NHS Shetland is facing a £495,000 shortfall in its finances which it is making strenuous efforts to recoup before the end of March.
Chief executive Ralph Roberts said the figures for the financial year to date represent the “most challenging financial report we’ve had” since he took up the post January 2011.
And he said it would be a “challenge” to tackle the situation without impacting on services.
The board’s finance chief Colin Marsland said the position was “not a crisis as yet” and he hoped the situation would be resolved by the end of the financial year. However it is £125,000 deeper into a shortfall than would have been expected by this stage of the year.
The situation has been blamed on “significant non-recurring pressures”, Mr Marsland said, mainly through the employment of locum doctors which are notoriously costly.
A locum medical consultant had been employed, which cost twice as much as the normal post. Locums had also been used in the Mid Yell health centre following the retirement of the GPs.
Mr Marsland said it was currently costing £5,000 per week to staff that centre with locums providing 24-hour cover. He said this was “significantly more” than employing GPs, who typically earn around £80,000 per year.
This year’s shortfall has also eaten into the health board’s one per cent contingency reserve.
Mr Marsland said: “We are looking at ways to be more efficient and smarter ways of delivering services.”
Some of these ways have been identified by patients, and could include negotiating for services locally rather than in Aberdeen, using the fund previously used for patients’ flights to provide this.
NHS Shetland board chairman Ian Kinniburgh questioned how “robust” the board’s financial management was.
He said the board appeared to have “got it wrong”.
“We are still behind the curve in getting to a financially stable position.”
Mr Roberts said that in the “bigger picture” Shetland had an “extremely good” financial record over a long time. According to the NHS staff newsletter, savings in non-clinical departments have achieved a 25 per cent savings target over five years.
Additionally the board ended last financial year with a small underspend, and achieved overall savings of £2.6million, the largest percentage savings of any health board in Scotland. This was reinvested.
However this year savings had not been made as quickly as hoped. The board would have to think “more creatively” in identifying savings up to 2015, and, when setting its budgets, be clearer on “non-recurrent targets”.
He also said that the board should discuss ways of sharing money with the community planning partnership.
Meanwhile the proposal to appoint a consultant obstetrician and gynaecologist was seen as a “spend to save” move.
Although it will increase expenditure in Shetland, it is expected to improve the local service and save up to £140,000 thanks to reduced patient travel and expenditure in Aberdeen.