Edinburgh’s Integrated Joint Board (IJB), the body that governs the city's health and care partnership (HSCP), has backed an ambitious programme to quicken the pace of health and care reform.

The transformation and change programme is to be funded with £2m from the £8m of reserves the partnership has built up.

With demand for services rising, the aim is to reduce pressure on the system by rebalancing the system towards prevention, early intervention and community support.

The report considered by the IJB at its meeting on Friday 8^th February paints a bleak financial picture. 

Increasing demand caused by an ageing population will have to be absorbed ‘with no corresponding increase in base budgets’, as additional funding required to keep delivering services in the same way is ‘simply not available’.

The capital also faces distinct challenges on social care, with serious recruitment and retention problems among the social care workforce and care home providers reporting ‘significant fragility’ in their business models.

Jointly funded by the council and NHS Lothian, the partnership faces a potential shortfall of nearly £30m in the next financial year.

Board members were told not allocating the cash to transformation could risk ‘non or only partial delivery of the IJB’s ambitions’.

The IJB agreed to allocate £2m from the partnership’s £8m of reserves to fund the reform programme, which represents a “significant shift” in the “offer and delivery” of health and care in Scotland’s capital.

The transformation programme is projected to last three to five years and consolidates existing reform initiatives in areas such as financial efficiency and older people’s services.

The proposals are divided into three key areas – prevention, supporting people in crisis and ongoing support.

A raft of wellbeing, early intervention and prevention projects are to be introduced in an attempt to build resilience ‘at the earliest possible point’. These include:

• The development of an overarching prevention strategy
• A ‘full review’ of the partnership’s grants programme
• Further development and implementation of a strategy for carers

Existing community-based crisis management approaches are to be reviewed and discharge to assess, which focuses on getting older people out of hospital as quickly as possible, is to be rolled out across the city.

Finally, improving the quality and capacity of ongoing care will see a new strategy for night-time support services and changes to respite and home care services.

Some of the £2m will fund the infrastructure required to deliver the changes – a new digital strategy, technology to help people live at home and project management.

During the meeting, board member Carolyn Hirst, who is also a non-executive director at NHS Lothian, said: “I don’t think we can underestimate the importance of this report for us as an IJB. I think is absolutely crucial, I think it is talking about a fundamental change that we need to make, that we have to make.”

Now the plan has been approved, the IJB is to focus on setting up the committees and governance structures that will oversee the three-pronged reform package.