CUTS to acute hospital services will have to be accelerated due to a funding gap that threatens the success of a flagship project to integrate of health and social care, finance chiefs have warned.

They also stress that current year's budget of £8.3 billion was not enough to meet demand and that unless the shortfall is reversed in future the "required shift in the balance of care will take longer to achieve".

The warnings have been issued in a joint submission by the finance chiefs of Scotland's 31 Integrated Joint Boards (IJBs) and the Chartered Institute of Public Finance and Accountancy (CIPFA) in a submission to Holyrood's Health and Sport Committee, who said the IJBs are wrestling with deficits of three to 14 per cent. The integration authorities are responsible for joining up services provided by the NHS, councils and others to shift care from hospital to community settings.

The paper states: "There is emerging evidence which indicates that the current level of resources is less than that required to meet current cost and demand pressures. In practical terms this means that the required shift in the balance of care will take longer to achieve...[we] recognise that realistically, additional resources will be at a premium and potentially resources will have to come from within the current financial envelope. This will however accelerate disinvestment in acute hospital services accompanied by a consequent transfer to community based services."

Although they highlight a reduction of delay discharges in some areas as evidence that the integration process is already relieving pressure on hospitals, they stress that the "focus needs to shift to prevention of admission and development of services which support this goal".

Dr Peter Bennie, chair of the BMA said health boards were being faced with "decisions over where to direct insufficient resources" instead of fully meeting local needs.

He added: “When there are plans to change parts of health services, or social care services, and how we are looking after patients, then the new services need to be in place and demonstrated to be working effectively before the old services can safely stop. That means extra money will be needed to run both services side by side until we are sure that the old services are no longer needed. Joining up services will not help, if none of the services involved have enough staff, or time, or money, to provide the care that patients need."

Dr Donald Macaskill, chief executive of Scottish Care, said the submission was "absolutely spot on".

He said: "The speed of change in terms the transfer from acute to community provision has not been as rapid as it could have been, and for that to happen to the degree that it needs to requires both additional finance and a change in political will locally to take some real hard decisions and perhaps sacrifice some sacred cows.

"You can't on the one had demonstrate to keep your local hospital open and on the other hand fail to properly understand that by keeping that hospital open you are withdrawing funds from social care provision.

"One of the consequences of cuts to local authorities over the last few years is to strip out a significant amount of funding towards social care. So perversely, at a time when we're supposed to be trying to prevent people from going into hospital, we haven't been able to advance the preventative agenda because we've been stripping out finance particularly from care at home."

Annie Gunner Logan, director of the Coalition of Care and Support Providers in Scotland (CCPS), said voluntary and third sector social care providers are typically bear the brunt of budget shortfalls.

She added: "Our experience is that if money is tight then it often third sector services that get put in the frontline for absorbing some of the cost. We are pretty stretched already."

Scottish Labour deputy leader Alex Rowley said the paper should be a "very serious warning" to the Scottish Government.

A Scottish Government spokeswoman said: “Our long term vision for the health service have been set out in both the National Clinical Strategy and Health and Social Care Delivery Plan. Health investment has increased in each and every year of this Government and is at a record high.

“Integration is one of the most ambitious programmes of work this Government has ever undertaken and one which we believe will deliver health and social care services that work more efficiently.

"We’re also committed to an increasing share of frontline NHS spending being invested in social care in each year of this parliament to help deliver integration."