Councillors will be warned the monetary problems which dogged the Health and Social Care (H&SC) partnership between local authority and health board last year threatens the financial sustainability of Scottish Borders Council.
The cash shortages experienced by the service in 2018/19 meant more than £3 million of top up funding had to be found from council sources to 'subsidise' the partnership in the face of increased demand for services.
In a report to next week's SBC Executive meeting finance officers also warn that it is essential the H&SC joint board takes robust steps to balance its books this year as the council will not be able to plug any gaps this time round.
According to the report: "2018/19 represents the third operational year of the Health & Social Care partnership which has resulted in a fundamentally different way of working with NHS Borders through the Integration Joint Board (IJB).
"Within integrated Health & Social Care services, during 2018/19, additional in-year budget allocations were made to the value of £3.2 million to support delayed discharge and alleviate service pressures of £1.8 million. In year £1.4 million of savings which were anticipated by the Financial plan were not delivered and this required additional financial resources from the Council to ensure that the Service did not overspend its allocated budget. Of this identified £3.2 million budget shortfall, £1.2 million has now been vired in to the service on a permanent basis.
"The H&SC partnership budget presents significant risks
to the Council and will require robust management action in 2019/20 and future
years to both contain demand pressures within existing budgets and deliver
required financial plan savings. It should be noted that the Council will not
be in a position to allocate substantial additional resources to the
partnership in 2019/20 and as such it is essential that managers manage their
services within approved resource levels."
And the fuller version of the document has this to say: "The Council experienced significant financial pressures
during 2018/19, primarily in Assets & Infrastructure and Health &
Social Care, attributable to increased costs and delays in the delivery of
planned savings in the revenue budget.
"[The Management Team] reviewed the position continually
through the year and took action through a range of alternative measures to
identify savings which offset this position and delivered an under-spend
position by the 31st March 2019.
"It is increasingly evident that the Council is
finding it more and more difficult to balance the revenue budget given the
sustained service demands e.g. in Adult Social Care. It is essential to ensure
the financial sustainability of the council that the revenue budget is balanced
and that this is achieved through the delivery of permanent savings in line
with the timescales approved in the Financial Plan.
"The 2019/20 Financial Plan
recognised the demand challenges within H&SC, robust management action is
now required to both manage demand pressures within existing budgets and
deliver required financial plan savings. The performance of the H&SC
partnership and ongoing concerns regarding the NHS Borders budget is a key risk
facing the Council."
The financial report for 2018/19 records an unaudited outturn net underspend of £1.344 million was achieved
in the 2018/19 revenue budget. The £1.344 million net underspend (0.52% of final
approved budget) was delivered following a number of earmarked balances
approved by the Executive Committee during 2018/19.
" It should be noted that, overall, as required
in the Financial Plan, savings of £16.414m were successfully delivered during
2018/19. Of these, £11.656m (71%) were delivered permanently. The remaining
£4.758m (29%) of savings were achieved on a temporary basis", the report says.
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