maximise the opportunity’ from every available resource.

He said: ‘Our Integration Joint Board is responsible for allocating finances and resources wisely, delivering services in the face of challenging local and national circumstances.

‘We will always maximise the opportunity provided from every available resource.  To this end, efforts were progressed during 2022/23 to over-recruit to key service areas including the multi-disciplinary teams that support GP Practices, including pharmacotherapy staff and advanced nurse practitioners.

‘While our forecast position at the end of the year will be an overspend of £3.788m against the set aside budget, managed by NHS Forth Valley, and an underspend of £2.119m against the integrated budget, these integrated funds will be carried forward to supplement our plans for next year and beyond.

‘This requires robust financial planning and long-term strategic planning to ensure resources are allocated responsibly and deliver best value for the people of Falkirk.’

It comes as a Scottish GP practice caring for more than 25,000 patients announced it will be handing back its NHS contract in September because there ‘simply are not enough trained GPs out there’ to recruit, and another nearby practice serving 8,974 patients also handed back its contract, also due to staff shortages.

In Edinburgh, the last single-handed GP practice will close this summer, with almost 2,000 patients needing to be re-registered elsewhere.

According to the BMA, about 2,000 new GPs are required to satisfy demand across practices in Scotland.

First Minister of Scotland Humza Yousaf said its party ‘will continue to invest in primary care’ as he was debating the Government’s priorities in Parliament earlier this week.

He said: ‘It is fair to say that we have a record number of general practitioners in Scotland. There are more GPs per head of population here than there are in the rest of the UK: our 95 GPs for every 100,000 people in Scotland compares with 79 GPs for every 100,000 people in England.

‘We are committed to further increasing the number of GPs in Scotland by 800 by the end of 2027.

‘We are committed to investing an additional £1 billion in our NHS. That is possible only because we did not listen to the Conservatives’ advice that we should give tax cuts to the wealthiest, which would have meant £500 million less to spend in the Scottish Government’s budget.’

A summary of Falkirk IJB’s financial position, as presented in meeting papers on 31 March:

A year-to-date underspend of £2.243m for integrated budgets, offset by an overspend of £3.788m against set aside budgets. This results in a net overspend of £1.545m, year to date.

A forecast integrated budget underspend of £2.119m and a forecast overspend of £3.784m for set aside (managed by NHS Forth Valley), and net overspend of £1.665m. Therefore, the forecast position at year end will be an integrated budget underspend of £2.119m, to be carried forward as a general reserve.

Note: This story was updated at 2:40pm on 25 April to reflect that the Falkirk IJB’s financial report does not include a £5 million underspend figure. A previous version of this story had said the board had reported an underspend of almost £5 million in primary and community care.