11 - 2025-06-18 IJB - Unaudited North Lanarkshire IJB Annual Accounts 2024-25 - Appendix 1
North Lanarkshire Council · 18 June 2025
Back to Health and Social Care Integration Joint Board — 18 June 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Appendix 1 UNAUDITED ANNUAL REPORT AND FINANCIAL STATEMENTS For the Year Ended 31 March 2025
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1 | P a g e CONTENTS Introduction 2 Management Commentary 3 Role of the IJB 3 National Health & Wellbeing Outcomes 4 A profile of North Lanarkshire 5 University Health & Social Care Partnership 6 2024/25 Achievements 7 Measuring Performance Under Integration 10 Key Risks, Uncertainties & Challenges 11 Financial Performance 2024/25 15 Reserves Strategy 17 Acknowledgements 18 Statement of Responsibilities 19 Remuneration Report 20 Annual Governance Statement 23 Comprehensive Income and Expenditure Statement 31 Movement in Reserves Statement 32 Balance Sheet 33 Notes to the Financial Statements 34 Note 1. Significant Accounting Policies 34 Note 2. Events After the Balance Sheet Date 36 Note 3. Expenditure and Funding Analysis by Nature 37 Note 4. Taxation and Non-Specific Grant Income 37 Note 5. Corporate Services 38 Note 6. Short Term Debtors and Creditors 38 Note 7. Useable Reserves: General Fund 38 Note 8. Related Party Transactions 39 Note 9. Hosted Services 40 Note 10. VAT 42 Note 11. External Audit Costs 42 Independent Auditors Opinion 43
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2 | P a g e Introduction This publication contains the annual report and financial statements of the North Lanarkshire Integration Joint Board (IJB) for the year ending 31 March 2025. The management commentary provides an overview of the key outcomes relating to the objectives and strategy of the University Health & Social Care Partnership (the Partnership). It considers the financial performance for the year 2024/25 and looks forward, outlining future plans, challenges and risks that will be faced as the Partnership strives to meet the needs of the people of North Lanarkshire.
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3 | P a g e Management Commentary Role of the IJB The IJB was established as a corporate body by Scottish Government and became operational in June 2015 with integrated delivery of health and social care services commencing on 1 April 2016. It is a joint venture between NHS Lanarkshire (NHSL) and North Lanarkshire Council (NLC). The functions delegated to the IJB, under the Public Bodies (Joint Working) (Scotland) Act 2014, are detailed in the formal partnership agreement between the two partner organisations, NLC and NHSL referred to as the Integration Scheme.1 The IJB’s primary purpose is to set the strategic direction for the delegated functions through its Strategic Commissioning Plan2 with NHSL and NLC being responsible for the operational delivery of those strategic directions which include: • Accident and emergency services provided in a hospital • Inpatient services related to general, respiratory and rehabilitation medicine • Palliative care services • Community health services including Lanarkshire wide hosted services • Social care services. 1 NL IJB Integration Scheme 2025 2 Strategic Commissioning Plan 2023-26
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4 | P a g e National Health & Wellbeing Outcomes While the IJB has overall responsibility for planning health and social care services within the area, consideration has to be given to the range of other local and national strategies to ensure the Strategic Commissioning Plan aligns with these. The outcomes that pull all the strategic and planning strands together are reflected in an agreed set of nine national Health and Wellbeing Outcomes which the IJB has a duty to deliver. Outcome 1 People are able to look after and improve their own health and wellbeing and live in good health for longer Outcome 2 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 Outcome 3 People who use health and social care services have positive experiences of those services and have their dignity respected. Outcome 4 Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services. Outcome 5 Health and social care services contribute to reducing health inequalities. Outcome 6 People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and wellbeing. Outcome 7 People using health and social care services are safe from harm. Outcome 8 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. Outcome 9 Resources are used effectively and efficiently in the provision of health and social care services. Whilst many older people are expected to enjoy better health than their predecessors did at an equivalent age, they will still have significant health needs, living with potentially multiple complex conditions. The impact of this will be a steadily increasing demand on health and social care services, including home support, care homes, increases in demand for community- based healthcare, equipment and adaptations and an increased demand for GP services and medication. This is supported by the statistics outlined in the next section.
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5 | P a g e A profile of North Lanarkshire Population 341,890 4th largest area in Scotland and the 5th most populated Population Trends 2011 – 2022 25 to 44 age group 7.3% Over 75’s 21% Population Projections to 2043 Population 1.2% Over 75’s 71.4% Unemployment 3.3% = lowest since 2005 Long Term sick or disabled 6% Health Comparisons 2011 – 2022 Individuals self-reporting as “not in good health”. 24.6% (+6039) Individuals self-reporting as in “fairly good health”. 15% (+7036) Individuals self-reporting with ‘long term health conditions’ 30.6% (+43,943) Individuals self-reporting mental health issues 158.6% (+24,903) Individuals self-reporting as providing informal / unpaid care 31.6% (+10,877)
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6 | P a g e University Health & Social Care Partnership Within North Lanarkshire, NHSL and NLC deliver integrated services as the Partnership therefore it is essentially staff from both organisations working together to plan and deliver services under the direction of the IJB. Purpose The long-term vision for the Partnership was set out in the original Strategic Plan 2016- 2026 and continues as the over-arching vision of the Strategic Commissioning Plan 2023-26. This states that the people of North Lanarkshire will achieve their full potential through: Ambitions To implement the vision, the Partnership has 6 key ambitions which were revised in 2023, following engagement with stakeholders, taking experience gained since 2016 and looking at the current and future challenges facing the Partnership. • Living safe, healthy and independent lives in their communities. • Receiving the information, support and care they need, efficiently and effectively, at the right time, in the right place and in the right way. • Ensuring North Lanarkshire is the best place in Scotland to grow up. KEY AMBITIONS 1. Do the right thing first time 2. Increased focus on prevention, early intervention and tackling inequalities by working with communities and people 3. Develop and support a workforce for the future 4. Improve mental health and wellbeing 5. Support people through a whole family approach
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7 | P a g e 2024/25 Achievements The progress made by the Partnership on the key strategic commissioning intentions and the key performance indicators are reported regularly to the IJB. The Strategic Commissioning Plan 2023-26 and Programme of Work Update Report 3 reflects on the achievements made throughout the year. There has been significant work completed in 2024/25 which continues to meet the key ambitions of the partnership, some of which are detailed below, with full detail included in the update report: Do the right thing first time The Partnership is a Pathfinder initiative for the national ‘Getting it Right for Everyone’ work led by the Scottish Government. This work is built on strong co-design routes to which has led to the development of prototypes to focus on My Plan and My Team. These developments are fully embedded within the whole system enabling approach being adopted to ensure Getting it Right for Everyone. The approach to improving the co-ordination of people’s support involves a ‘sticky person’ as a trusted point of contact who supports people with the coordination of their plan and appointments as an integrated member of a multi-disciplinary team, including when someone receives support from a variety of teams. Areas for further development and design include determining how the sticky person for each individual is allocated routinely across the Partnership operates and how the role might be undertaken by a family member, the wider community or the voluntary sector colleague. Getting it Right for Everyone includes the development of community hubs to ensure that individuals can connect with public services and with local people involved in supporting. This approach is building on the active work being undertaken in Newmains and St Brigid’s Community Hub, Riverbank and Chryston community hubs. Increased focus on prevention, early intervention and tackling inequalities The Lanarkshire Strategy for Preventing and Managing Frailty 2023 – 2028 was approved in November 2023. The implementation of the strategy is ongoing with a particular focus on strengthening frailty networks, with the aim of providing a collaboration between the multi- disciplinary teams on the acute sites and the partnerships who have experience in frailty work. This has led to richly informed conversations which has been at the forefront of driving realistic and patient-centred change for the people living in North Lanarkshire. Develop and support a workforce for the future There has been a significant development in the strategic academic collaborations within the Lanarkshire system. Both Lanarkshire Health and Social Care Partnerships have now been granted University Status with Glasgow Caledonian University. Work continues to develop the strategic academic approach with Strathclyde University and the University of the West of Scotland. 3 Strategic Commissioning Plan 2023-26 and Programme of Work Update
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8 | P a g e There has been an expansion not only in the volume of collaborative work undertaken but also in the complexity of projects and in the increasing diversity of links between NHSL and multiple departments and individuals across our strategic partnerships. The Care Academy is a collaborative initiative between NHSL, NLC and South Lanarkshire Council (SLC). The Academy is authorised to work with partners such as local councils, education departments, colleges, universities, the independent sector and third-sector organisations to attract and recruit staff to the health and social care workforce in Lanarkshire. Four workstreams have been established: • a focus on attraction, recruitment, retention and wellbeing • pathways for young people • adult pathways to care Improving prospects for working-age adults • funding, procurement, community wealth building and entrepreneurship. Improve mental health and wellbeing There have been 6 work streams supporting mental health and wellbeing that have all either been fully completed or are well progressed to a business-as-usual model of operational delivery: • Neurodevelopmental Service (NDS) All neurodevelopmental requests for assistance are now channelled via the established NDS. This combined three previous waiting lists (Child and Adolescent Mental Health Services (CAMHS), NDS and Paediatrics) and provided transparency of referral pathway, consistency of response and quality assurance of assessment. • Choices & Partnership Approach (CAPA) This new model of patient management has been operational since May 2023. It can now provide robust data capable of assuring planning of service capacity and informing trajectories over a longer time period. • HR & Workforce A full review of workforce in line with CAMHS and NDS specifications was undertaken and professional and support staff gaps addressed. • Communication and Engagement An Engagement Officer role has established a process that facilitates consultation with children, young people and their families. This provides assurance that the child’s voice is represented in our strategic planning and individual care planning. A website has been established and design of CAMHS and NDS logos were undertaken in partnership with New College Lanarkshire and decided by public vote. • eHealth Trakcare build completed to facilitate delivery of CAPA Model. Electronic case record now in place across whole service.
