ITEM 12 IJB Reserves Strategy 2025-26
North Lanarkshire Council · 19 March 2025
Back to Health and Social Care Integration Joint Board — 19 March 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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REPORT Item No: 12 SUBJECT: IJB Reserves Strategy 2025/26 TO: Integration Joint Board Lead Officer for Report: Chief Officer Author(s) of Report Chief Finance Officer DATE: 19 March 2025 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integrated Joint Board (IJB) for: For approval For endorsement For noting 1.2 This report provides an update on the review of the North Lanarkshire Integration Joint Board (IJB) reserves. 2. ROUTE TO THE INTEGRATION JOINT BOARD 2.1 This paper has been: Prepared By: Chief Finance Officer ☒ Reviewed By: Chief Officer ☒ Endorsed By: ☐ 3. RECOMMENDATIONS 3.1 It is recommended that the IJB: (1) Acknowledge the contents of the report. 4. VARIATIONS TO DIRECTIONS 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 Consistent with a number of other Health and Social Care Partnerships, an underspend of £18.710m was reported in the 2023/24 Annual Accounts which were presented to the IJB on 25 September 2024. This underspend included funding made available by the Scottish Government to progress policy commitments and national priorities and was transferred to reserves. 5.2 The 2024/25 reserves position has been reported to the IJB throughout this year. During January 2025 an exercise was undertaken within Health Services to reinstate a number of drawdowns that had been undertaken during the year. These were in relation to areas where 2024/25 funding was received and it was decided that this Yes No N/A
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funding would be used in year to allow the reserves balances to remain in place. This is a change in practice to previous years and amounts to £10.945m as shown in Table 2. 5.3 The annual review of the Partnership’s reserve strategy has been undertaken. As part of the financial planning process the reserves held have been assessed to ensure these remain consistent with current priorities. As a result of this exercise no realignments are proposed at this stage. This will be reviewed again following the closure of the 2024/25 accounts and a further report will be brought to the next IJB in June 2025. 6. CONCLUSIONS 6.1 It is essential for the long-term financial stability and the sustainability of the Partnership that sufficient funds are held in reserve to manage unanticipated pressures from year to year. The requirement for financial reserves is acknowledged in statute and is part of a range of measures in place to ensure that section 106 public bodies do not over-commit themselves financially. 6.2 The IJB Reserves Strategy 2025/26 provides an opportunity to strengthen long-term financial sustainability by considering all current reserves to ensure those held are still required and sufficient to meet on-going pressures. The IJB Reserves Strategy 2025/26 will enable the IJB to balance current commitments whilst planning and addressing financial risks. 7. IJB RESERVES STRATEGY 2025/26 7.1 As detailed Table 1, the reserve balances at 31 March 2024 were £75.524M. This figure comprised of £20.975m earmarked reserves to support the delivery of projects which span financial years and £24.114m ring-fenced monies to enable the Partnership to deliver on specific Scottish Government funded programmes. The remaining balance of £30.435m, are risk-based and contingency reserves which are not held to meet any specific liability and offer the Partnership some flexibility to deal with unforeseen events or emergencies. Table 1 LEAD SUMMARY Balance as at 31 March 2024 £m NHSL Ring-Fenced Reserves 24.114 NHSL & NLC Earmarked Reserves 20.975 NHSL & NLC Risk Based reserves 17.045 NHSL Contingency Reserve 13.390 TOTAL 75.524 7.2 A further in-year analysis and review was carried out with both partners in respect of all reserves to ensure the reserves held in 2024/25 and going into 2025/26 were still required and sufficient to meet on-going pressures. 7.3 No changes have been identified as a result of this review however this will be monitored on an ongoing basis.
