'Radical action needed' to fund Clacks and Stirling HSCP

For the Wee County local authority, the overspend is said to be approximately £3.85m.

Clackmannanshire’s Audit and Scrutiny Committee councillors met last Thursday, December 14, to discuss the latest financial reports and they were told that tough decisions lie ahead for both the council and the wider health and social care partnership.

The Integrated Joint Board (IJB) merged services provided by NHS Forth Valley and both Clackmannanshire and Stirling Councils with each partner taking responsibility for parts of the budget.

It provides adult social care, adult primary health care and unscheduled adult hospital care for the region. 

David Williams, chief officer, has only been in his role for a few weeks, but he told councillors the shortfall is “at a scale he has never seen”.

Clacks Council may have to find millions to plug the funding gap

He said: “You can see that there is significant demand beyond what was anticipated when the budget was set.

“We are looking at it litigiously, on a line-by-line basis to understand the scale of the overspend.” 

Simply put, the budget gap is largely due to the demand for care outstripping what the IJB can afford. 

“It’s a reflection of need and demand – and we need to respond to that,” Mr Williams added. 

Ewan Murray, chief finance officer, said: “There are a number of improvements across a range of things that is required, but that doesn’t take away from the point that we’re commissioned to undertake more care than we can afford.” 

He continued: “Given the size of the gap, it’s going to take pretty radical action to bring the budget in line.” 

Mr Murray emphasised that “nothing should be off the table” in terms of what the council and the IJB should consider in order to wrest control of the current overspends. 

He said: “The forthcoming pay settlement will require us to consider some options that have been unpalatable before because that’s where we are in the sector.

“It will take a number of things to resolve and it will take some difficult decisions. Discussions are ongoing and we’re putting a lot of effort into that.”

Stirling Council is one of the three partners in the joint board

The finance report revealed that the council’s Care at Home budget set aside money for approximately 12,800 hours of care per week, but demand has far exceeded this estimate. 

The service is currently committed to providing 15,500 care hours every week – an increase of 600 hours since the start of the year. This demand has resulted in a recurring financial pressure of £2.7m.

The average hourly rate for care has also increased by £1.20 per hour adding nearly a £1m to cost pressures. 

Likewise, the IJB budget provided for approximately 208 nursing home placements, but it is currently providing 237 placements. Weekly nursing home costs have increased by around £68 per week. 

It’s the same story for residential home placements where the weekly cost has increased by £52 per week since the start of the year. 

“It’s not just within the Clackmannanshire budget,” Mr Williams explained. “It’s also within the combined Clackmannanshire and Stirling HSCP budget.

"In November, the IJB approved use of general reserves to cover a significant portion of overspend.” 

He continued: “However, there continues to be a significant gap and we need to work out ways to cover that gap between now and end of the financial year.”

NHS Forth Valley will also share the cost of any funding shortfall

Councillors were told that a financial recovery plan has been developed and presented to the IJB.

If there is an overspend at the end of the year, the three health and social care partners will be required to find the money to cover the shortfall.

Clacks Council committee report stated: "It is essential that this recovery plan is implemented to ensure the partnership can manage spend within its budget.

"However, if there is an overspend at the end of the year this will be subject to risk share required to be covered by the three partners and additional funds would need to be passported from the council.

"This is a significant risk for the council in light of its own challenging financial position. Uncommitted reserves are just over 2 per cent and with its own in year pressures including the pay award, the council has a diminishing capacity to support risk share.

"Alongside the recovery actions there requires to be robust scrutiny over the financial projections to ensure these are accurate. This will also measure any reductions in spend as a result of the action plan and identify if any further recovery action is required."