Agenda item

5.1 Mrs Hazel Robertson advised that approval of the social care element of the budget had been requested at the previous meeting. At that point in time approval of the health care element had not been requested due to additional information being required. She was pleased to advise that she was now in the position of being able to seek approval for the full initial budget.

5.2 Mrs Robertson provided an overview of the report and highlighted the changes to the content of the report that had been made since the paper had been considered last. Specifically she drew the attention of the Board to: additional information regarding the estimated reserves position as a result of the earmarked allocations received by NHS Borders on the IJB’s behalf; the savings targets remained the same as in the previous version of the report however the level of savings required was significant across the partnership and the associated risk was high; the recommendation that a recovery plan be formulated to address the level of risk in the budget for the IJB to consider at its meeting in May; and using the recovery plan to cover a quarter of the allocated gap currently found in the budget.

5.3 Mrs Robertson also noted changes in the budget in section 4, and highlighted that: the Mental Health and Learning Disabilities line in the table had been adjusted for the non-inclusion of external commissioned services; and that Home First was included in the generic line of figures of £13m; and in regard to the National Care Home contract at paragraph 5.6, the narrative had been expanded in regard to the uplift to the contract which remained under negotiation.

5.4 Mrs Robertson explained that the recovery plan process and recovery would not be possible in one year and would require to be linked to the medium and longer term financial strategy. She suggested an approach across the partnership whereby the Integration Joint Board (IJB) and Scottish Borders Council (SBC) and NHS Borders had a financial model to look at the longer term period with a view to achieving financial balance. In regard to risk she highlighted the insufficient funding for the Primary Care Improvement Plan (PCIP) and the need to continue to seek a funding stream that would ensure the work programme could be taken forward.

5.5 Mrs Karen Hamilton welcomed the report, and understood the stresses and constraints surrounding its collation. She also welcomed the progress made in the reconciliation between the partners to ensure there was a better understanding of where the savings targets might sit. She also supported its approval as an initial partnership budget.

5.6 Dr R Mollart commented that it would be helpful if the report would capture the risk for PCIP and thanked Mrs Robertson for alluding to that in her explanation. The Chair agreed the inclusion should be noted in the next version of the report.

5.7 Mr Chris Myers commented that the IJB followed local government finance regulations which meant that the budget presented had to be balanced. He assured the Board that whilst the initial budget was not balanced, there were plans surrounding a medium and long term financial strategy which would promote sustainability. He emphasised that there was a need to make traction on the budget deficit and consequently there would be difficult choices to be made.

5.8 Mr Myers commented that at present the assumptions around brokerage with NHS Borders remained unclear and a balanced budget would be presented to the May meeting with a requirement for upfront brokerage from the Health Board.

5.9 Mr Tris Taylor echoed the compliments on the layout of the budget and the clarity of the financial position. He noted that the contextualisation of the deficit as a percentage of the budget made it much clearer.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the assumptions and risks described in the paper.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the 2023/24 initial HSCP budget.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the Annual Direction to work effectively across the partnership, live within budget, implement the Strategic Commissioning Framework, achieve performance outcomes and comply with Financial Regulations.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD endorsed the approach to development of an HSCP Recovery Plan and medium-long term Finance Strategy which will address savings targets and provide alignment with the Strategic Commissioning Framework and the Workforce Strategy.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD requested a Financial Recovery Plan and an update on medium – longer term financial planning to the May IJB.