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9 | P a g e • Capital/Strategic Planning Large scale refurbishment delivered in South Lanarkshire. Work ongoing across 3 sites in North Lanarkshire to deliver the same. The objectives initially set by Programme Board have been realised and have now progressed to a stage of sustainability of performance and quality assurance that is aligned with national specification. Support people through a whole family approach The partnership’s Carers Strategy 2024-27 was approved and published in May 2024 and the approach continues to be based on the principles of the Carers (Scotland) Act 2016 and Self- Directed Support (Scotland) Act 2013, promoting a whole system approach that enables people to have more choice and control in their lives. The development of the Carers Strategy was developed through engagement and participation activity with carers and supported people. This has resulted in a carer led and carer informed strategy, co-produced with carers and carer organisations locally. The sense of joint ownership that has emerged is something that carers, carer organisations and the Partnership can be proud of. A focused effort has been directed towards refreshing the Engagement & Participation Strategy that will serve as the foundation across all areas of our work. The final version of the Engagement & Participation Strategy 2024-27 was approved in May 20244. In the development of the Strategy, the Partnership actively engaged with stakeholders, representatives of community-based organisations, supported people, carers, and staff teams. Learning from these sessions has highlighted what is considered good engagement and participation. 4 Engagement and Participation Strategy 2024-2027
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10 | P a g e Measuring Performance Under Integration The Annual Performance Report for 2023/245 was published in September 2024 and provides an opportunity to reflect on the past year and celebrate the accomplishments of the Partnership, its employees and partners. It acknowledges the ongoing collaborative work undertaken and recognises the existing and future challenges that the Partnership faces, many of which are influenced by the long-lasting effects of the pandemic. Since 2016, IJBs have been required by legislation to report on the Core Suite of Integration Indicators. These indicators were developed to help IJBs review their progress towards achieving each of the National Health and Wellbeing Outcomes, which focus on improving how services are provided, and the difference health and social care services should make for individuals. The most recent reporting period available is 2023/24; this ensures that the findings are based on the most complete and robust data currently available: 5 Annual Performance Report 2023/24 Title North Lanarkshire Scotland UHSCNL Trend Scotland Trend Premature mortality rate (per 100,000 persons) 510 442 BETTER BETTER Emergency Admission Rate (per 100,000 of population) 15,396 11,707 WORSE WORSE Emergency Bed Day Rate (per 100,000 of population) 122,120 112,883 BETTER BETTER Emergency re-admission to hospital within 28 days of discharge (per 1,000 of discharges) 116 104 BETTER WORSE Proportion of last 6 months of life spent at home or in a community setting 89% 89% BETTER BETTER Falls rate per 1,000 population aged 65+ 21 23 WORSE WORSE Proportion of care services graded ‘good’ (4) or better in Care Inspectorate inspections 76% 77% WORSE BETTER Percentage of adults with intensive care needs receiving care at home 70% 65% WORSE BETTER Number of days people spend in hospital when they are ready to be discharged (per 1,000 population) 973 902 WORSE BETTER Performance is better than previous reporting period Performance is worse than previous reporting period
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11 | P a g e Key Risks, Uncertainties & Challenges Given the current political climate and the associated economic uncertainty, the Partnership faces significant risks, uncertainties and challenges. These include but are not limited to: Financial Risks & Uncertainties • Future funding levels from partner organisations and Scottish Government. • Continued increasing costs and raising inflation including future pay awards. • Increasing costs of equipment and adaptations • The outcome of the negotiations for the national care home rate • The impact of the increase to national insurance contributions for both direct staff and commissioned services and the potential lack of additional funding to support these • Impact of rising costs of commissioned services with providers outwith the national frameworks asking for significantly above inflation increases. • The level of non-recurring solutions included to meet the 2025/26 cost pressures. Operational Risks & Uncertainties • Impact of proposed savings options which could include an increase to delayed discharge figures and bed delays. • The ability to recruit and retain quality staff to continue to deliver services and manage increasing demand. • Unexpected shortage of supplies and materials. • Increasing level of complex care packages materialising that are currently unknown. • Volatility of the external care market and the support required in order to provide stability. • Increased numbers of providers seeking to set up separate companies and exit the National Care Home Contract which would lead to individual placement and price negotiations. • Operational impact of the increased contract prices from providers leading to issues with placement of individuals. • Changing political factors which influence the UK and Scottish Government priorities and policy initiatives. These were highlighted to the IJB as part of the Medium Term Financial plan and they will be monitored through the Partnership’s risk management process as detailed in the next section.