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7.4 Reserves are utilised as required throughout the year and table 2 shows the projected year end position at 31 March 2025. Table 2 7.5 A detailed analysis of the realignment and audit trail of the movement of reserves throughout this financial year is at Appendix 1. 8. RISK 8.1 As part of the development of the financial plan and in line with the Partnership’s Medium term Financial Plan, if possible, it is recommended that the risk-based and contingency reserves are established as a percentage of the mainstream financial envelope as follows: Year 2022/2023 2023 to 2030 Contingency Reserve % 3% 5% 8.2 The Partnership’s contingency and risk reserves currently equate to 4.5% of the financial envelope, however, following completion of the 2024/25 financial year end, it is anticipated this percentage may increase. 9. IMPLICATIONS 9.1 NATIONAL OUTCOMES People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care, and treatment they provide ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ LEAD SUMMARY Opening Balance as at 1 April 2024 Transfers To / From Reserves Use of Reserves Revised Balance as at 31 March 2025 £m £m £m £m NHSL Ring-Fenced Reserves 24.114 10.945 (10.531) 24.529 NHSL & NLC Earmarked Reserves 20.975 0.000 (1.969) 19.006 NHSL & NLC Risk Based reserves 17.045 0.000 0.000 17.045 NHSL Contingency Reserve 13.390 0.000 (0.250) 13.140 75.524 10.945 (12.749) 73.720TOTAL
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9.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. 9.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 9.4 RISK ASSESSMENT/RISK MANAGEMENT The strategic financial risks detailed in the IJB Risk Register has been updated where necessary and are included in a separate report to the IJB. Relevant Risk Register Details Current Risk Level Risk Owner Financial Challenges Very High Nicola Scott National Set-Aside Budget High Claire Rae Hosted Services Medium Claire Rae Prescribing Activity and Costs Very High Claire Rae Third and Voluntary Sector Low Claire Rae Ineffective Governance Arrangements Low Claire Rae 9.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Objectives Further details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes The Director of Finance of NHSL and the Chief Officer (Finance) of NLC both continue to be consulted on the financial position of the NL IJB. ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design, and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery Financial information is shared with stakeholders on a regular basis and is provided to the PFA and IJB on a quarterly basis. ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff
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☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership IJB Financial Plan and Reserves Strategy aligns and supports the IJB Strategic Commissioning Plan to ensure robust financial monitoring and scrutiny. 9.6 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed: Yes No N/A 10. BACKGROUND PAPERS None. 11. APPENDICES Movement of Reserves Year to Date Appendix 1 Nicola Scott Chief Finance Officer Members seeking further information about any aspect of this report, please contact Nicola on telephone number 07581 007187. CHIEF ACCOUNTABLE OFFICER (or Depute)
