01 -IJB 250926 - 25-26 Audited Annual Accounts
North Ayrshire Council · 25 September 2026
Back to Integration Joint Board — 25 September 2026 and its agenda
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Integration Joint Board 25th September 2026 Subject : 2025/26 Audited Annual Accounts Purpose : The Board is required to approve the audited annual accounts for 2025-26 for issue and to consider the report from External Audit. Recommendation : That the Board: (a) Note that Audit Scotland have completed their audit of the annual accounts for 2025-26 and have issued an unqualified independent auditor’s report; and (b) Approve the Audited Annual Accounts to be signed for issue. Direction Required to Council, Health Board or Both (where Directions are required please complete Directions Template) Direction to :- 1. No Direction Required x 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership 1. EXECUTIVE SUMMARY 1.1 The Integration Joint Board (IJB) was required to produce a set of annual accounts for 2025-26. These accounts were produced within the statutory timescale and have been subject to independent audit by the Integration Joint Board’s external auditors, Audit Scotland. 1.2 The external auditor is required to report on certain matters arising to those charged with governance in sufficient time to enable appropriate action to be taken before the financial statements are approved and certified. The audit process has been completed and Audit Scotland have issued an unqualified independent auditor’s report. 1.3 As part of the independent audit there were some minor presentational changes required and these have been updated in the final accounts. There are no changes
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to the overall financial position reported to the Performance and Audit Committee in June. 2. BACKGROUND 2.1 The Integration Joint Board is subject to the audit and accounts provisions of a body under section 106 of the Local Authority Government (Scotland) Act 1973. This requires annual accounts to be prepared with the reporting requirements specified in the relevant legislation and regulations. The requirements are proportionate to the number of transactions of the Integration Joint Board whilst complying with the requirement for transparency and true and fair reporting in the public sector. 2.2 The audited annual accounts have been prepared in accordance with the Code of Practice on Accounting for Local Authorities in the United Kingdom 2025-26. Additional guidance was issued by the Scottish Government Integrated Resources Advisory Group (IRAG) and CIPFA LASAAC and this guidance has been followed to produce the audited accounts. 2.3 The Audited Annual Accounts for 2025-26 are included as Appendix A and incorporate the independent auditor’s report. Audit Scotland are able to conclude that the Integration Joint Board’s accounts present a true and fair view of the IJB’s financial position. 2.4 Appendix B includes a letter of representation signed by the Head of Service (Finance and Transformation) as responsible officer. Audit Scotland’s External Audit Annual Audit Report to members, which summarises the findings of the audit, is a separate item on the agenda. 2.5 Audit Scotland have given an unqualified opinion that the 2025-26 financial statements give a true and fair view of the financial position and expenditure and income of the IJB for the year, concluding that the accounts have been properly prepared in accordance with relevant legislation, applicable accounting standards and other reporting requirements. The overall financial position remains as reported to the Performance and Audit Committee in June 2026. 2.6 The Integration Joint Board are required to formally approve the Audited Annual Accounts and thereafter they will be published on the partnership website. 3. PROPOSALS 3.1 The Board is invited to: (a) note that Audit Scotland have completed their audit of the annual accounts for 2025-26 and have issued an unqualified independent auditor’s report; and (b) approve the Audited Annual Accounts to be signed for issue.
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3.2 Anticipated Outcomes The annual accounts are a key statutory reporting requirement and can be a useful way to join up financial and service delivery performance information in a readily available public document. 3.3 Measuring Impact Progress against the recommendations will be reviewed by the Performance and Audit Committee during 2026-27. 4. IMPLICATIONS 4.1 Financial The IJB is required to consider and approve the Audited Annual Accounts for 2025- 26. 4.2 Human Resources None. 4.3 Legal None. 4.4 Equality/Socio-Economic None. 4.5 Risk The report falls in line with the agreed risk appetite statement which is a low-risk appetite in respect to adherence to standing financial instructions, financial controls and financial statutory duties and a high-risk appetite in relation to finance and value for money. 4.6 Community Wealth Building None. 4.7 Key Priorities None. 5. CONSULTATION 5.1 The unaudited annual accounts were advertised and made publicly available for inspection. There were no objections noted from the public inspection. The Chief Officer, Chief Finance Officer and other officers of the IJB have been consulted during the audit process as required.
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Caroline Cameron Director, Health and Social Care Partnership For more information please contact Eleanor Currie (Principal Manager, Finance/ Chief Finance Officer) (eleanorcurrie@north-ayrshire.gov.uk) Appendices Appendix A, Audited Annual Accounts 2025-26 Appendix B, Letter of representation
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 1 North Ayrshire Integration Joint Board Annual Accounts For the period ended 31 March 2026
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 2 Table of Contents Management Commentary 3 A snapshot of achievements during 2025–2026 8 Organisational Performance 11 Annual Accounts 13 Statement of responsibilities 36 Responsibilities of the Chief Finance Officer 37 Annual Governance Statement 38 Remuneration report 50 Financial statements 54 Notes to the financial statements 57 Glossary of Terms 68 Independent Auditor’s Report 71
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 3 Management Commentary This publication contains the Annual Accounts of North Ayrshire Integration Joint Board (IJB) for the period ended 31 March 2026. The Management Commentary outlines the key messages in relation to the IJB’s financial planning and performance for the period 2025 to 2026 and how this has supported delivery of the IJB’s strategic priorities. This commentary also looks forward, outlining the future financial plans for the IJB and the challenges and risks that we will face as we strive to deliver services that continue to meet the needs of the people of North Ayrshire. North Ayrshire IJB North Ayrshire Council, alongside East and South Ayrshire Councils and NHS Ayrshire and Arran, established the three Ayrshire Integration Joint Boards (IJBs) on 1 April 2015 under the Public Bodies (Joint Working) (Scotland) Act 2014. The purpose of the IJB is to improve the health and wellbeing of local people, support communities, and deliver integrated, person‑centred health and social care services, particularly for people with complex needs. North Ayrshire Council and NHS Ayrshire and Arran delegate responsibility for the planning and delivery of community health and social care services to the North Ayrshire Integration Joint Board. The IJB is the statutory decision‑making body for the Partnership and is responsible for setting strategic direction, agreeing priorities, and overseeing the effective and efficient use of resources. The IJB commissions services from both the Council and NHS and provides operational oversight of integrated services. The Chief Officer of the Health and Social Care Partnership is responsible for the operational management of these services and is accountable to the IJB. North Ayrshire Health and Social Care Partnership (NAHSCP/the Partnership) is the service delivery organisation for functions delegated to the IJB, which is comprised of staff from both North Ayrshire Council and NHS Ayrshire and Arran, though sits as its own organisation for carrying out these delegated functions together. The Chief Officer is supported by Heads of Service across all service areas, including the statutory roles of Chief Finance Officer and Chief Social Work Officer, alongside the wider senior management team.
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 4 NAHSCP Senior Management Structure Strategic Plan 2026 to 2030 In April 2022, the Partnership published ‘Caring Together 2022 to 2030’, its first long-term strategic plan. While originally intended to run for eight years, the legislation requires the plan to be reviewed at least every three years. Following a formal review in December 2024, the Strategic Planning Group agreed that a refreshed plan was required to reflect the significantly changed context in which the Partnership is now operating. The refreshed Strategic Plan 2026 to 2030 builds on Caring Together and responds to: • updated local evidence through a comprehensive Strategic Needs Assessment undertaken in 2025 • analysis of engagement feedback collected between 2023 and 2024 • a review of national and local policy, including the Population Health Framework 2025 to 2035 and the Health and Social Care Service Renewal Framework 2025 to 2035 • service performance data and feedback from staff and partners • increasing financial pressures, demographic change and rising demand for services Vision and Values The refreshed plan sets out a new vision for the Partnership: “To empower people in North Ayrshire to live safe, healthy and active lives with fair and equal access to sustainable health and care services.” This replaces the previous vision and reflects feedback from consultation emphasising empowerment, accessibility and sustainability. The Partnership’s values have also been updated to reflect how services are delivered and experienced:
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 5 • Caring • Compassionate • Respectful • Inclusive Strategic and Service Delivery Priorities To deliver the vision, the Strategic Plan 2026 to 2030 introduces a dual-priority approach: Strategic Priorities These aim to address future service requirements based on demographic changes and local inequalities and aim to better understand and assess how we may influence improved health and wellbeing. Strategies will be aligned to these goals and decision making will consider these priorities and impacts when implementing change. Service Delivery Priorities These reflect how services will be designed and delivered to address the health and care needs of the population. Service Planning will be aligned to these principles. These priorities are interlinked and are intended to guide decision-making, service redesign and investment over the life of the plan. Enabling Workstreams The Enabling Plans are supporting documents that will help with the delivery of the Strategic Plan. They are fundamental to supporting the way the organisation works and require detailed planning and analysis so are delegated into their own plans.
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 6 Enabling Plans and Delivery Delivery of the Strategic Plan is supported by a range of enabling plans, including: • A Transformation Plan (in place until 2027) • A Digital and Data Delivery Plan (developed in 2024) • Workforce Plan, with a new Plan to be developed in 2027 • Participation and Engagement Strategy Alongside the Strategic Plan, the Partnership will publish: • Delivery and Monitoring Plan • Strategic Needs Assessment • Report of Consultation • Housing Contribution Statement • Participation and Engagement Strategy for 2026 to 2030 More information about the refreshed Strategic Plan 2026 to 2030, and other strategies can be found at: NAHSCP Strategies, plans and publications. North Ayrshire Today North Ayrshire is home to an estimated total population of 134,010 (NRS, Mid-2024). The local area covers approximately 885 square kilometres and has a population density of c.151 persons per square kilometre. The National Records of Scotland (NRS) provides a population projection estimate using 2022 as a baseline year. Between 2013 and 2023 the population is estimated to have fallen from 137,100 to 133, 570, or 2.6% over the 10-year period. More recent projections indicate that this decline is expected to continue, with the population projected to fall to approximately 122, 374 by 2044, and further to 120,508 by 2047, representing an overall decrease of around 9 to 10% over the projection period. Not only is the overall population projected to decline, but the demographic profile is also expected to change, with continued reduction in the working-age population and a corresponding increase in older age groups. Current population estimates show that 59.8% of the population is aged 16-64 which is projected to decrease to 55% in 2047. Conversely, the 65 and over population is currently 24.6% and is expected to rise to 31.9% in 2047 (NRS). This demographic change has significant implications for local funding and spending as the number of working aged people paying taxes is decreasing, while the number of dependents, and therefore pressure on our health and care services is increasing.
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 7 Currently, 29.1% of local people are known to have some form of long-term condition. It is recognised that the prevalence of people with a long-term condition increases by age. For example, 1.7 people in every 10 under the age of 65 has a long-term condition, whereas 8.7 people in every 10 over the age of 85 has a condition. In contrast to the growth in the older population, the life expectancy figures for North Ayrshire have dropped in recent years. To measure life expectancy, averages are taken over a 3-year period, and for 2022 to 2024, female life expectancy was 79.7 years, compared to its highest point over the previous 10 years of 80.99 in 2012 to 2014. Current male life expectancy is 75 compared to its high of 76.47, also in 2012 to 2014. For both females and males, life expectancy is lower when compared to the Scottish Average. In the latest time-period available (2022 to 2024), the average healthy life expectancy in North Ayrshire was 52.6 years for men and 53.5 years for women. Healthy life expectancy data is only available from 2015, and the highest for females was 57.13 in 2015-17, and for males was 57.8 in 2015 to 2017. For women, healthy life expectancy has been steadily falling, but for men it was rising before it began to fall in recent years. When compared against life expectancy this suggests that, while women in general will live longer than men, they will spend a greater proportion of their life in ill health. Additionally, in North Ayrshire and nationally, over the last 20 years life expectancy for males has increased more than for females, so the gap between life expectancy is gradually reducing over time. Socio-Economic Profile The Scottish Index of Multiple Deprivation (SIMD) 2020 (the last available year), reports that 74 of North Ayrshire’s 186 data-zone areas are ranked in the 20% most deprived, or 39.8% of data zones in the area. An estimated 55,069 people live within these data zones which is around 41% of North Ayrshire residents. The last reported employment figures for North Ayrshire cover the period of October 2024 to September 2025, which shows that 70.8% of the population is economically active which represents a steady rise over the last year. This compares to 77.3% of Scotland’s population which has retained a consistent rate. The unemployment rate in North Ayrshire is currently 4.7%, which although is higher than the previous year, is still relatively low for the area and over time and compares to 3.7% in Scotland. This implies there is increasing economic inactivity in the area, which may be indicative of the older population across North Ayrshire. During that time period, 14.7% of the economically inactive population was retired compared to 15.5% in Scotland, and 43.5% were long-term sick compared to 33.8% of Scotland. The dependency ratio indicates the number of working aged people compared to dependents, or those under 16 and over working age. Historically 16 to 64 has been used as the working aged population despite recent changes to pension age and, although many people over 65 work, the ratio is worked out based on the population alone which is a ratio recognised internationally to allow for comparisons. Currently, the dependency ratio in North Ayrshire is 67.3 (NRS, Mid-Year 2024). which means that for every 100 working aged people, there are just over 67 dependents, compared to Scotland’s ratio of 58.0. In 2022, the dependency ratio in North Ayrshire was 65.9 and it is projected to increase to 81.9 by 2047, whereas in Scotland the change is projected to change from 57.5 in 2022 to 64.1 in 2047 – which is still lower than the current North Ayrshire figure. More rural areas tend to have a higher ratio than other areas, due to the smaller working age population which is an important factor for planning and funding health and social care services that meet the needs of this population.
