A CRISIS-HIT health board has a high risk of racking up an £18 million deficit this year due to a failure to make enough efficiency savings.

NHS Tayside, which has already been bailed out by the Scottish Government, is facing a black hole far higher than previously estimated.

Jenny Marra, a Labour MSP in the North East, said: “This is serious for patients, services and staff in Tayside.”

Audit Scotland, which investigates the finances of public bodies, issued a damning report into NHS Tayside earlier this year.

It revealed that the board had benefited from £24.3m in bailouts – described as “brokerage” loans – from the Government over a four-year period.

The watchdog projected a £11.6m potential deficit in the current financial year, 2016/2017, but concluded there was a “significant risk” this year’s plan might not be achieved.

In November, Auditor General Caroline Gardner followed up her report by warning MSPs that the situation was “very serious”. She added: “In my time as Auditor General, this is the most challenging position that I have seen.”

However, board papers on NHS Tayside's website show that the organisation’s finances for 2016/17 may be even worse than first feared.

NHS Tayside’s current position is that there may be a deficit of £11.6m, but this figure is dependent on making £46.75m of efficiency savings. However an appendix in the board’s corporate financial report for the period ending October 31st reveals a “high” risk that the £46.75m savings will not be met.

The risk assessment estimated that up to £7m of this total could be in jeopardy, which would increase the deficit to £18.6m.

A key problem is the high spending associated with prescribing, which is the second biggest NHS cost after staffing.

Another document in the tranche of board papers stated: “Concern was again expressed that prescribing had been an issue for over two years. There was not a sense that this was in any way further forward. There should be an understanding by now of why prescribing was an outlier.

“There needed to be a much greater sense of urgency to this as well as budgetary realism. All must live within the budgets and resources allocated to them.”

The financial woes come after the Sunday Herald revealed senior managers at the troubled body had been pocketing “progression” bonuses. In two of the bailout years, the performance of 32 staff managers was judged to be “superior” and they were rewarded with rises.

Marra, who is the convener of Holyrood’s Public Audit committee, said: "The board papers from NHS Tayside show that there is a severe risk that our local health service will fail to make projected savings reported by Audit Scotland and carry an even larger deficit at the end of the year.

“I will be questioning NHS Tayside bosses very closely at the Parliament's Audit Committee meeting on December 15 to find out why this financial situation has been allowed to escalate and what can be done to make sure services and jobs are not at risk."

NHS Tayside Director of Finance Lindsay Bedford said, “The Local Delivery Plan for NHS Tayside set a target level of efficiency of £58.4 million for 2016-17 in order to achieve financial balance.

“Following a robust review of local savings plans, the Board has approved a revised savings programme which will deliver £46.75m. This leaves a balance of £11.65m outstanding.

“Work continues to identify options to further reduce this balance, with a specific focus on improvements in prescribing costs and on reducing non-contract agency spend and delayed discharges.