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12 | P a g e Risk Management The IJB Risk Management Strategy complements the existing risk management processes within each partner by ensuring risk reports form a substantial item of business at all IJB and Performance, Finance and Audit (PFA) Committee meetings. There are three main risk registers across thePpartnership: • IJB risk register outlining the strategic risks to the IJB; • Health operational risk register, hosted within the NHSL system; and • Social Work operational risk register, hosted within NLC system. Strong ties have been maintained with the corporate risk managers in both partner organisations and the IJB Risk Management Strategy, has been developed in conjunction with these leads, linking closely to both the NLC and NHSL Risk Management Strategies. At time of writing, there are currently nineteen open risks identified within the North Lanarkshire IJB Risk Register with ten of these risks rated as very high or high. The table below shows a summary of these: Current Risk Level Category Summary of Risk Financial Strategic Financial Challenges: There are a range of financial challenges which will impact on the IJB’s ability to deliver the Strategic Commissioning Plan with the financial envelope available. Very High Financial Reputational Prevention and Detection of Fraud, Bribery and/or Corruption: There is a risk that the IJB is unable to prevent and detect fraud and corruption within services because of inadequate governance arrangements and internal controls. Low Financial Strategic Set-Aside Budget: There is a risk that the resources will not be transferred from Acute Services to the HSCP in line with the shift in the balance of care. High Financial Strategic Hosted Services: There is a risk of dispute between the North and South Lanarkshire IJB in respect of the financial allocations underpinning the Hosted Services budgets. Medium
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13 | P a g e Current Risk Level Category Summary of Risk (continued) Financial Operational Prescribing Activity and Costs: The risk is cost of prescribing could impact on the availability of medicines, healthcare techniques and technology and in respect of supply of medicines and medical devices, additional checks are now required at ports and EEA before goods can cross the border. Very High Financial Operational Pharmacy Pressures within Prison Service: Pharmacy costs have traditionally been the highest area of non-pay spend nationally in all prisons. There is currently a large overspend for the actual drugs brought associated with the management fees for the contract. Very High Financial Strategic Ineffective Governance Arrangements: There is a risk that the intensity of the required response to Covid-19 could result in a failure of governance impacting on the effectiveness of the IJB decision-making. Low Performance Oversight of Performance Activity: There is a risk the IJB is not provided with adequate or sufficient performance information to enable it to discharge its scrutiny and oversight role. Low Performance Staff Health & Wellbeing: There is a risk to the delivery of the Strategic Commissioning Plan as a result of sustained pressures on staff availability due to additional pressures associated with sickness absence, and redeployment. High Performance Care Homes: Inability of care homes to sustain service due to staffing and cost pressures resulting in closure to new placements and closure of care homes. Medium Strategic & Performance CAMHS: There is a risk that the CAMHS service cannot meet the increasing clinical demands due to a significantly high number of cumulative staff vacancies for both clinical and non-clinical post and challenges recruiting. Medium Strategic & Performance Cost of Living: There is a risk that the IJB’s Strategic Commissioning Plan will be unable to be delivered or not have the desired impact due to the cost of living rises being faced by residents across North Lanarkshire. High
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14 | P a g e Current Risk Level Category Summary of Risk (continued) Strategic National Care Service: There is a risk that the ongoing work around a National Care service could destabilise current service delivery due to significant change activity, time demands around the co-design process, staff uncertainty and partner organisations having to focus on the impact of change. Low Strategic & Performance Unscheduled Care: There is a risk that we cannot sustain whole system patient flow through peak winter pressures due to increased front door demand, workforce capacity, delays in onward movement of patients and care at home capacity. High Strategic & Performance Community Alarms: There is a risk that the community alarm system will be destabilised due to the national change from analogue to digital telephony by 2025. Medium Performance Service Sustainability: Due to competing service priorities and workforce and financial challenges, there is a risk that the IJB will be unable to implement the strategic plans. High Performance Workforce Sustainability: It is becoming increasingly difficult to recruit to particular roles across Health and Social Care as gaps in the workforce can result in reduction of service provision, increase in staff workload and inability to deliver the strategic plan. High Performance Speech and Language Therapy Service: There is a risk that the SLT service cannot meet the increasing clinical demands with variance in waiting list length by area, continued challenges around the recruitment and retention of new colleagues, funding streams from Local Authority being reduce therefore reducing staff WTE High
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15 | P a g e Financial Performance 2024/25 The challenges seen in 2023/24 continued to be seen in 2024/25 with funding not keeping pace with increasing costs and demand. The savings plan put in place to ensure the Partnership continued to meet its key ambitions, while undertaking service transformation, was not fully realised however the Partnership did deliver a year end underspend. This underspend was achieved by: o flexible use of recurring and non-recurring funding o creation and use of reserves for specific commitments o delivery of approved savings through efficiency measures and redesign o focusing on workforce planning and the Strategic Commissioning Plan Programme of Work o effective governance and audit controls As outlined on page 3 of this Annual report, North Lanarkshire IJB delivers and commissions a range of health and social care services to the local population. The Board is responsible for the strategic planning of the functions delegated to it and for ensuring the delivery of its functions through the locally agreed operational arrangements set out within the integration scheme. To successfully discharge the operational delivery of services, funding is provided through budgets delegated from both NLC and NHSL. The level of funding available to the IJB is therefore heavily influenced by these organisations’ grant settlement from Scottish Government. The total budget available to the IJB, inclusive of the Set Aside Budget and the budgets for a number of delegated services where South Lanarkshire IJB acts as lead host, was £861.000m. The final outturn against this budget, after the use of reserves, is £10.716m. Annual Budget 2024/25 In Year Drawdown From Reserves Revised Budget 2024/25 Final Outturn 2024/25 Final Outturn Variance 2024/25 £m £m £m £m £m North Lanarkshire IJB 861.046 (10.686) 850.360 839.644 10.716 Note: The figures differ to that in the Comprehensive Income and Expenditure Statement (CIES) due to differences in the presentation of in year adjustments between the partners. The final outturn variance is across a number of integrated services however there are 4 key variances worthy of highlighting:
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16 | P a g e Delegated Service Variance £m Over / Underspend Reason Ambition Statement Employee Costs 19.219 Underspend The Partnership continues to encounter challenges in terms of recruitment and retention across all service areas which has led to spend below budget. This underspend is also inclusive of non-recurring savings on pension costs 3 Hosted Services 2.865 Underspend North Lanarkshire IJB commissions a number of services where North Lanarkshire is the host organisation for services carried out within South Lanarkshire. Overall, there was an underspend however there are some services which delivered over budget, which include continence services, children’s diabetic nursing and prisoner healthcare. 1, 2, 4, 5 Payments to Other Bodies (1.073) Overspend Integrated services provided by Social Care on behalf of the IJB includes Care at Home and Care Homes. A net overspend was reported within these areas which is representative of the increasing demand on these services. 1, 3, 5 Prescribing (4.757) Overspend A significant spend within the services delegated to the IJB from the Health Service is the cost of Prescribing. The overspend being reported in here is attributable to both the number of medicines being prescribed and dispensed alongside higher prices. 2, 4 The year end underspend totalled £10.716m which included the drawdown of reserves in 2024/25 of £10.686m leaving a surplus on the provision of services of £0.030m as shown in the CIES on page 31 and Movement in Reserves on page 32. North Lanarkshire IJB Financial Outturn 2024/25 £m Underspend as at 31 March 2024 10.716 Use of Reserves In-Year (10.686) Surplus on Provision of Services (Page 27) Movement in Reserves (Page 28) 0.030
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17 | P a g e Reserves Strategy The IJB has the same legal status as a local authority and is therefore able to hold reserves under section 106 of the Local Government (Scotland) Act 1973. A reserve strategy was developed to provide security against unexpected cost pressures and to aid financial stability. The IJB Reserves Strategy 2024/25 allows for the flexibility in terms of potential fluctuations. This allows the IJB to increase contingency reserve balances where resources permit, providing future financial resilience for those years where the level of resources available to the IJB may be significantly constrained and will require a drawdown from these reserves in order to deliver financial balance. To protect the financial resilience of the IJB in the context of an increased financial risk profile, the total contingency reserve is 3.6% of the mainstream financial envelope. The IJB has also committed actions attached to the Strategic Commissioning Plan Programme of Works and funding is therefore earmarked to specific projects to allow spend to be managed in a way that represents best value for the IJB to achieve its national outcomes. It is also important that in year funding available from government priorities are able to be ring-fenced and carried forward into the following financial year. As these funding allocations are to meet specific commitments, they must be carried forward to meet the conditions attached to their receipt. The table below shows the breakdown of the underspend transferred to reserves at year end: Analysis of Underspend Transferred to IJB Reserves at Year End 2024/25 £m Ring Fenced Reserves 0.614 Earmarked Reserves 10.102 Total Underspend Transferred to Reserves 10.716