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 8 A snapshot of achievements during 2025 to 2026 Supporting the Improvement of Population Health • Health Visiting Action Plan 2025 to 2035 (enhanced delivery) - progressed delivery of Scotland’s Health Visiting Action Plan to strengthen health visiting support for families. Implementation aims to increase the proportion of pre-school children who can reach their full potential and attain the highest level of health and wellbeing. • West Road Centre (new mental health outpatient base) - opened a new centre in Irvine to support mental health care across Ayrshire and Arran. The centre provides a modern base for outpatient services, including the all-age Community Eating Disorder Service (CEDS) and the Neuro-CAMHS team, improving the environment for people to access support. • Shout text service (in-the-moment mental health support) - launched free text-based mental health support in North Ayrshire through a partnership with Shout. The service provides tailored support for people of all ages whenever they need it. • Hollyhealth app (mental health and wellbeing) - expanded access to 11,000 residents across all GP practices in Ayrshire, many acute and community services, and partners (for example, KA Leisure). Reported impact includes an 18% reduction in GP appointments (42% for frequent attenders), at least 10% improvement across healthy behaviours and an estimated year one return on investment of six times the value. People can access the app for free via this link. • Podiatry waiting time improvement - reduced waiting times and waiting list size to enable earlier assessment and treatment. This helped reduce pain, prevent deterioration and support mobility, contributing to improved physical wellbeing and reduced risk of secondary complications. • Community rehabilitation pathway development - developed more cohesive and streamlined community rehabilitation pathways to improve coordination between services and reduce delays in access to support. Clearer pathways supported smoother transitions through rehabilitation and reablement, helping people recover more effectively and regain independence closer to home. • Quality and safety improvement (rehabilitation settings) - carried out Quality and Safety walk-rounds to identify risks and support targeted improvement activity, including sustained falls reduction work. Positive patient feedback reflected confidence in care delivery and supported wellbeing during recovery. • NHS Renewal Programme (urgent and unscheduled care funding) - in June 2025, the Scottish Government allocated up to £10.079 million to NHS Ayrshire and Arran to improve urgent and unscheduled care. Funding supports the Operational Improvement Plan to reduce hospital occupancy, improve patient flow and shift care closer to home, including Hospital at Home, Delay without Discharge, frailty services and core unscheduled care. • Digital telecare transition (community alarms) - progressed the transition from analogue to digital telecare to improve reliability and resilience of community alarm services.
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 9 Supporting large numbers of people to move to digital systems reduced the risk of service failure ahead of the national switchover and provided reassurance to individuals and families relying on telecare to remain safe and independent at home. • Analogue to digital telecare project (Silver implementation award) - achieved the Silver Digital Telecare Implementation Award from Digital Telecare for Scottish Local Government. This recognises progress in switching community alarm and telecare equipment from analogue to digital ahead of analogue telephone lines being switched off in the UK in early 2027. • Dementia services quality improvement (Care Inspectorate) - achieved upgraded Care Inspectorate ratings of Very Good across all key areas. Findings highlighted personalised, outcome-focused care planning, strong staff engagement and effective quality assurance, with families reporting positive experiences and confidence in the care provided. • Working Together Occupational Therapy service (GP practices) - embedded Occupational Therapy within GP practices to enable earlier assessment and intervention for people experiencing functional decline. This is currently available in five GP practices in North Ayrshire, supporting timely advice, short-term intervention and onward referral, preventing deterioration and reducing escalation to more intensive services. • Moving and Handling Team (unpaid carers open days) - open days for unpaid carers at the Castleview Hub, Ardrossan. These events share support available from a wide range of partners, including dementia support services, Scottish Fire and Rescue, SP Energy Networks, AILN and Lemon Aid. • Care Home Oversight (multi-agency assurance) - provided coordinated oversight and support to care homes during periods of pressure, including respiratory outbreaks. Shared intelligence and joint decision-making enabled proportionate infection control measures and timely return to routine operation, reducing prolonged isolation for residents and supporting safe family contact. Tackling the root cause of health inequality • Money Smart service (welfare rights and money advice) – re-launched on Thursday 1 May 2025, bringing together the former Money Matters and Welfare Reform Advice teams. The service provides free, confidential and impartial welfare rights advice for eligible tenants, alongside debt and money advice for North Ayrshire Council tenants and eligible non-council tenants receiving welfare rights support. • Good North Ayrshire (Collaboration for Health Equity Scotland (CHES)) - progressed a two-year collaboration to strengthen action to improve health, increase wellbeing and reduce health inequalities, supported by Public Health Scotland and the Institute for Health Equity. A two-year collaboration working to strengthen and accelerate the action already underway to improve Scotland’s health, increase wellbeing and reduce health inequalities. The work is supported by Public Health Scotland and the Institute for Health Equity, London. The work is exploring which areas are the most impactful to close the gap in healthy life expectancy and what actions can be taken both nationally and locally to close the recognised implementation gap between policy and impact. Simplified branding and language around North Ayrshire’s CHES work has been developed. CHES work seeks to
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 10 progress a Good North Ayrshire that’s Fair for All, with targeted workstreams focused on Good Start, Good Jobs, and Good Health in identified localities and neighbourhoods. • Targeted welfare rights support (cancer pathways) - supported people affected by cancer to access disability benefits and practical financial assistance. This reduced financial stress during illness, supported household stability and helped individuals and families focus on treatment and recovery. • Community Link Workers (community-based support) - supported people experiencing complex vulnerability (including mental ill health, homelessness and social isolation) to access emergency food provision, attend housing appointments with advocacy and secure timely referrals to social work and community services. This reduced immediate crisis pressures, improved engagement with services and helped people stabilise within their communities. • Addressing geographic inequality (innovation testing) - tested innovative approaches such as drone transportation of medical materials between mainland and island hospitals to reduce geography-related delays. This demonstrated potential to improve equity of access to diagnostics and treatment for island communities. • North Ayrshire Learning Disability Service (digital inclusion project) - working with the Scottish Commission for People with Learning Disabilities (SCLD) and Scottish Care on a government-funded project to address digital inclusion for people with learning disabilities. A Care Connector (a role developed by Scottish Care and Glasgow School of Art) is mapping current activity and helping build on existing local strengths to create a replicable, design-led model and practical resources to tackle digital exclusion sustainably. • Palliative care training (Care at Home staff) - 12 Care at Home staff from NAHSCP completed a six-week programme with Ayrshire Hospice to build knowledge and skills in palliative and end of life care. Delivered over six half-day sessions, training covered practical care, communication, symptom management, grief and bereavement, and family support, alongside a week of hospice shadowing to strengthen confidence and capability in practice. • Supporting communities to plan ahead (Power of Attorney and Herbert Protocol) - Arran CVS and TACT hosted two community events to help residents, carers and families understand planning ahead and safeguarding. Sessions covered Power of Attorney arrangements and the Herbert Protocol (Police Scotland) and provided practical guidance to support peace of mind, quicker responses in a crisis and better protection for people at risk of harm.
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 11 Organisational Performance Our 2022–2030 strategic plan set of performance measures reflect the transformation of services to meet continual service improvement and demand. Where an indicator presents as being off track, commentary with proposed resolution and future mitigation is provided on how to improve future performance. Performance reporting comprises of a series of key performance indicators and key actions, which link directly to our strategic plan. Performance is reported at a number of levels within the organisation including the Integration Joint Board Performance and Audit Committee, the Integration Joint Board (IJB), the Joint Review with North Ayrshire Council and NHS Ayrshire and Arran Chief Executives, and service performance reviews within each service area. For 2025–2026 the set of performance measures were agreed and presented to the Performance and Audit Committee highlighting service defined changes. These included: • measure updates / target resetting • any changes to delivery timescale based on nationally available data For the year ending 31 March 2026, the Partnership ended the period reporting 29 performance measures across all service areas. At the time of writing, 26 of the 29 measures have been collated comprising 90% of all measures reported to the end of 2025–2026. Due to the time for collation and verification of the outstanding three measures at Quarter 4 reporting, we have included a RAG status based on performance to date which has resulted in two measures being On Target (Green) and one just Off Target (Amber). The latest Performance and Audit Committee Report shows progress against the key measures, and this is represented in the chart below.
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 12 As part of our commitment to continuous improvement, we recognise areas where we could do more and by monitoring indicators which present as significantly adrift enables us to identify and target plans to address performance issues. The key areas off target for 2025–2026 were: • increasing foster carer support • reducing the number of people on the waiting list for a Care at Home service in the Community and Hospital • reducing the number of people waiting for assessment • absence levels remain an area of review. The continual review of Foster Carer availability within our Children and Families Service seeks to find improved means of attracting and retaining foster carers. Our Fostering and Adoption Teams continue to actively recruit and given that most people today make use of social media. With the use of ‘Can Digital’ advertising network we have seen an increase to inquiries received with 50% of inquiries in the last quarter via this medium. This will hopefully translate into applications and ultimately new foster carers through the next year. This work is critical to achieve the ambitions in our Brighter Pathways programme. Health and Community Care services experience year on year sustained challenges in delivering frontline Care at Home Services. There remain ongoing workforce challenges related to sickness absence rates and vacancies resulting in delays in accessing Care at Home supports. The initial financial recovery plan submitted to the IJB in September 2024 required significant reductions in expenditure and introduced a recruitment freeze. This had an immediate and sustained impact on staffing levels throughout 2024 to 2025 and these measures continue into the current and forthcoming financial years. To help mitigate pressures, the service has continued to target bank recruitment following a review of casual staffing arrangements, with a focus on strengthening evening and weekend cover to support short-notice sickness absence. The Partnership, working with Ko-nekt, continues to support the recruitment pipeline by enabling candidate referrals from Care Academies and providing opportunities for individuals previously unsuccessful at interview. Our hospital-based team continues to support robust processes for assessing and prioritising care capacity, with an increased focus on early discharge where appropriate. The team also prioritises attendance at planned critical firebreak meetings and Long Length of Stay reviews across Acute sites These works are being undertaken under the umbrella of a further increase in community referrals for Care at Home support together with a rise in both hospital and emergency service requests.
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 13 Annual Accounts The Annual Accounts set out the financial statements of the IJB for the period ended 31 March 2026. The main purpose is to demonstrate the stewardship of the public funds that have been entrusted to the IJB for the delivery of its vision and strategic priorities as outlined in the Strategic Plan. The requirements governing the format and content of the Annual Accounts are contained in The Code of Practice on Local Authority Accounting in the United Kingdom (the Code). The Annual Accounts for 2025 to 2026 have been prepared in accordance with this Code. The Financial Plan Strong financial planning and management is paramount to ensure our limited resources are targeted to maximise the contribution to our objectives. Delivery of services in the same way is not financially sustainable. The refreshed Strategic Plan 2026–2030 reflects the significantly changed context in which the Partnership is operating, including increasing financial pressures, demographic change and rising demand for services. The financial plan therefore focuses on prioritisation, service redesign and investment decisions that support the Strategic Plan’s vision and priorities, while maintaining financial sustainability and delivering best value. The ability to plan based on the totality of resources across the health and care system to meet the needs of local people is one of the hallmarks of integrated care. Medium-term financial planning supports delivery of the Strategic Plan 2026 to 2030 by: aligning resources to the Strategic and Service Delivery Priorities; enabling planned shifts in investment towards prevention, early intervention and community-based support where this improves outcomes and sustainability; and ensuring the Transformation Plan and other enabling plans are affordable and deliverable within the resources anticipated to be available. This approach is supported by the Medium-Term Financial Outlook (MTFO) and ongoing financial governance arrangements, which help to identify emerging pressures and risks early, track delivery of savings and transformation activity, and ensure that investment decisions remain aligned to the Strategic Plan 2026 to 2030. Financial Performance The IJB set a balanced budget for 2025 to 26 on 20 March 2025. This did not require any draw on reserves but did include the approval of £4.019million of savings to achieve financial balance. Financial information forms part of the performance management framework, with regular reporting of financial performance to the IJB. This includes an integrated approach to financial monitoring, covering progress with savings delivery, key financial risks, recovery actions and any variations or changes to the delegated budget. There were significant financial challenges during the period; the main pressures were residential placements for children, supplementary staff in wards and Unplanned Activities (UnPACs) within the lead partnership for mental health. From the initial budget monitoring report in month three the projected position has been an overspend. The Integration Scheme requires the preparation of a recovery plan if an overspend position is being projected to plan to bring overall service delivery back into line with the available resource. Following the finalisation of the 2024 to 25 outturn position, the IJB agreed some initial recovery actions at the meeting in June and further financial recovery plan actions were developed and
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 14 approved by the IJB during 2025 to 26. These actions were in addition to those approved in 2024 to 25. The recovery actions which have been implemented in 2025 to 26 include: • Recruitment delay (“recruitment drag”): vacancy-scrutiny-approved vacancies held for four weeks before advertising to create additional payroll turnover (except clinical/registered services vacancies or where cover costs would be incurred). • High-cost care package group: remit expanded to include care packages for children with a disability and all UNPACS placement requests. • Oversight group for looked after and accommodated children in residential care: meets fortnightly to actively review all placements. • Senior managers in main overspend areas to prepare SBAR reports for Partnership Senior Management Team (PSMT), covering current and future actions to reduce overspends. • Director and Chief Finance Officer rolling programme of one-to-one meetings with budget holders to identify opportunities for cost reduction, service change and spend-to-save propositions (supporting 2026 to 2027 budget development and additional in-year reductions). • Care home placements: move to one admission for every two discharges (as per PSMT approval on 20 November 2025); care placements at CARG to be approved on the basis of risk and need rather than current care setting (with exceptions where risk is too great). • Care at home: recruitment freeze to gradually reduce the overspend position (with an acknowledged impact on wait times and service performance). • All care packages (outwith in-house care at home and older people placements agreed via CARG) to be considered for approval by the high-cost care package group. • Additional recovery actions proposed at month 9: improve sickness absence through the Promoting Attendance Policy; pursue cross-charge for persons admitted from out-of-area following failed placements in Ayrshire and Arran; and continue implementation of the Flexible Intervention Guideline to minimise duration of 1:1 (or higher) support. In order to facilitate greater scrutiny of the financial position and the delivery of the financial recovery plan, the IJB agreed in June 2024 to establish a ‘Finance Working Group’, chaired by the IJB Vice Chair. The Director and Heads of Service are members of the group. This FWG meets regularly to facilitate increased oversight and scrutiny of the financial position and transformation programme as well as detailed budget planning for future financial years. In 2025 to 2026 the Finance Working Group has covered: • 2024 to 2025 Financial Outturn • 2025 to 2026 Budget • National IJBs Position • NHS Reform - Financial and Operational • Montrose House Care Home • Day Services • Brighter Pathways • Unscheduled Care
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 15 • Care at Home Review • LD Services – Inpatient beds and complex care • Budget Engagement Approach • Learning Disabilities Change Programme • 2026 to 2027 Budget Gap and Planning • Care Packages – including eligibility criteria and thresholds for care • Agenda for Change - RWW • Medium Term Financial Outlook • Engagement Programme – “delivering social care services within budget - share your views” • 2026 to 2027 SG Budget Settlement and subsequent budget gap • Social Care Charges 2026 to 2027 • Adult Social Care Eligibility Criteria • Community Alarm Responder Service • Draft Budget Savings 2026 to 2027 • Phase 2 Early Engagement Feedback Since the initial recovery plan was agreed in June 2025 there has been a £3.498million reduction in costs. Whilst the full benefit of this has not been realised in-year in the bottom-line outturn, it has supported the delivery of mitigating a further deterioration to the position introduced through other in-year unexpected financial pressures of £1.006million. This has resulted in a net achievement of £2.492million recovery action. The outturn is an overall year-end underspend of £2.501million on an IJB basis, which when adjusted for new earmarked reserves of £1.805million is reduced to £0.696million (0.2%). The financial recovery plan has been effective in reducing the financial overspend projected and minimising the financial risk to funding partners, for instance, NHS Ayrshire and Arran and North Ayrshire Council, however this has not been impact free to the delivery of services or on performance, with a continued impact on workforce levels, waiting lists and delayed transfers of care. The table below reconciles the deficit on the provision of services of £0.339million as noted in the Comprehensive Income and Expenditure Statement to the financial outturn position of on-line.
