Edinburgh social care services overspending by £100,000 a day as council chiefs warn of more cuts to come
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The deepening funding crisis in the city’s Health and Social Care Partnership (EHSCP) is set to see measures agreed to plug the huge budget shortfall, which are almost certain to have a detrimental impact on lifeline care services. Councillors expressed anger at the “really awful” financial situation which they said left the authority “in dire straits” despite bosses being aware of the problems for several years.
Further cutbacks come as EHSCP already finds itself at breaking point, after a wide-ranging investigation found “significant weaknesses” in the delivery of services and a “litany of failures” in the management of the city’s social care system.
A group of councillors, NHS staff and service users who make up the Edinburgh Integrated Joint Board (EIJB) which oversees the health and social care partnership met last month and failed to balance the books for the year ahead. They agreed on £11m of cuts – only making a small dent in the £47m financial black hole they faced.
Finance chiefs told a meeting of the council’s finance committee on Tuesday, April 25 that options for bridging the remaining £35m gap will be presented to the EIJB in June – and warned it would be extremely challenging to do this without impacting the “quality and volume” of health and social care services in the capital.
Edinburgh City Council’s head of finance Hugh Dunn told councillors: “As we speak today we’re overspending by £100,000 a day.”
Moira Pringle, chief financial officer of the EIJB, stressed the June meeting would be “absolutely crucial”. She said: “The board will be presented with a plan which balances and the board will have to take a view on whether or not they believe that they can support that. For the last few years we’ve been able to reach a break even position, but that has been on a one-off non-recurring basis and that underlying deficit has been growing and increasing all the time.”
Ms Pringle blamed the increased financial pressure on a range of factors including an ageing and “frailer” population, a lack of additional funding to cope with this and the decision to in-source some services provided by EHSCP.
Conservative councillor Phil Doggart said these issues had been known about for years however, and said the board found itself “in crisis” because of a failure to “grasp the nettle”.
He said: “This has been forecast in the last four of five years, we knew we were coming to a crunch point at some stage. It seems that despite knowing about this for a long time we are still scratching the surface in terms of making the changes to services provided so we can actually get to a balanced budget position.”
Councillor Vicky Nicolson, SNP, who was elected to the council last year after working in the health and social care partnership as a local area coordinator, said it was “so concerning” to see the same issues coming up year after year.
The Greens’ Alex Staniforth added: “We do find ourselves in dire straits,” whilst Lewis Younie, Lib Dems, said the council found itself in a “really awful place”.
A report said: “Achieving financial balance will impact on some or all of: the level of service provided, activity levels, performance and service quality. NHS Lothian and City of Edinburgh Council will consider making interim funding available on a basis to be agreed between the parties, with repayment in future years on the basis of the revised recovery plan by the IJB.”
Officials told councillors that the majority of the £35m gap sits with social care services provided by the council, as opposed to the NHS.
Councillor Doggart hit back at the suggestion, saying elected members from all parties were “not going to let that happen”. He said: “I have zero reassurance after today’s questioning that the IJB is going to be in a position of having a balanced budget. These proposals should have been in place for the original budget meeting of the IJB, they weren’t. It is a service that is in crisis.”
He described a recent Care Inspectorate report on EHSCP as “a disgrace”. Published last month, it highlighted “insufficient leadership” and “too many people and carers not receiving services at the right time or place”. It said efforts to provide early support to people to prevent conditions worsening were “uncoordinated and inconsistent” whilst unpaid carers were not being sufficiently supported.
EHSCP was told to draft an improvement plan setting out how steps will be taken to address the”significant weaknesses” identified by inspectors.