eHealth Structures and Funding
The Scottish Government eHealth strategy (2011-17) defines eHealth as the use of ICT to meet the needs of individuals to improve the health of citizens including electronic information recording and sharing between individuals and bodies. The Scottish Government eHealth Division lead a run a range of workstreams, working with regional and other boards, to drive forward the eHealth agenda. The eHealth programme is administered by NHS NSS.
The eHealth activity is governed through eHealth Leads Group which includes senior representatives from regional boards, national boards (including NSS) and the Scottish Government eHealth Division. During 2016/17 the Scottish Government invested £73.6 million in core eHealth funding. This is allocated across the Boards, managed by the Scottish Government Health Division. Health boards also invest in eHealth programmes. However, there is no central monitoring of such expenditure and this is distinct from Scottish Government core investment. In addition, there are distinct elements of funding provided by the Scottish Government for individual programmes that may fall under the eHealth umbrella. For core eHealth funds, these are allocated to Boards through their wider IT budget allocations. Where central eHealth programmes are initiated these are transferred to NSS through the ‘payments on behalf of Board’ process.
The Head of Finance ( IT) within NSS then manages the progress v budget across eHealth programmes and NSS present reports to eHealth Leads and eHealth finance subgroup meetings. Wider IT programmes are not within the scope of our investigation.
eHealth Reinvestment fund
In 2012, eHealth agreed (as minuted) that the reinvestment fund balance for 2013/14 of £0.870 million, would be “carried forward” by NHS Tayside. This was transacted through Scottish Government Revenue Resource Limit ( RRL) allocations with NHS Tayside receiving an in-year increase in its allocation and NHS Tayside receiving an equal and opposite reduction.
In 2012/13, NHS Tayside recognised this allocation as part of its Core RRL in the annual financial statements. The transaction was reversed the following year, with the funding allocation effectively returning to NSS.
In each of the following years, this series of transactions took place for sums ranging between £0.538 million and £2.582 million. In each instance, the initial allocation of the eHealth reinvestment fund has been initiated by NSS and NHS Tayside and authorised by Scottish Government eHealth. Each of the transactions were reported to the eHealth Leads group (and while in operation the eHealth Finance subgroup) through disclosure in financial monitoring reports covering the eHealth programme.
From 2015/16, the amounts “held” by NHS Tayside included allocations that were outwith the original eHealth Reinvestment fund. This included £0.3 million ( CHI & Child health) and £0.35 million ( OOH). These arrangements were agreed with the Head of Primary Care. The funds are for eHealth related programmes and monitored through eHealth leads.