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North Lanarkshire IJB Movement on Reserves Audit Trail NHSL & NCL Opening Balance As At 1 April 2024 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 January 2025 Movement in Reserves 2024/25 £m £m £m £m £m NHSL Alcohol and Drug Partnership Funding 3.597 0.860 (1.021) 3.436 (0.161) 1, 2, 4, 5 NHSL Area Wide Services - Refugees and Dis 0.106 (0.029) 0.077 (0.029) 1, 2, 4, 5 NHSL Blood-Borne Viruses Services 0.194 (0.039) 0.155 (0.039) 1, 2, 4, 5 NHSL Children and Adolescent Mental Health 2.849 2.849 0.000 1, 2, 4, 5 NHSL Community Living Change Fund 1.164 (0.116) 1.048 (0.116) 1, 4, 5 NHSL District Nursing 0.292 0.178 (0.292) 0.178 (0.114) 1, 2, 3, 4, 5 NHSL Family Nurse Practitioner Funding 0.072 0.072 0.000 1, 2, 3, 4, 5 NHSL Frailty Nursing 0.401 (0.400) 0.001 (0.400) 1, 2, 3, 4, 5 NHSL Hospital at Home Services 0.962 0.276 (0.322) 0.915 (0.046) 1, 2, 4, 5 NHSL Learning Disabilities Health Checks 0.491 0.491 0.000 2, 3 NHSL Long Covid Pathways 0.234 0.193 (0.233) 0.193 (0.040) 2, 3, 4, 5 NHSL Mental Health Action 15 0.729 0.730 (0.730) 0.730 0.000 1, 2, 4, 5 NHSL Mental Health Covid Clinicians 0.052 0.052 0.000 1, 2, 4, 5 NHSL Mental Health Diagnostic Support Service Dementia Post 0.972 0.337 (0.274) 1.035 0.063 1, 2, 3, 4, 5 NHSL Mental Health Digital Therapy Post 0.111 0.110 0.221 0.110 1, 2, 3, 4, 5 NHSL Mental Health Distress Brief Intervention 3.396 3.375 (3.396) 3.375 (0.021) 1, 2, 4, 5 NHSL Mental Health Eating Disorders 0.036 0.036 0.000 1, 2, 4, 5 NHSL Mental Health Neurodevelopmental Pathways 0.074 (0.074) 0.000 (0.074) 1, 2, 4, 5 NHSL Mental Health Recovery Renewal - Facilities Projects 1.029 1.029 0.000 1, 2, 4, 5 NHSL Mental Health Wellbeing in Primary 0.148 0.148 0.000 1, 2, 4, 5 NHSL North Planning Band 2-4 Posts & Multi-D 2.719 2.719 (2.719) 2.719 0.000 1, 2, 3, 4, 5 NHSL PCR Prison Care Network Transforming 0.013 (0.012) 0.001 (0.012) 1, 2, 3, 4, 5 NHSL Pharmacy Mental Health Recovery & NE 0.341 0.640 (0.341) 0.640 0.299 1, 2, 3, 4, 5 NHSL School Nursing 0.622 (0.348) 0.274 (0.348) 1, 2, 3, 4, 5 NHSL Specialist Doctor Contracts 0.194 0.194 0.000 1, 2, 3, 4, 5 NHSL Staff Wellbeing 0.254 0.254 0.000 3 NHSL Third Sector Initiatives To Improve 0.247 (0.172) 0.075 (0.172) 1, 2, 3, 4, 5 NHSL Unscheduled Care Funding 2.790 2.790 0.000 1, 2, 3, 4, 5 NHSL Upper GI Dietetics Band 4 0.027 (0.013) 0.014 (0.013) 3 NHSL MH Outcomes 1.527 1.527 1.527 1, 2, 4, 5 24.114 10.945 (10.531) 24.529 0.414 Opening Balance As At 1 April 2024 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 January 2025 Movement in Reserves 2024/25 £m £m £m £m £m NHSL Adult Social Care Winter Preparedness F 1.000 1.000 0.000 1, 2, 3, 4, 5 NLC Adaptations Fund 0.308 0.308 0.000 2, 4 NLC Adult Protection (share with C&F and NHSL) 0.050 0.050 0.000 1, 2, 4, 5 NLC Advocacy Services 0.065 0.065 0.000 1, 2, 4, 5 NHSL Breast Feeding Team (2 year funding) 0.705 (0.285) 0.420 (0.285) 1, 2, 5 NLC Business Case - Non-Recurring NLC 1.319 1.319 0.000 1, 2, 3, 4, 5 NLC Carers Act 2018 - Support 2.596 2.596 0.000 1, 2, 4, 5 NHSL Children and Adolescent Mental Health 0.268 0.268 0.000 4 NHSL Childrens Services - Paediatric Band 7, 0.107 (0.107) 0.000 (0.107) 3 NHSL Development of Chryston Community 0.212 0.212 0.000 1, 5 NHSL Dietetics Services - Double Running 0.064 (0.009) 0.055 (0.009) NLC Digital and IT Strategy Technology 0.465 0.465 0.000 2, 3 NLC Digital and IT Strategy Technology 3.699 3.699 0.000 2, 3 NLC Digital and IT Strategy Technology 0.389 0.389 0.000 NLC Digital and IT Strategy Technology 