Community health services in Scotland face a staggering financial blackhole of more than £226 million, according to new analysis seen exclusively by The Sunday Post.
Leading figures in medicine and social care warn the sector faces a “deeply worrying” financial crisis that could send shockwaves across the entire health service.
Documents including board minutes and financial planning papers published by health and social care partnerships across the country reveal that in recent months:
- Aberdeenshire topped the list with the largest projected deficit of £25.7 million, followed by Fife (£21.6 million), Highland (£21.2 million) and Edinburgh (£20.5 million).
- Several partnerships brought forward the prospect of severe cuts to deal with the projected deficits.
- Fife Health and Social Care Partnership proposed a cut in respite provision from six to three weeks for new cases, raising the threshold for access to social work services, and changes to urgent out-of-hours services.
- Edinburgh Health and Social Care Partnership’s draft three-year financial strategy stated balancing its budget will require “significant savings” and that it is “extremely unlikely that the current level of service provision can be sustained”.
- Minutes of a meeting of Midlothian Health and Social Care Partnership, which is facing a £9.1 million projected overspend, noted “all the reserves had to be used to break even for 2023/24” and that “nothing can be carried forward into 2024/25”.
A public spending watchdog warned in July that health and social care, including mental health support, drug and alcohol programmes and older people’s care, faces “unprecedented pressures”.
The services are run by integration joint boards that work between local government and health boards.
Deeply worrying crisis
Last December, the Scottish Government delayed its plan to set up a National Care Service by three years to 2028-29.
Ministers say they have handed out record investment in health and social care but industry leaders warn the gulf from what is truly needed is already forcing services to make “unsustainable savings” by not filling staff vacancies.
Norman Provan, associate director of the Royal College of Nursing in Scotland, said: “The financial crisis facing Scotland’s health and social care partnerships is deeply worrying and will have a serious knock-on effect on the rest of the health service.
“Too often the focus is on the hospital overcrowding, but this is a symptom of the lack of investment and prioritisation of community services.
“The whole health and care system is at breaking point.”
© SYSTEM“Lack of investment in community health and social care means that staff are operating with their hands tied behind their backs, and patients and communities are suffering as a result.”
Meanwhile Dr Iain Kennedy, chair of BMA Scotland, described the size of the funding shortfall as “alarming” and said it reflects a failure over many years to ensure community care has the resources it needs.
“The crisis the NHS is currently facing is being exacerbated by a lack of capacity across the system,” he said.
“When patients face challenges in accessing social care, it piles additional pressures on GPs and A&E, while the ongoing problem of delayed discharge has a major impact on patient flow in hospitals and reduces the availability of beds.
© Supplied by Iain Kennedy“Therefore there needs to not only be additional investment in health and social care, but a clear vision and comprehensive plan for implementing improvements across all areas, which the health service desperately requires.”
Under immense pressure
The latest analysis was compiled by the Scottish Liberal Democrats.
Party leader Alex Cole-Hamilton said the figures offer a “dramatic insight” into the scale of the immense pressure health and social care services are under.
He said: “Those in charge of delivering services are facing tough decisions about how to balance the books.
“This could be the toughest winter for our overwhelmed health and care services yet.
“The gap between the services we want and the services that the health service can provide seems to be getting wider and wider.
“Every time I go out knocking on doors, I meet people are struggling to get the support they need.
© Colin D Fisher/CDFIMAGES.COM“There is no magic bullet for getting our health and care services back on track, but one thing is clear and it is that the SNP’s proposed plan for a billion-pound bureaucracy and ministerial take-over of social care will do nothing to help.
“The money being devoted to this centralisation of social care would be far better spent on frontline services and staff who are firefighting on every shift. We need confirmation that the government’s plans are dead in the water.”
The Scottish Government said its draft budget sets out £21 billion of investment for health and social care, exceeding its target to increase funding in social care by 25% by more than £350 million.
It added: “Health and social care partnerships are jointly funded by local government and health boards, and are responsible for allocating their own resources.
“We have taken steps to improve the allocation of key social care funding, including over £300 million to deliver the Real Living Wage to Adult Social Care workers.”
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