NHS BORDERS has failed to meet six of its eight key performance targets, a new report has revealed.

Audit Scotland’s annual review of the country's health service has issued a stark warning on the future of the NHS, reporting that health boards across Scotland are struggling to break even and no area of the country has managed to achieve all eight key waiting time targets.

NHS in Scotland 2018 found that the health service’s performance continued to decline in 2017/18 with only one key target met nationally – for 90 per cent of patients referred for drug and alcohol treatment to receive treatment within three weeks.

Caroline Gardner, Auditor General for Scotland, said: "The performance of the NHS continues to decline, while demands on the service from Scotland's ageing population are growing.

"The solutions lie in changing how healthcare is accessed and delivered, but progress is too slow.

"The scale of the challenges facing the NHS means that decisive action is needed now to deliver the fundamental change that will secure the future of this vital and valued service.

"Alongside longer term financial planning, this must include effective leadership, and much more engagement with communities about new forms of care and the difference they make to people's lives. This will help to build support among the public and politicians for the changes required."

NHS Borders met two of the eight standards - to begin cancer treatment within 62 days from a patient being referred, and to begin cancer treatment within 31 days following a decision to treat.

But they missed their targets to provide an A&E waiting time of less than four hours; an 18 week ‘referral to treatment time’; a wait time of less than 12 weeks for day case or inpatients; to see outpatients in less than 12 weeks following their first referral; and for drug and alcohol patients to be seen within three weeks

The target missed by the greatest margin locally was for Child and Adolescent Mental Health Services (CAMHs) patients to be seen within 18 weeks. The target standard is 90 per cent with NHS Borders managing just 48.2 per cent.

A spokeswoman for NHS Borders: “Demand for our services continues to increase which can present challenges in relation to achieving national performance targets.

"Despite these challenges the on-going hard work and commitment from all our staff continues to ensure that we provide high quality services across the Borders.

“It is widely recognised that there are a number of workforce challenges for the NHS, such as recruitment and retention issues, an ageing population and in turn an ageing workforce.

"Despite this we have made a number of successful appointments to senior clinical posts here in the Borders - consultant vacancies in September 2018 were running at around three percent, the lowest vacancy rate for many years.

"Although the recruitment challenge is not going to diminish, we will continue to use every opportunity to create a more resilient workforce.

In 2017/18, the health budget was £13.1 billion – 42 per cent of the total Scottish budget. Taking inflation into consideration, this was a 0.2 per cent decrease from 2016/17.

The annual review identified that boards across the country are struggling to meet rising demands and cost pressures and, whilst they achieved savings of £449.1 million in 2017/18, these relied heavily on unsustainable, one-off savings.

In the Borders, a saving of £8.3m was made with 66 per cent of it being non-recurring.

The review also highlighted that the reliance on loans from the Scottish Government by health boards had increased in 2017/18, with “significantly more” borrowed compared with the previous year. NHS Borders, along with NHS Ayrshire and Arran, Highland and Tayside have predicted they will need loans totalling £70.9 million in 2018/19.

The NHS Borders spokeswoman added: “We were anticipating an overspend, and hence brokerage, of somewhere in the region of £10million this year until the recently announced write-off of brokerage which includes NHS Borders.

"We expect we may have a financial shortfall in the coming years, but this will depend on what funding uplift is made available to us and this is still to be determined across Scotland.

“We remain focused on our clinical services being fit for the future, shifting the balance of care and providing the best possible care to our patients.”

This week's report has been met with calls for further investment.

Chair of British Medical Association Scotland (BMA), Dr Lewis Morrison said: “One warning is repeated over and over again in Audit Scotland’s latest report: That the NHS is not in a financially sustainable position.

“This stark warning could not be any blunter, but will come as no surprise to frontline doctors who have faced the consequences of inadequate funding year after year.

“As the BMA and others have warned for some considerable time, funding in the NHS is simply not keeping pace with demand and that has pushed NHS services across the country into the parlous position this report details.”