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North Ayrshire Integration Joint Board Audited Annual Accounts to 31st March 2026 16 Reconciliation Table 2024 to 2025 2025 to 2026 (Surplus) / Deficit on provision of services 2.349 0.339 Earmarked reserves released to services during the year (4.730) (2.840) Sub Total (2.381) (2.501) NEW Earmarked Reserve Balances 2.381 1.805 Financial Outturn (underspend) 0 (0.696) The table below summarises the financial performance for 2024 to 2025 and 2025 to 2026. This notes the budget outturn on a managed basis (including the full allocation for North HSCP lead partnership services) and adjusts this for the net impact of lead partnership allocations across North, South and East Ayrshire and also for new earmarked balances. The table includes the financial performance for services managed by the IJB during the period, therefore it excludes the large hospital Set Aside Budget of £41.833million which was allocated at the end of the period to the IJB. The set aside budget is included within the financial statements. 2024 to 2025 Budget £000 2024 to 2025 Actual £000 Variance (Fav) / Adv £000 Service 2025 to 2026 Budget £000 2025 to 2026 Actual £000 Variance (Fav) / Adv £000 92,549 98,181 5,632 Health and Community Care 101,333 102,239 906 108,721 107,823 (898) Mental Health 119,856 119,590 (266) 43,717 44,294 577 Children, Families and Justice 41,437 41,790 353 53,575 53,662 87 Primary Care 52,996 53,035 39 10,748 10,749 1 Allied Health Professionals 11,480 11,480 0
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 17 2024 to 2025 Budget £000 2024 to 2025 Actual £000 Variance (Fav) / Adv £000 Service 2025 to 2026 Budget £000 2025 to 2026 Actual £000 Variance (Fav) / Adv £000 13,970 10,186 (3,784) Management and Support Costs 13,995 10,814 (3,181) 1,635 1,725 90 Chief Social Work Officer 1,910 1,763 (147) 1,710 1,773 63 Financial Inclusion 1,160 1,221 61 4 4 0 National Commissioned Service 0 0 0 326,629 328,397 1,768 Total expenditure 344,167 341,932 (2,235) (326,629) (326,629) 0 Total income (344,167) (344,167) 0 0 1,768 1,768 Outturn on a managed basis 0 (2,235) (2,235) 0 (556) (556) Lead Partnership Allocations 0 (266) (266) 0 1,212 1,212 Outturn on an IJB basis 0 (2,501) (2,501) 0 2,381 2,381 New Earmarking 0 1,805 1,805 0 3,593 3,593 Outturn position prior to additional funding contributions 0 (696) (696) 3,593 0 (3,593) Additional funding contributions 0 0 0 3,593 3,593 0 Final outturn position 0 (696) (696) The main areas of variance during 2025 to 26 are noted below:
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 18 Health and Community Care – overspend of £0.906million mainly relates to overspends in care home placements, integrated Island Services, specialist rehabilitation wards and Wards 1 and 2, partly offset by underspends in care at home, Telecare, adaptations, physical disability services and Unscheduled Care. Mental Health – underspend of £0.266million which relates to underspends in community mental health, Hospital Based Complex Continuing Care, Enhanced Mental Health Outcome Framework, Action 15 and mental health pharmacy, partly offset by overspends in learning disabilities, Adult Inpatients, UNPACS, Learning Disability Services within the Lead Partnership, elderly inpatients and psychiatry. Vacancy savings across the Lead Partnership also contributed to the favourable position. Children, Families and Justice – overspend of £0.353million which is mainly related to overspends in care experienced children and young people, including children’s residential placements, residential respite, employee costs and Section 29 payments. These were partially offset by an underspend in looked after and accommodated children, grant funding in relation to Unaccompanied Asylum-Seeking Children, and the Whole Family Wellbeing Fund which is earmarked for use in 2026 to 27. Management and Support Costs – underspend of £3.181million mainly relates to slippage in transition funding, additional funding received in-year, over-achievement of payroll turnover across social care and health services, and other centrally held budget variances, partly offset by contractual inflation and NHS savings shortfall held centrally. Movement in Projected Outturn Position: The overall movement in the projected outturn during the period is illustrated below:
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 19 Lead Partnership Services The final outturn is adjusted to reflect the impact of Lead Partnership services. In the absence of detailed service activity information and alternative risk sharing arrangements, it was agreed that the outturn for all Lead Partnership services would be shared across the three partnerships on an NRAC (NHS Resource Allocation Committee) basis. The outturn of the lead partnership services for each IJB is provided below, the adjustment to the North IJB outturn reflects the impact of reallocating a share of the North lead partnership services underspend to the other two areas and receiving an NRAC share of the outturn for the South and East partnerships. In addition, any allocations of ring-fenced funding are returned to each IJB in line with allocations and expenditure to allow each IJB to carry forward for future use. IJB £000 Over/Under Explanation of Outturn North 44 Underspend Mental health services, mainly due to overspends on UnPACs, elderly inpatients, psychiatry offset by vacancy savings. Children’s lead partnership underspend includes carried forward funds from 2024 to 25. South 154 Overspend Mainly due to pressures from the continence service. East 240 Underspend Underspends in the Prison and Police healthcare and AHP services offset by overspends on Primary Care and other lead services. Set Aside Budget The Integration Scheme establishes that pressures in respect of large hospital set aside budgets will be managed in-year by NHS Ayrshire and Arran. Work has been undertaken with partnerships to progress and develop set aside arrangements to fully implement the legislative requirement. This includes arrangements in relation to the use of Directions, Joint Commissioning Plans and overall progression towards fair share allocations of resources. Further work has been undertaken through the Ayrshire Finance Leads group to establish baseline resources for each partnership and how this compares to the NRAC “fair share” of resources. Ayrshire Finance Leads have now agreed a baseline methodology for set aside budgets which involves using the average of the four full years prior to the pandemic, 2016 to 2017 to 2019 to 2020 inclusive. The table below shows the cost at 2025 to 2026 prices. The 2025 to 2026 actual usage information is not known until later in the year.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 20 IJB Set Aside 2024 to 2025 at 2025 to 26 prices £m 24/25 Bed Days % Baseline Budget Share at 25/26 Prices £m Over / (Under) Baseline Share £m East Ayrshire 33.336 30.5% 28.948 4.388 North Ayrshire 41.833 37.9% 38.627 3.206 South Ayrshire 34.161 31.6% 32.579 1.582 Total 109.330 100.00% 100.154 9.176 Climate Change The Climate Change (Duties of Public Bodies: Reporting Requirements) (Scotland) Order 2015 came into force in November 2015, as secondary legislation made under the Climate Change (Scotland) Act 2009. The Order requires bodies to prepare reports on compliance with climate change duties. This includes Integration Joint Boards established by order under section 9(2) of the Public Bodies (Joint Working) (Scotland) Act 2014. Scottish Government guidance was issued to IJBs in May 2017, setting out detail of the new duty to produce an annual climate change report. The report requires to be approved by the IJB, with returns to be submitted on the Sustainable Scotland Network (SSN) online portal by 30 November each year. The report was submitted in November 2025, but the IJB haven’t been asked to approve as the IJB don’t have staff, fleet vehicles or property so the return refers to the North Ayrshire Council and NHS Ayrshire and Arran climate change reports. Both North Ayrshire Council and NHS Ayrshire and Arran submit separate reports to the SSN and these are published online. As the parent bodies of the IJB, both North Ayrshire Council and NHS Ayrshire and Arran retain responsibility for employees who are managed within the Health and Social Care Partnership. The employees, therefore, contribute to support the implementation of both bodies’ Climate Change Plans. North Ayrshire IJB has no direct responsibility for employees, buildings or vehicles, which are contained within the parent bodies’ reports, however full consideration of climate change implications will form part of future IJB service redesign, as part of the transformational change programme. Overall position It is essential that the IJB operates within its delegated budget and commissions services from the Council and NHS Ayrshire and Arran on that basis. For 2025 to 2026, the year-end position is an overall underspend of £2.501million on an IJB basis, which reduces to £0.696million after the provision for new earmarked reserves of £1.805million. This represents an improved position compared with the in-year overspend projections and reflects the impact of recovery actions, strengthened financial controls and non-recurring benefits realised during the year. However, this position does not remove the underlying recurring pressures across a number of service areas, and there remains a continued risk that without sustained service redesign, delivery of approved savings and ongoing cost control, future years will again require reliance on one-off measures or support from partner organisations.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 21
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 22 Financial outlook, risks and plans for the future 2026-27 and beyond The Scottish Government’s medium-term fiscal outlook is set out through publications including Scotland’s Fiscal Outlook: The Scottish Government’s Medium-Term Financial Strategy (MTFS) and related budget documents. The MTFS sets out Scotland’s fiscal outlook over the coming years, including the key opportunities and risks that may impact the overall fiscal position. In line with the recommendations of the Budget Process Review Group, the MTFS is intended to provide the context for future budgets rather than set out detailed new spending plans, with specific prioritisation decisions taken through the Scottish Budget process. The Scottish Government’s funding is comprised of five high level categories: 1. The Block Grant – this is the single largest source of funding for the Scottish Government. The Barnett Formula determines the Block Grant and annual growth is dependent on the UK Government’s overall fiscal plans and its spending priorities. 2. Devolved taxes – the Scottish Government receives the revenue from these taxes, the largest of which is Scottish Income Tax. The Scottish Budget is then reduced based on how quickly revenues of the corresponding tax have grown in the rest of the UK (rUK) on a per head basis. 3. Non-domestic rates (NDR) – this revenue is raised by Local Authorities on non-domestic properties. All revenue raised is ultimately returned to Local Government via the Local Government Settlement. 4. Social Security Block Grant Adjustments – this is funding provided by the UK Government for devolved social security payments, based on the growth in expenditure on the corresponding payment in UK on a per head basis. 5. Other income and expenses – other revenue and costs including resource borrowing and associated costs as well as revenues from the Scottish Crown Estate The Scottish Government MTFS models three scenarios (a central resource funding outlook and an upside and downside scenario, indicating plausible alternative funding paths) and outlines the immediate and longer-term pressures on public spending which need to be considered when developing spending plans to ensure that they meet the needs of a changing population and build resilience for the future. The Scottish Government published its seventh Medium-Term Financial Strategy, Scotland’s Fiscal Outlook, on 25 June 2025, alongside a Fiscal Sustainability Delivery Plan. Together, these publications set the medium-term strategy for sustainable public finances and bring together the key actions intended to deliver the fiscal strategy over the next five years (to 2029 to 30). The Scottish Government has stated that these publications provide the basis for the 2026 to 2027 Scottish Budget and the Scottish Spending Review. In particular, the 2025 MTFS provides the economic and fiscal context for the Scottish Budget and reiterates a three-pillar approach to strengthening the sustainability of Scotland’s public finances over the medium term. The three pillars of the 2025 Medium-Term Financial Strategy are: Pillar 1: Ensuring public money is focused on delivering government objectives, underpinned by reform and prioritisation to maximise impact.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 23 Pillar 2: Supporting sustainable, inclusive, economic policies with the greatest potential to grow Scotland's economy, expand and broaden the tax base to fund public services. Pillar 3: Ensuring a strategic approach to tax revenues, which considers the longer-term impact of our tax choices and competitiveness. This Strategy, alongside future Scottish Budgets and updates to the MTFS and related fiscal publications, will be considered in the next update of the Medium-Term Financial Outlook as part of planning for 2026 to 27 and beyond. Medium Term Financial Outlook A Medium-Term Financial Outlook (MTFO) is a critical part of the strategic planning process. The financial context for public services remains very challenging and so it is vital that the IJB’s strategic ambitions are set against the financial resources which are anticipated to be available. The MTFO provides key information on the possible financial position of the IJB over future years. It identifies the financial challenges which will be faced by the IJB enabling the IJB to see the impact of current and future decisions on its medium-term financial health. The MTFO will also be used to identify pressure points and inform decisions which are required to ensure the Partnership remains financially sustainable. There are a range of factors which influence the financial planning of the IJB. These are considered through the MTFO and include the following: • Demographic changes. • Local priorities. • Workforce challenges. • The UK and Scottish Economy. • Policy and Legislation. • Cost and demand pressures. • Available funding. As in previous years, a Medium-Term Financial Outlook has been prepared to identify what the financial position may look like moving into 2026 to 2029. This was presented to the December 2025 IJB. 2026 to 2027 Budget As part of the Scottish Government budget and finance settlement funding letters were issued to NHS Boards and Councils, these detailed the requirements in relation to the level of funding to be delegated to IJBs in 2026 to 2027. The specific requirements and funding provision is as follows: NHS Ayrshire and Arran • NHS Boards will receive a 2% uplift on baseline funding in 2026 to 27. NHS Ayrshire and Arran are required to passport this 2% through to IJBs (£2.890million to North Ayrshire).
