Integration Joint Boards (IJBs) have reached a critical point in Scotland with a significant risk they will become financially unsustainable within the next 12 to 24 months, according to the Accounts Commission.

A new report says IJBs have been relying on substantial additional funding from their partners in the NHS and councils and urges them to plan their finances more realistically.

Malcolm Bell, member of the Accounts Commission said: ‘The cost of delivering services is rising faster than available funding. Tackling this could include difficult decisions about redesigning or reducing services, and whether new or additional charges need to be made. Whatever decisions are made, service users, their families and wider communities must be consulted.'

Funding to Scotland's 30 IJBs increased by over 2% in 2024/25 to more than £12bn but they still faced an almost £450m gap.

Bell warned that ‘without radical change the services delivered by IJBs can't be sustained'.

COSLA health and social care spokesperson, Councillor Paul Kelly, said ‘The Accounts Commission report on Integration Joint Board finances for 2024-25 confirms the stark reality our health and social care partnerships face; that severe financial challenges continue to pose a risk to the sustainability of social care, which threatens the every day lives of our most vulnerable citizens and communities.'

Cllr Kelly said the challenges threatened the sustainability of councils, who invested £163m invested over and above Scottish Government funding in social care in 2024-25.

COSLA called for an immediate investment of £750m in social care from the Scottish Government.

Sharon Graham Unite general secretary said: ‘Unite has demanded decisive action by the Scottish Government to provide the finances necessary to deliver sustainable health and social care services.

‘The Accounts Commission report starkly spells out that deep cuts are already underway.'

Social care minister Tom Arthur said: ‘While this report acknowledges a real-terms increase in IJB funding between 2023/24 and 2024/25, we recognise the financial pressures facing the health and social care sector and remain committed to meaningful reform.

‘We have provided a record settlement for local government and will deliver funding of almost £22.5bn to health and social care in 2026-27.

‘The integration of health and social care planning is essential in ensuring services are well-co-ordinated and responsive to the population's evolving needs. This report recognises the need for local collaboration in setting budgets.

‘Through the National Care Service programme, and the delivery of the Service Renewal Framework, we are taking practical steps towards our vision of a Scotland where people live longer, healthier and more fulfilling lives.'

Lee Peart is editor of Hemming Group’s Healthcare Management magazine.