NHS Grampian will be forced to make savings of almost £20 million this year in a bid to make a balanced budget, according to forecasts.

The health board estimates it will need to save a total of £18.3m during 2018/19, over and above any savings agreed in previous years.

The draft revenue budget, which was agreed in February, indicates NHS Grampian will be able to achieve a balanced budget, should savings be made in areas such as reducing medical locum spend and delivering on other efficiencies.

The board’s annual operational plan, which was to be considered by its members today, said: “The total of £18.3m covers both those services which are directly managed by NHS Grampian (£12.7m), and those services which are delegated to our three Health & Social Care Partnerships (£5.6m).

“The main areas which will be targeted for achievement of savings in 2018/19 are medical locums and other agency staffing, savings on the cost of medicines and savings delivered through service and productive efficiencies.”

Under the current funding formula the local health service receives less than the 90% of the Scottish average per head of population than it is entitled to under the NRAC formulas (NHS Scotland Resource Allocation Committee).

North-east Labour MSP Lewis Macdonald said “less efficiencies” would be required if the Scottish Government stuck by its own funding formula.

He added: “It’s 10 years after they agreed to do it. NHS Grampian have an extremely efficient health board and they have to be because they are the lowest-funded health board in the country and they’re not even receiving the money they should from the Scottish Government.

“Secondly, £18m is a lot of efficiencies to have to find on top of year after year of funding efficiencies and that will be a challenge for them but they’re right to try to do that in ways that don’t effect patients directly.

“In order for them not to have the need for locum doctors, they need to be able to appoint people directly to do those jobs and that’s cheaper in the long run.

“But the Scottish Government needs to do more to assist with recruitment.”

It was revealed in October that health chiefs spent a total of £18.8m on medical agency locums in 2016/17 – up 18% on 2015/ 16 – and £3.4m on nursing agency staff.

Health Secretary Shona Robison said: “As part of our budget for 2018/19, we have increased health funding by more than £400m, which includes a 2.1% increase for NHS Grampian – the highest percentage uplift of any territorial board. In addition they will also receive a share of £175 million investment in reform.

“This comes on top of a £16.2m increase in funding last year which helped NHS Grampian invest in 800 additional staff

“Every year NHS Boards identify a level of savings which are then retained for local reinvestment, and we expect all Boards to ensure they make the best use of available resources.”

It was also reported last month that health chiefs hope to stop prescriptions for drugs of “limited clinical value” in a bid to plug a £1.8m black hole.

The Aberdeen City Integration Joint Board (IJB), along with the other IJBs in Grampian, is facing “significant overspends” in its budgets for prescribing.

The drugs include herbal treatments, omega-3 fatty acid compounds, a supplement used in cardiovascular disease, and a paracetamol and Tramadol combination product for pain relief – which is cheaper when prescribed separately.

A report is also to be prepared detailing other drugs being prescribed with limited clinical value and recommending the process to de-prescribe these.

Meanwhile, board members were expected to hear progress on £53.3m of investment across the NHS Grampian estate when they meet today.

The infrastructure investment update report said a new health and community care hub in Inverurie is expected to become operational in late July.

The hub will include a new community maternity unit, an X-ray department and accommodation for visiting specialists.

Members were also to hear the Stonehaven Community Renal Unit, located at Kincardine Community Hospital, is nearing completion and is expected to become operational next month.

The facility was fully funded by charitable donations mainly raised by the local community.

The board is also expected to endorse the purchase of land next to the existing Ellon Health Centre, from Aberdeen-shire Council, in order to develop it into a new medical centre.

Earlier this week it was revealed NHS Grampian has secured part of the site at the former Ellon Academy on Schoolhill Road – which was demolished in April 2017.