NHS Tayside Transformation Support Team: report

1. AAG Recommendation 1 – Financial Outturn

"We recommend that NHS Tayside should take urgent and robust action in order to maximise the likelihood of achieving the planned in-year savings and delivery of NHS Tayside's projected financial outturn for 2017/18. Detailed action plans must have support from key stakeholders and include anticipated financial impact, identified timetables and milestones. There should be clear trigger points for escalation to ensure swift action when delivery is found to be at risk."

1.1 NHS Tayside's Assessment – Rating = Red

"The Board has initiated a rigorous continuous review of its financial position in the current year to revise the financial forecast outturn for 2017/18 and has developed a schedule of additional risk-assessed efficiency savings to aim to meet the agreed financial target. We will require to increase the level of efficiency savings further to ensure that there is sufficient volume of savings to meet our financial objectives in year when taking account of risk assessment against delivery and will produce delivery plans for each initiative to mitigate the risk of underperformance. In the second phase, between October and end of December 2017, we will ensure that there is further strengthened budgetary control on current spend while implementing the additional savings plans. At this stage, given the need to deliver substantial additional savings in the second half of the year, the status of this recommendation is assessed as 'Red'."

1.2 TST comment - Rating = Red

This recommendation is a priority area and while the Director of Finance is the responsible lead, the whole Executive Team needs to work collectively and take corporate responsibility in order for it to be achieved. NHS Tayside recognises this and has identified further areas for potential savings although further work is needed to establish clear processes and timescales for implementation. The paper which went to the Finance and Resources Committee on 12 September reflects this.

The TST took a view that the steps taken to produce robust, detailed action plans should have been initiated sooner and progressed more rapidly. Although momentum has now been built up and all internal stakeholders have a more realistic assessment of the expected out-turn, there is a need for the Board to demonstrate that they can take and implement decisions rapidly, in order to see real improvements in the position before the end of the financial year.

In terms of future action, to retain confidence in the delivery of the agreed outcomes the TST would expect to see, between the end of September and the end of December, concrete evidence of savings being delivered against the original plan and against new areas identified for action.