HEALTH and social care services across Dumfries and Galloway are facing unprecedented financial pressures — prompting warnings that the quality and breadth of service provision is likely to be affected in the months ahead.
The region’s Integration Joint Board (IJB) is facing a funding shortfall of nearly £58 million this financial year. While more £25 million in savings has already been identified, this still leaves a gap of £32.7 million.
Despite determined efforts to balance the books, senior officials now warn that difficult choices lie ahead.
Interim Chief Finance Officer Mathew Crosby described the situation as ‘the most difficult financial position the IJB has encountered’, and said: “Even with a very ambitious savings programme, we are left with a funding gap that threatens the stability of essential services.
“We’ve worked hard to identify savings and drive efficiencies, but the pressures around staffing, prescribing, and care provision are far beyond anything that can be solved through marginal cuts.”
Both health and social care services are being asked to deliver further savings — £18.2 million within the NHS and £12.5 million from adult social care — through a range of measures including medicines optimisation, contract reviews, energy efficiency work, and new models of care.
However, officials caution that this will inevitably have consequences for the way services are delivered.
Chief Officer of the Health and Social Care Partnership Nicole Hamlet said: “Our absolute priority is to sustain essential services.
“However, we need to be honest that the scale of the financial challenge means we will not be able to provide everything that people might want or, in some cases, might previously have been entitled to. We are having to focus on critical care and essential supports.”
Within social care, new restrictions have already been introduced on the authorisation of care packages, with high-cost support requiring sign-off from the most senior officers—including the Chief Officer and Chief Social Work Officer.
Chief Social Work Officer Stephen Morgan said: “We’re not questioning professional assessments of need — but we must make sure that the most significant financial decisions are taken with full visibility at senior levels. This means that some care packages may take longer to approve, or may need to be reconsidered to ensure that we can meet the most urgent needs across the whole system.”
Chair of Dumfries and Galloway Integration Joint Board Kim Dams has acknowledged the seriousness of the situation.
Ms Dams said: “We’re in a very serious position, and we must be realistic about the scale of the challenge.
“Our responsibility is to protect vital services while making sure they are financially sustainable. That will mean some difficult decisions, but also close collaboration right across our health and care system.
“We’re keen to ensure that all stakeholders are aware of this situation, and would ask them to lend as much understanding and support as possible as we take the tough but necessary decisions required to safeguard critical services and ensure the long-term sustainability of health and social care in our region.”