Publication - Transparency data

NHS Scotland and Integration Authorities consolidated financial reporting: 2019-2020

Published: 24 January 2020
Directorate: Health and Social Care Finance Directorate
Topic: Health and social care

Reporting information on the financial performance of NHS Boards and Integration Authorities for 2019 to 2020.

NHS board performance escalation framework

Stage	Description	Response
Stage 1	Steady state “on-plan” and normal reporting	Surveillance through published statistics and scheduled engagement of Annual Reviews/Mid Year Reviews
Stage 2	Some variation from plan; possible delivery risk if no action	Local Recovery Plan – advice and support tailored if necessary. Increased surveillance and monitoring Scottish Government. SG Directors aware.
Stage 3	Significant variation from plan; risks materialising; tailored support required	Formal Recovery Plan agreed with Scottish Government. Milestones and responsibilities clear. External expert support. Relevant SG Directors engaged with CEO and top team. DG aware.
Stage 4	Significant risks to delivery, quality, financial performance or safety; senior level external support required.	Transformation team reporting to Director General and CEO NHS Scotland.
Stage 5	Organisational structure / configuration unable to deliver effective care.	Ministerial powers of Intervention.

At present, NHS Greater Glasgow & Clyde, NHS Tayside, NHS Highland, and NHS Borders are at Stage 4 of the Performance Escalation Framework, and NHS Ayrshire and Arran are at Stage 3.

NHS Lothian are at Stage 4 for specific issues relating to the Royal Hospital for Children and Young People, and at Stage 3 for specific issues relating to performance.

The decision to move a Board to Stage 3 or 4 is made by the Health and Social Care Management Board (HSCMB). In the case of escalation to Stage 3 this may be prompted by awareness of a known weakness or the identification of an increasing level of risk in relation to a particular Board. In relation to Stage 4, consideration of the Board’s position within the Escalation Framework would normally be prompted by a Board failing to deliver on the recovery actions agreed at Stage 3 or the identification of significant weaknesses considered to pose an acute risk to financial sustainability, reputation, governance, quality of care or patient safety.

The decision to escalate a Board to Stage 5, the highest stage in the Framework, is taken by the Cabinet Secretary for Health and Sport, with advice from the HSCMB. Escalation to Stage 5 involves the exercise of Ministers’ powers of intervention under the National Health Service (Scotland) Act 1978.

The designation of a Board as Stage 1 or Stage 2 is a policy specific process. This is managed by Scottish Government policy leads directly with individual Boards, as indicated by the reference in Stage 2 of the Framework to local recovery plans. A Board may be at Stage 1 (‘steady state’) in relation to one aspect of its operations and at Stage 2 in another. The decision for one policy area to place a Board at Stage 2 by requesting a local recovery plan does not place the whole Board at Stage 2.

NHS boards

The reports within related downloads summarise the monthly financial position for NHS Scotland for the reporting year 2019-2020. The reports set out the year to date position and the forecast position for the year end. The information contained in the reports is a consolidation of the financial position as reported by all 22 NHS boards. All NHS boards report regularly and publicly on local financial performance. This information is available through individual NHS board websites.

Integration Authorities

The report within related downloads is produced and consolidated by Integration Authority Chief Financial Officers. The report consolidates information already in the public domain as published by individual Integration Authorities. Financial reporting by Integration Authorities is aligned to their individual board meetings. These reports will be produced on a quarterly basis.

This publication was updated on 22 November 2019 to include the section on the NHS board performance escalation framework.

I n light of Coronavirus (COVID-19), the monthly publication of NHS Scotland consolidated financial reporting has temporarily been suspended. This page will be updated in due course.