Health and Social care integration underfunded, warns IJB finance chiefs

Integration joint boards - Scottish Government

The integration of health and social care in Scotland has neither the resources nor a long term financial strategy to tackle the challenges facing Scotland’s ageing population, the chief finance officers of Scotland’s integration authorities have warned.

Scotland’s Integrated Joint Boards (IJBs) are responsible for linking social care services with the NHS to shift care into more homely settings.

But in a joint submission to Holyrood’s Health and Sport Committee, the senior finance professionals of all the IJBs said the new authorities are already running deficits and under pressure to deliver savings.

“There is emerging evidence which indicates that the current level of resources is less than than required to meet current cost and demand pressures,” the submission said.

“In practical terms this means that the required shift in the balance of care will take longer to achieve.”

Current budget levels will require an “acceleration” of cuts to hospital services in order to transfer funds to community based services, it added.

The IJBs are mainly funded through NHS boards, which are under pressure to deliver ‘efficiency savings’ as a result of public finance pressures. Budgetary pressures are also being felt by local authorities.

According to the finance officers, additional funding should also be paid directly to the IJBs to invest in community based services and prevention.

Commenting on the submission, head of the Chartered Institute of Public Finance and Accountancy (CIPFA) in Scotland, Don Peebles, said: “The integration of health and social care services in Scotland will make a meaningful and lasting difference to the sector. Therefore, it is crucial that there is enough long-term investment to make sure services, which are facing significant pressures, can afford such transformation.

 “It is illogical that there is no medium to long-term financial strategy for the integration of services in Scotland already in place. We urge the Government to outline funding plans for future years to ensure outcomes can be boosted for the benefit of communities.”

Glasgow’s chief finance officer Sharon Wearing, who chairs the IJB chief finance officers group, said: “With emerging evidence of current budget deficits of integrated authorities between 3 per cent and 14 per cent, there is a careful balance to be struck between the level resources necessary to manage current demand while planning for system redesign. 

“It is of crucial importance that there is integration, however it needs to be properly planned for to ensure the sustainability of services.”