The Accounts Commission has examined the finances of Integration Joint Boards (IJBs) in Scotland and says that the situation is “increasingly precarious” and that urgent reform is needed.
The verdict is that the boards are not sustainable as they stand, but that IJBs cannot manage their financial pressures in isolation from the local councils and NHS partners. The boards are made up of representatives from both local authorities and health boards.
In Edinburgh the Chief Officer, Pat Togher, had been in post for barely a year before quitting his £180,000 job just before the end of last year. The commission has mentioned the high turnover of senior members of staff at a time when “strong and stable collaborative leadership is crucial”. The Edinburgh Integration Joint Board (EIJB) has a working deficit of around £50 million, and had planned cuts of £4.5 million from third sector organisations. This move has been postponed, but has been criticised as it is a drop in the ocean in the EIJB budget of £900 million – and the grant funding is spread across the city helping people of all ages.
The financial picture is woeful with overspending, running down of reserves and reliance on one-off savings all highlighted as usual throughout Scotland. The funding gap was projected to raise from £357 million in 2023/24 to £457 million in 2024/25.
The report states that IJBs, alongside their NHS and council partners, need to be transparent with communities about what this means for services, and collaborate to plan for the major reforms required.
Malcolm Bell, Member of the Accounts Commission said: “For too long, Integration Joint Boards have been fire-fighting immediate financial challenges. Now they must shift from making one-off savings and relying on reserves to transform how services are delivered if they are to tackle their precarious finances.
“A stronger focus on prevention is needed, with candid conversations with communities, councils and NHS partners vital around the difficult choices that need to be made.”
A further report will be published on the services provided by IJBs by Audit Scotland in autumn this year. (Audit Scotland provides services to the Auditor General for Scotland and the Accounts Commission.)
Scottish Labour’s Health Spokesperson Jackie Baillie said: “The SNP must heed the warnings in this report before the crisis in health and social care spirals even further out of control.
“We need strong and effective leadership on health and social care more than ever, yet this perfect storm of funding pressures, staffing shortages and growing demand has left services at breaking point.
“IJBs are supposed to make these vitally important services more stable, yet the report shows overspend that will only lead to cuts next year.
“As Finance Minister John Swinney only added to the instability by clawing back the reserves IJBs were supposed to draw on.
“The SNP must work with IJBs, councils and health boards to undo the damage they’ve caused and come up with a sustainable plan — or it will be vulnerable Scots who pay the price.”
Scottish Liberal Democrat health spokesperson Alex Cole-Hamilton MSP said: “There is a mountain of pressure facing health and social care services.
“SNP ministers have failed to relieve that strain from boards. They’ve allowed problems to boil over and spill out into the rest of the NHS. If people can’t get a care home place or a care package, too often they are left sitting in hospital, even if they are otherwise well enough to leave. That gums up the whole medical system from A&E onwards.
“Only Scottish Liberal Democrats have a plan to fix the crisis in social care by introducing a new minimum wage for care workers that is £2 higher. That’s how we can get people care at home or in the community and free up space in hospital, helping everyone get seen faster.”
Founding Editor of The Edinburgh Reporter.
Edinburgh-born multimedia journalist and iPhoneographer.
