Borders council chiefs agree £3.2m bailout for region’s joint health board

Council chiefs have handed over an extra £3.2m to the region’s joint health board to help it balance its books as concerns mount over the state of NHS Borders’ finances.

Scottish Borders Council's Newtown headquarters.
Scottish Borders Council's Newtown headquarters.

Scottish Borders Council is giving that money to the health and social care integrated joint board (IJB), a partnership between the local authority and NHS Borders, to fill a funding gap opening up as it once again fails to make ends meet.

However, it has warned health bosses that that level of funding can’t carry on indefinitely.

At a recent meeting of the board, it revealed it needs to make £11.7m of savings this financial year, and a predicted overspend by NHS Borders accounts for £11m of that.

That means NHS Borders will again be seeking a bailout from the Scottish Government, as it has done for the last few years.

The council, on the other hand, made £16.4m worth of savings last year, £11.6m of them permanent and not needing to be repeated annually.

At a meeting of the council’s executive on Tuesday, June 4, David Robertson, its chief financial officer, told councillors: “I just want to highlight one thing about the affordability of the integrated joint health partnership, and I ask members to note that it received an additional £3.2m from the council for this year – this level of support is unsustainable.

“There is pressure on the board to make savings to make it sustainable.”

In October last year, NHS Borders received a £10m bailout from the Scottish Government as it cancelled debts owed by the health service nationwide, but, in return, it demanded that the struggling board draw up a three-year plan to get its books back in order.

And in March, members of the NHS Borders board were called before the Scottish Government’s health and sport committee to explain its financial shortcomings.

Now, NHS Borders finance officers face further questioning by the IJB as they have been asked to attend its next meeting to explain to the board how much progress they have made on their three-year financial plan.

Tracey Logan, the council’s chief executive, said: “The NHS is working on the financial plan for the next three years, and that’s expected to be delivered in the next few months.

“As it stands today, there is no substantive plan to bridge the budget gap, which is not far off 10% of the NHS Borders budget.

“It’s a gap of about £22m to £23m in their budget, which is around £250m, so it’s a massive, massive issue.

“I think, from a joint management perspective, we are very keen to be allowed to engage with financial planning at NHS Borders because we are so inextricably linked.

“We can’t separate it out, so if there’s an issue with NHS Borders’ financial planning, then there’s an issue for us.”

A report from Mike Porteous, chief financial officer for NHS Borders, admits that it will need to seek a bailout from Holyrood again.

He told the integrated board’s meeting last month that it will be a challenge to meet patients’ needs and balance its books, saying: “The requirement to deliver £11.7m of savings in 2019-20 will place a significant challenge on the IJB’s ability to commission and deliver sufficient levels of service to meet the needs of the Borders’ population.

“The key risk to the IJB is to their ability to deliver strategic change in the context of the forecast financial position.

“There is also a risk that NHS Borders’ requirement for brokerage increases, placing further pressure on services to cut costs.

“At this stage, brokerage has not been agreed with the Scottish Government, and there is a risk that the full requirement cannot be met through negotiations with them.”