0.700 0.700 0.000 2, 3 NLC Financial Strategy - Changes to LA 0.027 0.027 0.000 NHSL Health Inequalities - Screening 0.044 (0.023) 0.021 (0.023) 2 NHSL Health Visiting Students/Trainees 0.311 (0.279) 0.032 (0.279) 3 NLC Home Support Resilience (2 year 0.656 0.656 0.000 3, 4 NHSL HR Employability Team (2 year funding, 50:50 split between North and South) 0.087 0.087 0.000 3 NLC IJB Helpline (2 years funding) 0.360 0.360 0.000 1, 4, 5 NHSL Kylepark Works 0.134 0.134 0.000 4, 5 NLC Mental Health Social Workers 2 x NL10 0.162 0.162 0.000 3, 4 NHSL Mental Health Wards Window 0.650 0.650 0.000 2, 4 NHSL Minor Capital Works 1.027 1.027 0.000 3 NHSL Neonatal & Paediatrics Dieteics 0.450 (0.146) 0.304 (0.146) 1, 2, 5 NHSL Organisational Development Fund 0.260 0.260 0.000 3 NHSL Paediatric Diabetes Insulin Pumps and 0.569 (0.031) 0.538 (0.031) 1, 2, 3 NLC Planned Date of Discharge - Discharge 0.109 0.109 0.000 1, 5 NHSL Podiatry Services - Foot Screening 0.350 (0.007) 0.343 (0.007) 1, 2 NHSL Prisioner Healthcare - Transitional 0.020 (0.019) 0.001 (0.019) 3 NHSL Regrading of Posts Including Backpay 0.250 0.250 0.000 3 NHSL Scottish Clinical Leadership Fellowship 0.060 (0.031) 0.029 (0.031) 3 NHSL Sexual Health Services - Forensic 0.152 (0.152) 0.000 (0.152) 1, 2 NHSL Sexual Health Services - Long-Acting 0.404 (0.107) 0.297 (0.107) 1, 2 NLC Social Care Contracting Staff within 0.087 0.087 0.000 3 NLC/NHSL Staff Training Academy 2.042 (0.500) 1.542 (0.500) 3 NHSL Vulnerable and Complex Cases - Test 0.816 (0.273) 0.543 (0.273) 5 20.975 0.000 (1.969) 19.006 (1.969) Ambition Statement & Performance TOTAL EARMARKED RESERVES TOTAL RING-FENCED RESERVES LEAD EARMARKED RESERVES To Be Drawn Down 2024/25 To Be Drawn Down 2025/26 Ongoing APPENDIX 1 LEAD RING-FENCED RESERVES To Be Drawn Down 2024/25 To Be Drawn Down 2025/26 Ongoing Ambition Statement & Performance
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Opening Balance As At 1 April 2024 Transfers To / From Reserves Pending Drawdown from Reserves Revised Balance As At 31 January 2025 Movement in Reserves 2024/25 £m £m £m £m £m NHSL Prescribing Fund 4.361 4.361 0.000 2, 4 NLC Social Care Demand 12.684 12.684 0.000 2, 4 17.045 0.000 0.000 17.045 0.000 Opening Balance As At 1 April 2024 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 January 2025 Movement in Reserves 2024/25 £m £m £m £m £m NHSL Contingency Balance Held By NHSL 13.390 (0.250) 13.140 (0.250) 13.390 0.000 (0.250) 13.140 (0.250) Opening Balance As At 1 April 2024 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 January 2025 Movement in Reserves 2024/25 £m £m £m £m £m 0.000 0.000 0.000 0.000 0.000 75.524 10.945 (12.749) 73.720 (1.804) KEY 1 2 3 4 5 Improve mental health and wellbeing. Supporting people through a whole family approach. TOTAL CLOSED RESERVES TOTAL RESERVES Ambition Statement & Performance Do the right thing first time. Increased focus on prevention, early intervention and tackling inequalities by working with communities and people. Develop and support a workforce for the future. Ambition Statement & Performance TOTAL CONTINGENCY FUND RESERVES LEAD CLOSED RESERVES To Be Drawn Down 2024/25 To Be Drawn Down 2025/26 Ongoing Ambition Statement & Performance TOTAL RISK-BASED RESERVES LEAD CONTINGENCY FUND RESERVES To Be Drawn Down 2024/25 To Be Drawn Down 2025/26 Ongoing LEAD RISK-BASED RESERVES To Be Drawn Down 2024/25 To Be Drawn Down 2025/26 Ongoing Ambition Statement & Performance