Health chiefs have come under fire after being accused of not being ambitious enough in setting out a three-year strategy.
The Edinburgh Integration Joint Board (IJB), made up of city councillors and NHS officials, agreed its draft strategy for 2019-2022 to be put out for public consultation next year, once the final plan has been agreed.
But a report to board members, highlighted that financial pressures could mean the final strategy will not be approved.
A report to board members said: “The final version of the strategic plan and strategic commissioning plans will be brought back, with financial plans and final directions, to the IJB in February.
“There is a risk that the plans are not affordable within the 2019-2022 budgets and will not be able to be approved by the IJB in 2019.”
Currently, the IJB is on course to be £10.3m over budget by the end of this financial year – with £1.3m drained from reserves to help reduce the deficit.
Key aspects of the draft plan include providing health and social care for people “to be well in communities for as long as possible” and “only providing acute hospital care when it is medically required”. A change in culture will need an “understanding that to reduce our demand on acute care, we must invest more to support people to be well in communities”.
But board member Martin Hill warned that the draft strategy is not ambitious enough to bring about an overhaul needed to improve services.
He said: “I’m just wondering whether we’ve missed a trick here and are we being sufficiently ambitious?
“If we sit back and say what have we actually achieved over the past few years by following these words, are we making sufficient progress to get up-stream and even meeting the targets we have got?”
He added: “I don’t think we have made the progress that we would like to make. If we want to be ambitious, we need a different model. There’s a lot of good worthy stuff in here that you would expect to see within an IJB strategic plan, but where’s the big ideas? Where’s the ambition?
“I would like to see a very different style of strategic plan – one that reflects the fact the IJB is something different that we can fashion, which has got some bright ideas about how we can address the kind of ambition we need to deal with the challenges that we have been unable to deal with in the last few years. I don’t want to see more of the same but this strikes me as more of the same.”
Fellow board member Richard Williams raised opposing fears that the IJB could struggle to meet expectations, given the financial pressures.
He said: “My concern is around being too ambitious and perhaps setting us up to fail with too unrealistic and unachievable strategy.
“I think we need to see this in more detail before it goes out for consultation.”
Chairman of the IJB, Cllr Ricky Henderson, said the process would be a balancing act.
He added: “We want to be ambitious, we want to have a vision for the future. That will have to be balanced with the reality of what we can do with the resources that we have available.
“We will not be doing anybody any favours if we promise this, that and the next thing and miserably fail to deliver on them after three years. We just need to strike that balance.”
