About you
3. What is your name?
Name
(Required)
Fay Richmond
5. Are you responding as an individual or on behalf of an organisation?
Organisation
NHS Fife
Budget context
6. How would you see these planned budget increases meeting the various challenges facing health and social care over the next four years, including: addressing the treatment backlog; the planned creation of a National Care Service; cost and demand pressures in areas such as NHS pay, drug costs and demographic pressures?
Please provide your response in the box provided.
Whilst the increase in funding is welcome, the financial and economic outlook across NHS Scotland, the wider public sector and the UK generally is hugely challenging. The cost of national pay deals, cost of living crisis, high levels of inflation on energy and other essential services are driving costs in excess of the budgets available to all NHS Boards.
The percentage increase on budgets is one factor in determining what can be done to meet the challenges detailed in the points above. There are other factors which will greatly influence the ability to meet these challenges, including: the supply levels and availability of the range of skills required to support a resilient and sustainable clinical workforce; and the increase in the acuity of patients who have been waiting for some time for procedures who now require more specialist and complex care.
The percentage increase on budgets is one factor in determining what can be done to meet the challenges detailed in the points above. There are other factors which will greatly influence the ability to meet these challenges, including: the supply levels and availability of the range of skills required to support a resilient and sustainable clinical workforce; and the increase in the acuity of patients who have been waiting for some time for procedures who now require more specialist and complex care.
Longer-term outlook
7. Given the short-term and immediate pressures on the health and social care system, how can the Scottish Government take the more radical decisions required around service redesign, or reducing/stopping existing services?
Please provide your response in the box provided.
There are no easy answers to this question. The key for government will be having an open and transparent conversation with the public on what the NHS will need to look like in the future, including changing models of care, increasing focus on population health and wellbeing, and supporting people to manage their own health conditions where that is possible.
8. Is there any evidence of longer-term thinking in budgeting for health and social care, either in Scotland or elsewhere in the UK or abroad?
Please provide your response in the box provided.
There is considerable literature and examples on longer-term thinking internationally and within the UK. In developing the recently approved NHS Fife Population Health & Wellbeing Strategy, we have used the 'Three Horizons' model to underpin our strategic approach. We recognise the key to influencing longer-term budgeting and resource allocation requires investment “upstream” to support communities to stay well, rather than focus solely on responding when people are acutely unwell or in crisis.
Financial Sustainability
9. Is the achievement of financial sustainability a realistic prospect in the face of continuing pressures around pay costs, treatment costs and rising demand?
Please provide your response in the box provided.
Financial sustainability should not be considered as a separate objective, it can only truly be tackled where it underpins organisational delivery and effective resource allocation. Financial sustainability needs to be considered as part of the overall strategy to create a sustainable NHS offer for the future and this will have to reflect factors such as clinical workforce supply and public engagement on key priorities.
10. How can or should any additional health and social care funding be directed to support alternative models of service delivery?
Please provide your response in the box provided.
The level of service change required to create a sustainable NHS for the future will require testing service change and new delivery models, and there clearly will be a cost associated with taking this forward.
Health and social care outcomes
11. How should health and social care budgets be prioritised in this landscape of multiple frameworks and targets and which targets or outcomes should take precedence?
Please provide your response in the box provided.
There is no easy answer to this question. Each service framework and associated set of targets have been established as unique but specific government priorities. A good starting point in terms of prioritisation might be to focus on “outcomes” for people, such as those with evidenced improvements in quality of life and health and wellbeing opportunities.