Report highlights pressures on community health and social care

Rising costs, demand and financial uncertainty threaten services.

A new report from the Accounts Commission on Integration Joint Board (IJB) finances and performance says that pressures on IJBs are undermining the delivery and funding of community health and social care support.

IJBs plan and commission many vital community-based health and care services. But community services are facing rising levels of unmet and complex need, while funding for IJBs has decreased by over £1 billion since last year.

Integration aims to improve people’s outcomes by ensuring that people receive the right care when they need it, with a focus on community-based and preventative care. However, the report found there has been little progress toward shifting the balance of care from hospitals to communities while managing the crisis has shifted focus away from prevention.

Among the key challenges facing IJBs highlighted in the report are financial uncertainty and increasing cost pressures, rising demand on services and increasing complexity of people’s needs, and pressures on the workforce including issues around recruitment and retention. This reflects what we have heard through our most recent ALLIANCE members survey that highlights the challenges in retaining and recruiting staff in the third sector.

The cost-of-living crisis is also affecting both demand for health and social care services and the ability to provide them, while increased costs have had a particular impact on smaller, independent and third sector providers. The ALLIANCE Stretched to the Limit, report shared the impact of the cost of living crisis on Scotland’s third sector.

Internally, IJBs governance makes planning and decision making difficult and a  turnover of senior leadership can disrupt planning. Moreover, uncertainty around what the National Care Service will look like has made medium and long-term planning challenging.

Although the report is focused on IJBs, the Accounts Commission is clear that a collaborative, whole-system approach is needed to respond to the complexity of challenges in primary and community health and social care. This includes working collaboratively with all partners to redesign services focused on early intervention and prevention, addressing workforce challenges, data sharing and commissioning reforms.

“Whole system collaborative working is needed as part of a clear national strategy for health and social care that will promote improved outcomes across Scotland but reflects the need to respond to local priorities.”

These findings reflect what we have heard from our members and across the third sector in Scotland. Earlier this year, the ALLIANCE’s Integration Support Programme published a review of IJB strategic plans which highlighted the difficulty of achieving these objectives in an increasingly challenging environment and economic uncertainty.

Find out more about our Integration Support programme on our website.

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