by DOUGLAS SHEPHERD
The mounting pressure on health and social care services in the Scottish Borders is set to intensify even further with the region's "over 75s" set to rise by no less than 30 per cent by 2026, according to a report from the so-called Integrated Joint Board (IJB).
NHS Borders has already received brokerage (extra cash) from the Scottish Government after exceeding its budget due to excessive demand for services. Meanwhile the IJB which represents the Borders Health and Social Care Partnership has also had its finances topped up by the partners.
The report which contains the IJB's annual accounts for 2020/21 paints a graphic picture of the issues associated with an ever-aging population.
It says: "58.8% of the population of the Scottish Borders is aged between 16 and 64 years of age. This is against a national average of 64%. Conversely, 24.8% of its population is over 65 years of age, significantly above the national average of 19.10%.
"Whilst the overall population of the Scottish Borders may not be projected to increase significantly over the coming years, the average age of the Scottish Borders population is expected to continue to increase: i.e. as the current older working-age cohort become pensioners with an increased life expectancy, there is expected to be fewer younger people to replace them.
"The Borders 16- 24 age group is projected to further decrease by over 10% before 2026), and the 75+ age group is projected to increase by almost 30% over the same period. These demographic factors therefore have a unique and challenging impact on the models of health and social care provision in the Scottish Borders and their costs and directly drive the strategic objectives, transformation requirements, planned shifts in the balance of care and resource realignment targeted by the Health and Social Care Partnership."
The partnership spent over £175 million on delegated functions in the last financial year.
And the report explains: "Additional funding allocations were made by the Scottish Government during the year to mitigate the net financial pressures. Additional contributions also required to be made by partners to deliver the reported position. At the end of the financial year, £0.093 million of corporate support was provided to Health and Social Care functions by Scottish Borders Council and £3.925 million of additional support was provided by NHS Borders. This additional budget delegated was primarily available as a result of under-spends and additional funding allocations across non-delegated Health and Social Care functions."
A commentary on the financial outlook for the IJB warns: "The IJB continues to face significant financial challenges and both of its partners are facing challenges in meeting the demand for health and social care services within the financial quantum available. This, going forward, will have a direct impact on the levels of funding provided to the IJB.
"Within the IJB, the key barriers to managing the financial position arises from demographic pressures of demand, together with capacity to plan and deliver required levels of transformation and efficiency savings. The significant growth anticipated in the number of older people and their need for suitable services, requires innovative solutions to allow services to be provided within funding levels available and, the ability of the partnership to transform services to help meet this demand."
The report also lists a number of 'risks' facing the service going forward.
"With pressures across all health board and council functions
as a result of the Covid-19 pandemic, both delegated and non-delegated, there
is a risk that if these are not funded by the Scottish Government
in full, neither partner will be in a position to make additional contributions
to top-up the budget delegated to the IJB or Set-Aside as it has in previous
financial years. Accordingly, the Partnership may be at risk of over-spend,
without mitigating solutions, at the end of the financial year.
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