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 24 • In addition to the 2% uplift, NHS Ayrshire and Arran are expected to fund the difference between the 2% baseline pay assumption and the 3.75% Agenda for Change pay settlement (£1.824million for North Ayrshire delivered services). Taken together, it is anticipated that a total of £4.714million of funding contribution towards pay and inflation pressures will be allocated from NHS Ayrshire and Arran. • There is also funding of £150million nationally (recurring) to support implementation of the reforms committed to as part of the 2023 to 24 Agenda for Change pay deal, including the additional one-hour reduction from 1 April 2026. A share of this funding will be allocated to support associated costs for NHS staff in delegated functions, and it is anticipated at this stage that the costs of the pay reform (including the final hour reduction to the Reduced Working Week) will be fully funded moving into 2026 to 27. • While funding for reform and improvement measures will be routed through NHS Boards, elements will support activity in the community and be delivered via Integration Authorities. Part of this package is intended to support shared ambitions to alleviate pressure across the health and social care system. North Ayrshire Council • North Ayrshire Council met on 25th February to set their budget for the coming year including the contribution to the IJB. • There was no direct general investment in the Scottish Government budget for social care and no national directive about the level of resource for Councils to pass on and this will be locally determined. • The settlement letter references “I am confident that Local Government will pass more in total to IJBs than is provided as an in-year transfer by Scottish Government. However, I do acknowledge that partnership working will be even more critical this year to ensure that the technical changes applied to the Adult Social Care GAEs are appropriately reflected locally.” • The draft Scottish Government Budget included the transfer additional funding of £167million to Local Government to support social care and integration for 2026 to 27. This relates specifically funding for the following areas: • Real Living Wage for Adult Social Care • Free Personal and Nursing Care • The allocation for the Real Living Wage was reviewed at the draft budget stage with Scottish Government allocating an additional £20million in total to make up the shortfall. This takes the national funding to: • £174.7million for adult social care workers in commissioned services. • An additional £13.4million to improve pay for early learning and childcare workers in commissioned services. • £13.9million to support development of people working in children’s social work. • £7million to support provision of Free Personal and Nursing care.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 25 • The North Ayrshire share of the additional £20million has still to be confirmed but is included at an estimated £0.500million for the budget estimates. • Additionally, in line with the agreed approach North Ayrshire Council have passed through all other funding or adjustments to Social Care allocations in the budget settlement. • Additional funding approved at the Council budget setting meeting on 25th February which reflected North Ayrshire Council’s General Grant uplift and a Council Tax increase of 7% - £4.961million. This has resulted in a net increased contribution to the Partnership of £13.759million through the NAC budget setting process. Some elements of this relate to previous years and were already assumed in the Partnership base budget and this is shown in the table below. Area £m Childrens Services Additional Funding 0.651 Scottish Disability Allowance – reduction in grant (0.094) Health and Social Care Uplift – Real Living Wage 4.688 Scottish Govt funding of the 2026 to 2027 Pay Award 0.441 Baseline additional uncommitted funding to the HSCP 4.961 Share of the additional £20million (estimate) 0.500 Per the HSCP budget plans 11.147 Reconciling Items to the Council Budget Paper Amounts already included in HSCP base budget: Area £m Scottish Govt funding of the 2025 to 26 Pay Award 0.777 Criminal Justice Social Work 2.335 Share of the additional £20million (estimate) still to be distributed (0.500) Per Council Budget paper 13.759
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 26 Moving into 2026 to 2027 the Partnership is proactively working to provide safe and effective services for the residents of North Ayrshire within the financial envelope, this is supported by approving a balanced budget and a focus on the delivery and alignment of financial plans through the transformation plan. The IJB approved a one-year balanced budget for 2026 to 2027 on 13 March 2026. More information about the 2026 to 2027 budget can be found here: 2026 to 2027 Budget. This budget included new budget pressures for health and social care services totalling £22.007million. These were developed in partnership, with Finance supporting front line services to identify current and emerging financial pressures considering historic demand and costs and potential future variations. The provision of funding for pressures has the impact of increasing the budget gap to be addressed through savings, therefore the pressures are only included in budget plans where these are absolutely unavoidable. The new cost and demand pressures resulted in a requirement to identify and approve additional savings of £9.138million, as noted in the summary below, this includes an over-delivery of in-year savings to address estimated recurring areas of overspend from 2025 to 26 and to seek to accelerate savings plans to support future year’s budget gaps: Description Social Care (NAC) £m Health (NHSAA) £m Total £m Funding Increase (11.147) (4.714) (15.861) Service Pressures 17.152 4.855 22.007 In-year Budget Gap 1.400 1.592 2.992 Approved Savings (7.405) (1.239) (8.644) Revised Gap 0 0.494 0.494 The remaining budget gap for Health/NHS services is smaller in value and primarily reflects current year pressures recurring to an extent next financial year, rather than a significant pressure on core funding, therefore it is recommended that the remaining health services gap is monitored closely in-year during 2026 to 2027 with further recovery actions identified as required. The approved savings are shown on the table below:
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 27 Description Social Care (NAC) £m Health (NHS AandA) £m Total £m Previously Agreed Savings and Adjustments (0.140) (0.350) (0.490) Operational Savings (0.770) (0.106) (0.876) Policy – Models of Care or Efficiency (0.667) (0.272) (0.939) Policy – Service Reduction or Cessation 0 (0.511) (0.511) Non eligibility savings (1.577) (1.239) (2.816) Gap to be met by revised Eligibility Criteria (5.828) - (5.828) Total savings (7.405) (1.239) (8.644) The Partnership has undertaken extensive community engagement which commenced early December 2025 on the challenges of delivering social care services within budget. A separate paper was presented to the IJB for consideration, with a recommendation that the remainder of the Social Care/Council gap is met through the review of eligibility criteria and the three interlinked proposals which have been developed to implement the reductions to care packages, namely: • Proposal 1 - Changing Eligibility – Support Only for People at Critical Risk • Proposal 2 - Best Value Care Funding Framework • Proposal 3 - Prioritising Personal Care The Integration Joint Board, in common with most Public Sector bodies, is facing a period of significant financial challenge with cost and demand pressures. The most significant financial pressures continue to be pay awards for staff, inflationary cost increases for contracted services and demographic changes driving increased demand for services - funding these unavoidable pressures year-on-year drives our savings requirement. 2025 to 2026 Opening Position The 2025 to 26 projection was reviewed to establish the anticipated impact on the 2026 to 2027 position and any element of recurring over and underspends. Following a robust review by the Finance Team and budget holders the adjusted opening projection for 2026 to 2027 is a predicted £2.992million overspend. This is higher than 2025 to 26 as the in-year position includes one off underspends due to a draw on reserves as part of the recovery plan. This reflects the full year impact of part year cost reductions achieved in 2024 to 25, including - care at home, Brighter
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 28 Pathways, care packages, vacancy management and supplementary staffing – targeted improvement in other areas. It assumes all mitigations and controls established in 2024 to 25 and 2025 to 26 continue throughout 2026 to 2027 as it is recognised that the same uncertainty and risks remain into 2026 to 2027 and there needs to be tight grip and control over expenditure overall. The opening projected overspend for 2026 to 2027 is predicated on maintaining Financial Recovery Plan Controls, and: • Removing the care home overspend and manging the number of placements in line with the budgeted level. • Reducing agency costs at Montrose House on Arran • The Brighter Pathways programme of work bringing children’s placement budgets into line across different settings including residential, fostering, kinship – recognising the impact of the change programme and new supports in place for 2026 to 2027 • Significant reduction or removal of overspends on supplementary staffing across wards through focussed improvement work supported by the General Manager, Lead Nurse and responsible Senior Managers The main areas of continued risk and where overspends are anticipated as part of the £2.992million are: • Physical Disability Care Packages • Integrated Island Services • Learning Disability Care Packages • Section Payments • Inpatient Ward Staffing – for Community Rehab and Mental Health Wards • UnPACs • Psychiatry There are inherent risks in moving into 2026 to 2027 with the level of overspends across a range of service areas and focus will remain across services to manage these, the IJB will receive regular updates through the financial monitoring report for 2026 to 2027 on progress and on the final outturn position for 2025 to 26 There are a number of ongoing financial risk areas that may impact on the 2026 to 2027 budget during the year, these include: • Growing demand for services. • Staff recruitment and retention challenges across a number of service areas.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 29 • The expectation that performance will continue to be maintained or improved despite the significant resource challenges. • Ongoing delivery costs of Scottish Government policy directives, particularly where these are not fully funded or inflation proofed. • Unearmarked reserves are depleted; there is no scope to absorb in-year variances, with any overspends requiring additional funding from partners. • The ongoing review of the Integration Schemes, where there is a focus on financial arrangements and risk share. • The wider system financial challenges and impact across the whole system; for example, the financial position of NHS AA and the decisions taken to reduce the Board’s deficit may have impacts on other parts of the health and care system. • The ability to re-pay funding partners in-year for previous year overspends given continued financial challenges. • The overall sustainability of commissioned care providers. • Progress with the work to develop set aside arrangements and the risk sharing arrangements agreed as part of this. • The recurring underlying levels of overspend which may impact on the Partnership’s ability to continue to sustain service levels in the future. • The use of supplementary staffing for enhanced observations across a number of service areas and the use of high-cost agency staff to support frontline service delivery in areas where there are recruitment challenges. • Agenda for Change Pay Reform programme – including Nursing Band 5-6 regrade, protected learning time and reduction to the working week. • Risk related to NHS Reform investment being allocated by Scottish Government on a payment by results basis and in arrears. • A risk of meeting legal obligations to deliver a balanced budget set against continued increased demand for services, inflationary impacts on the cost of care and the more difficult decisions which are required to reduce spend. These risks will be monitored during 2026 to 2027 and any financial impact reported through the financial monitoring report. The National Position The Audit Finance Bulletin 2024 to 25 (published 26 February 2026) outlined the wider national context affecting Integration Joint Boards (IJBs) in Scotland, and provided background to the scale of the financial challenge and the implications for service delivery. It highlights the level of projected budget gaps, the position on reserves, and the need for prioritisation and transformation to sustain health and social care services.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 30 • Scale of challenge: A significant national budget gap is reported for 2025–2026, with IJB budget gaps varying widely across Scotland. • Reserves: Many IJBs have depleted reserves, limiting the ability to absorb in-year pressures and increasing reliance on partner support. • Service impact: The national picture points to increasing risk to service provision and performance expectations, alongside a need to manage public and political expectations about change. • Key themes for action: Greater national visibility of the collective challenge, appropriate prioritisation of community services, recognition of local variation in solutions, and continued focus on transformation and provider sustainability. There is regular reporting by IJBs of individual and collective financial positions through internal governance, audit processes and returns to the Scottish Government Health Finance Directorate. In March 2025, Chief Officers met with the Cabinet Secretary to present an overview of the national picture for IJBs, the context of rising pressures and service costs, and the impact of the financial position on service delivery, risks and performance expectations. The Cabinet Secretary received a presentation which highlighted: • 2025–26 projected budget gap, including the worsening position for reserves. • Historical funding settlements for IJBs. • Trends in health and adult social care spend. • Risks to the financial position, service provision and performance. • Scale of impact in terms of service provision levels and the need for prioritisation (including priority of need and risk management). • Social care provider sustainability risks. • A case study illustrating the link between financial resources and delayed discharge performance. • Links to national priorities and policy directives. Chief Officers set out a number of asks, including: building more regular national visibility of the collective challenge; influencing future prioritisation decisions so that community services are appropriately prioritised for investment; recognising local variation (and that solutions may differ between areas); and support to manage public and political expectations about the scale of change, service impacts and performance implications. COSLA has also highlighted a significant gap for social care services moving into 2026 to 2027 and called for urgent investment to stabilise the sector; this was not reflected in the Scottish Government budget for 2026–27. Set Aside The Partnership works with University Hospital Crosshouse and University Hospital Ayr to plan services that are largely unscheduled. The Set Aside budget covers the acute services most commonly used through the unplanned care pathway and supports strategic planning to improve flow and shift care closer to home. • Accident and emergency
