The Health & Social Care Integration Joint Board met on Wednesday 18 March 2026 to discuss the 2026/27 payment offer from Scottish Borders Council and the anticipated offer from NHS Borders, alongside the Q3 financial monitoring position. The Board also received an update on the urgent and unscheduled care programme, which aims to transform services and improve patient flow.

2026/27 Payment Offer Update

The Board was presented with the 2026/27 payment offer from Scottish Borders Council (SBC), which amounts to £88.7 million. This offer was approved by SBC's budget on 19 February 2026. While a formal offer from NHS Borders has not yet been received due to capacity constraints, broad principles have been communicated. The SBC budget, though balanced, is expected to be challenging to deliver due to significant price and demand pressures. The NHS offer is anticipated to be broadly based on last year's figures with a general uplift. Once the NHS offer is received, the five-year medium-term plan will be updated and presented to the Board to set the IJB budget. The report highlighted ongoing financial challenges within the wider public sector, with IJBs across Scotland facing significant pressures.

The Board was asked to accept the payment offer from Scottish Borders Council and acknowledge the principles expected within the payment offer from NHS Borders.

IJB 2025/26 Quarter 3 Financial Monitoring Position

The Board received an update on the IJB's financial position as at 31 December 2025, with a forecast outturn position for 31 March 2026. The IJB continues to experience significant financial difficulties due to increasing need and complexity across services. Delegated services are forecast to be overspent by £8.9 million by the end of the financial year, which will need to be funded by the respective partners. Set aside services are forecasting an overspend of £6.9 million, which remains the responsibility of NHS Borders. The report anticipated that a significant level of savings will be required to set a balanced budget for 2026/27.

The Board noted the forecast financial position and the ongoing risk to the financial sustainability of the IJB due to current funding levels compared to running costs and demand, and the anticipated impact of this in 2026/27.

Urgent and Unscheduled Care Paper

An update was provided on the NHS Borders and Scottish Borders Council's Urgent and Unscheduled Care Programme, which aims to deliver a transformation across health and social care services over a 2-3 year period to reduce system pressure and improve patient care. The programme is addressing sustained high occupancy across the urgent and unscheduled care system, primarily due to prolonged patient stays.

Key priority projects for 2025/26 include the development of a separate Frailty Unit, the creation of an Integrated Discharge Team (IDT), expansion of Discharge to Assess and Home First capacity, expansion of virtual Hospital at Home capacity, and strengthening of processes for patient pathways. Early operational data suggests a positive change in pathways for frail and older patients since the new Frailty model was implemented in December 2025. The programme for 2026/27 will build on the Frailty model and focus on extending reablement provision, locality alignment, optimising trusted assessment, community equipment stores, technology-enabled care, and the Coming Home programme for learning disability and complex care.

The Board was asked to note the significant work underway across unscheduled care, including developments in the Frailty pathway.

Clinical & Care Governance: CSWO Annual Report

The Chief Social Work Officer (CSWO) Annual Report for 2024-2025 was presented, highlighting key developments and achievements across children's and adult services. Significant progress was noted in preventing care placements for children, reducing delayed discharges, and expanding the Shared Lives programme. The report also detailed work on public protection, justice services, and digital transformation. Challenges remain in recruitment and retention, particularly for Occupational Therapists, and in addressing out-of-authority placements for children and adults with learning disabilities. The report outlined priorities for 2025/26, including locality development, digital innovation, financial stability, and embedding lived experience in service design.

The Board was asked to note the CSWO Annual Report.

Strategic Planning Group Minutes: 18 June 2025

The minutes of the Strategic Planning Group meeting held on 18 June 2025 were presented for noting. Key discussions included a housing brief focusing on homelessness and prevention, the Eildon Day Supports Review, and an update on the Hospital at Home service. The minutes detailed actions agreed, including exploring broader NHS engagement in the Strategic Housing Forum, mapping early intervention and prevention gaps, and ensuring appropriate representation at upcoming partnership workshops. The Board was asked to note these minutes.