Funding to Scotland’s 30 IJBs increased by over 2% in 2024/25 to more than £12 billion. But this was insufficient to meet rising costs and demands, with many IJBs using dwindling reserves to help meet the almost £450 million gap between demand and available funding.

In a new report published today, the Accounts Commission said increasing demand, rising costs and a growing number of people with long-term complex needs are placing mounting financial pressures on IJBs. The boards have reached a critical point, with a significant risk they will become financially unsustainable within the next 12 to 24 months.

Alongside savings and using reserves, IJBs have been relying on substantial additional funding from their partners in the NHS and councils. IJBs need to plan their finances more realistically to reduce this reliance, as health boards and councils face their own significant financial pressures.

Malcolm Bell, member of the Accounts Commission, said: “The cost of delivering services is rising faster than available funding. Tackling this could include difficult decisions about redesigning or reducing services, and whether new or additional charges need to be made. Whatever decisions are made, service users, their families and wider communities must be consulted.

“But without radical change the services delivered by IJBs can’t be sustained. The gap between funding available and the cost of meeting demand is widening, and the gap of nearly £450 million cannot be bridged with savings alone.”

COSLA health and social care spokesperson, Councillor Paul Kelly, said: “The Accounts Commission report on Integration Joint Board finances for 2024-25 confirms the stark reality our Health and Social Care Partnerships face; that severe financial challenges continue to pose a risk to the sustainability of social care, which threatens the every day lives of our most vulnerable citizens and communities.

“The challenges also threaten the sustainability of our councils, who have continued to prioritise social care, with an additional £163m invested over and above Scottish Government funding in 2024-25. This level of additional funding is unsustainable for partners, but in many cases the only option given the diminishment of reserves held by Partnerships.

“The report makes clear the validity and need for our budget lobbying ask of an immediate investment of £750m in social care. We will continue to press the Scottish Government for this investment to avoid further cuts, reductions and increased charges in future.”

Responding to today’s report, Age Scotland chief executive Katherine Crawford said: “The dire state of health and social care services outlined in this Audit Scotland report is something that sadly we are all too aware of. The closure of lifeline social and community services across the country are already having a devastating impact on older people, affecting their wellbeing and exacerbating loneliness and social isolation.

“The deteriorating situation shows just how important it is to fix social care in this country which is why we want the party political leaders to get round the table after the Holyrood election and, once and for all, come up with a deliverable plan to sort out the mess that social care has become.

“Social care reform requires significant investment from governments and some real accountability. Services are crumbling and we can’t afford another five years of hand-wringing and failure to act. Voters have a right to know if politicians are going to make fixing social care a priority. It is a vitally important service that deserves proper support, not just for older people but for all of us.”