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 31 • Inpatient services for general medicine • Geriatric medicine • Rehabilitation • Respiratory • Learning disability, psychiatry and palliative care services provided in hospital Each Health Board, in partnership with the Local Authority and the IJB, must fully implement the delegated hospital budget and set aside budget requirements of the legislation, in line with statutory guidance. Full implementation of set aside arrangements is key to planning across the whole unplanned care pathway and ensuring arrangements are fit for purpose. Work is ongoing across Ayrshire to progress set aside implementation, including use of Directions, Joint Commissioning Plans and progress towards fair-share allocations of resources. Ayrshire Finance Leads have agreed a baseline methodology for set aside budgets using the four full years prior to the pandemic (2016 to 2017 to 2019 to 2020), with HSCPs to agree their final baseline shares while the overall total remains unchanged. Against this backdrop, NHS Ayrshire and Arran continues to face a material underlying deficit within acute services, driven by the following factors: • Unachieved efficiency savings • Length of Stay (LoS) and emergency admission rates in NHS Ayrshire and Arran acute hospitals are above the Scottish average. • High expenditure on medical and nursing agency staff, high rates of absence and vacancies causing service pressure. • Delayed transfers of care and high acuity of patients. The IJBs and the Health Board continue to work closely to develop a joint strategic commissioning plan for unscheduled care, with the aim of supporting more care in the community and reducing reliance on acute beds. Ayrshire Finance Leads have agreed a revised Set Aside costing approach based on actual bed usage and average costs, with a baseline usage level set using the average of 2016 to 2017 to 2019/20. A pan-Ayrshire Joint Commissioning Plan is being developed to set out the level of acute unscheduled care provision to be commissioned from NHS Ayrshire and Arran, aligned to Set Aside resources and delivered through Directions. The NHS AA Chief Executive has requested the development of a joint strategic commissioning plan to enable the setting of directions to provide to NHS Ayrshire and Arran for Unscheduled Care, aligned with the Set Aside resources. Furthermore, seeking the support from the three IJBs in the review, and onward approving and monitoring of the delivery of a Strategic Commissioning Plan in line with the provisions laid out in the Integration Schemes, as outlined below: • The NHS Board will consult with the Ayrshire Integration Joint Boards to ensure that any overarching Strategic Plan for Acute Services and any plan setting out the capacity and resource levels required for the Set Aside budget for such Acute Services is appropriately coordinated with the delivery of Services across the Ayrshire and Arran area. The parties
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 32 shall ensure that a group including the Director for Acute Services and Chief Officers of the three Ayrshire Integration Joint Boards will meet regularly to discuss such issues. • The initial Set Aside base budget for each Integration Joint Board will be based on their historic use of Acute Services. The actual unit cost which would apply as part of any change to activity or service redesign is dependent on the scale of change planned and requires agreement in advance by all Parties. Any redesign of service requires to be agreed across the three Integration Joint Boards and be reflected in the Strategic Plans. • In year pressures in respect of Set Aside budgets will be managed in year by the Health Board, with any recurring over or underspend being considered as part of the annual budget setting process. In this joint strategic commissioning plan each IJB will consider and outline a clear framework for commissioning, at a strategic level, the urgent and unscheduled care service funded from the ‘set aside’ budget. There is an ambition that the commissioning plan will indicate an expectation of service delivery that will see sustained and affordable improvement in relation to performance outcomes for the citizens of Ayrshire and assure best value to support the financial balance of urgent and unscheduled care provision through a review and system wide redesign of the preferred models of care. Following consideration by the three IJBs, the Plan will be enacted operationally through the mechanism of Directions by the Local Authorities and NHS Ayrshire and Arran. This work remains ongoing and there is an opportunity to refresh this alongside the national focus on NHS Renewal for Unscheduled Care. Thorough the Scottish Government’s Operational Improvement Plan and associated funding Pan Ayrshire work to invest in services to support hospital flow commenced early 2025 to 2026, this work is ongoing with plans drafted to propose resource transfer from acute health settings to community services to enable further improvement in the quality and performance of services, with a focus on delayed transfers of care. This work would be a first step towards progress in shifting the balance of care and resource from acute services in Ayrshire and Arran. Directions The Scottish Government issued Statutory Guidance in January 2020 outlining the requirements for the use of Directions from Integration Authorities to Health Boards and Local Authorities. The guidance sets out expectations for consistent practice in the issuing (by IJBs) and implementation (by Health Boards and Local Authorities) of Directions issued under the Public Bodies (Joint Working) (Scotland) Act 2014, and it supersedes the Good Practice Note on Directions issued in March 2016. The Scottish Government worked with IJB Chief Officers and local systems to understand variation in practice and identify good practice, including through partnership engagement with Health Board and Local Authority Chief Executives. Across Ayrshire, the three Health and Social Care Partnerships worked together to develop and adopt a consistent template for Directions as the formal mechanism to communicate IJB decisions to the constituent Local Authorities and to NHS Ayrshire and Arran. This approach was implemented from April 2023 for IJB decisions that impact on service delivery by the Council and/or the Health Board.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 33 In North Ayrshire, the direction of travel is to strengthen how Directions are used to support whole-system planning, particularly in relation to delegated hospital (set aside) resources and urgent and unscheduled care. Work is ongoing across Ayrshire to develop a pan-Ayrshire joint strategic commissioning plan for unscheduled care (aligned to agreed set aside baselines and resource envelopes) which can then be implemented operationally through Directions to NHS Ayrshire and Arran and, where required, to North Ayrshire Council. Risks The strategic risks faced by the IJB over the medium to longer term were presented to the April 2026 IJB. There are 12 risks noted on the Strategic Risk Register, with a number of these graded as very high or high risk. While there are a number of controls and mitigations in place there may be further actions required to reduce the risks further in line with the level of risk tolerance. The current Strategic Risk Register is available to view here: Strategic Risk Register. Five risks increased in score since 2025: Ref Title Description SRR01 Financial Sustainability Resources have not kept pace with the demand for and cost of social care services. Financial modelling suggests significant ongoing challenges across the medium-term with 2026 to 2027 being particularly challenging. This results in a greater risk to the financial sustainability of the IJB. The gross risk remained at 25 (Very High) but the residual risk increased from 16 (High) to 20 (Very High). SRR05 Transformation Programme Failure to deliver the transformational change required to meet current and future demands and ensure our long- term financial sustainability. The gross risk remained at 12 (High) but the residual risk increased from 6 (Moderate) to 9 (Moderate). SRR09 Local Impact of Scottish Government Policies Risk of further legislative, policy developments or change which impacts on the IJBs ability to deliver on strategic objectives. The gross risk remained at 16 (High) but the residual risk increased from 12 (High) to 16 (High) mainly in relation to the ongoing uncertainty around the Reduced Working Week (RWW) and any future policy intent following the Scottish Parliamentary Elections. SRR13 Provider Failure (commissioned services) There is an ongoing risk of social care supplier failure due to staffing and recruitment challenges and the financial viability of care providers. Supplier failure leads to risk to service users, potential for withdrawal of care and disruption to care plans. The gross risk remained at 16 (High) but the residual risk increased from 12 (High) to 16 (High). SRR15 Risk of Harm A lack of resources combined with an increase in both demand and complexity is leading to increasing numbers of residents waiting for services, whether that be for referral, assessment or the provision of care and support. Resources will be directed at those with the greatest need, reducing capacity for early intervention and
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 34 Ref Title Description prevention supports. This results in a greater likelihood of residents experiencing harm as a result. The gross risk increased from 16 to 20 which reflects the current financial position and the move to critical eligibility criteria for access to social care services. The full Strategic Risk Register is summarised below: Ref Title Gross Risk (score pending further controls) Residual Risk (score after further controls) SRR01 Financial Sustainability 25 Very High 20 Very High SRR02 Infrastructure (ICT Integration) 12 High 9 Moderate SRR05 Transformational Change Programme 12 High 9 Moderate SRR06 Governance 9 Moderate 3 Low SRR07 Demography and Inequality Pressures 16 High 12 High SRR08 Workforce 12 High 9 Moderate SRR09 Local Impact of Scottish Government Policies 16 High 16 High SRR12 Clinical and Care Governance 9 Moderate 9 Moderate SRR13 Provider Failure (commissioned services) 16 High 16 High SRR14 Asylum Arrivals 12 High 12 High SRR15 Risk of Harm 20 Very High 16 High SRR16 Growth and expansion of specialist complex care developments 25 Very High 15 High
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 35 The Risk Appetite Statement was also approved by the IJB in April 2026. The purpose of the Risk Appetite Statement is to set out clearly and transparently the level of risk the Integration Joint Board is prepared to tolerate in delivering health and social care services. It supports consistent, risk-aware decision-making across the Partnership and provides an important link between our strategic objectives, financial planning, transformation activity and the Strategic Risk Register. The Statement recognises that delivering services in the current environment involves managing significant uncertainty, particularly in the context of ongoing financial pressures, rising demand and workforce challenges. Conclusion 2025 to 2026 has been an extremely challenging year for the Partnership financially, driven by the cost of delivering services to meet demand across the system. The IJB has a strong track record in delivering approved savings and will continue to pursue transformational change in how it supports individuals, families and communities to live independently from statutory services for as long as they can safely do so. This is not only about changing how services are structured; it also requires a shift in how services are planned and delivered, with increased emphasis on prevention, early intervention and community-based support. In the context of continuing financial pressures, this will require difficult prioritisation decisions and, unless further national investment is forthcoming, may reduce the level of service provision available in North Ayrshire. Our health and social care services must reflect and respond to the needs of local people. We remain committed to planning and designing services together with local people, our staff and our key partners, including acute health services, housing, community planning and the third and independent sectors. Through the refreshed Strategic Plan 2026 to 2030, the IJB sets out a clear vision and priorities for improving health and wellbeing and tackling inequality, while ensuring services remain sustainable. Delivery is supported by the Transformation Plan which focuses on redesigning services, shifting support closer to home and delivering the changes required to respond to demographic pressures, rising demand and the financial challenge ahead. Looking ahead, we will continue to work proactively to address the financial challenges while maintaining safe, effective and sustainable health and social care services for the communities of North Ayrshire. This will be supported through robust financial governance, delivery of agreed savings and recovery actions, and continued progress with transformation and service redesign in line with our Strategic Plan 2026 to 2030. Where to find more information If you would like more information on IJB strategies, plans and policies and our performance and spending, please refer to the North Ayrshire Health and Social Care Partnership website.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 36 Statement of responsibilities Responsibilities of the IJB The IJB is required to: • Make arrangements for the proper administration of its financial affairs and to secure 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 authority, 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 financial statements are prepared in accordance with legislation (The Local Authority Accounts (Scotland) Regulations 2014), and so far, as is compatible with that legislation, in accordance with proper accounting practices (section 12 of the Local Government in Scotland act 2003) • Approve the Annual Accounts for signature. Joyce White IJB Chair 25 September 2026
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 37 Responsibilities of the Chief Finance Officer The Chief Finance Officer is responsible for the preparation of the IJB’s Annual Accounts in accordance with proper practices as required by legislation and as set out in the CIPFA/LASAAC Code of Practice on Local Authority Accounting in the United Kingdom (the Accounting Code). In preparing the annual accounts, the Chief Finance Officer has: • Selected suitable accounting policies and then applied them consistently. • Made judgements and estimates that were reasonable and prudent. • Complied with legislation. • Complied with the local authority Code (in so far as it is compatible with legislation). The Chief Finance Officer is also required to: • Keep proper accounting records which are up to date. • Take reasonable steps to ensure the propriety and regularity of the finances of the Integration Joint Board. I certify that the financial statements give a true and fair view of the financial position of the North Ayrshire Integration Joint Board as at 31 March 2026, and its income and expenditure for the period then ended. Eleanor Currie CPFA Chief Finance Officer 25 September 2026
