'Unprecedented' cash crisis forces changes to Dr Gray's plan, as Moray hospital faces £12 million overspend, NHS Grampian board meeting hears
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NHS Grampian's "absolutely unprecedented" funding crisis has forced it to redraw the 10-year plan for Dr Gray's.
Budget cuts topping £77 million will need to be made this year, an NHS Grampian board meeting heard today, after the Scottish Government indefinitely paused long-awaited work on Moray's primary hospital.
Meeting documents show that Dr Gray's Hospital, which was recently inspected, is currently facing a £12 million overspend.
NHS Grampian pinned the cash gap on the Scottish Government having halted efforts to install a new MRI scanner and make Ward 4, Moray's inpatient mental health unit, safe for its vulnerable patients.
Also to blame for the significant backlog, was the hospital's reliance on stand-in locum and agency staff.
This was "a consequence and a direct cause of the scale of the hospital overspend", the report claimed.
And the hospital depends on expensive temporary staff because consultant jobs in Acute and General Medicine, Anaesthetics and theatre nursing roles "are not attractive".
Both projects depended on funding from Holyrood, as did improvements to Buckie's Seafield Hospital which were supposed to be finished so that Ward 4 patients could be housed there during the works.
The Scottish Government's decision to stall the projects was blamed on a "10 per cent cut" to capital budgets by Westminster.
However, NHS Grampian has claimed that plans to bring a full maternity service back to Moray will not be affected despite the shortfall.
The ten-year plan for Dr Gray's, named Plan for the Future, was agreed in June 2022.
But yesterday's board meeting heard that funding pressure and the paused projects had forced the health board to "refocus on affordability and sustainability".
Business manager Christina Cameron said changes to the plan would "achieve improvements in affordability and sustainability".
The updated report, released before yesterday's meeting, detailed three main changes to the Dr Gray's plan.
First, NHS Grampian will consider changes to "the menu" of surgeries available at the hospital, along with closer links to Aberdeen and Raigmore hospitals.
Current surgical offerings are "already at risk" due to a national staff shortage, the report argues, and making changes would improve "the linked issues of quality and capacity of limited theatre facilities".
Also included in the report is advice for communication the report's changed to the public, which suggests that existing services at Dr Gray's will "likely" be changed.
Second is a bid to change how the hospital's beds and operating theatres are allocated across departments and uses.
This needs to be done, the report argues, to meet likely demand for the Accident and Emergency department and a full maternity service in the future.
Internal studies showed the need for a "significant improvement and redesign of utilisation to provide capacity and sustainability".
Finally, third, are changes to how the public access Dr Gray's Hospital and how to get more clinical staff involved with initial medical enquiries at what the report calls the "Front Door".
This is understood to primarily mean the hospital's A&E.
As a result, patients could be seen by a wider range of clinicians when they come to Dr Gray's with a health problem.
Measures for providing hospital care at home have also been rolled out in other areas of NHS Grampian, and have been seen as a way to manage current demand on acute medical services including A&E.
"Acute medical assessment represents much of the presentation mix at the front door," the report said.
"Resign and redevelopment to a new model of working, with pathways designed to match this activity will improve flow through the hospital."
During yesterday's meeting, NHS Grampian board member Derick Murray shared his "disappointment" that both the MRI scanner and Ward 4 works, to make it safe for patients in distress by removing ligatures, had been postponed.
He asked whether the two projects, bundled as part of NHS Grampian's National Treatment Centre project, could be separated to make it more affordable for the Scottish Government.
Chief executive Mr Coldwells replied that, while the health board could ask: “I think the national funding is very unlikely to come forward."
In a statement at the beginning of the meeting, he said an internal committee would consider whether the Ward 4 scheme should go ahead using NHS Grampian's own "limited money".
Acute medical director Dr Paul Bachoo earlier appeared to suggest that the blow to the Moray MRI project was an "opportunity to have a rethink" about the location and type of scanners – highlighting a potential need for one in Aberdeen's Baird Family Hospital.
He said: "Earlier on, we spoke about the Baird Family Hospital.
"There's also a very strong case to be made for an MRI scanner going into that facility to make it future proof."
And, he added: "And it may well be that we need MRI scanners, and maybe in Moray, but maybe not in a hospital setting, although that was the best preferred option previously."
