More than £1 million was spent on agency nurses in Ayrshire and Arran in October as the NHS in the area faces a £30m funding gap.

The predicted shortfall of £30.4m for the current financial year is £4m more than officials budgeted for in April.

The Scottish Government has told the local NHS that it must at least plug that initial gap of £26.4m.

However, a number of subsequent issues have made that already difficult target even more of a challenge.

As well as the rising spend on agency nurses, due staff shortages, added pressures include increasing delayed discharges from hospitals and £3.3m spend on agency doctors over the first six months of the current financial year.

Health chiefs face an overspend of £5m in GP prescribing due to increased prices.

Ayrshire and Arran Health Board heard that a plan that would have saved money by reducing waiting lists would not be achieved, with some services predicted to ‘deteriorate further’.

It was also acknowledged that, unlike previous years, there was no opportunity to carry over unspent allocations into the next financial year.

The report to the health board stated: “Covid-19 and high unscheduled care demand continues to drive expenditure, and commitments entered into around additional wards and test and protect will require to reduce spend.

“Operational pressure, including 249 delayed discharges in the week commencing October 31, will make the bed reductions required to hit our financial target extremely challenging to deliver.”

It was revealed that the main issues around delayed discharges were predominantly in South Ayrshire, with the area's integration joint board (IJB) - which oversees the work of the South Ayrshire health and social care partnership - asked to pay for the additional spend.

The report continued: “There are particularly high levels of delayed discharge within South Ayrshire.

"The South IJB has been asked to contribute to the additional costs being incurred in acute services as a result of the above average levels of delays, but it is uncertain if any funding will be forthcoming.

“The £7.9m now confirmed for access will not enable us to reduce waiting lists beyond the existing trajectory.

“Some specialities will deteriorate further.”

In an attempt to mitigate this, £1m of the board's reserve funds have been taken.

Although the spend on agency nurses in October was similar to a spike at the turn of the year, there has been a consistently higher spend throughout the 2022/23 than in previous years.

The report continued: “We spent £1.1m on agency nursing staff in October, an increase of £300,000 over September.

“This is well in excess of previous years spend at this point in the year and is the first time monthly spend has exceeded £1m this year.

“We used 907 whole time equivalent (WTE) medical staff in October, including locums and agency.

“This was 29 above establishment and is the main reason for the £2m overspend.

“The high cost of some medical agency staff is a driver for an overspend against the medical staff budget.

“Staff sickness absence from work has organisational impact beyond the individual staff member, affecting other staff, service delivery, productivity and cost, where backfill arrangements have to be put in place.”

Sickness absences jumped in September and October, from five to six per cent. However, much of this was attributed to the fact that Covid-related absences were no longer excluded from the wider absence figures.