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 38 Annual Governance Statement Executive Summary The Annual Governance Statement explains how North Ayrshire IJB complies with the Code of Corporate Governance and meets the requirements of the CIPFA / SOLACE Framework ‘Delivering Good Governance in Local Government 2016’ and the ‘Code of Practice for Local Authority Accounting in the UK: A Statement of Recommended Practice’, in relation to the Statement on the System of Internal Financial Control. In May 2025 CIPFA released an addendum to the 2016 Code which replaced chapter 7 of the Framework. The seven principles from the 2016 publication remain unchanged. Based on the review undertaken, the IJB considers that its governance arrangements were fit for purpose during 2025 to 2026, providing reasonable assurance that responsibilities were discharged and objectives progressed. The review identified effective arrangements in place for the following key areas: • Strategic planning and performance management aligned to Strategic Commissioning Plan • A risk management framework, including an approved risk appetite statement and regular updates to the strategic risk register • Established arrangements for financial management, scrutiny and oversight, supported by regular reporting On-going financial pressures and pace of transformation require the continued focus on strong governance arrangements and actions have therefore been identified for 2026 to 2027 to support financial sustainability and ensure governance arrangements remain resilient. A number of targeted actions have been identified, and this includes enhancing financial oversight, improving commissioning arrangements. North Ayrshire IJB is responsible for ensuring that its business is conducted in accordance with the law and proper standards, and that public money is safeguarded and properly accounted for and used economically, efficiently and effectively. The IJB is also responsible for putting in place proper arrangements for the governance of its affairs and facilitating the effective exercise of its functions, which includes arrangements for the management of risk. In discharging this responsibility, the Chief Officer has put in place arrangements for governance which includes the system of internal control. Reliance is placed on these controls which are designed to manage risk to a reasonable level but cannot eliminate the risk of failure to achieve policies, aims and objectives. It can therefore only provide reasonable but not absolute assurance of effectiveness.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 39 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 and the activities through which it accounts to and engages with the community. It enables the IJB to monitor the achievement of its strategic priorities and to consider whether those priorities have led to the delivery of appropriate, cost- effective services. The system of internal control is a significant part of that framework and is designed to manage risk to a reasonable level. The system of internal control is based on an ongoing process designed to identify and prioritise the risks to the achievement of North Ayrshire IJB’s policies, aims and objectives, to evaluate the likelihood of those risks being realised and the impact should they be realised, and to manage them efficiently, effectively and economically. Governance framework The main features of the governance framework that was in place during 2025 to 2026 are summarised below: • The IJB, comprising all IJB Board members, was the key decision-making body. The Performance and Audit Committee considered all matters in relation to Internal and External Audit, Risk Management and Performance and fulfilled the requirements of the CIPFA document ‘Audit Committees: Practical Guidance for Local Authorities and Police.’ • Strategic decision-making is governed by the IJB’s key constitutional documents including the Integration Scheme, standing orders, scheme of administration, scheme of delegation to officers and financial regulations. • The Integration Scheme sets out the process to determine financial contributions by partners to Integration Joint Boards. This has been supplemented by directives from the Scottish Government in relation to the level of resources for delegation by the Council and NHS Board for Health and Social Care Integration. It is acknowledged that the Integration Scheme is overdue review and a Pan Ayrshire approach to reviewing the three integration schemes is ongoing. • The IJB’s purpose and vision are outlined in the IJB Strategic Commissioning Plan 2022-30 which links closely to the vision of the North Ayrshire Community Planning Partnership and the Local Outcome Improvement Plan (LOIP) 2022 to 2030 and is underpinned by an annual action plan and performance indicators. The new refreshed Strategic Plan was approved by the IJB in December 2025, with the new plan launched for the period 2026 to 30 from April 2026. Quarterly performance reports are provided to the Performance and Audit Committee on the delivery of the values and strategic priorities set out in the strategic plan, with a formal Annual Performance Report published each year. • The performance management framework focuses firmly on embedding a performance management culture throughout the IJB. Regular reporting to Board Members takes place. • A risk management strategy, strategic risk register and risk appetite statement is in place for the IJB. The third version of the risk appetite statement was approved by the IJB in June 2025 alongside the triennial review of the IJB’s Risk Management Strategy. The next
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 40 update to the risk appetite statement will be presented to the IJB Board in April 2026. The strategic risk register is updated annually with the next approval going to the IJB in April 2026 and the operational risk registers are updated in line with the IJB’s risk strategy. • The Health and Care Governance Framework covers governance arrangements in relation to complaints and customer feedback, risk management, health and safety, Internal Audit, workforce planning and public protection. Regular updates are provided to the IJB by the Clinical and Care Governance Group. • The IJB has adopted a ‘Code of Conduct’ for all its Board Members and employees, a register of interests is in place for all Board members and senior officers. • The IJB has in place an informal development programme for all Board Members, the Partnership Senior Management Team and senior managers across the Partnership. • Refresher training on Code of Conduct is planned during 2026 to 2027 as well as an updated induction pack for new IJB members, this will incorporate the legislative changes to voting rights which come into force from September 2026. • In order to facilitate greater scrutiny of the financial position, the IJB agreed to establish a ‘Finance Working Group’, chaired by the IJB Vice Chair. Now in place since August 2024 this group has facilitated increased oversight and scrutiny of the financial position and transformation programme as well as detailed budget planning for future financial years and has become part of our regular governance arrangements. • Performance and Personal Development schemes are in place for all staff, the aim of which is to focus all staff on their performance and development that contributes towards achieving service objectives. • The Strategic Planning Group (SPG) has oversight of developing and monitoring the Strategic Plan, and the Locality Planning process, as well as enabling strategies to maintain a consistent strategic approach. SPG is chaired by the Vice Chair of the IJB and the IJB receives copies of the minute to keep Board members informed of its activity. • The IJB has established five locality planning review groups, reflecting the previously agreed local planning areas, and has an integrated approach with the Community Planning Partnership for Locality Planning in Arran. These provide Board Members, health and social care staff and local community representatives with the opportunity to be involved in considering and influencing priorities for each area. Locality planning arrangements are being reviewed to further bring mainland areas into line with CPP arrangements with the IJB endorsement of this approach in April 2026. • A Transformation Board is in place, which recognises the significant change programme which is required to support delivery of the priorities within the new 2026 to 30 strategic plan. Terms of Reference, updated in December 2025, are in place which detail the Board’s membership, duties, authority, reporting and governance. The Board meets bi- monthly. The governance framework was in place during the period ended 31 March 2026. Review of effectiveness North Ayrshire IJB has responsibility for conducting, at least annually, a review of the effectiveness of its governance framework including the system of internal control. The review of the effectiveness of the framework is informed by the work of the Partnership Senior Management Team who have responsibility for development and maintenance of the governance environment,
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 41 the annual report by the Chief Internal Auditor and reports from Audit Scotland and other review agencies. The Annual review of the governance framework was undertaken with reference to the seven principles of good governance set out in the CIPFA Delivering Good Governance in Local Government Framework. The review confirmed that the IJB’s core governance arrangements are operating effectively and drew evidence across a range of assurance sources such as performance and risk reporting, the Chief Internal Auditors annual opinion, external audit and scrutiny arrangements. The Chief Internal Auditor reports directly to the IJB Performance and Audit Committee on all audit matters, with the right of access to the Chief Officer, Chief Finance Officer and Chair of the Performance and Audit Committee on any matter. In accordance with the principles of the code of corporate governance, regular reports were made to the IJB’s Performance and Audit Committee during 2025 to 2026. The Internal Audit function has independent responsibility for examining, evaluating and reporting on the adequacy of internal control. As of the 1st April 2025 the Public Sector Internal Audit Standards have been replaced by the Global Internal Audit Standards. A formal self-assessment against the new standards, and the associated CIPFA Application Note and the CIPFA Code of Practice for the Governance of Internal Audit, is underway as part of the Internal Audit quality assurance arrangements, the results of which will be reported as part of the annual audit report. An action plan, setting out the improvements to be achieved to obtain full conformance, will be presented to Committee in 2026 to 2027. The Chief Internal Auditor is responsible for forming an annual opinion on the adequacy and effectiveness of the systems of internal control. The approved IJB internal audit plan for 2025 to 2026 focussed on a review of the IJB’s arrangements in relation to Financial Sustainability. The results of the assignment are still be reported to Committee, but it is anticipated this will be an opinion of reasonable assurance. It is the opinion of the Chief Internal Auditor that the systems of internal control relied upon by the IJB continue to provide reasonable assurance against loss. System of internal financial control The governance framework described operates on the foundation of internal controls. The system of internal financial control is based on a framework of regular management information, financial regulations, administrative procedures (including segregation of duties), management supervision, and a system of delegation and accountability. Development and maintenance of these systems is supported by NHS Ayrshire and Arran and North Ayrshire Council in relation to the operational delivery of health and social care services. These systems include: • Financial regulations and codes of financial practice • Comprehensive budgeting systems
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 42 • Regular reviews of periodic and annual financial reports that indicate financial performance against the forecasts • Setting targets to measure financial and other performance • Formal project management disciplines • A Transformation Board to provide further scrutiny of service re-design and financial delivery • An effective Internal Audit function The IJB’s financial management arrangements conform to the governance requirements of the CIPFA statement: ‘The Role of the Chief Finance Officer in Local Government (2016)’. The IJB complies with the CIPFA Financial Management Code. Through the counter fraud arrangements that are in place within NHS Ayrshire and Arran and North Ayrshire Council, the IJB conforms with the CIPFA ‘Code of Practice on Managing the Risks of Fraud and Corruption.’ During 2025 to 2026, the Principal Manager – Finance/Section 95 Officer continued to lead on improvement work to review and tighten controls across a number of areas in the HSCP. Recovery action will continue into 2026 to 2027 and be reported via the budget monitoring report. Developments during 2025 to 2026 The elements noted below incorporate progress with the further actions or developments identified in the 2025 to 2026 Annual Accounts. Medium-Term Financial Outlook (MTFO) A medium-term financial outlook was prepared covering the period from 2025 to 2026 to 2026 to 2027 and initially presented to the IJB in March 2024. An MTFO update was provided to the IJB in December 2025 and a further update was presented to the IJB Board in March 2026. This outlined significant potential budget gaps in 2027 to 2028 and 2028 to 2029. Review of IJB key governance documents The IJB continues to review its key governance documents on a rolling basis. Clinical and Care Governance Group (CCGG) Clinical and Care Governance is the system in which the HSCP is accountable for continuously improving quality and safeguarding high standards of care. The Partnership has developed Clinical and Care Governance arrangements in line with the commitments and requirements contained in the Integration Scheme. The CCGG meets on a monthly to discuss and review a number of topics and an annual report was provided to the IJB on 21st August 2025.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 43 Care Home and Care at Home Oversight Arrangements The HSCP stepped up oversight arrangements for Care Homes and Care at Home Services in North Ayrshire as part of the accountability and assurances sought by Scottish Government during the Covid pandemic; these forums have been invaluable to oversee the quality and sustainability of provision in North Ayrshire and as such both groups now remain part of the core governance structure. These multi-disciplinary groups are made up of key clinical and care professionals who have a lead role in the oversight of care and support services based in the North Ayrshire area. The year past has seen our governance strengthened through the introduction of an operational subgroup of the CHOG to ensure quicker responses to operational issues affecting the care home sector. Carer’s Strategy 2023 to 2025 One of the responsibilities of the Carer’s (Scotland) Act 2016 is a duty for a local carer strategy and the establishment and maintenance of an information and advice service for carers resident or caring for someone in the local authority area. The Carer’s Strategy 2026 to 2029 "Together We Care" was endorsed by the Carers Champion Board in September 2025 and IJB in December 2025, with the four pillars Identify, Inform, Involve and Support being taken forward with the strategic partner, Unity Enterprise. Looking ahead (2026 to 29), priority areas include: • Extending service hours (for example 8am to 8pm) and enhancing hybrid engagement • Strengthening locality-based supports and therapy access • Expanding financial assistance and discount schemes • Deepening co-production through Carers Champion Boards and peer-led groups • Improving data systems for outcomes and impact measurement • Scaling mental health and wellbeing supports • Enhancing awareness campaigns and early identification pathways for all carers Children’s Services Plan 2023 to 2026 The Children’s Services Plan 2023 to 2026 was approved by the IJB in June 2023, and builds on the progress made since the previous Children’s Services Plan 2020 to 2023. The Children’s Services Plan is aligned to the Children’s Poverty Strategy and Action Plan and Children’s Rights Report, together forming the suite of children’s services planning documents. During 2025 to 2026, The Children’s Services Strategic Partnership agreed that a new style of Children and Families Plan for 2026 to 2029 would be developed to set out our collective strategic responsibility to promote the wellbeing, rights, and outcomes of babies, infants, children and young people and their families in North Ayrshire. This responsibility is underpinned by three key statutory duties, including:
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 44 • Children’s Services Planning: Every local authority and its Health Board must jointly prepare a Children’s Services Plan for each three-year period. • Child Poverty Reporting: The local authority and Health Board must jointly produce an annual Local Child Poverty Action Report. • Children’s Rights Compliance: Local authorities and Health Boards, as listed public authorities, must act in a way that is compatible with the UN Convention on the Rights of the Child (UNCRC) and embed children’s rights in their decision-making and service delivery. Recognising the links across these areas, we have aligned our planning and reporting, which will be supported by a shared set of child and family wellbeing actions and indicators. This streamlines processes, strengthens accountability, and will enable more effective targeting of resources to improve outcomes for babies, infants, children, young people, and families and aligns to our wider ambitions of strengthening whole family support. We are one of the Scottish Government’s ‘early adopter’ authorities, with that programme established to address the twin barriers of: i) policy complexity and overlap, and ii) funding and reporting approaches. The Children and Families Plan 2026 to 2029 will be presented to Cabinet and IJB for approval in September/ October 2026. Strategic Plan 2026 to 2030 Refresh NAHSCP has a clearly articulated and shared vision, set out in the Strategic Plan 2026 to 2030, which was formally refreshed following a statutory review of the previous ‘Caring Together 2022 to 2030 plan’. The IJB approved the refreshed Strategic Plan on 11 December 2025. The Partnership’s vision is: “To empower people in North Ayrshire to live safe, healthy and active lives with fair and equal access to sustainable health and care services.” This refreshed vision reflects extensive engagement with communities, service users, staff, third sector partners and statutory partners. The vision was updated following consultation in 2025 to place greater emphasis on empowerment, accessibility, inclusion and sustainability, responding directly to stakeholder feedback. The vision and values will be communicated and embedded through: • The Strategic Plan and associated Delivery Plan • Public IJB meetings and published papers • Partnership engagement activity and locality planning • Alignment with Community Planning Partnership priorities Participation and Engagement Strategy 2026 to 2030 North Ayrshire Health and Social Care Partnership (NAHSCP), working with its Community Planning partners, recognises that people and communities must be at the heart of decisions that
