Cost-cutting proposals that affect some of Renfrewshire's most vulnerable residents are returning to the table this week, as decision-makers scramble to address spiralling spending pressures. The Renfrewshire Health and Social Care Partnership (HSCP) Integration Joint Board (IJB) will revisit the measures on Friday, which were originally drafted to help close a recurring £14 million budget black hole.
Financial Strain Intensifies
A report from the chief finance officer warns that the IJB faces increasing financial pressure due to rising demand, increasing costs, and funding that is not keeping pace. The board has overspent for three consecutive years and has relied on reserves that are projected to be fully depleted by 2027/28. A recurring funding gap of approximately £14 million is forecast.
The report states: "Financial recovery is a last-resort position where a balanced budget cannot be set and reserves are no longer available. It involves immediate cost containment measures, shifting focus from service improvement to short-term financial control." If triggered, this could lead to longer waiting times, reduced access to services, service prioritisation, and increased pressure on staff and carers.
Eight Proposals Under Review
Senior officials view approval of the eight proposals, which were deadlocked last year, as a critical initial step to avoid financial recovery. The proposals include:
- Reduction of health visiting
- Redesign of older people's day services model
- Redesign of learning and physical disability day services model
- Review of respite provision
- Closure of Flexicare and Autism Connections
- Removal of the assertive outreach model
- Changes to Childsmile community and practice programme
- Redesign of district nursing and care at home overnight service (already approved)
Last September, NHS Greater Glasgow and Clyde representatives were willing to accept all measures except the Childsmile programme, while Renfrewshire Council elected members intended to reject all but the overnight service redesign, resulting in a 4-4 stalemate.
Updated Assessments
Integrated impact assessments have since been updated, with changes described as minor. The proposals remain the same, except for Childsmile, which now proposes a revised and targeted approach to supporting children most in need of oral health advice, and older adults day services, which reflects learning from an unplanned closure of Ralston Day Centre in December.
If all eight proposals are passed on Friday, they would generate savings of approximately £2.6 million. However, their return has caused uncertainty among carers who have fought to prevent them.
Carer Concerns
Campaigner Jennifer Lindsay, who has family members attending the Disability Resource Centre in Paisley and Milldale Day Opportunities in Linwood, expressed exhaustion: "It's just exhausting... that feeling of here we go again. We're trying to rally everybody, trying to keep spirits high, but it becomes more and more difficult to keep everybody staying positive."
She added: "This time round, it feels like a bit of a mountain to climb and the vibe is definitely different. Everybody is just feeling a lot more anxiety and they're tired."
HSCP Response
An HSCP spokesperson said: "Our goal is to deliver the best possible outcomes for as many people as possible, within the budget available. Demand for services continues to rise as does the cost of delivering those services, meaning that the resources available to deliver services aren't able to keep pace – a picture that is unlikely to improve over the coming decades."
The spokesperson emphasised a focus on prevention and early intervention, working with communities and other organisations to share resources, and making the most of digital solutions. "The majority of proposals being presented to the IJB aim to help us shift to these new ways of working, while protecting and improving the efficiency of existing, essential services for the most vulnerable."
The financial challenge is urgent, with reserves projected to run out in the near future. The HSCP is exploring all available options, including the savings proposals and longer-term transformational changes through its 'Foundations of Transformation' programme, to achieve a sustainable financial position.
