Health and social care’s £6m overspend

NHS Borders, Newstead
NHS Borders, Newstead

Local Democracy Reporter

The Scottish Borders health and social care integrated joint board (IJB), which is funded as a partnership between the council and the local NHS board, will have to be bailed out by the partners due to the overspend.

A large proportion of the £6m overspend is due to the IJB’s failure to make required savings from its healthcare budget as well as high levels of patient activity and rising staff sickness levels.

The IJB’s 2018/19 financial plan called for £5.2m of unidentified savings to be made in the joint board’s healthcare budget, and while some savings have been found, there is still £4.8m of savings which need to be made.

A report by Scottish Borders IJB’s chief financial officer Mike Porteous reads: “The ongoing monitoring of schemes identified to address the efficiency targets continues and the position remains largely the same at this point in time. The unidentified savings balance within health is reported at £4.8m.

“While work has begun on identifying and modelling potential savings plans for the health and social care partnership they will not deliver financial balance in the current year.”

In this financial year, the council gave £45.8m while the NHS board gave £122.5m, meaning NHS Borders can be expected to foot nearly two-thirds of the IJB’s bill.

However, NHS Borders is currently experiencing its own financial difficulties after it recently emerged that the board had been escalated to stage four on the Scottish Government’s NHS board performance escalation framework. That places it just one stage away from ministerial intervention being required.

The health board is currently trying to secure extra funding from the Scottish Government, part of which would be used to cover the Integration Joint Board’s overspend.

The report continues: “The overriding risk is that the budget allocation received from NHS Borders and Scottish Borders Council will not be sufficient to cover expenditure incurred.

“A commitment has been given by both funding bodies to fund any expenditure in excess of the delegated budget, and the progress of discussions on brokerage gives an appropriate level of assurance that commitment will be delivered.

“There is a risk that the financial recovery plan will not identify sufficient savings to deliver a balanced financial plan going forward. The recovery plan must explore all options across the partnership and produce an integrated plan.”