Glasgow health and care services in peril over £86m funds black hole

And the HSCP's own risk register has stated that it is "almost certain" that it will fail to meet legal requirements over the provision of vital services.

Its decision-making Glasgow Integration Joint Board policy accepts that holding low levels of reserves - which are held by public bodies to deal with unforeseen events or emergencies and manage financial risks from year to year - represents a "significant risk" to them.

It states that it is also important for its long-term financial stability and sustainability.

READ MORE: Councils warn of new wave of Scots homelessness emergencies

GMB Scotland said that for vital services to be in "financial peril" is "obscene" and they warned: "Safety nets are being cut away from those Scots most in need of help and support."

The Glasgow HSCP - the amalgamation of Glasgow City Council and NHS Greater Glasgow and Clyde - has already had to undertake £22m in budget cuts in this financial year - including the loss of 197 full-time equivalent posts.

A financial analysis carried out for the public spending regulator Audit Scotland seen by the Herald said that the most recent forecasts highlights a "worsening" of the financial position as a result of a rise in the demand for homeless accommodation as a result of a Home Office move to clear a backlog of asylum claims.

According to the financial examination by accounting firm EY, outside the cuts the board have also had dip into vital reserves to the tune of £17.2m to balance the books in 2023/24 having overspent by £24.3m.

It said that the organisation's financial outlook estimates a shortfall in funding over three years to 2025/26 of £86m with £42m of that in 2023/24.

A new risk analysis by the HSCP from December seen by the Herald rates as "very high" and "critical/almost certain - their gravest rating - that it will be be unable to deliver "appropriate level of essential services due to required annual level of savings.

It states the effect of that would be being "unable to meet demand for services, failing to ensure safety and prevent harm to the service user [and] failing to meet statutory requirements..."

It states the effect of what was classed as a 'very high' risk over support services to people at risk of homelessness and providing safe housing would be being "unable to meet demand for services, failing to ensure safety and prevent harm to service user [and] failing to meet statutory requirements..."

They say the effect of that would be an "increase in rough sleeping with associated increased risk of harm, disorder, public health issues, additional knock-on pressures on primary care and education services, breaching statutory duties in relation to housing, significant increase in projected overspend in homelessness (and other HSCP) services [and] negative media and political attention leading to loss of public confidence."

The HSCP - the amalgamation of Glasgow City Council and NHS Greater Glasgow and Clyde which delivers community health and social care services - has already been seeking to cut back on its use of high cost hotel and bed and breakfast accommodation.

An EY audit plan has warned that additional costs as a result of the move to clear the backlog has amounted to £13.6m.

It said that the most recent forecast outlined an overspend of £24.3m with reserves slashed to just £2m with the prospect that they will be "exhausted" in 2024/24.

At March 31, 2022, before the latest financial problems, the IJB had a reserve of £28.6m which amounted to 1.95% of net expenditure and below its policy recommendation that it should be 2%.

An overview of the financial position from Sharon Wearing, the HSCP's chief officer for finance and resources admits: "Operating in this climate is no longer sustainable."

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The Scottish Tenants Organisation (STO) said the HSCP appeared to be heading towards "financial meltdown" and said the Scottish Government should intervene with emergency funding to stave off a "social care catastrophe".

"The HSCP is in such appalling financial difficulties that this could lead to cuts to life saving services in the Glasgow area for the homeless, children and older people in all it forms," they said.

The EY study said that this year's overspend: "There is a risk that the IJB's reserves will be exhausted in 2024/25 and that a sustainable financial plan is not achievable in the short term."

It comes as it was believed that the HSCP is considering rehab cuts at a time when Scotland has the worst drug death rate in Europe.

It is believed services for children living with addicts could also be axed and care home places for older people cut as part of a massive “savings” plan.

A scenario of slashing care placements for children also appears to have been suggested.

It comes in the wake of Glasgow City Council making a symbolic housing emergency declaration in the wake of concerns over social unrest following moves o accelerate the clearance of a backlog of asylum claims by the Home Office.

The council has been considering legal action against the Home Office as it fears it will breach the law through being unable to cope with the backlog - while attempts to source extra funding from government have so far failed.

An overview of the financial position from Sharon Wearing, the HSCP's chief officer for finance and resources states: "Operating in this climate is no longer sustainable. The system is already working under extreme pressure, and this cannot be sustained over the medium term. This requires the organisation to fundamentally reset service delivery to a level which is sustainable both in terms of meeting the demands of the population of Glasgow City but also be sustainable within the financial envelope which is available.

"The acceleration of Home Office asylum decisions will impact on the financial sustainability of the IJB, if additional funding is not secured."

It comes as a senior city council official said they had been presented with an "impossible challenge" to meet a legal duty to find accommodation for hundreds of homeless refugees who have now been granted asylum but are still to find a home.

The council is dealing with more than 400 refugee households who have been given a positive Home Office decision to stay in the country but have not been found a place to stay.

The city council has been searching for alternative temporary accommodation because of a shortage of hotel rooms and has looked at using vacant nursing and care homes as it seeks to deal with the households who have to leave accommodation provided by housing company Mears to accommodate those who are seeking asylum.

Keir Greenaway, GMB Scotland senior organiser in public services, said the financial pressures facing the Glasgow Joint Integration Board would inflict further pain on some of the most vulnerable people in Scotland’s biggest city.

“The board is responsible for delivering crucial frontline services that change and save lives but how many lives need to be damaged or lost because of these relentless cuts?

“Ministers have been told and told again but do nothing to protect these services or deliver adequate, sustainable funding.

“For such vital services to be in such financial peril is obscene and safety nets are being cut away from those Scots most in need of help and support.

“They have waited in vain for the Scottish Government to offer that support while unelected officials on the Joint Integration Board are allowed to weigh up lives in pounds and pence.

“The message to the people of Glasgow is simple: don’t be homeless, don’t be a child at risk; don’t need social care; don’t be vulnerable; don’t be poor.”

Sean Clerkin, campaign co-ordinator for the STO said: "The Scottish Government have to intervene now with emergency funding. Glasgow needs tens of millions of pounds now to stop a social care catastrophe from happening and give our most vulnerable citizens be they homeless people, children at risk, or our senior citizens the support they badly need as anything else will lead to disaster in Scotland’s largest city."

A Glasgow HSCP spokeswoman said: “Glasgow City IJB faces the same financial challenges that the public sector across Scotland face and is working hard with our range of stakeholders to manage and address these challenges."

Health secretary Neil Gray said: "We are providing over £14.2 billion for NHS Boards in 2024-25 to support services, a real time increase, despite the UK Government’s autumn statement only generating additional funding in health equivalent to 0.06% of Scotland’s health budget.

“Despite this significant investment, NHS Boards, like other public services, are under unprecedented pressure as a result of UK Government austerity, inflation, Brexit and Covid and we are continuing to work with each Board to recover and reform services and address the financial challenge this year and beyond.

“Budget setting for health and social care partnerships remain a decision for local areas.”