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18 | P a g e Acknowledgements We would like to acknowledge the significant effort required to both produce the annual accounts and successfully manage the finances of the IJB and to record our thanks to the Finance teams in both NLC and NHSL and colleagues in other services for their continued hard work and support. Brian Moore Chair Date: 17 September 2025 Claire Rae Chief Officer Date: 17 September 2025 Nicola Scott CPFA Chief Finance Officer Date: 17 September 2025
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19 | P a g e Statement of Responsibilities Responsibilities of the North Lanarkshire Integration Joint Board The North Lanarkshire IJB is required to: • Make arrangements for the proper administration of its financial affairs and to ensure that the proper officer of the board has responsibility for the administration of those affairs (section 95 of the Local Government (Scotland) Act 1973). In this IJB, that officer is the Chief Finance Officer. • Manage its affairs to secure economic, efficient, and effective use of resources and safeguard its assets. • Ensure the Annual Accounts are prepared in accordance with legislation (The Local Authority Accounts (Scotland) Regulations 2014), and so far, as is compatible with the legislation, in accordance with proper accounting practices (section 12 of the Local Government in Scotland Act 2003). • Approve the Annual Accounts. I confirm that these Annual Accounts were approved for signature at a meeting of the North Lanarkshire Integration Joint Board on 17th September 2025. Signed on behalf of the North Lanarkshire Integration Joint Board Brian Moore Chair Date: 17 September 2025
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20 | P a g e Remuneration Report The Local Authority Accounts (Scotland) Regulations 2014 (SSI No.201/200) require local authorities and IJB’s in Scotland to prepare a Remuneration Report as part of the annual statutory accounts. The information in the tables below is subject to external audit. The explanatory text in the Remuneration Report is reviewed by Audit Scotland to ensure it is consistent with the financial statements. Voting Board Members Voting IJB members constitute councillors nominated as board members by constituent authorities and NHS representatives nominated by the NHS Board. The voting members of North Lanarkshire IJB were appointed through nomination by NLC and NHSL. The regulations require disclosure of remuneration information for ‘relevant’ persons. A ‘relevant’ person in relation to the Remuneration Report includes a senior officer holding office with associated authority, whether on a permanent or temporary basis, in the financial year to which that Remuneration Report relates. The Board Members do not receive remuneration or expenses directly from the IJB. Any remuneration or reimbursement of expenses for voting board members is governed by the relevant IJB partner organisation. The IJB does not provide any additional remuneration to the Chair, Vice Chair or any other board members relating to their role on the IJB. The IJB does not reimburse the relevant partner organisations for any voting member costs by the partner. The details of the Chair and Vice Chair appointments held during 2024/25 are outlined in the table below: The IJB does not have responsibilities, either in the current year or in future years, for funding any pension entitlement of voting IJB members. Therefore, no pension rights disclosures are provided for the Chair or the Vice Chair. There were no exit packages payable during the financial year. Name Post Held Nominated by Cllr Michael McBride IJB Chair (1 April 2024 - 27 April 2024) North Lanarkshire Council Cllr Anne McCrory IJB Chair ( 28 April 2024 - 31 March 2025) North Lanarkshire Council Brian Moore IJB Vice Chair ( 1 April 2024 - 31 March 2025) NHS Lanarkshire
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21 | P a g e Officers of the IJB The IJB does not directly employ any staff in its own right, however specific post-holding officers are nonvoting members of the Board. The Chief Officer and the Chief Finance Officer are appointed by the North Lanarkshire IJB and employed by NLC. Both posts are seconded to the IJB in line with the local arrangements. The Chief Officers received the following remuneration in the period: Total Earnings Name and Post Title Total Earnings 2023/24 2024/25 £ £ 124,425 Ross McGuffie 62,333 Chief Officer 1 April 2024 - 30 September 2024 81,854 Amanda Kilburn 43,960 Chief Finance Officer 1 April 2024 - 9 October 2024 - Claire Rae 62,466 Chief Officer 1 October 2024 - 31 March 2025 - Nicola Scott 31,249 Chief Finance Officer 18 November 2024 - 31 March 2025 Pay band information is not separately provided as all staff pay information has been disclosed in the information above. Pension Benefits In respect of officers’ pension benefits the statutory liability for any future contributions to be made rests with the relevant employing partner organisation. On this basis, there is no pension liability reflected on the IJB balance sheet for the Chief Officer or the Chief Finance Officer. The IJB however, has responsibility for funding the employer contributions for the current year in respect of the officer time spent fulfilling the responsibilities of their role on the IJB. The following table shows the IJB’s funding during the year to support officers’ pension benefits. The table also shows the total value of the accrued pension benefits which may include benefits earned in other employment positions and from each officer’s own contributions.
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22 | P a g e Name and Post Title In Year Pension Contribution Accrued Pension Benefits For Year to For Year to For Year to For Year to 31/03/2024 31/03/2025 Description 31/03/2024 31/03/2025 £ £ £ £ Ross McGuffie 24,014 2,676 Pension 16,236 18,554 Chief Officer Lump Sum - - Amanda Kilburn 15,798 3,030 Pension 16,902 8,209 Chief Finance Officer Lump Sum - - Claire Rae - 4,060 Pension - 1,310 Chief Officer Lump Sum - Nicola Scott - 2,031 Pension - 13,050 Chief Finance Officer Lump Sum - 13,180 Brian Moore Chair Date: 17 September 2025 Claire Rae Chief Officer Date: 17 September 2025
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23 | P a g e Annual Governance Statement The Annual Governance Statement reports on the effectiveness of the IJB’s governance arrangements and system of internal control and explains how the IJB complies with the Code of Corporate Governance6 and meets the requirements of the ‘Delivering Good Governance in Local Government’ framework developed by CIPFA and SOLACE in 2016. Scope of Responsibility The IJB is responsible for ensuring that its business is conducted in accordance with the law and appropriate standards, that public money is safeguarded, properly accounted for, and used economically, efficiently, and effectively. The IJB also aims to foster a culture of continuous improvement in the performance of the IJB’s functions and to make arrangements to secure best value. To meet this responsibility, the IJB has established arrangements for governance which includes a system of internal controls. The system is intended to manage risk to support the achievement of the IJB’s policies, aims and objectives. Reliance is also placed on the NLC and NHSL systems of internal control which support compliance with both organisations’ policies and promotes achievement of each organisations aims and objectives, as well as those of the IJB. This system can only provide reasonable and not absolute assurance of effectiveness. Purpose of the Governance Framework The governance framework comprises the systems and processes, and culture and values, by which the IJB is directed and controlled. It enables the IJB to monitor the achievement of the objectives set out in the IJB’s Strategic Commissioning Plan. The governance framework is continually updated to reflect best practises, new legislative requirements, and the expectations of stakeholders. The system of internal control is based on an ongoing process designed to identify and prioritise the risks in the achievement of the IJB’s objectives, to evaluate the likelihood of those risks being realised, the impact should they be realised, and to manage them effectively. Governance Framework and Internal Control System The IJB comprises of eight voting members, with one from each partner organisation assuming the role of Chair and Vice Chair. Four are Council Members nominated by NLC and four are Non-Executive Members appointed by NHSL. The term of office is for a period of three years. There are also a number of non-voting professional and stakeholder members on the IJB board. Stakeholder members currently include third sector, carers, staff representatives, service users and professional members including the Chief Officer and Chief Finance Officer. The IJB, via a process of delegation from NLC and NHSL, has responsibility for the planning, resourcing and operational delivery of all delegated health and social care within its geographical area. The main features of the governance framework are: 6 Code of Corporate Governance
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24 | P a g e Principles ▪ The IJB follows the principles set out in the Convention of Scottish Local Authorities (COSLA) and the Accounts Commission in 1996 Code of Guidance on Funding External Bodies and Following the Public Pound for both resources delegated to the IJB, and resources paid to its Local Authority and Health Service partners. Formal Frameworks ▪ The IJB is formally constituted through the Integration Scheme agreed by NLC and NHSL and approved by Scottish Ministers. ▪ The IJB operates within an established procedural framework. The roles and responsibilities of board members and officers are defined within standing orders, scheme of delegation and financial governance arrangements which are subject to regular review. The IJB Code of Corporate Governance was approved by the IJB on 18 July 2017 and is subject to ongoing updates as required. Board members adhere to an established Code of Conduct and are supported by induction and ongoing training and development. ▪ The Partnership has robust structures in place with our partners, which are based on service delivery, care and interventions that are person centred, timely, outcome focused, equitable, safe, efficient, and effective. Reports are presented to the IJB throughout the year which provides evidence to demonstrate the delivery of our core components within our framework and the Clinical and Care Governance principles specified by Scottish Government. Strategic Planning ▪ The overarching strategic vision and objectives of the IJB are detailed in the IJB Strategic Commissioning Plan which sets out the key outcomes that the IJB is committed to delivering with its partners. ▪ The Strategic Commissioning Plan Board sets out the IJB’s approach to engage with stakeholders. Consultations on the future vision and activities of the IJB is undertaken with its Local Authority, Health Service partners and stakeholders. The IJB regularly publishes information regarding its performance. ▪ The financial plans outline the financial challenges and opportunities the Partnership faces in the medium to long term and provides a framework which will support the IJB to remain financially sustainable. It complements the IJB Strategic Commissioning Plan, highlighting how the financial plans will support the delivery of the IJB’s strategic objectives and priorities. Oversight ▪ Effective scrutiny and service improvement activities are supported by the formal submissions of reports, findings and recommendations by Inspectorates and the appointed Internal Audit Service to the Partnership’s Senior Management Team, the main IJB board and the Performance, Finance and Audit Committee, as appropriate.
