Exclusive:SNP facing social care 'meltdown' as £560m black hole risking service collapse

Social care is on the verge of a “total meltdown” because a £560 million black hole means services cannot be sustained, local leaders have warned.

In a letter to social care bosses, seen by The Scotsman, Health Secretary Neil Gray said ministers “sympathise with the pressure the social care sector is facing”.

But the SNP minister has been accused of having “pushed vital local services to the brink” by “chronic underfunding and a lack of leadership”.

Adult social care alone contributed more than £5 million to the overspend.

Health and social care is jointly provided and funded by local councils and NHS boards - with 31 integration joint boards (IJBs) issuing directives to health and social care partnerships across Scotland.

The financial strain has emerged after the Scottish Government was forced to shelve its plans to set up a National Care Service when all opposition parties withdrew their support, voicing concerns about centralisation plans by councils leaders and trade unions.

Read more: Nursing bosses warn lack of staffing needs puts SNP's NHS vision at risk of falling flat

Opponents have claimed that the National Care Service ambition has taken the focus away from improving services.

Across all of Scotland’s IJBs, a funding gap of around £560m now exists for services to simply stand still, before taking on some of the vital reforms needed to modernise to cope with a elderly population. The gap is leading to IJBs cutting services or draining already-depleted reserves to balance the books.

Health and Social Care Scotland has warned that the £560m financial gap could pay for more than 18,000 care home beds or more than 11,000 band 5 nurses.

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In Edinburgh, up to £31m of savings are required across health and social care in this financial year, with officials starkly warning services are “facing an unprecedented financial challenge”.

Glasgow IJB has identified a £41.5m budget gap, amid a warning by officials that “funding settlements are not keeping pace with the demand and inflationary pressures which are being faced within the health and social care system”.

The city is bracing for “a funding deficit of £120m over the next three years”. Savings plans for this year include cuts to a supporting living service for the elderly, including people with dementia, as well as counselling for sexual assault victims at the Sandyford clinic. Dozens of jobs are also at risk.

Fife IJB has a budget gap of £40.6m, in Perth and Kinross the deficit is £19.8m while the gap in Midlothian is £6.8m.

Professor Soumen Sengupta, the chair of Health and Social Care Scotland, has written to the Health Secretary, warning about the financial situation across Scotland.

In the letter, seen by The Scotsman, Prof Sengupta warns that “the scale of the financial shortfalls that IJBs are facing present an escalating risk to our collective ability to deliver services”.

Soumen believes it will keep more people close to their loved ones and communities.

He added: “This has been reflected in our regular financial returns to Scottish Government, public reporting at IJB meetings and in our audited annual accounts.

“The Audit Commission report on integration joint boards' finance and performance 2024 highlighted that the then projected funding gap for IJBs in 2023/24 was £357m, almost triple that of 2022/23.

“That Audit Commission report also stated that the projected financial position was set to worsen – and unfortunately, that prediction has come to fruition. Analysis completed by Health and Social Care Scotland of the projected budget positions of all 31 IJBs has confirmed an estimated recurrent financial gap of circa £560m for 2025/26.”

Read more: SNP confirm National Care Service has been scrapped - here is what happens next

Prof Sengupta told the Health Secretary that “with the cost of and increased demand for health and social care outstripping any funding increases, it will not be possible to sustain existing levels of care across all services”.

Scottish Labour health and social care spokesperson Jackie Baillie said: "These vast black holes in the integrated joint board budgets threaten to turn what is already a crisis in social care into a total meltdown.

Scottish Labour deputy leader Dame Jackie Baillie | PA

“Essential care services are suffering devastating cuts and individual care packages are under threat.”

She added: “We need strong and effective leadership on health and social care more than ever, but the lack of funding will only increase the pressure on frontline providers and the services they deliver.

"At the same time, the number of Scots relying on these services is growing at pace.

"The SNP must work with Health and Social Care Partnerships to come up with a sustainable plan — or it will be vulnerable Scots who pay the price."

Scottish Conservative shadow health secretary Dr Sandesh Gulhane said: “The staggering funding gap facing Scotland’s health and social care services exposes years of gross mismanagement by the NHS.

Conservative MSP Dr Sandesh Gulhane

“Years of chronic underfunding and a lack of leadership have pushed vital local services to the brink.

“Yet SNP ministers' only idea was to waste tens of millions on a National Care Service that was doomed to fail from the start and took away resources from local care services.

“Alongside integrated joint boards, patients are being let down by those in charge and this crisis is only going to escalate if urgent action is not taken.

“It is time for money to get to the frontline in our health and social care services, rather it being squandered on pointless bureaucracy.”

Scottish Lib Dem leader, Alex Cole-Hamilton, has warned that IJB finances are “under immense strain”.

Read more: SNP aims to create 'biggest hospital in Scotland' with 2,000 extra beds at home

He added: “When so many people can’t get care at home or in the community, hospitals become overwhelmed and waiting times shoot up.

“For four years, the SNP wasted £30m on a bureaucratic, ministerial power grab of social care which they have been forced to junk. That was money that could have paid the salaries of 1,200 care workers.

“Scottish Liberal Democrats are the party of care. We want to see a new UK-wide minimum wage for care workers that is £2 higher, getting people the help they need and easing pressure across the health service.”

In a letter to Health and Social Care Scotland, seen by The Scotsman, the Health Secretary, has stressed that SNP ministers “sympathise with the pressure the social care sector is facing”.

SNP Health Secretary Neil Gray needs to make his intentions clearer, say medical professionals. Picture: Andrew Milligan

Mr Gray added: “The 2025-26 budget includes over £15bn for the local government settlement and almost £2.2bn for social care and integration – exceeding our commitment to increase funding by 25 per cent by almost £350 million.

“It also includes £289m of undirected general revenue alongside £37.1m of undirected general capital grant. At £21.7bn, the overall financial envelope for health and social care also reached record levels.

“I’m sure I do not need to remind you that whilst the Scottish Government has overall policy responsibility for health and social care support policy in Scotland, decisions on how to deliver services to local communities are ultimately for integration authorities and locally elected representatives to make.”

Mr Gray has also called for “complete financial transparency”, warning that quarterly data for the last financial year was “incomplete” from IJBs.

He added: “Reliable data is key to helping us understand the issues and I am aware my officials are engaging with IJB chief finance officers on how best we can work together to improve the data we receive.

“It is imperative that we receive accurate data at the right time to support decision making around funding and I will ensure that my officials work with you on the best approach to this for the coming year.”