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 45 affect their everyday lives. Community bodies, as defined in the Community Empowerment (Scotland) Act 2015, are central to NAHSCP’s approach to strategic planning, service design and delivery. This commitment is set out clearly in the Partnership’s Participation and Engagement Strategy 26-30, which provides a structured, rights-based framework for meaningful and continuous engagement with communities across North Ayrshire. NAHSCP demonstrates early and meaningful engagement with communities to identify and understand local need and to inform decisions affecting service planning and delivery. Engagement is embedded as a core component of strategic and service-level activity, rather than as a one-off or retrospective exercise. The Participation and Engagement Strategy commit the Partnership to proportionate, ongoing engagement, aligned with national guidance including Planning with People and the National Standards for Community Engagement. Equality Outcomes Plan 2022 to 2025 / Equality Mainstreaming and Outcomes Reporting The Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012 places additional duties on Scottish public bodies to identify a set of equality outcomes to further the Public Sector Equality Duty for those that experience discrimination and disadvantage. The Equality Outcomes Plan for 2025 to 2029 was produced following an evaluation of the 2022– 25 Equality Outcomes, a review of national/local policy, extensive engagement (198 participants across 22 groups, plus earlier engagement), equalities data, and national learning. The Plan was approved by IJB in May 2025. An interim report on progress will be presented to Strategic Planning Group in June 2026. The previous Equality Outcomes Plan (2022 to 2025) ran for three years to align with North Ayrshire Council and the wider Ayrshire Equality Partnership. Transformation Plan 2024 to 2027 The HSCP Transformation Plan for 2024 to 2027 was approved by the IJB in March 2024. This is an ambitious programme of change which consists of a range of improvement and reform projects across all service areas, each aiming to improve the quality of service and contribute to the long- term sustainability of health and care in North Ayrshire. The Transformation Plan links closely to the high-level aspirations which are set out in the Strategic Plan and is mapped to one or more key drivers (savings/overspend reduction, investment, improving quality and safety, and national or local policy). The Transformation Plan will be overseen by the HSCP Transformation Board who will provide assurance on progress and effectiveness to the IJB. Updates on the Transformation Plan were reported to the IJB in August 2025 and March 2026. NAHSCP Learning and Development Strategy (Social Work and Social Care) 2023 to 2028 “Be the Best You Can Be” The Learning and Development Strategy, which was approved by the IJB in October 2023, consolidates the HSCP Offer of development opportunities and the need to ensure the workforce feels valued and supported in meaningful ways. The strategy takes cognisance of current and
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 46 ongoing workstreams and agendas in the HSCP. It also considers the professional and technical learning and development needs of the social work/care workforce operating within the HSCP. The Strategy is updated annually with a revised version launched each year in October and reflects any national and local emerging themes. The Key elements for consideration in implementing this strategy are: • Continuous Professional Learning (CPL) requirements of social work practitioners aligned to SSSC re -registration criteria • Known requirements related to care inspectorate inspections of services • Policy and procedural requirements/development and drivers relevant to social work practice both locally and nationally • Operational Service Plans • Service redesign, improvement, quality assurance and cultural activity. Membership of IJB There has been stability in the roles of Chair and Vice Chair throughout 2025 to 2026 and these positions rotated in May 2025 per the IJB Standing Orders. The Chair and Vice Chair of the Performance and Audit Committee rotated in 2025. Changes in legislation mean that, from September 2026, voting rights on the IJB will be extended to include unpaid carer, lived experience and third sector representatives. During 2025 to 2026, the following changes have been made to the membership of the IJB • In 2025, Linda Semple replaced Sharon Morrow as a new non-Executive NHS Ayrshire and Arran member of IJB. • Paul Smith, the Carer Representative, has since resigned, creating a vacancy for the carer representative. Chief Officers Eleanor Currie was appointed permanently to the Section 95 Officer position on 23 June 2025. Annual Performance Report The IJB endorsed the Annual Performance Report for 2024 to 2025 at the meeting in August 2025. This report outlined the performance of the Health and Social Care Partnership and how it delivered against the strategic priorities and the national outcomes. Quarterly performance reports are published on the Partnership’s website once they have been reviewed by the Performance and Audit Committee. This supports a commitment to make more performance information accessible and available for public scrutiny.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 47 Workforce Planning and Engagement The HSCP published its current Workforce Plan (2022 to 2025) in October 2022, in line with Scottish Government timescales. The Workforce Plan focusses on the five pillars of workforce planning identified by the Scottish Government. From these, the HSCP identified our own local workforce priorities that map directly to the five pillars. They are: • Understanding our workforce (PLAN). • Promoting our organisation (ATTRACT). • Investing in our people (TRAIN). • Building our Workforce (EMPLOY). • Growing our people (NURTURE). The two-year progress report was presented to Performance and Audit Committee in January 2025, where positive progress against the 31 actions within the plan were noted. Scottish Government requested a further update and a workforce return in March 2025 with a focus on reporting on areas of workforce importance including Agenda for Change Pay Reform, local demographic challenges, financial pressures, recruitment challenges, integration progress, hard to fill posts, recruitment and retention approaches and role diversification. Further guidance for IJBs on the next phase of workforce planning is awaited from Scottish Government. In March 2026, the Performance and Audit Committee approved the three-year progress report and evaluation of the 2022 to 2025 Workforce Plan. The report noted the following: • Overall, the HSCP workforce has increased over the three-year period, with staffing rising to 4108 in 2025, an overall increase of 482 staff since the start of the plan. The largest proportion of staff continue to sit within Health and Community Care services, which reflects the operational focus of the partnership. • Absence levels have increased slightly in the most recent year, while turnover has also seen a small increase compared with the previous year, although both remain broadly consistent with the trends observed across the three-year period. • While the increase in staffing has supported service capacity and delivery, the report recognises that ongoing workforce pressures and demographic changes mean that workforce sustainability will continue to be a key strategic focus going forward. Work will begin on a new Workforce Plan in early 2027 The annual iMatter Staff Experience survey took place in June 2025, providing all staff the opportunity to provide feedback on their experiences of working in the Health and Social Care Partnership. Overall iMatter seeks to measure how engaged staff are in the workplace. The response rate for the 2025 survey was 55% which is the lowest rate in the last 6 years, and a drop from the 58% response rate from the previous year. However, the HSCP reported a positive
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 48 engagement index of 79, a marginal reduction on the 81 in the previous year when it was the highest ever score. Pan Ayrshire Integration Work Work progresses including representatives from NHS Ayrshire and Arran and the three Ayrshire IJBs to make progress in the following areas: • Directions – a consistent approach to the format and issuing of directions is in place for decisions made by the IJB which impact on the service delivery of the Health Board and/or the Council. • Lead Partnership Services – Ayrshire Finance Leads have developed improved reporting on Lead Partnership service financial monitoring which is now incorporated into budget monitoring reports to the IJBs • Joint commissioning plan and set aside budgets – work is being taken forward around the development of a joint commissioning plan by colleagues from NHS Ayrshire and Arran and the three Ayrshire HSCPs. Alongside this, Finance Leads have developed a set aside model to determine the cost of large hospital services which are being used by each of the HSCPs. • Whole System Flow Improvement planning – through Scottish Government focus on the Operational Improvement Plan and associated funding Pan Ayrshire work to invest in services to support hospital flow commenced early 2025 to 2026, this work is ongoing with plans drafted to propose resource transfer from acute health settings to community services to enable further improvement. In addition, work has commenced locally to review the Integration Scheme, in close liaison with the other Ayrshire HSCPs in order to remain consistent and support the Health Board in working with all IJBs. A number of workstreams have been established, overseen by a programme board which is co-chaired by the chief executives of NHS Ayrshire and Arran and East Ayrshire Council. Further actions for 2026 to 2027 The IJB has identified the following actions for 2026 to 2027 that will assist with the further strengthening of corporate governance arrangements: • Develop commissioning plans and associated directions in relation to the acute set-aside resources. • Support the Local Authorities and NHS Board with the requirement for a Pan Ayrshire Review of the Integration Scheme(s). • Develop health and social care locality plans for each locality planning area to ensure a local community approach to identifying and addressing priorities. • Following the development of the MTFP for 2027 to 2028 onwards and the financial challenges anticipated, develop a robust approach to developing service plans and the transformation plan to ensure future financial and service sustainability.
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 49 • Given the scale of the financial challenges and volatility of capacity and demand across services, further refine financial monitoring arrangements and ensure robust governance, reporting and development of financial recovery plans where required. • Embed health and care governance arrangements, ensuring robust arrangements in place across all areas of service with appropriate escalations through formal governance forums, ensuring these reflect the new Health and Care Staffing Act requirements. • Build on the work of the Eligibility Criteria Programme Board to provide strategic oversight, assurance and direction for the implementation, governance and evaluation of the revised Eligibility Policy – Critical Only Access to Funded Adult Social Work and Social Care Services, as approved by the Integration Joint Board (IJB). • Support the Pan Ayrshire Transformation Board which has been established to focus on opportunities for joint working across the HSCP and Health Board – with a focus on Shared Services/Lead Agency, Right Care Right Place, Adults with Incapacity (AWI), Digital Transformation and Communications, ensuring all opportunities for improvement in North Ayrshire are maximised. • Following the regulations for voting rights on IJB which come into place in September 2026, with support of the IJB Monitoring Officer update Standing Orders, Code of Conduct and ensure the membership of the IJB is representative of the new legislative requirements. Assurance Subject to the above, and on the basis of the assurances provided, we consider the governance and internal control environment operating during 2025 to 2026 to provide reasonable and objective assurance that any significant risks impacting on the achievement of our actions will be identified and actions taken to avoid or mitigate their impact. Systems are in place to continually review and improve the governance and internal control environment and action plans are in place to address identified areas for improvement. The Annual Governance Statement explains how North Ayrshire IJB complies with the Code of Corporate Governance and meets the requirements of the CIPFA / SOLACE Framework ‘Delivering Good Governance in Local Government 2016’, as supplemented by the May 2025 addendum and the ‘Code of Practice for Local Authority Accounting in the UK: A Statement of Recommended Practice’, in relation to the Statement on the System of Internal Financial Control. The Annual Governance Statement was approved by the IJB Performance and Audit Committee on 26 June 2026. Caroline Cameron, Chief Officer, 25 September 2026 Joyce White, IJB Chair, 25 September 2026
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 50 Remuneration report This remuneration report is provided in accordance with the Local Authority Accounts (Scotland) Regulations 2014. It discloses information relating to the remuneration and pension benefits of specified IJB members and staff. The information in the tables below is subject to external audit. The explanatory text in the Remuneration Report is reviewed by the external auditor to ensure it is consistent with the financial statements. Remuneration: IJB Chair and Vice Chair The IJB comprises eight voting members appointed through nomination in equal numbers by NHS Ayrshire and Arran and North Ayrshire Council. A Chair and Vice Chair are appointed in accordance with the Integration Scheme and the Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Order 2014. As required in Article 4 of the Order the nomination of the IJB Chair and Vice Chair post holders alternates between a Council and Health Board representative, with the Vice Chair appointment by the constituent authority which did not appoint the Chair. 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 board member costs borne by the partner. There were no taxable expenses paid by the IJB. Therefore, no remuneration disclosures are provided for the Chair or Vice Chair. The IJB does not have responsibilities, either in the current year or in future years, for funding any pension entitlements of voting IJB members. Therefore, no pension rights disclosures are provided for the Chair or Vice Chair. Remuneration: Senior Officers of the IJB The IJB does not directly employ any staff in its own right, however specific post-holding officers are non-voting members of the Integration Joint Board. Chief Officer and Chief Finance Officer The appointment of an Integration Joint Board Chief Officer is required by section 10 of the Public Bodies (Joint Working) (Scotland) Act 2014 which includes the statement “an Integration Joint Board is to appoint, as a member of staff, a chief officer”. The Chief Officer for the IJB has to be appointed and the employing partner has to formally second the officer to the IJB. The employment contract for the Chief Officer adheres to the legislative and regulatory framework of the employing partner organisation. The remuneration terms of the Chief Officer’s employment are approved by the IJB. As the IJB is constituted as a Local Government body as set out by Section 106 of the Local Government (Scotland) Act 1973, it also requires to appoint an officer responsible for the proper administration of its financial affairs, the Chief Finance Officer (Section 95 Officer).
