Action must be taken now if the NHS as we know it is to continue

The National Health Service is one of our most valued public services – one we all rely on at some stage in our lives, whether that’s as a patient, a carer, a family member or AS_Twitter_COVERfriend. So how is the NHS in Scotland performing and what lies ahead in its future?

Almost 140,000 NHS staff provide a variety of high-quality services, support and advice in hospitals, GP and dental surgeries, community facilities and patients’ homes in Scotland. The level and quality of care provided has contributed to people living longer, alongside continued advances in diagnosis, treatment and care.

Although Scotland’s population is living longer, demand for healthcare is increasing as older people are more likely to have complex health and care needs. In recent years, the cost of delivering health services has increased significantly, coinciding with a period of constrained public finances. In 2014/15, spending by health boards was £11.4 billion – around a third of Scotland’s total budget.

Last week we published our annual overview report on the NHS in Scotland, which looks at the performance of health boards and comments on the many challenges and pressures facing the NHS. It also looks ahead to assess what progress the Scottish Government is making towards achieving their 2020 vision which aims to enable everyone to live longer, healthier lives at home or in a homely setting by 2020.

It will come as no surprise to many people that the NHS continues to experience significant pressures such as tighter budgets, rising costs, tougher performance targets and greater demands on its services. Our report highlights that, overall, boards managed their finances well given the size of the budget and the scale of pressures faced. However, we found that performance against many of its key waiting time targets has deteriorated in recent years. Similarly, recruiting and retaining medical professionals is one of the biggest challenges facing health boards today, leading to more money being spent using temporary staff to help keep services running. Getting the right skills in the right place, on a permanent basis, is essential to ensuring an effective health service. We also found that the Scottish Government has not made sufficient progress towards achieving its 2020 vision. Our report says that they need to step up the pace of change and make fundamental changes now if it is to achieve its longer-term ambitions.

It’s clear that these pressures and challenges are going to be felt for a number of years to come. This means it’s more important than ever that the Scottish Government and health boards demonstrate value for money in their spending. It’s also why healthcare will continue to be a key focus of our audit work. In the coming months for example, we’ll be publishing the first of a series of reports looking at the new arrangements for Health and Social Care Integration as well as publishing our findings from work looking at changing models of health and social care in Scotland.

About the author

Michael_OliphantMichael Oliphant, Audit Manager, led the ‘NHS in Scotland 2015’ report team. He joined Audit Scotland in 2004 and has since managed a number of national performance audits looking at different areas of the public sector, including the Commonwealth Games, police reform, major capital investment and Scotland’s public finances.