The Scottish Borders Health & Social Care Integration Joint Board (IJB) met on 30 September 2026 to discuss significant financial challenges, performance updates, and strategic planning. Key decisions included the approval of the audited annual accounts for 2025/26, noting the ongoing risk to financial sustainability, and agreeing to a joint proposal and route map for financial planning in 2026/27. The Board also received updates on unscheduled care, the Distress Brief Intervention programme, and performance reporting.

Financial Sustainability and Planning

The Board was presented with a stark picture of the IJB's financial situation, with a projected £34 million budget gap over the next five years. Lizzie Turner, the interim Chief Finance Officer, highlighted that the current running costs of services significantly exceed the funding available from partner organisations, NHS Borders and Scottish Borders Council. The Q1 financial monitoring report indicated a projected overspend of £5.5 million for delegated services and £6.8 million for set-aside services. To address this, the Board agreed to a joint proposal and route map for financial planning in 2026/27, which includes a three-stage approach of grip and control, transformation and redesign, and choices. A key decision was to approve the use of £172,000 per annum from the general reserve for two years to bolster strategic planning, performance, and commissioning capabilities, including funding for two new posts. The Board noted that further financial recovery plans and strategic decisions would likely be required.

Performance and Service Updates

Unscheduled Care: Gareth Clinkscale, Director of Urgent Care, Community Services and Mental Health, and Chris Myers, Director of Adult Social Work and Care, presented an update on the Unscheduled Care programme. They highlighted significant progress in reducing hospital admissions and improving patient flow, with a notable reduction in social work referrals and improved four-hour performance in A&E. The programme is moving into phase two, focusing on optimising and expanding successful initiatives, with a particular emphasis on increasing reablement capacity. A business case for expanding reablement services in the central region is being developed for a future meeting.

Distress Brief Intervention (DBI): Louise Kerr provided an update on the Distress Brief Intervention programme, highlighting its effectiveness in reducing distress and improving mental health outcomes for individuals presenting in crisis. The Scottish Borders has demonstrated strong engagement rates and positive feedback, with the programme cited as an example of good practice. The Board noted the programme's success in reducing self-reported distress and its role in providing a timely and compassionate response.

Performance Reporting: Gill Main, Chief Officer, presented a revised approach to performance reporting, aiming to provide a clearer picture of the IJB's contribution to national health and wellbeing outcomes. The report included updated national indicator data and Ministerial Steering Group (MSG) targets. The Board was invited to consider developing local improvement standards and new strategic metrics to better inform commissioning decisions and monitor progress.

Governance and Strategic Planning

The Board discussed the implications of recent legislative changes, including the extension of voting rights to lived experience members and updated Scottish Government guidance on IJB roles and responsibilities. It was agreed that the Chair, Vice Chair, and Chief Officer would write to NHS Borders and Scottish Borders Council to request necessary amendments to the Scheme of Integration. The Chair and Chief Officer will also review IGB membership requirements. A review of Standing Orders and wider governance arrangements will be overseen by the Audit Committee.

The Board also noted the ongoing work to strengthen the IJB's strategic role, including the development of a new Strategic Commissioning Plan. The Chief Officer highlighted the importance of this work in light of potential reforms to public services and the need for a clear focus on the people of the Borders.

Audited Annual Accounts

The Board approved the audited annual accounts for 2025/26, which confirmed an unqualified audit opinion. Lizzie Turner, interim Chief Finance Officer, presented the accounts, noting a delegated services overspend of £6.5 million, with partners remaining liable for increased costs. Savings of £6.5 million were delivered, and reserves stood at £16.6 million. The audit report included three recommendations related to financial sustainability, transparency of governance decisions, and the IJB's strategic role, all of which have been agreed by management.

Meeting Schedule

The Board approved the meeting schedule for 2027/28 and noted the revised dates for 2026/27. It was also noted that service visits or officer liaison sessions could be scheduled upon request.

The meeting concluded with the confirmation of the next IJB meeting on 21 October 2026.