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25 | P a g e ▪ Performance management, monitoring of service delivery and financial governance is provided by the Partnership to the IJB, who are accountable to both the Local Authority and the Health Board. It reviews reports on the effectiveness of the integrated arrangements including the financial management of the integrated budget. This ensures there is a regular scrutiny at senior management, committee, and board level. Information on performance can be found in the Annual Performance Report published on the Partnership’s website7. Risk Management ▪ In line with the continued and ongoing review of the IJB Risk Register, new and emerging risks or changes in risk level are agreed at each Senior Management Team, IJB and PFA meeting as appropriate. The current risks at time of writing are summarised in the Management Commentary. Financial Control ▪ The Board’s CFO has designated responsibility for the administration of the Board’s financial affairs. The CFO is responsible for advising the Board on all financial matters and for monitoring and reporting on the Boards financial performance and position. The CFO will also oversee the development and implementation of appropriate strategies to manage risk, control the delegated resources and comply with governance standards. NHSL and NLC remain fully accountable for the financial performance of their service area against the budget allocated. Transformational Change ▪ The IJB financial plans and the Strategic Commissioning Plan recognises the need to transform the way in which the UHSCNL delivers services to ensure the sustainability of health and social care services going forward. Together with the IJB Reserves Strategy, these plans are regularly reviewed over their lifespan and amended as necessary to reflect the current challenges and pressures the Partnership face. Review of Adequacy and Effectiveness ▪ Due to the nature of the IJB membership, a conflict of interest can arise between individual board and committee members and the responsibilities they have to the IJB. It is the responsibility of board and committee members to declare any potential conflicts of interest, and it is the responsibility of the Chair of the relevant board or committee to ensure sure declarations are appropriately considered and acted upon. ▪ The IJB has responsibility for conducting an annual review of the effectiveness of the system of internal control and the quality of data used throughout the organisation. The review is informed by the work of the Senior Management Team, who have the responsibility for the development and maintenance of the internal control framework, the work of the internal and external audit teams and other independent inspectorates. ▪ Internal Audit undertake an annual programme following an assessment of risk completed during the strategic audit planning process. The appointed NHSL Chief Internal Auditor in 7 UHSCNL Website
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26 | P a g e conjunction with the NLC Chief Officer (Audit and Risk), provide an annual report to the IJB PFA Committee giving an independent opinion of the adequacy and effectiveness of the governance framework, risk management and internal controls. ▪ Based on the audit work undertaken directly on behalf of the IJB and being informed by internal audit, work undertaken independently by each respective internal audit function within NLC and NHSL, the NHSL Chief Internal Auditor and the NLC Chief Officer (Audit and Risk) are able to conclude that a reasonable level of assurance can be placed upon the adequacy and effectiveness of the IJB’s framework of governance, risk management and internal controls. Roles and Responsibilities The Chief Officer is the Accountable Officer for the Partnership and has day to day operational responsibility to monitor delivery of integrated services, with oversight from the IJB. The IJB complies with the CIPFA statement on ‘The Role of the Chief Finance Officer in Local Government 2014’. The IJB Chief Finance Officer (CFO) has responsibility for the Partnership’s financial arrangements and is professionally qualified and suitably experienced to lead and advise the IJB finance functions. The IJB complies with the requirements of the Public Sector Internal Audit Standards and the approved Internal Audit Charter for the IJB. The appointed NHSL Chief Internal Auditor has responsibility for the IJB internal audit functions and is professionally qualified and suitably experienced to lead and direct internal audit staff. The Internal Audit Service operates in accordance with the CIPFA ‘Public Sector Internal Audit Standards 2017’. Board members and officers of the IJB are committed to the concept of sound internal control and effective delivery of health and social care services. The IJB PFA Committee operates in accordance with CIPFA ‘Audit Committee Principles in Local Authorities in Scotland and Audit Committees Practical Guidance for Local Authorities’. The committee core function is to provide the IJB with independent assurance on the adequacy of the risk management framework, the internal control environment, the integrity of the financial reporting and governance arrangements.
