Overview of Scotland’s health and NHS performance 2006/07 – podcast transcript

Simon:  We’re here today talking to Nick Hex, Portfolio Manager at Audit Scotland about Audit Scotland’s latest report, Overview of Scotland’s health and NHS performance 2006/07. So Nick, what’s this report about and what have you found?

Nick:  Well, the report brings together financial and performance information on the NHS in Scotland it covers general trends in health, performance against targets, service delivery and financial performance.  What we’ve found is that mortality rates and life expectancy is improving but public health concerns continue to grow.  We’ve also found that performance against waiting times is getting better but there’s room for improvement against cancer waiting times, delayed discharges and older people’s readmission to hospital. The NHS is shifting the balance of care from acute to community based services but there’s no evidence that resources are shifting to support these changes.  And the financial performance of NHS boards improved in 2006/07 and only one board, which is Western Isles, did not meet one of its financial targets.  

Simon: So what is the impact of those things on patients?

Nick:  The report summarises Scotland’s health and the performance of the NHS. It also outlines changes in the way the NHS is being run.  While most of this information is publicly available this is the only report that collates it to one document.  

Simon:  Why did you do this report?

Nick:  The Scottish Government doesn’t publish an annual report which provides a comprehensive summary of Scotland’s health and the performance of the NHS and the Auditor General has a duty to scrutinise the economy, efficiency and effectiveness of the NHS and this type of overview report helps us to do that.  

Simon: You said a moment ago that the financial situation appears to have improved over the past year, what’s the outlook now for the near future?

Nick:  Well the report shows that overall boards are forecasting for the underlying recurring deficit to reduce from just over 1 percent of NHS income this year to around 0.3 percent next year.  However, there are several cost pressure which could put these forecasts at risk including service redesign, pay modernisation, waiting times and initiatives and drugs costs.  

Simon: Your report says that the NHS in Scotland spent 9.4 billion in the past year.  How much is that per head of population and how does that compare with the other countries in the UK?

Nick:  In 2005/06 expenditure per head was £1,643 in Scotland compared to £1,437 in England and £1,513 in Wales and £1,549 in Northern Ireland.  However, we don’t have enough information to be able to answer the question as to whether Scotland is actually performing better than England in health terms. We know that Scotland spends relatively more per head on health and that the performance against targets is generally improving but we wouldn’t be able to say whether the value of money for that expenditure is better or worse in Scotland.

Simon: What do you want to see happen now as a result of your report?

Nick:  We’ve included some recommendations to help the NHS improve its performance and financial management.  These centre on ensuring that performance information’s comprehensive, can support the Scottish Government’s development of outcome measures and agreements and that boards remain within financial balance.  We would like there to be clearer information to show the impact of spending on the NHS and we see the overview report as part of a public reporting suite of information but the Scottish Government still have an obligation to provide comprehensive information themselves.

Simon: Thanks very much for your time Nick.