The Moray Integration Joint Board (IJB) will meet on Thursday 27 March to finalise spending plans for 2025/26 and determine measures to safeguard essential health and care services amid a significant funding shortfall.
With a projected funding shortfall of £12.2m, the Board will be asked to consider a range of service redesigns and savings proposals necessary to achieve a balanced budget.
The Moray IJB is responsible for overseeing a 2025/26 revenue budget of £214m for community health, social work and social care services managed and delivered through Health & Social Care Moray (HSCM). Like other public sector organisations in Grampian and across the country, it faces mounting financial pressures due to rising demand for services and increasing operating costs
The budget report to the Board published yesterday (20 March) outlines that the annual funding the Moray IJB receives from its partners – Moray Council and NHS Grampian – is not enough to maintain services in their current form.
Good progress has been made in delivering savings identified for the current financial year and an additional £5.5m in savings is expected to be achieved in 2025/26 through the continuation of multi-year service redesign projects already agreed by Board members.
Judith Proctor, Chief Officer of the Moray IJB and HSCM, said: “Despite our diligent efforts to control spending and secure best value, the unprecedented scale of the financial pressures facing us means there are no easy choices left.
“The actions required to close this funding gap and set a balanced budget will inevitably impact how services are provided. However, we remain committed to working closely with our staff and communities to navigate these difficult challenges together.
“Our priority remains protecting essential care and support for the most vulnerable, while ensuring the long-term sustainability of services that help people live well and as independently as possible. Achieving this requires a bold programme of change to secure the most effective, efficient and high-quality health and care system we can for the people of Moray.”
A total savings target of £9.4m has been identified, including both new and previously agreed savings proposals. Additionally, £1m from earmarked reserves will be used to help bridge the funding gap.
The new savings proposals identified by HSCM teams for 2025/26 include:
- Review of self-directed support (SDS) packages to increase recovery of surplus direct payment funds (saving £350,000);
- Prescribing efficiencies programme working with GP practices and care homes to promote cost effective prescribing (saving £169,000);
- Reduction in staff overtime (saving £200,000);
- Review of provision of palliative care services (saving £117,000);
- Vacancy management across all services (saving £1.135m);
- A 3.4% budget reduction on all services not already subject to an agreed savings proposal (saving £2.021m).
Previously agreed savings for full implementation in 2025/26 include:
- Review and redesign of internal care at home service (saving £122,000);
- Redesign of mental health in-patient service including use of locums (saving £261,000);
- Redesign of GMED out of hours service (saving £110,000);
- Review of care packages and use of spot purchase spend versus block contract spend (saving £1.7m);
- New model of planned and emergency respite provision (saving £413,000);
- Embedding a proportionate care approach to meeting the complex moving and handling needs of individuals for internal and external providers of care (saving £555,000);
- Redesign of nighttime model of care delivery in services for people with a learning disability (saving £277,000);
- Redesign of community hospitals (saving £200,000);
- Review of contracts with commissioned service providers (saving £350,000);
- Review of day services (saving £220,000);
- Review of staffing arrangements for complex and challenging behaviour service (saving £159,000);
- Review of use of beds in care homes for people with a learning disability (saving £491,000);
- Digital and technology strategy (saving £100,000);
- Review of contract arrangements for transport (saving £146,000).
The budget report highlights that achieving the full savings target is challenging, with a risk of a potential shortfall of up to £1.507m requiring further intervention if not met. Key risks include prescribing costs that remain highly volatile, and rising service demand and demographic changes leading to additional unfunded pressures. Uncertainty around pay awards for NHS and council-employed staff could add pressure to the financial plans.
View the Moray IJB papers for 27 March, including the budget proposals, on the Moray Council website here.
