Report warns of ‘risks and challenges’ facing integration joint boards

Scotland’s integration joint boards (IJBs) face “significant risks and challenges” in the future despite a real-terms funding increase of nearly 10% in the last year, a report has warned.

Financial analysis by the Accounts Commission shows £10.6 billion was received by the boards in 2020/21, but this was mainly due to one-off Covid-19 mitigation payments from the Scottish Government.

IJBs are partnerships between councils and NHS boards, which work together to co-ordinate health and social care services for their local area.

The boards have full power to make decisions over using resources and delivering delegated services to improve quality of care and people’s outcomes.

But the analysis warned IJBs across Scotland are facing uncertainty over future funding, in addition to rises in demand and the potential impact of a National Care Service.

Proposals from the Scottish Government to create a National Care Service could see Holyrood becoming accountable for Scotland’s adult social care.

Health Secretary Humza Yousaf previously suggested doing so will “end the postcode lottery of care in Scotland”.

But the Accounts Commission has warned such plans are causing difficulties for IJBs when it comes to securing longer-term financial planning, with only five of the 30 IJBs in Scotland having long-term plans.

The analysis also shows that reserves tripled for the year 2020/21, which it said reflected unspent Covid-19 funding and a late allocation of cash for services such as primary care, community, mental health and alcohol and drug support.

However, some 81% of the money held in reserves is ringfenced, resulting in a lack of flexibility in how it can be used.

There remains a “significant” budget gap of £151 million as of 2021/22, the Accounts Commission said, adding to further financial challenges for IJBs.

Accounts Commission chairman William Moyes said: “Scotland’s 30 integration joint boards face an increasingly uncertain future, with mounting financial and service pressures.

“All IJBs must put in place robust, detailed longer-term financial plans, helping design sustainable services.

“The pressures and demands on health and social care services are significant. The long-term, adverse impacts of Covid-19 on our health is as yet unknown, alongside pre-existing rising demand, serious recruitment challenges across the social care sector, continued inflation and uncertain longer-term funding for IJBs.

“This comes alongside plans to develop and implement a National Care Service, which has the potential to significantly change the way IJBs operate.”