The NHS in Scotland continues to face "growing pressure from a population that is living longer", according to a new report by Audit Scotland.
The report also says that more people were seen and treated on time in the last year and patient safety improved. But just two out of eight key waiting time standards were met as staff struggled to meet rising demand for care.
Caroline Gardner, the Auditor General for Scotland, said:
The NHS in Scotland is running too hot, with intense pressure on staff and a service model that will remain financially unsustainable without a much greater focus on health and social care integration.
We're beginning to see examples of new ways of delivering healthcare but they're some distance from the system-wide reform the NHS needs. The challenge for the Scottish Government and its partners will be to agree new priorities that enable large-scale change and which create a leadership culture that supports and respects all staff.
Audit Scotland say that achieving financial sustainability also remains a major challenge for health boards. Half of all NHS savings were non-recurring, while predicted deficits and reliance on additional financial support from government have increased. The capital budget has also reduced by 63 per cent over the last decade and there is a near £1 billion of backlog maintenance and issues around high-profile capital builds.
Health and social care integration remains too slow, according to Audit Scotland.
Commenting on the Audit Scotland report, Professor Derek Bell OBE, President of the Royal College of Edinburgh said:
This report highlights the current challenges facing the NHS in Scotland. While some of its conclusions are of course disappointing, it is important that now more than ever, those working in health and social care are united by the single goal of maintaining and improving patient outcomes.
Audit Scotland has highlighted particular challenges around financial arrangements for health boards and health and social care integration. The Quality Governance Collaborative at the Royal College of Physicians of Edinburgh has been working with experts in this field, to discuss how to improve the governance arrangements of health boards and Integration Joint Boards in Scotland.
Given recent reports about negative working arrangements for junior doctors in some of Scotland’s hospitals, it is vital that efforts are undertaken to improve workplace culture, rota structure and general working conditions. All of our health professionals must be properly valued.
Despite the challenges, the NHS in Scotland has made some good progress on patient safety, experience of hospital care, keeping drug costs down, and on delivering healthcare in new and innovative ways.
