Health chief have refused to agree a budget for the next financial year – which began on Monday – after a stark admission that the board cannot “carry on pretending we can deliver services”.
The Edinburgh Integration Joint Board (IJB), which is made up of partners, the city council and NHS Lothian, agreed to £11.6 million of cuts for the coming year – but has been left with a black hole of £12.6m.
Front-line services could be in the firing line if the council and NHS Lothian cannot bridge the gap.
Included in the agreed £11.6m to be cut from next year’s spending plans, Gylemuir House care home will shut in a bid to shed £2.25m, £2.1m of “efficiencies” in prescribing medication will be made, and charges for care at home, day care, telecare and community alarm services will increase by five per cent in a bid to save £500,00 in the 2019/20 financial year.
But the IJB refused to agree a budget because it cannot plug the £12.6m deficit.
Board member Mike Ash called for financial officers to go back to the council and NHS Lothian and “ask them to take responsibility” for being unable to provide services.
He said: “The council and health board have chosen to provide less funding. I can’t see how we can carry on agreeing papers where there’s £12.6m just as a gap.
“We need to make sure our partners are fully aware of the implications of this, that they don’t expect us to come up with fanciful things that are not achievable.
“I really don’t think we can carry on pretending we can deliver the services that people think we are delivering with the money that we have got.”
As part of further proposals to bridge the gap, which won’t be made public or considered until May, £2.3m could be cut from the Edinburgh Drug and Alcohol Partnership (EDAP) as well as money specifically allocated to mental health services and supporting older people.
The IJB has around £13m in its reserves, of which only £4m is not allocated for specific front-line services.
Cllr Melanie Main said: “We need to have a realistic budget or we’re going to have to say, we will remove £12.6m of services. If our partners are unable to help us at this point, then perhaps the conversation has to go down the road to Holyrood.
“I’m very nervous about the idea of using reserves to plug a revenue gap because we will have to find it again next year and we will not have any reserves next year.”
Health and social care services in the 2018/19 financial year are set to overspend by £7m – offset by one-off payments from the city council in order to balance the books.
Cllr Ricky Henderson, chairman of the IJB, said: “The board has received budget offers from its funding partners NHS Lothian and the City of Edinburgh Council.
“Both offers, while welcome, still require the EIJB to make significant savings and, once combined, provide us with a savings target for 19/20 of £12.6m.
“This is a very challenging target and will involve us making significant changes to the way we work and the services we offer.
The board agreed to continue working positively with our partners to develop further proposals and options to identify realistic savings programmes and achieve a balanced financial position in line with our principles.”