The Scottish Borders Health & Social Care Integration Joint Board (IJB) met on Wednesday 5 August 2026 to discuss performance, financial plans, and legislative changes. Key decisions included approving the Health and Social Care Partnership Annual Performance Report for 2025/26 and the IJB's Medium-Term Financial Plan for 2026/27 to 2030/31. The Board also noted legislative changes that will extend voting rights to lived experience representatives from September 2026.

Performance and Delivery Report

The Board received a routine Performance and Delivery Report, with discussions focusing on Child and Adolescent Mental Health Services (CAMHS), social work assessment waiting times, care at home performance, commissioning activity, and delayed discharge arrangements. Concerns were raised about the completeness of CAMHS reporting, particularly regarding neurodevelopmental demand. The IJB requested that future reporting provide a more integrated overview of system pressures, linking delayed discharge, assessment waiting lists, and community capacity. The Board also requested that the Chief Officer and General Manager for Mental Health & Learning Disabilities develop future reporting on neurodevelopmental demand and wider CAMHS performance, including the possibility of a dedicated CAMHS update.

HSCP Annual Performance Report 2025/26

The statutory Health and Social Care Partnership (HSCP) Annual Performance Report for 2025/26 was considered. While the report was welcomed, members questioned whether additional contextual information should be included regarding the prolonged vacancy in the Chief Officer post during the reporting period. Concerns were also raised about the accessibility of the report for the public, with a commitment made to improve readability in future years. The IJB approved the report for publication, subject to the inclusion of a change to reflect the impact of the Chief Officer vacancy.

IJB Audit Committee Annual Report 2025/26

The Chair of the Audit Committee presented the Committee's Annual Report, highlighting attention given to the governance impacts of the Chief Officer vacancy, strategic planning, and the Board's oversight responsibilities. The report noted a continuing need to strengthen scrutiny of strategic commissioning and associated governance processes. The IJB approved the Audit Committee's Annual Report and acknowledged the assurances and areas for improvement identified by the committee. The Chief Officer was requested to review strategic commissioning governance and the Audit Committee's role in supporting assurance and scrutiny.

2026/27 Medium Term Plan

The Board considered the Medium-Term Financial Plan for 2026/27 to 2030/31, acknowledging significant national and local financial pressures, including forecast deficits for delegated NHS services and uncertainty regarding resource transfer arrangements. Discussions centred on the relationship between financial sustainability, prevention, strategic commissioning, and risk appetite. The IJB approved the Medium-Term Financial Plan and requested a review and refresh of the IJB Strategic Risk Register, risk management approach, and risk appetite arrangements. Proposals are to be developed to clarify the Board's strategic commissioning role, risk framework, and future assurance reporting requirements.

IJB 2025/26 Quarter 4 Financial Monitoring Position

The Board reviewed the 2025/26 year-end financial position, noting continuing overspends in learning disability and social care services, alongside pressures from demand, workforce costs, and prescribing expenditure. The strategic risk arising from increasing complexity of need, particularly in learning disability services, was highlighted. The IJB noted the final year-end position and the ongoing risk to financial sustainability due to current funding levels compared to running costs and demand.

Resourcing Equality, Diversity and Human Rights Function

A paper on resourcing the equality, diversity, and human rights function was not considered for decision as it had not followed the agreed governance process. However, the underlying issues were acknowledged as important and requiring further work. Discussions focused on the Board's statutory responsibilities under the Public Sector Equality Duty and concerns regarding reduced stakeholder engagement in equality impact assessment processes. The Chief Officer will conduct a review of current arrangements and develop proposals to clarify Board responsibilities, assurance mechanisms, and governance. The IJB noted the current risk relating to statutory compliance in equality, diversity, and human rights.

Children (Care, Care Experience and Services Planning) (Scotland) Act 2026

The Board received an overview of the implications of the Children (Care, Care Experience and Services Planning) (Scotland) Act 2026, which strengthens the IJB's role in children's services planning. The discussion highlighted the inter-dependence between adult services, carers, mental health, transitions, and outcomes for children and families, recognising opportunities to strengthen prevention, commissioning, and joint planning. The IJB noted that the Chief Officer will present a paper in December 2026 detailing how the IJB can optimally contribute to Children's Services Planning arrangements.

Scottish Borders Coming Home Programme Update

An update on the national Coming Home Programme for adults with learning disabilities was provided, noting ongoing challenges with housing availability, workforce capacity, and funding. The Board recognised the financial and clinical risks associated with out-of-area placements and prolonged hospital stays. Progress made through local test-of-change work was welcomed, with support for building services around individual aspirations and needs. The IJB noted that housing availability remains the principal factor affecting delivery timescales and supported continued work with partners to progress future transition arrangements.

IJB Voting Rights

The Board received an update on legislative changes requiring voting rights to be extended to lived experience representatives from 1 September 2026. Discussions covered governance responsibilities, conflicts of interest, training, and implications for Board decision-making. The IJB noted the legislative changes and remitted the Chief Officer and Board Secretary to review the implications and report back with proposed changes to the IJB's governance and membership arrangements.