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27 | P a g e Action Plan To ensure continual improvement of the IJB’s governance arrangements, the following action plan has been agreed. Included within this are improvements highlighted as part of the IJB self- assessment process as well as improvement areas identified by Audit Scotland within their Annual Audit Report. Regular updates on progress of the agreed actions will be presented to and monitored by the IJB PFA. 2022/23 Ref Improvement Area Agreed Action Responsible Person Date 1 Service Level Agreement (SLA) To agree an SLA with Children, Families and Justice for future hosting arrangements following the budget disaggregation exercise. Work is currently underway to agree, approve and implement the new SLA in partnership with Children, Families and Justice Services. Chief Officer September 2025 2 National Care Service To develop a sound understanding of the impact for the Partnership of the National Care Service legislation. Paper presented to the IJB in January 24 giving an update on timescales for implementation. Further updates will be presented to the board as details are released. Chief Officer September 2025
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28 | P a g e 2023/24 Ref Improvement Area Agreed Action Responsible Person Date 1 2023/24 Self- Assessment Agreed actions 1. Development of a revised framework for North Lanarkshire which will ensure engagement and participation in the development of the Strategic Commissioning Plan across the entire health and social care system. Chief Officer December 2025 2. Undertake an exercise to review performance output and associated data from other Health Boards and Local Authorities. 3. Recognition that there is a formalised risk sharing agreement in place with NHSL, NLC and SL IJB within the risk management strategy but no reference to similar in relation to performance and finance. 2 Presentation of financial and non- financial information in the annual accounts In the production of future accounts, the IJB should review the presentation of both financial and non-financial information to ensure this reflects the organisation’s role as a strategic commissioning body. Chief Finance Officer September 2025 3 Presentation of financial and non- financial information in the financial performance reports The financial reports will be further defined to give an overview in the delivery of services against the overall funding aligned to the Strategic Commissioning Plan and Medium- Term Financial Plan/Long Term Financial Plan including earmarked reserves. Chief Finance Officer September 2025
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29 | P a g e 2024/25 Ref Improvement Area Agreed Action Responsible Person Date 1 2024/25 Self- Assessment Agreed actions 1. Holding to Account - effective scrutiny, challenge and support of services by the Management Team and also by IJB members when reviewing presented papers. Chief Officer December 2025 2. Vision for IJB should be clear and ambitious with membership being diverse and engaged. Management team to review induction process and liaison sessions 3. Review what goes to IJB and PFA and ensure there are appropriate development sessions to support the financial picture. Internal Audit Opinion Internal control remains, primarily, a management responsibility to ensure that the partnership conducts its business in a manner that has due regard to the principles of good governance. Overall, the results of work undertaken to provide assurance include reports produced by Audit Scotland and a range of governance reports undertaken jointly with the partner organisations to help to inform an opinion on whether the internal controls for the Partnership have in place are adequate. The joint internal audit opinion is that reasonable assurance can be placed upon the adequacy and effectiveness of the IJB’s framework of governance, risk management and internal control. Conclusion and Opinion on Assurance It is our opinion that reasonable assurance can be placed upon the adequacy and effectiveness of the IJB’s governance arrangements. The IJB has adhered to the stated principles of good governance, acted in the public interest, and been committed to continuous improvement. The scrutiny and oversight of the IJB PFA Committee contributes effectively to these arrangements. There were no significant control weaknesses, issues, or failure in the expected standards for good governance, risk management and internal control. We consider that the internal control environment provides reasonable and objective assurance that any significant risks impacting on the IJB’s principal objectives will be identified, actions taken to avoid or mitigate their impact and are consistent with the recommendations of the CIPFA/SOLACE Framework (2016).
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30 | P a g e Brian Moore Chair Date: 17 September 2025
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31 | P a g e Comprehensive Income and Expenditure Statement This statement shows the actual cost of providing services in accordance with generally accepted accounting practices. It includes, on an accrual basis, all expenses and related income. There are no statutory or presentation adjustments which affect the IJB’s application of the funding received from partners. The movement in the General Fund balance is therefore solely due to the transactions shown in the Comprehensive Income and Expenditure Statement. Consequently, an Expenditure and Funding Analysis is not provided in these annual accounts. Gross Expenditure Gross Income Net Expenditure Gross Expenditure Gross Income Net Expenditure £m £m £m £m £m £m 259.695 259.695 Social Care Services 263.773 263.773 78.95 78.950 Health Care Services 83.086 83.086 126.015 126.015 Family Health Services 135.965 135.965 189.595 189.595 Hosted Services 9 199.089 199.089 0 0.000 Housing Services 0.000 0.000 0 0.000 Transport Services 0.000 0.000 0.308 0.308 Corporate Services 5 0.278 0.278 78.442 78.442 Prescribing 81.709 81.709 74.575 74.575 Set Aside for Hospital Acute Services 74.537 74.537 0.227 0.227 Covid-19 Costs (0.283) (0.283) 807.807 0.000 807.807 Total Cost of Services 838.154 0.000 838.154 (785.385) (785.385) Taxation and Non-Specific Grant Income 4 (838.184) (838.184) 807.807 (785.385) 22.422 (Surplus) or Deficit on Provisions of Services (Movement in Reserves) 838.154 (838.184) (0.030) 2023/24 North Lanarkshire Integration Joint Board Note 2024/25
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32 | P a g e Movement in Reserves Statement This statement shows the movement in year on the IJB’s reserves. The movements which arise due to statutory adjustments which affect the General Fund balance are separately identified from the movements due to accounting practices. Total Reserves General Fund £m Opening Balance at 1 April 2023 (97.946) Total Comprehensive Income and Expendiutre (Increase) or decrease in 2023/24 22.422 Closing Balance at 31 March 2024 (75.524) Opening Balance at 1 April 2024 (75.524) Total Comprehensive Income and Expendiutre (Increase) or decrease in 2024/25 (0.030) Closing Balance at 31 March 2025 (75.554) Movement in Reserves during 2023/24: North Lanarkshire Integration Joint Board Movement in Reserves during 2024/25:
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33 | P a g e Balance Sheet The balance sheet shows the value of the IJB’s assets and liabilities as at 31 March 2024. The net assets of the IJB (assets less liabilities) are matched by the reserves held by the IJB. 31 March 2024 North Lanarkshire Integration Joint Board Notes 31 March 2025 £m £m 75.524 Current Assets 6 75.554 Short Term Debtors 0.000 Current Liabilities 6 0.000 Short Term Creditors 75.524 Net Assets 75.554 75.524 Usable Reserves: General Fund 7 75.554 75.524 Total Reserves 75.554 The Statement of Accounts presents a true and fair view of the financial position of the North Lanarkshire Integration Joint Board as at 31 March 2025 and its income and expenditure for the year then ended. Notes to the Financial Statements numbers 1 to 11 found on pages 34 - 42, form part of the financial statements. The audited accounts were authorised for issue on 17 September 2025. Balance Sheet signed by: Nicola Scott CPFA Chief Finance Officer Date: 17 September 2025
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34 | P a g e Notes to the Financial Statements Note 1. Significant Accounting Policies General Principles The financial statements summarise the transactions of the IJB for the financial year 2024/25 and its position at 31 March 2025. The IJB was established under the requirements of the Public Bodies (Joint Working) (Scotland) Act 2014 and is a Section 106 body as defined in the Local Government (Scotland) Act 1973. It is a joint venture between NLC and NHSL. The financial statements are therefore prepared in compliance with the Code of Practice on Local Authority Accounting in the United Kingdom 2024/25, supported by the International Financial Reporting Standards (IFRS), unless legislation or statutory guidance requires different treatment. Each partner complies with their accounting policies as appropriate. The accounts are prepared on a going concern basis, which assumes that the IJB will continue in operational existence for the foreseeable future. The historical cost convention has been adopted. Accruals of Income and Expenditure Activity is accounted for in the year that it takes place, not simply when settlement in cash occurs. In particular: • Expenditure is recognised when goods or services are received, and their benefits are used by the IJB. • Income is recognised when the IJB has a right to the income, for instance, by meeting any terms and conditions required to earn the income and receipt of the income is probable. • Where income and expenditure have been recognised but settlement in cash has not taken place, a debtor or creditor is recorded in the balance sheet. • Where debts may not be received, the balance of debtors is written off. Funding The IJB is primarily funded through contributions from its statutory funding partners, NLC and NHSL. Expenditure is incurred as the IJB commissions specified health and social care services from the funding partners for the benefit of service recipients in North Lanarkshire and service recipients in South Lanarkshire for services that are delivered under hosted arrangements and on a pan-Lanarkshire basis. The funding relating to the year under review is recognised as income in the CIES and will normally be income added to the General Fund. There are no statutory or presentation adjustments which affect the IJB’s application of the funding received by partners. The movement in General Fund balance is therefore solely due to the transactions shown in the CIES.
