Angela Constance, Scotland's Health Secretary and local MSP for West Lothian, will be invited to meet the West Lothian Integration Joint Board (IJB) to discuss the deepening crisis in social care. The Board required an additional £2 million from West Lothian Council and NHS Lothian to balance its budget this year, and has exhausted its cash reserves.
Financial Strain and Reserve Depletion
John Innes, chair of the Board, told the June meeting that the financial situation mirrors a national study by the Accounts Commission, which highlighted similar pressures across Scotland. He stressed that these challenges “should be underscored” to elected representatives. A report by Chief Financial Officer Hamish Henderson revealed that the operational budget was again overspent, with a break-even position achieved only by drawing down £2.4 million from IJB reserves and receiving additional one-off payments from both partners. Reserves fell from £4.1 million to £2.4 million at the end of 2025/26, leaving the IJB with no buffer to absorb in-year shocks or emerging pressures without immediate savings or extra partner funding.
National Context and Local Impact
The Board, responsible for primary and social care across West Lothian, is jointly funded by West Lothian Council and NHS Lothian. Mr. Innes noted that the Accounts Commission report “reiterated the messages that we have been trying to get across to our elected representatives.” He added, “We can communicate these messages to our local representatives… The challenges we are facing should be underscored to our local representatives.” Alison White, chief officer of the West Lothian Health and Social Care Partnership, stated that the Accounts Commission report shows all IJBs are in crisis. Despite a real-term funding increase of 2.3% in 2024/25, financial pressures and demand for services continue to outstrip available resources. Total reserves across IJBs fell by 12% to £404 million, with almost half holding no contingency reserves. The majority of IJBs reported operational overspends, and additional financial contributions from NHS boards and councils have increased significantly, a trend deemed unsustainable given the financial pressures on partner organisations.
Public Consultation and Service Cuts
Almost 400 people responded to a public consultation last year on proposed cutbacks ahead of the West Lothian budget. Responses strongly opposed any measures reducing adult day services, and as a result, no such measures were proposed. Instead, proposals focused on reducing the cost of supplementary staffing, medicines, and equipment. Other plans include service transformation, reducing the cost of care at home, cost per bed day, and intermediate care. The Board continues to face difficult choices, including reducing or cutting services.
