Mental health services, community hospitals and care for those with learning disabilities are at risk as Health and Social Care Moray faces making £12.2 million budget cuts.
The gaping black hole, which is 5% of the organisation’s entire budget, comes amidst warnings there are “no easy choices left” to make savings.
Officials have had to overhaul the books in an attempt to find as many savings as possible with an admission that finding all of the money will be “challenging”.
Every single service will be affected, with even those not subject to a specific budget cut being ordered to slash costs by 3.4%.
Bosses have proposed about £9.4m of cuts, which will be debated next week, with £1m due to come from savings – meaning £1.5m is still unaccounted for.
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Proposed cuts include a “review” of community hospitals, “redesigning” mental health care at Ward 4 at Dr Gray’s and driving down prescription costs.
Palliative care arrangements, the GMED out-of-hours support and slashing staff overtime are also included in budget papers.
Several of the proposals have been labelled “contentious” in budget papers amidst warnings of “reputational damage” for the provider.
‘No easy choices left’
Health and Social Care Moray is a partnership and funded jointly between NHS Grampian and Moray Council.
Stark warnings in this year’s budget papers highlight that the cash it receives from the organisations is not enough to maintain services in their current form.
Chief officer Judith Proctor has described the scale of the task facing staff as “unprecedented”.
She said: “Despite our diligent efforts to control spending and secure the best value, the unprecedented scale of the financial pressures facing us means there are no easy choices left.
“The actions required to close this funding gap and set a balanced budget will inevitably impact how services are provided.
“However, we remain committed to working closely with our staff and communities to navigate these difficult challenges together.
“Our priority remains protecting essential care and support for the most vulnerable while ensuring the long-term sustainability of services that help people live well and as independently as possible.
“Achieving this requires a bold programme of change to secure the most effective, efficient and high-quality health and care system we can for the people of Moray.”
Why huge social care cuts are needed
Health and Social Care Moray says a “change in focus” is needed to make services more sustainable in the long term.
Despite an additional £6.7m of funding going to the partnership this year, it is still needing to make the huge cuts.
Shifts to an older population with more people living with multiple and complex conditions is adding significantly to budgets, sometimes with little warning.
Prescription costs are among the most volatile with a 5% increase in costs to £23.8m expected in the coming year.
In a report, chief financial officer Deborah O’Shea said: “A change in focus for Moray is required to deliver improved care and better outcomes, ensuring sustainability for the future, rather than to deliver cost savings only in the short term.
“The health and care system is often seen as hospital-focused, however, an integrated and holistic response is required that encompasses community assets.
“This requires a system with increased generalism and multidisciplinary teamworking, with practitioners able to hold risk and enable people to live healthily in their communities, with a focus on prevention and reablement.”
In Full: 20 cuts proposed by Health and Social Care Moray
- Working with GP practices and care homes to reduce prescription costs – £169,000
- Reduction in staff overtime – £200,000
- Redesign of mental health in-patient service at Dr Gray’s Ward 4 including use of locums – £261,000
- Redesign of GMED out-of-hours service – £110,000
- Review of self-directed support (SDS) packages to increase recovery of surplus direct payment funds – £350,000
- Review and redesign of internal care at home service – £122,000
- Review of provision of palliative care services – £117,000
- Review of care packages – £1.7m
- New model of planned and emergency respite provision – £413,000
- Embedding a proportionate care approach to meeting the complex moving and handling needs of individuals – £555,000
- Redesign of nighttime model of care for people with learning disability – £277,000
- Redesign of community hospitals – £200,000
- Review of contracts with commissioned service providers – £350,000
- Review of day services – £220,000
- Review of staffing arrangements for complex and challenging behaviour – £159,000
- Review of use of beds in care homes for people with learning disability – £491,000
- Digital and technology strategy – £100,000
- Review of transport contract arrangements – £146,000
- Vacancy management across all services – £1.135m
- A 3.4% budget reduction on all services not subject to specific budget cut – £2.021m
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