ONE of Scotland’s largest health boards has warned ministers it needs at least £150 million to respond to the Covid-19 crisis as front-line costs continue to soar.

NHS Lothian, which has been placed in special measures by ministers, has told the Scottish Government that it is already facing “additional costs of £149.8 million associated with the Covid-19 response”.

HeraldScotland: Camley's Cartoon: NHS Lothian in funds call.Camley's Cartoon: NHS Lothian in funds call.

The warning comes as health boards across Scotland have drawn up local remobilisation plans which, according to the Scottish Government’s routemap out of lockdown, will act as a blueprint to “increase the provision for the backlog of demand, urgent referrals and the triage of routine services” as healthcare begins to restart across Scotland.

NHS Lothian handed its first draft of its remobilisation plan over to ministers on May 25 before a second and final version was submitted and approved by the Scottish Government .

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The final plan covered the health board’s “initial priorities focused on the period to the end of July 2020” but officials expect they will be asked for extending plans in which would cover the period running up to March 2021, “including details of our winter plan”.

NHS Lothian’s local remobilisation plan adds that of the £150 million, “£71 million is anticipated in the four months to the end of July”.

It says: “In line with Scottish Government requirements, NHS Lothian ceased all non-urgent elective activity from March 16.

“Over 70,000 outpatient appointments and 3,000 inpatient and day case procedures have since been cancelled, resulting provisionally in 36,321 outpatients waiting longer than 12 weeks in May 2020.

“This is a 74 per cent increase on figures for March 20, when Covid began. Provisionally 8,405 inpatients were also waiting longer than 12 weeks as a result of Covid - an increase of 147 per cent on March 2020 performance when pandemic cancellations began.”

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It adds: “Cancellations have also resulted in significant increases in waits for key diagnostic tests including endoscopy, the largest portion of gastroenterology diagnostics, for urology diagnostics (cystoscopy) and for radiology.”

NHS Lothian said that the costs could even by hiked up further as the pandemic continues.

Susan Goldsmith, director of finance at NHS Lothian, said: “The costs associated with our response to Covid-19 are reviewed and refined every month, based on our activity levels and the impact of remobilising services.

“We work closely with Scottish Government on all aspects of this work.”

In the plan, NHS Lothian points to its priorities including diagnostics and treatment for cancer, urgent treatment for cardiac disease, transplants and mental health.

Greater Glasgow and Clyde NHS has indicated that during April and May, it has spent more than £42 million on Covid-19 costs, including £6.8 million on an additional 144 beds and a "significant increase in ICU capacity".

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It has also spent £2 million on testing, £2.6 million on deep cleaning and £1.5 million on PPE.

Before the pandemic, integration joint boards across Scotland, NHS and council partnerships delivering health and social care services, were facing total budget deficits of more than £180 million – but appear to be just a fraction of the Covid-19 costs needed to balance the books.

The latest paperwork for the NHS Lothian board shows that after one month of the financial year, there is an overspend of £5.6 million – including “an estimated £5 million related to additional unfunded expenditure relating to Covid”.

Officials have warned that "there is no additional funding assumed" to be handed over by the Scottish Government for this year's budget "at this point".

In a report to board members, Ms Goldsmith added: “The most significant impact on the financial position for April 2020 is the costs incurred in supporting the services to deal with Covid-19.

“There is no additional funding assumed from the Scottish Government at this point for 2020/21.

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“Any planned expenditure in excess of £1 million, the threshold for larger boards including Lothian, will be required to seek approval from the Scottish Government to commit this spend."

So far this financial year, NHS Lothian has faced Covid-19 costs of £12 million including £1.6 million on extra staffing, £1.3 million on overtime payments and £3.3 million on ward costs. The costs have been partly offset by £5 million of internal funding from ward budgets and almost £2 million in underspend on medical supplies.

Scottish Conservative health spokesperson, Miles Briggs, has called on the Scottish Government to offer support to health boards acting as the front line to the Covid-19 pandemic.

He said: “NHS Lothian was facing significant financial challenges before Covid-19 struck and now these financial challenges are even greater.

“SNP ministers must ensure that health boards are properly funded to deliver essential health services during this public health crisis and have appropriate measures in place.”

He added: “The poor management of NHS boards by consecutive SNP health secretaries has meant that NHS Scotland was not in as strong a position as we should have been to deal with this crisis.

“Waiting times for operations are going to be longer in all health boards and I do not have confidence that SNP Ministers will be able get on top of these long treatment waiting times.”

The Scottish Government has stressed that it will offer financial support to health boards in tackling the coronavirus pandemic and restarting services.

A Scottish Government spokesperson said: “The Scottish Government is working closely with all NHS boards and integration authorities to understand actual costs arising from Covid-19 and to provide the necessary additional funding across the sector.

“NHS Lothian have set out initial estimates of their spend, and this will be further developed in line with plans to remobilise services.

“The Scottish Government will take all steps to protect our frontline services and has passed on all health and social care consequentials received from the UK Government so far to Scotland’s health and social care services. We continue to expect the UK Government to deliver its funding obligations through Barnett consequentials in full.”