Funding to Integration Joint Boards increases, but significant risks and challenges ahead

Funding of Integration Joint Boards (IJBs) in 2020/21 increased by nearly 10 per cent in real terms, bringing total funding to £10.6 billion. This was mainly due to one-off Scottish Government funding to mitigate the impacts of Covid-19.

Reserves also tripled, reflecting unspent Covid-19 funding and the late allocation of specific funding for primary care, community, mental health and alcohol and drug support.

All Scotland's IJBs, however, face significant financial sustainability issues: uncertainty of future funding, rising demand and the potential impacts of a national care service. This means:

• across all 30 IJBs there remains a significant overall budget gap - this was £151 million in 2021/22, with some IJBs facing significant financial challenges
• making recurring savings and delivering services differently is essential to addressing future budget gaps
• 81 per cent of money held in reserves is ringfenced, creating a lack of flexibility in how IJBs can use this money
• Securing longer-term financial planning – only five IJBs have long-term financial plans

William Moyes, Chair, Accounts Commission 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.