Chamber and committees

As has been the case in previous years, all NHS boards will require to achieve efficiency savings in 2016-17. The preparation for this is at the early stages of development, with formal submissions expected as part of the local delivery planning process in advance of 1 April 2016. All NHS boards are expected to ensure that resources are spent in a way that improves the health and wellbeing of the community and delivers best value for taxpayers. It is important to note that efficiency savings are a key component of financial plans, contributing to the overall performance of NHS boards. Boards consider a range of efficiency measures with a view to identifying those that will impact positively on patient care by reducing unwarranted variation in service provision, removing waste and eliminating harm. Efficiency savings are retained locally by territorial boards for reinvestment in frontline services. The combination of increases in funding and local retention of savings, ensure priorities are safeguarded.

Last year (2014-15) NHS boards delivered over £285 million of efficiency savings, equivalent to 3.1% of baseline funding. For 2015-16, NHS boards are forecasting that over £293 million of efficiency savings will be delivered, equivalent to 3.0% of baseline funding.

NHS Greater Glasgow and Clyde routinely provide copies of their board papers, which for the meeting of 16 February 2016 were received on 9 February 2016. These savings are retained locally for reinvestment in frontline services and are in addition to a baseline funding uplift of £103.7 million (5.2%) for 2016-17.

For the current year 2015-16, NHS Greater Glasgow and Clyde are forecasting that they will deliver £59.6 million of efficiency savings.

Section 52 of the Public Bodies (Joint Working) (Scotland) Act 2014 provides ministers with powers to direct integration authorities, including integration joint boards, in relation to their carrying out of functions conferred on them by the Act.

Resource transfer arrangements have been superseded by the resource delegation arrangements required by the Public Bodies (Joint Working) (Scotland) Act 2014. The legislation requires agreement to be reached on budgets for delegation to integration authorities by 1 April 2016.

The £250 million of integration funding provided for in the local government settlement will be allocated to health boards, to whom ministers will give written direction to delegate the full sum to their integration authorities. Integration authorities will then allocate their share of the resources to their local authorities to meet the commitments set out in the settlement.

The NHS senior leaders forum are the Director General for Health and Social Care and Chief Executive of NHS Scotland, directors of the Scottish Government’s Health and Social Care Directorate, NHS Scotland chairs and chief executives, and the chairs of the NHS Scotland medical directors and nurse directors groups. The forum forms part of regular engagement between Scottish Government and NHS boards.

The National Scheduled Care Programme known as “Getting Ahead – sustainable whole systems management for elective services” has been discussed in detail with the NHS Scotland Chief Operating Officers Group and other informal discussions with a number of NHS boards as well as the British Medical Association.

The Health Directorate Access Support Team will be meeting with all boards to support them in taking forward this work over the next few months.

Integration joint boards will be required to set a budget that allocates their share of the integration funding included within the local government settlement, to meet as a minimum the settlements’ commitments in relation to social care, i.e. in relation to the living wage and changes to the charging thresholds.

The Scottish Government will distribute the £250 million to health boards via their annual allocations, using the same allocation formula as was used for distribution of the Integrated Care Fund. This approach takes account of funding formulae used for the NHS and local government, using a 1:1 ratio of the National Resource Allocation Committee formula for the NHS and grant aided expenditure formula for local government.

The number of (a) private and (b) voluntary/ third sector workers in the care sector in each local authority area is available in the Scottish Social Services Council (SSSC) annual workforce survey (table 4). This can be found on the SSSC website (http://data.sssc.uk.com/data-publications).

The investment required to meet the living wage in contracted out adult social care services will vary across authorities in Scotland according to local circumstances, for example, the volume and balance of contracted out care and the progress some councils have already made towards payment of the living wage. We would expect a more finely grained analysis of the situation regarding wages and fair work within contracted out care services to be undertaken at integration authority level.

Details of the National Scheduled Care Programme titled "Getting Ahead – sustainable whole system management for elective services" was issued on 25 January 2016 under a Health Directorate Director letter. This can be accessed at the following link: http://www.sehd.scot.nhs.uk/dl/DL(2016)02.pdf.