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35 | P a g e Cash and Cash Equivalents The IJB does not operate a bank account or hold cash. All transactions are settled on behalf of the IJB by the funding partner. Consequently, the IJB does not present a ‘Cash and Cash Equivalent’ figure on the balance sheet. There is therefore no requirement for the IJB to produce a cash flow statement. The funding balance due to and from each funding partner as at 31 March 2025 is represented as a debtor or creditor on the IJB’s balance sheet. Employee Benefit The IJB does not directly employ staff. Staff are formally employed by the funding partners who retain the liability for pension benefits payable in the future. The IJB therefore does not present a Pensions Liability on its balance sheet. The IJB has a legal responsibility to appoint a Chief Officer. A CFO has also been appointed to the IJB. More details on these arrangements are provided in the remuneration report. The charges for the employing partners are treated as employee costs. Where material, the absence entitlement at 31 March is accrued, for example in relation to annual leave earned but not yet taken. In the case of North Lanarkshire IJB any annual leave earned by the Chief Officer and CFO, but not yet taken is not considered to be material. Provisions, Contingent Liabilities and Contingent Assets Provisions are liabilities of uncertain timing or amount. A provision is recognised as a liability on the balance sheet when there is an obligation on 31 March due to a past event, settlement of the obligation is probable, and a reliable estimate of the amount can be made. Recognition of a provision will result in expenditure being charged to the CIES and will normally be a charge to the General Fund. A contingent liability is a possible liability arising from events on or before 31 March, whose existence will only be confirmed by later events. A provision that cannot be reasonably estimated, or where settlement is not probable, is treated as a contingent liability. A contingent liability is not recognised in the IJB’s balance sheet but is disclosed in a note where it is material. A contingent asset is a possible asset arising from events on or before 31 March, whose existence will only be confirmed by later events. A contingent asset is not recognised in the IJB’s balance sheet but is disclosed in a note only if it is probable to arise and can be reliably measured. Indemnity Insurance / Clinical and Medical Negligence The IJB has indemnity insurance for costs relating primarily to potential claim liabilities regarding board member and officer responsibilities through the Clinical Negligence and Other Risks Indemnity Scheme (CNORIS). NLC and NHSL have responsibility for claims in respect of the services for which they are statutorily responsible for and that they provide. Unlike NHS Boards, the IJB does not have any ‘shared risk’ exposure from participation in CNORIS. The IJB participation in the scheme is therefore comparable to normal insurance arrangements.
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36 | P a g e Known claims are assessed as to the value and probability of settlement. Where it is material, the overall expected value of known claims taking probability of settlement into consideration, is provided for in the IJB balance sheet. The likelihood of receipt of an insurance settlement to cover any claims is separately assessed and where material, presented as either a debtor or disclosed as a contingent asset. Debtors and Creditors Financial instruments are recognised in the balance sheet when an obligation is identified and released as that obligation is fulfilled. Debtors are held at fair value and represent funding due from partner bodies that was not utilised in year. There are no creditor balances. Reserves A reserve is the accumulation of surpluses, deficits, and appropriation over a number of years. Reserves of a revenue nature are available and can be spent or earmarked at the discretion of the IJB. Reserves should be split between usable and unusable on the balance sheet. As at 31 March 2025, the usable reserve balance totals £75.554m. There are no unusable reserves. Hosted Services Within Lanarkshire, each IJB has operational responsibility for the service which it hosts on behalf of the other IJB. In delivering these services each IJB has primary responsibility for the provision of the services and bears the risk and reward associated with this service delivery in terms of demand and the financial resources required. As such the IJB is considered to be acting as ‘principal’, and the full costs are reflected within the annual accounts for the services which it hosts. This is the basis on which North Lanarkshire IJB accounts have been prepared. The relevant share of the pan Lanarkshire and area wide service expenditure is therefore included in the North Lanarkshire IJB on the basis of 52% of the total expenditure, 48% of the services relating to the South Lanarkshire IJB are also included as the North Lanarkshire IJB is acting as the principal for the delivery of these services. In line with the Integrated Resource Advisory Group Guidance, the IJB responsible for the management of the hosted service is also responsible for managing overspends. As a result, these are accounted for within the Annual Accounts of the lead IJB. The same accounting treatment was adopted where an underspend arose in respect of a hosted service. Note 2. Events After the Balance Sheet Date The Chief Finance Officer authorised the unaudited annual accounts for issue on 18 June 2025. Events after the balance sheet date are those events that occur between the end of the reporting period and the date when the statements are authorised for issue. Where events take place before the date of authorisation and provide information about conditions existing as at 31 March 2025, the figures in the financial statements and notes would be adjusted in all material aspects to reflect the impact of this information. There have been no material events since the date of the balance sheet which require revision to the figures in the Annual Accounts.
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37 | P a g e Note 3. Expenditure and Funding Analysis by Nature The following table shows the gross expenditure and funding for North Lanarkshire IJB against subjective headings: Expenditure and Funding Analysis by Nature 2023/24 2024/25 £m £m Social Care Services 259.695 263.773 Health Care Services - Localities 66.933 70.341 Health Care Services - Area Wide 7.621 8.420 Health Care Services - Out of Area 4.396 4.041 Family Health Services 126.015 135.965 Hosted Services - Led by North IJB 148.954 155.183 Hosted Services - Led by South IJB 40.641 43.907 IJB Operating Costs 0.308 0.278 Prescribing Costs 78.442 81.709 Covid-19 Costs 0.227 0.000 Set Aside 74.575 74.537 Total Cost of Services 807.807 838.154 Partners Funding Contributions and Non-Specific Grant Income (785.385) (838.184) (Surplus)/Deficit on Provision of Services 22.422 (0.030) Note 4. Taxation and Non-Specific Grant Income The following table shows the funding contribution from the two partner organisations: Taxation and Non-Specific Grant Income 2023/24 2024/25 £m £m Funding Contribution from NHS Lanarkshire (590.418) (630.159) Funding Contribution from North Lanarkshire Council (194.967) (208.025) Total (785.385) (838.184) The funding contribution from the NHSL Board shown above includes £74.537m in respect of ‘Set Aside’ resources relating to acute hospital services. These are provided by NHSL which retains responsibility for managing the costs of providing these services. The IJB however has responsibility for the consumption and level of demand placed on these resources.
