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Funding wrangle over social care spending rumbles on as NHS Fife slams ‘unfair’ arrangement

Tricia Marwick, chairwoman of the endowment fund trust has welcomed plans for the new wellbeing hub.
Tricia Marwick, chairwoman of the endowment fund trust has welcomed plans for the new wellbeing hub.

NHS Fife has branded social care funding arrangements unfair after picking up most of the tab for a council overspend.

A risk-sharing agreement drawn up by Fife Health and Social Care Partnership (HSCP), means the health authority must meet 72% of social care overspend, with the rest coming from Fife Council.

NHS Fife bosses hit out after contributing £8.3 million for an overspend of more than £10m, despite the board itself being in the black.

During a virtual meeting on Wednesday, board members were told the situation was “impacting materially on the NHS Fife overall financial position.”

Tricia Marwick, who chairs NHS Fife Board, said: “If you take our underspend into it, which was deducted before that split was made, we’ve actually in Fife NHS contributed 82% of the overspend and Fife Council has contributed 18% when all of that overspend was for services that should have been funded by the council.”

Non-executive director Rona Laing said: “This position really concerns me. Every year we have this conversation.”

Ms Laing said the financial burden on NHS Fife appeared to increase every year, adding: “It’s not sustainable in terms of the position for Fife council in managing its budget.”

She said: “I don’t think it was ever intended that one of the partners would, it would appear, consistently every year have to find additional money from its budget to balance the books.

“I think that’s not a healthy position for the partnership to be in and I think it must really risk the partnership relationship if this continued, and I think there as to be a better way of managing this and a fairer way.”

Labour councillor David Graham, the council’s spokesperson for health, said: “When looking at the financial picture of the health and social care partnership in Fife we cannot look at them in silos of NHS Fife and Fife Council.

“The government’s requirement for the shift of the balance of care from hospital to home requires the spend to be higher in social care than it ever has been before. The care of the people of Fife is what is most important and government needs to consider whether the funding which is being made available to health and social care partnerships is actually fully adequate for the longer term.”

Fife HSCP said it was facing “significant” financial challenges as demand increased for services.

Nicky Connor, Fife’s Integration Joint Board chief officer, said “massive in-roads” had been made over the past six to nine months to keep within the budget that was agreed in March 2019.

She added: “A new three year strategic plan for the partnership has been agreed, an integrated transformation board established and the continuing development of a medium to long-term financial strategy is in place, all of these will help towards the partnership becoming financially sustainable.”