Scotland’s health and social care partnerships say the government’s urgent moves to try to balance the books – which have seen plans to develop mental health and wellbeing capacity within primary care put on pause – are putting “unprecedented pressure” on existing budgets and creating huge difficulties planning future services.

The UK Chancellor Jeremy Hunt yesterday announced an increase in NHS and social care spending in England of £3.3bn in each of the next two years and told SNP MPs that £600m of the additional £1.5bn to be received by the Scottish government will be due to extra health spending.

The Scottish government’s decision to cut some spending during the current financial year to meet the cost of inflation – which has reduced the value of the Scottish budget by £1.7bn – and pay increases is now leading some local NHS and social care leaders to ask whether promised initiatives will go ahead.

Mental health assessment, care and support in Scotland was to be bolstered by the development of multidisciplinary teams within primary care, with the creation of 1,000 new staff posts including community link workers and mental health nurses, backed by annual funding of £10m.

However the bodies responsible for primary care planning in Scotland say the Scottish government have told them to pause all planning of this programme amidst uncertainties over the upcoming budget review.

Angus Integration Joint Board (IJB) board papers from last month show it was anticipating funds to take forward the programme to rise to at least £30m by 2024/25 – but it has now been told to shelve its plans.

Deputy First Minister John Swinney earlier this month announced £1.2bn of cuts from this year’s budget, £400m of it in health services, including £65m in primary care and £38m in mental health.

Part of the money saving exercise is cutting the amount IJBs will receive for primary care improvement relative to the amount held in their reserves, much which has been built up because of recruitment challenges during the pandemic.

The Chief Officer of Angus IJB – which has suffered disproportionately from this decision due to its proportionately large reserves - says the removal of this funding “represents a series of lost opportunities for local primary care” and that their IJB has “significant challenges to meet in terms of developing sustainable local primary care models”.

According to board papers, Inverclyde IJB is facing a £1.236m reduction in its Primary Care Improvement funding this year.

A report to the IJB says, while core funding will allow existing services to continue, the cuts will challenge progression of an urgent care model, delivery of a pharmacotherapy hub and development of a model for chronic disease management monitoring.

Recruitment of additional professionals, like community link workers and advanced physiotherapy practitioners, will also be halted.

Katie Rocks, Chief Officer of Inverclyde Health and Social Care Partnership, added that the conclusion of covid consequential has placed unprecedented pressure on existing health and social care budgets.

A government sustainability payment for all GP practices, to be paid in two instalments of £15m each in December 2021 and April 2022, has also been cut by £5m due to funding constraints.

This payment was to support practices transition to new services, like pharmacotherapy and community treatment and care, as part of delivering the commitments under the 2018 General Medical Services Contract – implementation of which had fallen behind schedule due to covid-19.

A survey by BMA Scotland published earlier this week shows that 81% of practices are experiencing demand exceeding capacity, with more than a third reporting at least one GP vacancy.

Dr Andrew Buist, chair of the BMA’s Scottish GP Committee, has called for the cuts to funding directly supporting General Practice be “urgently reconsidered and the cash reinstated”. 

 

Read more: Lack of structure holding back social prescribing; Integration Joint Boards’ £151m budget gap

 

 

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