Scotland's public services watchdog says integration joint boards (IJBs) and their NHS and council partners must take urgent decisions on redesigning, reducing or discontinuing services if they are not to run out of money.

A report published today says the bodies that oversee the work of Scotland's health and social care partnerships need to plan their finances more realistically as the cash reserves they have been using to plug their funding gaps run out.

The Accounts Commission’s Integration Joint Boards Financial Bulletin for 2024/25 says that, despite a 2.3% real terms increase in IJBs’ funding compared with the year before, the budget gap hit £449 million.

The report says that funding for Scotland’s health and social care partnerships is insufficient to meet the rising costs of supporting the growing number of people with long-term, complex needs.

The watchdog acknowledges that significant savings have been made and money has been pumped into services from reserves. But, it says, this cannot continue as boards have reached a "critical point" with a "significant risk" that they will now become financially unsustainable within the next 12 to 24 months.

One of the authors of the report, Accounts Commission member Malcolm Bell, says IJBs need to plan their spending more realistically given that the NHS boards and local councils that provide their funding are themselves facing significant financial pressures:

“The cost of delivering services is rising faster than available funding. Tackling this could include difficult decisions about redesigning or reducing services, and whether new or additional charges need to be made.

“Whatever decisions are made, service users, their families and wider communities must be consulted.

“But without radical change the services delivered by IJBs can’t be sustained. The gap between funding available and the cost of meeting demand is widening, and the gap of nearly £450 million cannot be bridged with savings alone.”

Social Care Minister, Tom Arthur MSP says the answers lie in further integration and joint planning:

“While this report acknowledges a real-terms increase in IJB funding between 2023/24 and 2024/25, we recognise the financial pressures facing the health and social care sector and remain committed to meaningful reform.

“We have provided a record settlement for local government and will deliver funding of almost £22.5 billon to health and social care in 2026-27.

“The integration of health and social care planning is essential in ensuring services are well-coordinated and responsive to the population's evolving needs. This report recognises the need for local collaboration in setting budgets.”

Mr Arthur adds:

“Through the National Care Service programme, and the delivery of the Service Renewal Framework, we are taking practical steps towards our vision of a Scotland where people live longer, healthier and more fulfilling lives."

Health and Social Care spokesperson of local government organisation COSLA, Councillor Paul Kelly, says the report justifies their calls for a significant cash injection by the government into social care:

"The Accounts Commission report on Integration Joint Board finances for 2024-25 confirms the stark reality our health and social care partnerships face; that severe financial challenges continue to pose a risk to the sustainability of social care, which threatens the everyday lives of our most vulnerable citizens and communities.

"The challenges also threaten the sustainability of our councils, who have continued to prioritise social care, with an additional £163m invested over and above Scottish government funding in 2024-25. This level of additional funding is unsustainable for partners, but in many cases the only option given the diminishment of reserves held by partnerships.

"The report makes clear the validity and need for our budget lobbying ask of an immediate investment of £750m in social care. We will continue to press the Scottish government for this investment to avoid further cuts, reductions and increased charges in future."

 

Read more:  Additional funds for care and hospices; Users to get voting rights at IJB meetings; Councils warn of social care cuts ahead; Fixing social care funding must be council “priority”

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