Audit Scotland has published its annual report into the finances of NHS Scotland.
The key message is:
“The NHS in Scotland managed its finances well in 2012/13 but needs to focus more on long-term financial planning and sustainability to make the changes needed to meet increasing demands. In 2012/13, pressures on the NHS’ capacity became more apparent and the health service spent more on short-term measures to deal with them.”
Put another way, the NHS is putting sticking plasters on long term funding problems.
The report also indicates that demands on healthcare are rising and signs of pressure on the NHS were apparent. In particular, some boards missed waiting times targets; staff vacancies increased; and spending on bank and agency staff and private health care rose.
Agency staff and private care spending is a good example of short term spending that is hugely wasteful. The report calls for stronger long-term financial planning to address this.
The report also highlights spending of over £115 million on the top ten high-cost, low-volume (HCLV) drugs in hospitals in 2012/13. These can be a pressure on NHS boards as spending increases at a higher rate than other costs and it can be less predictable. The top ten drugs are generally a specialist type of drug used to treat rheumatology conditions and irritable bowel conditions (anti-TNFs) and cancer drugs. Spending on HCLV drugs increased more than spending on overall hospital drugs and drugs prescribed in general practice over the past two years.
This again highlights the importance of addressing drug costs in NHS Scotland.