Health and social care chiefs in Fife have been told critical corrective measures are needed to plug a massive £8.5 million budget gap – just as a damning report raised serious concerns over the region’s long-standing financial difficulties.
Members of the Fife Integrated Joint Board (IJB) have been warned about the severity of the situation after an Audit Scotland report slammed the organisation for overseeing “significant and ongoing” financial problems and failing to deal with recurring overspends.
The Accounts Commission, Scotland’s local authority watchdog, reported the IJB has had overspends in 2018/19 and in the previous two years which had to be met by the IJB’s two partners, NHS Fife and Fife Council.
As a result, the Commission says the continuing cash pressures will “likely undermine” how the IJB will be able to improve vital health and social care services for the people of Fife.
The grim report comes just as IJB members were updated on the bleak financial outlook for 2020/21, with the forecast deficit of more than £8.5 million sitting almost £2 million above a previously approved budget deficit of £6.5 million.
Audrey Valente, chief finance officer, described the need to reduce or close the gap as “critical” and said the level of overspend required “urgent management action”.
And she added: “It is not acceptable for the partnership to not manage within the agreed budget and it is business critical that senior management take corrective action to ensure this is achieved.”
IJB members were told around £3.4 million of the overspend was down to a number of additional complex packages for adult placements commissioned since the budget was set.
Work is going on to reduce that burden, but Ms Valente noted demand still exceeds the resources available.
Ms Valente told the board: “If I take you back to the December position of the IJB we were reporting an £11m overspend, with a planned in year recovery of £1.8m so what we’d planned to see today was a £10m overspend.
“I think I would like to thank all of the leadership team and the partnership for all the good work to bring that down to £8.5m and we will continue to try and reduce that by year end.”
The Accounts Commission has called on the IJB to address the shortfall “as a matter of urgency”, and also tackle weaknesses in its performance reporting, commit to delivering on agreed recovery actions and address a lack of clarity regarding the roles and responsibilities of the IJB and its partners.
Graham Sharp, chair of the Accounts Commission, revealed: “The Accounts Commission are seriously concerned about slow progress in Fife IJB and its clear ongoing financial sustainability issues.
“If this persists it will inevitably affect the ability of the IJB and its partners, Fife Council and NHS Fife, to improve health and social care services local people depend on.”
Labour MSP Alex Rowley has also written to health secretary Jeane Freeman requesting an urgent meeting to discuss the situation.
“In Fife my perception of things is that NHS Fife have not engaged the new set up with enthusiasm but more with a sense of a requirement they must do,” he said.
“To add to that, or perhaps because of it, there has been a real lack of and failure in leadership in driving the new health and social care agenda forward in Fife.”
But Nicky Connor, director of Fife’s health and social care partnership, stressed Fife was not alone in facing significant challenges and valued the Commission’s findings.
“There has been progress made with a new strategic plan for the next three years approved, an integrated transformation board created and a medium to long-term financial strategy is in development,” she said.