Falkirk GP questions NHS £5m underspend as health services stretched

Falkirk’s Integration Joint Board (IJB), which oversees health and social care in Falkirk, reported an underspend of £400,000 on primary health care and £3.5 million on community health care services.

Dr David Herron, who is the GP clinical lead for Falkirk Health and Social Care Partnership, said this was “disappointing” at a time when people in Falkirk are finding it difficult to get appointments and access to GP services.

At a recent meeting of the IJB, he said: “How do we ensure we are more responsive next year to changes and ensure that we don’t have an underspend in these areas because these areas are ones we should be putting extra funding in? I think it’s really important to the people of Falkirk that they have access to primary care services.

“We’re struggling from a lack of investment and we can’t provide the staff and services that the people of Falkirk need – then we see a budget that shows an underspend.”

Members of the board heard that much of the underspend links to staffing and vacancies across services as recruitment continues to prove difficult.

The underspend in community health care was mainly due to the closure of four wards in Falkirk Community Hospital (FCH), which accounts for £2.095m of the year-to-date underspend.

Last June, members of the IJB agreed that the cash freed up by the closure of the wards should be directed toward community care.

Chief finance officer Stephen Kirkwood said that the process of spending the money had started.

“There are various developments, but they take time to implement, so there has been slippage” he said. “It’s been more challenging during this time where everyone is stretched, where we don’t have the levels of staff that we’d like and don’t have the capacity to do these things at full throttle.”

Dr Herron, who is a GP at Polmont Park Medical Group, said he understood why the money had not been spent but added that staff not being recruited meant services not being delivered to patients, adding: “I think I’d like to see us be more responsive to that and take a look at our risk-taking strategy here.

“We know there will be an underspend, so lets recruit far higher and if we’re failing to recruit lets look at diverting that money to other services that can provide services to patients in a quicker way to deliver as many services as we can, rather than sitting on an underspend.”

Overall, the IJB heard there was an overspend in the NHS Forth Valley’s part of the budget of nearly £4 million, but this will be met by the NHS.

Looking further ahead, however, board members were warned that the financial outlook looks much more difficult and savings of £13.493 million are expected to be needed in 2023/24.

Additional recurring savings requirements of around £2 million per annum will be needed in each subsequent year, with an estimated £19.057 million required over four years.

Members heard that given global economic uncertainty, the impact of the war in Ukraine, the cost of living crisis, Brexit and Covid pandemic uncertainties and the widespread pressures on public spending, it would be vital to plan spending carefully in the years to come.