SCOTLAND’S health boards have warned they face “emergency budget measures” amid the Covid-19 pandemic – while already sitting on pressures of more than £180 million this financial year.

Concerns have been raised that health and social care services could struggle to cope with day-to-day needs as Scotland emerges from the lockdown, which has resulted in medical procedures being paused for focus to be put on dealing with the coronavirus outbreak.

But Scotland’s 31 integration authorities, mostly made up of integration joint boards (IJB), which deliver health and social care services with funding from local councils and the NHS, were facing a stark financial picture before the pandemic took grip.

Audit Scotland has described the financial situation of IJBs as “unsustainable” as many health and social care partnerships are forced to strip their own assets, make internal cuts and use one-off savings from their dwindling reserves.

It added: “Financial pressures across health and care services make it difficult for integration authorities to achieve meaningful change.”

As IJBs sat down to set their budgets for the 2020/21 financial year, they were being forced to draw up plans to cut or make savings of a combined £184.9 million, in order to balance their books - with some already earmarking cuts for further years ahead.

Aberdeen IJB indicated £13.4 million of “budget pressures” for this financial year, with East Dumbartonshire reporting a gap of £9.6 million. Edinburgh IJB, which was unable to set a balanced budget last year until October due to the financial constraints it found itself in, was drawing up £23.9m of saving plans for this year. In Glasgow, officials identified a £14 million funding gap and almost £40 million of “pressures”.

In March, Renfrewshire IJB agreed to hold back £400,000 of money set to be used for drug and alcohol services “for the health and social care partnership to draw down in support of its transformation programme”.

But the financial situation across Scotland was thrown into more turmoil as health and social care became the front line for dealing with the Covid-19 pandemic.

Aberdeenshire IJB warned there was now “less focus on financial management” due to the situation – while East Ayrshire IJB stressed that “extraordinary costs are being incurred and will continue to be incurred for the foreseeable future”. Officials also say they “may require to consider emergency budget measures as the impact, financially and operationally of mobilisation and response to Covid-19 are better understood”.

Many boards are working on the “assumption” that the Scottish Government will step in and cover the additional costs.

Scottish Conservative health spokesperson, Miles Briggs, said: “IJBs will be more important than ever in the coming months for delivering social care in each local authority and implementing measures to keep care home residents safe.

“Across Scotland, IJBs have been forced to make cuts to their budgets because of decisions made by SNP ministers and now it is unclear what is happening with money made available to the Scottish Government, through Barnett consequentials, that was meant for councils.”

He added: “SNP ministers must urgently review the funding deal that they have with local authorities and health boards, so that they are in a position to effectively deal with Covid-19 and its aftermath.

“Cuts to local authority funding have a knock on effect to funding available for third sector organisations who provide invaluable care for vulnerable people in the community, which will be so vital in the coming months.”

Liberal Democrats have also called for more support to be offered from the Scottish Government.

Lib Dem health spokesperson, Alex Cole-Hamilton, said: “Joint boards are in a very tough position. The Scottish Government promised they would have a groundbreaking impact on health and social care but they have consistently faced challenges over finances and the flow of patients through the health service even before Covid-19 arrived.

“The last thing we need is a further budgetary crisis in the midst of the virus crisis. The Scottish Government must ensure that joint boards have the support and resources they need to do their jobs.”

Nicola Sturgeon has indicated that healthcare will continue to be a priority of the Scottish Government once the country emerges from the emergency situation.

She said: “The financial implications of this virus are going to be felt in almost every area of our lives. We have a duty and a responsibility to manage this and to protect what matters most. As we found out with this pandemic, it has been reinforced, there are few things that matter more than health and caring for the health of the population.

“We will work with health boards, we will work with IJBs. We have been very clear with health boards and local authorities that financial constraints should not be affecting how we deal with this crisis right now.”

Ms Sturgeon added: “As we go into a recovery phase, as we start to resume more routine healthcare, these discussions will continue – so that we can ensure that we have the ability and the capacity to deal with this virus, which we are going to have to continue to do for quite some time to come, but also the day-to-day health needs of all people across the country.

“None of these issues are going to be straightforward or easy for any government anywhere in the world to deal with but we have a good foundation here in Scotland and will continue to make sure that we work in a responsible way that is about protectiing the things that matter most to us.”

COSLA, the umbrella organisation for Scottish local authorities, has warned that frontline care, waiting times and people’s mental health are being put on the line when officials are not handed enough money to provide services.

A COSLA spokesperson said: “As we said in our essential services document for the recent spending review, the risks of not investing in local government include increased costs in acute care and hospital waiting times, social isolation and depression when older people can’t continue to live in their own community.

“Well-being is about much more than investment in the NHS – it’s about investing in the social determinants of health and wider public health – the everyday services that enhance the lives of individuals, families and communities. It is about investing in early intervention and protecting the vulnerable discretionary services so that Scottish and local government shared policy objectives can be met.”