AUDIT and scrutiny councillors were told on Thursday that  Clackmannanshire and Stirling Health and Social Care Partnership will need to consider “previously unpalatable” decisions in light of a £12.5 million blackhole. 

The Wee County’s portion of partnership has overspent its budget by £6.471 million as of June 2024, and councillors were told that a financial recovery plan containing “difficult options” is actively being developed. 

“We are talking about a level of service reduction required, and that is always really difficult for how we plan and deliver that,” Ewan Murray, the chief finance officer for the Partnership’s Integration Joint Boards (IJB), said. 

“It’s going to be probably our most challenging period going forward and some of what we’re going to have to do is over the winter when demand for health and social care services goes up – that comes with a level of risk.”

The IJB has been directed to create a full financial recovery plan in November, and Mr Murray said that plan will “look at things that have previously been unpalatable”. 

He went on: “Those options are going to be really difficult but that illustrates the urgency that the board as a whole are taking.

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“It is really difficult to solve this challenge, and it will take some real difficult and courageous decision making across both IJBs and across constituent authorities for whole system solutions to sustainability.” 

Clackmannanshire is not the only local authority facing challenges across health and social care.

“We are not in this position alone. There are a number of other partnerships in a really similar position [across Scotland],” he added. 

“There is something we’re observing across the whole country that post pandemic, the level of demand for social care has materially increased. In some areas it has more than materially doubled compared to long term pre pandemic trends.” 

Some of that is about the country’s ageing demographics and changing care needs associated with that. 

“Some of it is probably something we don’t quite fully understand yet,” Mr Murray added.

“People are living longer but not healthier, and they are living longer with significant, multiple, complex needs. That makes decision making really difficult.” 

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Part of the challenges come from the requirement for IJBs to “live within their resources” and stick to budgets while also complying with “significant legal requirements” in terms of statutory care obligations. 

The local IJB currently requires high cost cases to go before the senior resource allocation group for scrutiny, but in many cases Mr Murray said there is “a level of need and a lack of alternatives” where the IJB has “no alternative” other than to agree to the packages of care. 

The health and social care financial recovery plan will be presented to the Clackmannanshire and Stirling HSCP in November. 

In addition to the recovery plan, Mr Murray said the IJB is in contact with the Scottish Government about its position and the risks that lie ahead. 

“I don’t expect them to come up with additional money, but in terms of help, they may be able to provide support for our journey towards sustainability,” he said.