Health and social care savings breakdown from the Scottish Government Pre-Budget Fiscal Update: FOI release

Information requested

A breakdown of the health and social care savings set out in annex A of the Scottish Government Pre-Budget Fiscal Update: Letter to Finance Committee, published 3rd September, available here.  This included

1. For each heading (EG community eyecare, general medical services etc), please provide a breakdown of all the individual savings lines under that heading, broken down by cash value. For example, for education and training, this would mean providing the savings to be realised from each aspect such as NHS Academy, Leadership talent management and other lines not mentioned. Please provide a short description of how each savings is to be realised.

2. In addition, please provide the following information about specific lines:

a. For “general medical services” please provide a breakdown of the budget lines, setting out which work has been paused or re-profiled. Where work has been reprofiled please set out the original timescales and funding, and the updated timescales and funding.

b. For “health improvement and protection”, please provide i) the original profile of spend on innovation and immunisation and ii) the updated profile.

c. Under “mental health services”, the i) original and ii) new start date for the Changing Places Toilet fund (along with funding profiles).

d. A detailed breakdown of the ‘non staff spend’ associated with delivery of the National Care Service. Please provide i) original planned spend and ii) updated spend profiles.

 

Response

A breakdown of anticipated savings set out in the Fiscal Statement is provided at Annex A based on individual level 4 budgets. Work remains ongoing in terms of how those savings will be realised over the remainder of the financial year across individual programmes, including final values at programme level. However in the absence of confirmed additional consequential UK Government funding, any emerging in-year pressures can only be funded by difficult choices elsewhere in the budget, with the £115.8 million of spending reductions identified within the Health budget redirected to emerging pressures within Health, not used for wider SG spending.

In terms of updated profile and timescales of paused or re-profiled work, given that these savings relate to the 2024-25 financial year, the impact of these savings on future year budget planning will need to be considered as part of the annual budget setting process for 2025-26 and beyond.

Specifically in respect of question 2, parts a and b, the original value and breakdown of the General Medical Services and Health Improvement and Protection level 3 budgets can be found in the published 2024-25 budgets here: Supporting documents - Scottish Budget: 2024 to 2025 - gov.scot (www.gov.scot). The published General Medical Services budget was £1,276.583 million therefore adjust for savings is £1,265.603 million. The immunisations published budget was £38.868 million therefore revised budget post-savings is £37.868 million. For the Innovation Fund a budget of £5.000 million was earmarked post budget publication therefore taking savings into account revised budget for 2024-25 is £3.350 million.

Regarding question 2 part c, the Scottish Government is committed to investing in Changing Places Toilets (CPT) in order to increase the number of these facilities across the country, allowing people easier access to events and outdoor venues. Whilst the Scottish Government had set out the intention to make CPT funding available across financial years 2024-25 and 2025-26, unfortunately it is no longer possible to launch the fund in the current financial year and £3.250 million originally profiled for 2024-25 will be reprofiled into future years as part of the 2025-26 budget process.

Regarding question 2 part d, the National Care Service ‘non-staff spend’, below is the detailed breakdown of original and updated planned spend.

	Original Planned Spend	Updated Planned Spend
NCS National	£156,000	£153,000
NCS Local	£100,000	£0
Wider Programme	£1,145,274	£610,488

Annex A

Community Eyecare	£2,393,000.00
Community Eyecare - General Ophthalmic Services	£2,393,000.00
COVID-19 funding and other services	£20,262,379.00
Other Board Services and Miscellaneous Income	£19,636,100.00
Board Resilience	£626,279.00
Education and Training	£8,177,799.00
AHP Policy	£20,000.00
AHP/HCS Policy	£5,000.00
Capacity & Recruitment Strategy	£3,125,000.00
Distinction Awards	£1,600,000.00
Leadership, Training and Capacity	£790,000.00
Safe Effective Person Centred	£930,000.00
Other below £2m	£1,707,799.00
General Medical Services	£10,979,700.00
Miscellaneous Other Dental Services	£39,000.00
Primary Care Fund	£10,934,700.00
Other below £2m	£6,000.00
Health Improvement and Protection	£4,140,613.00
Gender Identity and Healthcare Access	£246,000.00
Immunisations	£1,000,000.00
Innovation Fund	£1,650,000.00
Organ Donation Policy	£2,500.00
Research Data Scotland	£200,000.00
Tobacco Control (Smoking)	£253,000.00
Other below £2m	£789,113.00
Mental Health Services	£18,769,783.59
Complex Care	£3,350,000.00
Mental Health & Wellbeing	£1,150,271.59
Mental Health Services	£14,269,512.00
National Care Service / Adult Social Care	£13,645,865.00
Health & Social Care Integration	£1,100,000.00
Independent Living Fund	£3,000,000.00
Social Care Support and NCS Delivery	£9,030,340.00
Other below £2m	£515,525.00
Quality and Improvement	£7,794,006.00
Long COVID	£85,811.00
Person Centred and Participation	£1,031,500.00
Stroke and Thrombectomy	£2,350,000.00
Other below £2m	£4,326,695.00
Revenue Consequences of NPD Schemes	£2,000,000.00
Revenue Consequences of NPD Schemes	£2,000,000.00
Other	£27,690,972.00
Active Healthy Lives	£1,225,000.00
Other Board Services and Miscellaneous Income	£6,135,000.00
Board Resilience	£6,862,558.00
Corporate support	£2,000,000.00
Digital Health and Care	£700,000.00
Family Nurse Partnership (FNP)	£250,000.00
Forensic Medical Services (FMS) Act Implementation	£645,000.00
General Dental Services	£86,000.00
Health Innovation	£400,000.00
Health Research	£1,500,000.00
IVF	£100,000.00
Maternity and Neonatal Services	£414,000.00
Mesh injured women's support fund	£500,000.00
Multiple child removals	£1,100,000.00
NHS Territorial Boards	£3,251,664.00
Sportscotland	£911,750.00
Young Persons Family Fund	£700,000.00
Other below £2m	£910,000.00
Grand Total	£115,854,117.59

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