EFFORTS to help vulnerable groups of people are being hampered by disagreements in Scotland's least populated council area, according to the public spending watchdog.

Tensions between the two largest public bodies in the Orkney Islands are obstructing key Scotland-wide reforms to integrate health and social care provision.

These are supposed to ensure seamless support for people with long term conditions and disabilities, many of whom are elderly. But Orkney Islands Council and NHS Orkney have been unable to agree on how to proceed and it is leaving the islands lagging behind the rest of the country.

In its report published today, the Accounts Commission and the Auditor General for Scotland said Orkney Community Planning Partnership (CPP) lacks effective leadership.

Like the 31 other CPPs in Scotland, it was set up to improve the way local bodies plan and provide public services. But the report says all its partners, who between them spend about £137 million in the islands each year, need urgently to agree priorities and align resources to deliver the services.

It says the partnership lacks focus on the significant challenges it faces. These include sustaining its fragile communities, pressures on public finances, an ageing population, alcohol misuse, and obesity levels among children.

These and other significant challenges, such as joint resourcing and prevention, had not been given sufficient focus by the partnership's steering group, it says.

The report adds there was scope for "all partners to better contribute" to shaping the group's agenda. But it was particularly critical of the council and health board's failure to progress the "integration reforms".

While there are examples of effective partnership working at an operational level, there are significant strategic tensions between the CPP's two largest partners, the council and the NHS. These tensions are having a negative impact on shared strategic leadership.

The document adds: "They have contributed to the slow progress in agreeing the CPP's priorities and in agreeing responses to other important developments, such as health and social care integration."

It said the health board and council had found it difficult to agree a way forward, what the model for integration should be and who should lead it.

Douglas Sinclair, chair of the Accounts Commission, said: "Community planning is not delivering what it should for the people of Orkney. The Partnership is aware of some of the areas in which it needs to improve, but has been slow to implement necessary changes and improvements."

"There is substantial potential for it to build on vibrant community engagement and the strength of the voluntary sector to deliver better services. But this needs effective leadership from the top to make it happen."

The partnership said it accepted the report's recommendations. Sally Inkster, chief executive of Orkney Housing Association, who chairs the partnership liaison group, said: "Many of the recommendations made are in line with improvements already planned for the way community planning is delivered in Orkney."

Orkney MSP Liam McArthur called on the partnership to learn promptly from the report, saying: "The findings are very disappointing.

"Orkney has always prided itself on the way we pull together as a community to deliver for those living and working in the islands. Indeed, the Accounts Commission has commented on the vibrancy of community spirit and strength of voluntary sector in Orkney."