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38 | P a g e Note 5. Corporate Services NLC and NHSL provide a range of support services for the IJB including finance, personnel, planning, audit, payroll, debtor, and creditor services. There is no charge to the IJB for these support services. The costs associated with running the IJB are shown in the following table: IJB Operating Costs (Corporate Services) 2023/24 2024/25 £m £m Staff Costs 0.272 0.240 Audit Fees 0.033 0.035 Administration Costs 0.003 0.003 Total 0.308 0.278 Note 6. Short Term Debtors and Creditors Short Term Debtors 2023/24 2024/25 £m £m NHS Lanarkshire 50.719 50.276 North Lanarkshire Council 24.805 25.278 Total 75.524 75.554 Short Term Creditors 2023/24 2024/25 £m £m NHS Lanarkshire - - North Lanarkshire Council - - Total - - Note 7. Useable Reserves: General Fund The purpose of the General Fund is detailed in the IJB Reserves Policy and summarised below: • Funding received for a specific purpose and not yet spent will be allocated to a ring-fenced reserve. • Funding for future expenditure needs and key financial risks will be allocated to earmarked reserves. • A contingency reserve is required to cushion the impact of unexpected events or emergencies. At 31 March 2025 the IJB transferred funding to ring-fenced reserves to enable the IJB to deliver on specific Scottish Government funded programmes and earmarked reserves to support the delivery of programme of works. In addition, the contingency reserve has been increased as part of the IJB financial strategy. This will be used to manage the risk of any future unanticipated events and support service provision that may materially impact on the financial position of the IJB in later years. The following table shows the movement of reserves during 2024/25:
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39 | P a g e USEABLE RESERVES Balance as at 31 March 2024 Net Transfers during 2024/25 Balance as at 31 March 2025 £m £m £m Alcohol and Drug Partnership Funding 3.597 0.084 3.681 Blood-Borne Viruses Services 0.194 0.124 0.318 Children and Adolescent Mental Health Services 0.000 0.000 0.000 Community Living Change Fund 1.164 (1.110) 0.054 Long Covid Pathways Funding 0.234 0.056 0.290 Hospital at Home Services 0.962 (0.046) 0.916 Mental Health and Learning Disability Services 5.700 (0.495) 5.205 North Planning Band 2-4 Posts & Pharmacy Training 2.719 0.000 2.719 Nursing Funding 0.913 (0.267) 0.646 Ring-Fenced Reserves - Other Services 0.720 0.290 1.010 Total Ring-Fenced Reserves 16.203 (1.364) 14.839 Adult Social Care Winter Preparedness Fund 1.000 0.000 1.000 Carers Act Support 2.596 0.008 2.604 Children and Adolescent Mental Health Services 3.117 (0.075) 3.042 Digital and IT Strategy 4.863 (1.218) 3.645 Earmarked Reserves - Other Services 5.247 0.978 6.225 Home Support Resilience 0.656 (0.079) 0.577 IJB Financial Plan 2023/2026 4.672 (2.057) 2.615 Mental Health 1.029 1.888 2.917 Minor Repair and Replacement Programme of Works 1.811 0.000 1.811 Prescribing Fund 4.361 0.705 5.066 Social Care Services 0.162 0.154 0.316 Winter Planning and Enhanced Supports Business Case 1.319 (1.010) 0.309 Total Earmarked Reserves 30.833 (0.706) 30.127 Total Contingency Reserve 26.074 4.514 30.588 Total Closed Reserves 2.414 (2.414) 0.000 TOTAL USEABLE RESERVES 75.524 0.030 75.554 Note 8. Related Party Transactions The IJB has related party transactions with NLC and NHSL. In particular the nature of the partnership means that the IJB may influence and be influenced by its partners. Non-voting board members are not directly employed by NHSL however, a contribution of 50% of the cost of the Chief Officer is made by NHSL along with the full cost of the CFO. This payment is included in the IJB Operating Costs (Corporate Services) in the CIES and detailed at Note 5. The following transactions and balances included in the IJB Annual Accounts are presented to provide additional information on related party relationships.
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40 | P a g e There are elements of expenditure which are shown against NLC but where the resource is provided by NHSL. Resource Transfer which includes the Social Care Fund are therefore part of the NHSL budget but are used to deliver social care services supplied by NLC. Expenditure on Services Provided 2023/24 2024/25 £m £m NHS Lanarkshire 547.613 574.141 Resource Transfer to North Lanarkshire Council 54.266 56.462 NHS Lanarkshire Total 601.879 630.603 North Lanarkshire Council 260.193 264.013 Resource Transfer from NHS Lanarkshire (54.266) (56.462) North Lanarkshire Council Total 205.927 207.551 Income Received 2022/23 2024/25 £m £m NHS Lanarkshire - - North Lanarkshire Council - - Total 0.000 0.000 Funding Contributions Received 2022/23 2024/25 £m £m NHS Lanarkshire (590.418) (630.159) North Lanarkshire Council (194.967) (208.025) Total (785.385) (838.184) Debtors 2022/23 2024/25 £m £m NHS Lanarkshire 50.719 50.276 North Lanarkshire Council 24.805 25.278 Total 75.524 75.554 Note 9. Hosted Services North Lanarkshire IJB act as the lead for a number of delegated services on behalf of South Lanarkshire IJB. It therefore commissions services on behalf of South Lanarkshire IJB and reclaims the costs involved. Since North Lanarkshire IJB is acting as ‘principal’ in these transactions, the total gross expenditure and the consequential reimbursement is included in the CIES even though 48% of the hosted budget is consumed by South Lanarkshire.
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41 | P a g e Host: North Lanarkshire North Lanarkshire Services 2023/24 Consumed by South Lanarkshire 2023/24 Service North Lanarkshire Services 2024/25 Consumed by South Lanarkshire 2024/25 £m £m £m £m 1.667 0.833 Blood Borne Virus Services 1.667 0.879 13.648 6.975 Children and Adolescents Mental Health Services 13.683 6.901 14.482 6.410 Children’s Services 16.556 6.881 3.465 1.187 Continence Services 3.210 1.213 4.152 2.115 Dietetics Services 4.339 2.212 3.367 1.773 Hospital at Home 3.046 1.463 5.815 2.721 Immunisation Services 4.925 2.991 - 0.272 Integrated Equipment and Adaptation Store 0.000 0.392 84.074 43.706 Mental Health and Learning Disability Services 90.305 44.674 4.873 2.405 Podiatry Services 4.627 2.480 3.047 0.982 Prisoner Healthcare Services 2.327 1.019 3.569 1.661 Sexual Health Services 3.819 1.849 6.796 3.426 Speech and Language Therapy Services 6.678 3.607 148.954 74.466 Total Services Hosted by North Lanarkshire IJB 155.182 76.561 Similarly, South Lanarkshire IJB acts as the lead for a number of delegated services on behalf of North Lanarkshire IJB. The value consumed by North Lanarkshire equates to 52% of South Lanarkshire IJB hosted budget. As this expenditure is incurred for the residents of North Lanarkshire, it is included in the CIES. Cost: South Lanarkshire Consumed by North Lanarkshire 2023/24 South Lanarkshire Services 2023/24 Service Consumed by North Lanarkshire 2024/25 South Lanarkshire Services 2024/25 £m £m £m £m 4.288 7.422 Community Dental Services 4.529 7.687 1.477 2.773 Brain Injury Unit 1.302 2.455 2.395 4.633 Diabetic Services 2.613 6.200 - - Improving Cancer Journey 0.244 0.638 4.669 8.739 Occupational Therapy Services 4.712 8.460 5.227 9.991 Out of Hours Services 5.565 10.103 3.941 7.507 Palliative Care Services 5.097 7.707 6.103 11.581 Physiotherapy Services 6.407 10.959 - - Telehealth - - 0.467 0.790 Primary Care Services 0.476 0.762 12.074 23.220 Primary Care Improvement Fund 12.962 24.927 40.641 76.656 Total Services Hosted by South Lanarkshire IJB 43.907 79.898
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42 | P a g e The table below shows the total of hosted serviced included in the CIES: 2023/24 Hosted Services 2024/25 £m £m 148.954 Total Services Hosted by North Lanarkshire IJB 155.182 40.641 Total Services Hosted by South Lanarkshire IJB and Consumed by North 43.907 189.595 Total Included in Comprehensive Income and Expenditure Statement 199.089 Note 10. VAT The IJB is not VAT registered and does not charge or recover VAT on its functions. The VAT treatment of expenditure and income within the accounts depends on which of the partners is providing the service as these bodies are treated differently for VAT purposes: • Where NLC is the provider, income and expenditure exclude any amounts related to VAT, as collected VAT is payable to HM Revenue & Customs and all VAT paid is recoverable from it. On a very limited number of items that NLC are not entitled to fully recover VAT, expenditure for these specific items will include the full cost to the IJB. • Where NHSL is the provider, expenditure will include the full cost to the IJB as generally, NHSL cannot recover VAT. The services provided by the Chief Officer to the IJB are outside the scope of VAT as they are undertaken under a specific legal regime. Note 11. External Audit Costs Fees payable to Audit Scotland in respect of external audit services undertaken in accordance with Audit Scotland's Code of Audit Practice in 2024/25 were £35,180 (2023/24 £33,360). Audit Scotland did not undertake any non-audit services.
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43 | P a g e Independent Auditors Opinion