Health and social care budget rises by 10 per cent but warning made over Covid-19 impact

THIS year’s budget for Shetland’s health and social partnership is set to rise by around 10 per cent compared to 2019/20 – amounting to an extra £5 million.

A meeting of Shetland’s integration joint board (IJB) heard that the 2020/21 budget is based on the current costs of services provided by partners Shetland Islands Council and NHS Shetland.


The IJB’s chief financial officer Karl Williamson, however, said the board’s budget is likely to change over the coming months as “more information and costs become available” relating to the response to Covid-19.

The IJB oversees services in Shetland such as community care, primary care, mental health, oral health and community nursing.

The organisation’s total budget stands at £50.736 million after being approved by members of the IJB in a virtual meeting on Thursday, subject to the NHS Shetland board’s approval in August.

This is the first time since the inception of the IJB in 2015 that it will begin the financial year with a balanced budget position.


Williamson said unlike in previous years NHS Shetland had agreed to provide its share of the money up front, instead of making a top-up payment at the end of the financial year.

Members were warned though that savings would still have to be delivered.

“Although the opening position is a balanced budget it is important to recognise that redesign over the medium to long term is still required to establish a sustainable delivery model for Shetland,” Williamson said in his report.

“Short term savings during 2020/21 will also have to be delivered as and when the opportunities arise.”


Williamson told members on Thursday that the use of costly temporary locum staff was still providing a financial headache.

The payments to the IJB from the council and NHS Shetland also take into account estimated pay awards and pension contributions, as well as a medicine cost inflation of 10.2 per cent.

Board chair Emma Macdonald said the budget being fully funded from the outset was “really important”, but she reiterated that the IJB itself needs to be driving redesign.

“It’s our job to make sure we have the redesign in place,” she said.

Councillor Robbie McGregor noted it was difficult for officials to predict what the financial future may look like due to Covid-19, but he asked when there may be movement on redesign.

Interim chief officer Jo Robinson said some proposals were due to come forward later this year.

Williamson, however, conceded that “a lot of plans have been derailed a bit from Covid”, although he said the board is doing the best it can at this stage.

Following a question from councillor Stephen Leask, Williamson also said the budget did not take into account cost pressures from locums – highlighting the desire to reduce the reliance on temporary staff.