The three main challenges delivering health and social care in Perth and Kinross
An ageing population with an increasing level of need coupled with fewer working-aged residents and who want to work in social care are the biggest challenges facing Perth and Kinross Health and Social Care Partnership (HSCP).
Perth and Kinross Integration Joint Board (IJB) - which governs the Perth and Kinross HSCP - is having to address a whopping predicted £8 million overspend.
At a meeting of Perth and Kinross Council's (PKC) Scrutiny and Performance meeting on Wednesday, September 18 a health chief was asked to outline the main challenges in delivering health and social care services in the area.
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At last week's meeting, Conservative Strathallan ward councillor Keith Allan asked what the three biggest challenges facing the IJB currently were. He raised the question as councillors scrutinised a report on the Clinical Care and Professional Governance of the Perth and Kinross HSCP.
Perth and Kinross HSCP chief officer Jacquie Pepper said: "I think our three main challenges in Perth and Kinross firstly relate to our ageing population and the increasing level of need. And our population projections demonstrating much higher levels of older people over the age of 85 and everything that comes with that in terms of health conditions for people who have been perhaps healthy all their lives and what old age brings with that, including dementia.
"We're predicting a real increase in the proportion of people who experience dementia. So that is a significant challenge for us because to deliver the care services that are required for that with our current demographic which is a falling population of working age and people who want to work in social care, that's our top two areas of concern.
"The third is being able to deliver those services across such a huge geography with the varying context which we all know very well."
The committee's convener - who also happens to be the IJB chairperson - said there was also a need to invest to save money down the line but no financial ability to do so.
Independent councillor Colin Stewart said: "I think one of the other challenges is that we would like as a board and HSCP to invest in early intervention and prevention and long-term thinking in terms of improving people's overall general health so that once they get to old age we don't have the demand and amount of need that we see.
"But you're then talking about investing for 15 or 20 years hence rather than for a maximum of three years hence when we're dealing with a budget.
"You know investing £1 now to save £15 or £20 in 15 or 20 years' time is a challenge that there currently isn't the capacity for so that's one of the longer term issues."
At Monday's meeting of the IJB Audit and Performance Committee on September 23 the committee was told the IJB's latest overall projected overspend for 2024/25 is £8 million. The predicted overspend has been reduced to £4.8m after dipping into general and earmarked reserves.
A full financial recovery plan will be presented to the IJB next month.
The financial report for the IJB put before the committee stated: "The Chief Officer and Executive Management Team will continue to work on actions to reduce projected cost pressures across the service where possible and develop and present a full financial recovery plan to the IJB on 2 October 2024."
Conservative councillor David Illingworth described the financial situation as "deeply concerning".
He said: "This is deeply concerning, a fairly significant overspend that wipes out all our reserves. It does seem to me that we will have to make difficult decisions that will impact the level of service we deliver and we're going to be looking for the least bad options rather than optimising."
The committee's convener SNP councillor Sheila McCole responded: "There are indeed very tough decisions that not just this IJB but every one throughout Scotland is facing at the moment."