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Fundamental changes are needed to NHS services as pressures continue to rise

Fundamental changes and new ways of delivering healthcare are required now to ensure the NHS is able to continue providing high-quality services in the future.

NHS in Scotland 2015, published today by Audit Scotland, reports on the annual performance of the NHS and its future plans. It says that tightening budgets, rising costs, higher demand for services, demanding targets and standards, and increasing staff vacancies are placing significant pressure on the service. The report states that as pressures continue, the NHS will not be able to provide services in the way it currently does and that it needs to increase the pace of change if it is to achieve its longer-term ambitions.

The report found that health boards spent £11.4 billion in 2014/15 and ended the year with an underspend of just £10 million. This is commendable given the financial challenges faced. However many health boards are experiencing real pressures and needed one-off savings or extra financial support from the Scottish Government to break even. All area boards found it difficult to meet national performance targets within their budgets. At March 2015 only two of nine key waiting time targets and standards were met, reflecting a general decline in performance in recent years.

Around 140,000 people work in the NHS in Scotland - its highest ever level of employees. The level and quality of care provided by staff have contributed to people living longer with continued advances in diagnosis and treatment. However, the report highlights that recruiting and retaining permanent staff is a significant problem for boards, leading to more being spent on temporary staff.

The Scottish Government recently launched a national conversation as part of plans to change the way healthcare services are delivered in the future. Today's report includes recommendations for the Scottish Government and health boards to help ensure future changes are underpinned by sound long-term financial and workforce planning.

Auditor General for Scotland Caroline Gardner said:

"We all depend on the NHS and its staff who provide high-quality care. But it will not be able to provide services as it does at present due to the number of pressures it faces within the current challenging financial environment.

"We have highlighted concerns around targets and staffing in previous reports. These have intensified over the past year as has the urgency for fundamental changes such as introducing new ways to deliver healthcare and developing a national approach to workforce planning. It is important that the Scottish Government and health boards work closely together to help alleviate these pressures and also increase the pace of change necessary to meet its longer-term ambitions."

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