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 51 Other Officers No other staff are appointed by the IJB under a similar legal regime. Non-voting board members who meet the criteria for disclosure are included in the tables below. 2024 to 2025 Total Remuneration £ Name and Post Title 2025 to 2026 Salary, fees and allowances £ 2025 to 2026 Taxable Expenses £ 2025 to 2026 Total Remuneration £ 133,720 Caroline Cameron, Chief Officer 1 April 2025 to 31 March 2026 Employing organisation: North Ayrshire Council 139,069 0 139,069 81,807 Paul Doak Chief Finance Officer 1 April 2024 to 19 January 2025 Employing organisation: North Ayrshire Council 0 0 0 21,814 Eleanor Currie Chief Finance Officer Interim CFO post held until 23rd June 2025 and then employed on a permanent basis to 31 March 2026. Employing organisation: North Ayrshire Council 91,573 0 91,573 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 pensions liability reflected on the IJB balance sheet for the Chief Officer or any other officers. The IJB however has responsibility for funding the employer contributions for the current period in respect of the officer time spent on fulfilling the responsibilities of their role on the IJB. The following table shows the IJB’s funding during the period to support officers’ pension benefits. The
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 52 table also shows the total value of accrued pension benefits which may include benefits earned in other employment positions and from each officer’s own contributions. In Period pension contributions Officer 2024 to 2025 (£) 2025 to 2026 (£) Caroline Cameron, Chief Officer 7,777 7,783 Paul Doak, Chief Finance Officer 5,317 0 Eleanor Currie, Chief Finance Officer 1,314 5,952 Accrued pension benefits Officer Type of benefit 2024 to 2025 (£) 2025 to 2026 (£) Caroline Cameron, Chief Officer Pension 17,065 19,799 Caroline Cameron, Chief Officer Lump Sum 0 0 Paul Doak, Chief Finance Officer Pension 46,079 0 Paul Doak, Chief Finance Officer Lump Sum 71,734 0 Eleanor Currie, Interim Chief Finance Officer Pension 40,319 43,318 Eleanor Currie, Interim Chief Finance Officer Lump Sum 45,392 47,005 Disclosure by pay bands As required by the regulations, the following table shows the number of persons whose remuneration for the period was £50,000 or above, in bands of £5,000. Number of employees in band 2024 to 2025 Remuneration band Number of employees in band 2025 to 2026 0 £135,000 to £139,999 1 1 £130,000 to £134,999 0 0 £125,000 to £129,999 0
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 53 Number of employees in band 2024 to 2025 Remuneration band Number of employees in band 2025 to 2026 0 £95,000 to £99,999 0 0 £90,000 to £94,999 1 1 £80,000 to £84,999 0 Exit packages There were no exit packages during 2024 to 2025 or 2025 to 2026. Caroline Cameron, Chief Officer, 25 September 2026 Joyce White, IJB Chair, 25 September 2026
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 54 Financial statements The Comprehensive Income and Expenditure Statement shows the cost of providing services for the period according to accepted accounting practices. 2024 to 2025 Gross Exp £000 2024 to 2025 Gross Income £000 2024 to 2025 Net Exp £000 Area of Service 2025 to 2026 Gross Exp £000 2025 to 2026 Gross Income £000 2025 to 2026 Net Exp £000 98,181 0 98,181 Community Care and Health 102,643 0 102,643 38,208 0 38,208 Mental Health 41,192 0 41,192 45,634 0 45,634 Children’s Services and Criminal Justice 48,398 0 48,398 53,662 0 53,662 Primary Care 54,092 0 54,092 13,365 0 13,365 Management and Support Costs 10,849 0 10,849 10,749 0 10,749 Allied Health Professionals 12,657 0 12,657 120,555 0 120,555 Lead Partnership and Set Aside 129,083 0 129,083 1,725 0 1,725 Chief Social Work Officer 1,763 0 1,763 382,079 0 382,079 Cost of Services 400,677 0 400,677 0 (135,243) (135,243) North Ayrshire Council Funding 0 (142,673) (142,673) 0 (244,487) (244,487) NHS Ayrshire and Arran Funding 0 (257,665) (257,665) 0 (379,730) (379,730) Total Taxation And Non- Specific Grant Income (note 5) 0 (400,338) (400,338)
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 55 2024 to 2025 Gross Exp £000 2024 to 2025 Gross Income £000 2024 to 2025 Net Exp £000 Area of Service 2025 to 2026 Gross Exp £000 2025 to 2026 Gross Income £000 2025 to 2026 Net Exp £000 382,079 (379,730) 2,349 (Surplus) or Deficit on Provision of Services 400,677 (400,338) 339 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 financial statements. The Movement in Reserves Statement shows the movement in the period on the reserves held by the IJB. The movements which arise due to statutory adjustments which affect the General Fund balance are separately identified from the movements due to accounting practices. In 2025 to 2026 there were no statutory adjustments. Note 8 to the accounts provides more detail on the movement in reserves. Total Reserves 2024 to 2025 Movement in reserves General Fund – Debt to NAC 2025 to 2026 General Fund 2025 to 2026 Earmarked Reserves 2025 to 2026 Total Reserves 2025 to 2026 5,510 Opening balance as at 1 April 0 0 3,161 3,161 (2,349) Total Comprehensive Income and Expenditure 0 696 (1,035) (339) 0 Adjustments between accounting basis and funding basis under regulations 0 0 0 0
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North Ayrshire Integrated Joint Board Audited Annual Accounts to 31st March 2026 56 Total Reserves 2024 to 2025 Movement in reserves General Fund – Debt to NAC 2025 to 2026 General Fund 2025 to 2026 Earmarked Reserves 2025 to 2026 Total Reserves 2025 to 2026 (2,349) Increase\ (Decrease) in period 0 696 (1,035) (339) 3,161 Closing Balance as at 31 March 0 696 2,126 2,822 The Balance Sheet shows the value of the IJB’s assets and liabilities as at the balance sheet date. The net assets of the IJB (assets less liabilities) are matched by the reserves held by the IJB. 31 March 2025 £000 Balance Sheet Description Notes 31 March 2026 £000 3,161 Short Term Debtors 6 2,822 0 Long Term Creditors 7 0 3,161 Net Assets Not applicable 2,822 3,161 Usable Reserve: General Fund 8 2,822 3,161 Total Reserves Not applicable 2,822 The Statement of Accounts present a true and fair view of the financial position of the Integration Joint Board as at 31 March 2026 and its income and expenditure for the period then ended. The unaudited financial statements were authorised for issue on 26 June 2026. Eleanor Currie CPFA, Chief Finance Officer, 25 September 2026
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 57 Notes to the financial statements Note 1 – Significant Accounting Policies General principles The Financial Statements summarise the authority’s transactions for the 2025 to 2026 financial period and its position at the period-end as at 31 March 2026. The North Ayrshire 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. The Financial Statements are therefore prepared in compliance with the Code of Practice on Local Authority Accounting in the United Kingdom 2025 to 2026, supported by International Financial Reporting Standards (IFRS), unless legislation or statutory guidance requires different treatment. The accounts are prepared on the going concern basis, which provides that the entity will continue in operational existence for a minimum of 12 months from the date of these accounts. In accordance with the Code, the going concern concept will apply as there is the assumed continuation of service provision into the future. The historical cost convention has been adopted. Accruals of expenditure and income Activity is accounted for in the period that it takes place, not simply when cash payments are made or received. 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 down. For the Integration Joint Board financial statements, a debtor and/or creditor will be recorded where the partner contributions differ from the actual net expenditure in period, this allows any surplus or deficit on the provision of services to be transferred to the reserves held by the Integration Joint Board. Funding The IJB is primarily funded through contributions from the statutory funding partners, North Ayrshire Council and NHS Ayrshire and Arran. 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 Ayrshire.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 58 Cash and cash equivalents The IJB does not operate a bank account or hold cash. Transactions are settled on behalf of the IJB by the funding partners. Consequently, the IJB does not present a ‘Cash and Cash Equivalent’ figure on the balance sheet. The funding balance due to or from each funding partner as at 31 March is represented as a debtor or creditor on the IJB’s Balance Sheet. Employee benefits The IJB does not directly employ staff. Staff are 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 and a Chief Finance Officer. More details on the arrangements are provided in the Remuneration Report. The charges from the employing partner are treated as employee costs. Where material the Chief Officer’s and Chief Finance Officer’s absence entitlement at 31 March is accrued, for example in relation to annual leave earned but not yet taken. 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 as at 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 Comprehensive Income and Expenditure Statement 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. Reserves The Integration Joint Board’s reserves are classified as either Usable or Unusable Reserves. The IJB’s only Usable Reserve is the General Fund. The balance of the General Fund as at 31 March shows the extent of resources which the IJB can use in later years to support service provision. Indemnity insurance The IJB has indemnity insurance for costs relating primarily to potential claim liabilities regarding Board member and officer responsibilities. NHS Ayrshire and Arran and North Ayrshire Council have responsibility for claims in respect of the services that they are statutorily responsible for and that they provide. Unlike NHS Ayrshire and Arran, the IJB does not have any ‘shared risk’ exposure from participation in CNORIS (Clinical Negligence and Other Risks Indemnity Scheme). The IJB participation in the CNORIS scheme is therefore equivalent to normal insurance arrangements.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 59 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’s 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. VAT Status The IJB is a non-taxable body and does not charge or recover VAT on its functions. Note 2 – Critical Judgements and Estimation Uncertainty The critical judgements include: • On behalf of all IJBs within the NHS Ayrshire and Arran area, the IJB acts as the lead partner for Mental Health Services. It commissions services on behalf of the three Ayrshire IJBs and reclaims the costs involved. This arrangement is treated as an agency arrangement. In the absence of an alternative agreement or approach being outlined in the Integration Scheme, the recharges across the partnerships for lead services are based on an NRAC share of costs, this may not reflect the actual cost of delivering services to the population in the three areas. • In applying the accounting policies, the IJB has had to make a critical judgement relating to the values included for Set Aside services. The Set Aside figure included in the IJB accounts is the baseline of 2024 to 25 bed days at 2025 to 26 prices as the 2025 to 26 actual usage is not known until after the date of accounts signing. As such, the Set Aside sum included in the accounts will not reflect the true cost of actual hospital usage in 2025 to 26. There are no material estimation uncertainties included within the Financial Statements. Note 3 – Events after the Reporting Period The audited annual financial statements will be authorised for issue by the Chief Finance Officer on 1 October 2026. Events taking place after this date are not reflected in the financial statements or notes. Events after the Balance Sheet date are those events, both favourable and unfavourable, that occur between the end of the reporting period and the date when the Annual Accounts are authorised for issue. Two types of events can be identified: • Those that provide evidence of conditions that existed at the end of the reporting period - the financial statements are adjusted to reflect such events. • Those that are indicative of conditions that arose after the reporting period – the financial statements are not adjusted to reflect for such events, but where a category of events would have a material impact disclosure is made in the notes of the nature of the events and their estimated financial effect. There are no such events to report for 2025 to 2026.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 60 Note 4 - Expenditure and Income Analysis by Nature 2024 to 2025 £000s Description 2025 to 2026 £000s 163,908 Services commissioned from North Ayrshire Council 170,836 218,137 Services commissioned from NHS Ayrshire and Arran 229,806 34 Auditor Fee: External Audit Work 35 (379,730) Partners Funding Contributions and Non-Specific Grant Income (400,338) 2,349 (Surplus) / deficit on the Provision of Services 339 Note 5 - Taxation and Non-Specific Grant Income 2024 to 2025 £000’s Description 2025 to 2026 £000’s (135,243) Funding Contribution from North Ayrshire Council (142,673) (244,487) Funding Contribution from NHS Ayrshire and Arran (257,665) (379,730) Taxation and Non-specific Grant Income (400,338) The funding contributions from the partners shown above exclude any funding which is ring-fenced for the provision of specific services. Such ring-fenced funding is presented as income in the Cost of Services in the Comprehensive Income and Expenditure Statement. There was no ring-fenced funding in 2024 to 2025 or 2025 to 2026. The funding contribution from NHS Ayrshire and Arran shown above includes £41.833million (2024 to 2025 £39.966million) in respect of ‘set aside’ resources relating to acute hospital and other resources. These are provided by the NHS which retains responsibility for managing the costs of providing the services. The IJB however has responsibility for the consumption of, and level of demand placed on, these resources.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 61 Note 6 - Debtors 31 March 2025 £000’s Description 31 March 2026 £000’s 3,161 North Ayrshire Council 2,585 0 NHS Ayrshire and Arran 237 3,161 Total Debtors 2,822 Amounts due from to the funding partners are stated on a net basis. Debtor and Creditor balances recognised by the funding partners but not yet settled in cash terms are offset against the funds they are holding on behalf of the Integration Joint Board. Note 7 - Creditors 31 March 2025 £000’s Description 31 March 2026 £000’s 0 North Ayrshire Council 0 0 NHS Ayrshire and Arran 0 0 Total Creditors 0 Note 8 – Usable Reserve: General Fund The IJB holds a balance on the General Fund which will normally comprise one of three elements: • As a working balance to help cushion the impact of uneven cash flows. • As a contingency to manage the impact of unexpected events or emergencies. • As a means of building up funds, often referred to as earmarked reserve, to meet known or predicted liabilities.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 62 The table below shows the movements on the General Fund balance, analysed between those elements earmarked for specific planned expenditure and the amount held in unallocated reserves. The unearmarked reserves of £0.696million represents 0.2% of the 2025 to 2026 budget which is below the recommended reserve level of 2-4% of the budget (£6.88million to £13.76m). It is acknowledged that uncommitted reserves require to be restored to the minimum recommended level. However, in the short-term, service pressures mean that this would not be achievable without implementing further reductions in service delivery that would impact on the levels of care provided and increase the levels of risk for service users. Transfers Out 2024 to 2025 Transfers In 2024 to 2025 Balance at 31 March 2025 Area of Reserves Transfers Out 2025 to 2026 Transfers In 2025 to 2026 Balance at 31 March 2026 Earmarked Funds (641) 353 353 Alcohol and Drug Partnership (353) 147 147 (57) 135 135 Mental Health Action 15 (135) 0 0 0 46 46 Primary Care Improvement Fund (46) 183 183 (994) 0 780 Service Redesign / Challenge Fund (459) 0 321 (377) 0 0 Community Living Change Fund 0 0 0 (1,313) 934 934 Family Wellbeing Fund (934) 906 906 0 0 0 Telecare / community alarms 0 180 180 0 0 0 Magic Notes 0 88 88 0 0 0 Adult Social Work Restructure resource 0 38 38 (50) 0 0 Wellbeing Fund 0 0 0 (26) 36 36 Breast Feeding Network (36) 0 0 (546) 365 365 MH Recovery and Renewal (365) 0 0 (23) 0 0 Buvidal 0 0 0 0 82 82 LD – Coming Home (82) 212 212
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 63 Transfers Out 2024 to 2025 Transfers In 2024 to 2025 Balance at 31 March 2025 Area of Reserves Transfers Out 2025 to 2026 Transfers In 2025 to 2026 Balance at 31 March 2026 0 92 92 Early Intervention in Psychosis (92) 51 51 (5) 0 0 Brooksby 0 0 0 0 1 1 Donation – Police Scotland (1) 0 0 (4) 0 0 Cossette Funding 0 0 0 (55) 0 0 Expansion of Primary Care Estates 0 0 0 (63) 3 3 GP Premises Improvements - tranches 1 and 2 (3) 0 0 (81) 0 0 Mental Health Wellbeing in Primary Care 0 0 0 0 303 303 Primary Care Improvement Plan (303) 0 0 (29) 29 29 Dental Practice Improvement (29) 0 0 (2) 2 2 Appropriate Adult Scheme (2) 0 0 (19) 0 0 Adult Tier 3 Weight Management Service 0 0 0 (22) 0 0 Phlebotomy 0 0 0 (66) 0 0 LD Health Checks 0 0 0 (4,373) 2,381 3,161 Total Earmarked (2,840) 1,805 2,126 (357) 0 0 Unallocated General Fund 0 696 696 (4,730) 2,381 3,161 General Fund (2,840) 2,501 2,822 Note 9 – Agency Income and Expenditure On behalf of all IJBs within the NHS Ayrshire and Arran area, the IJB acts as the lead manager for Mental Health Services. It commissions services on behalf of the other IJBs and reclaims the costs involved. The payments that are made on behalf of the other IJBs, and the consequential
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 64 reimbursement, are not included in the Comprehensive Income and Expenditure Statement (CIES) since the IJB is not acting as principal in these transactions. The amount of expenditure and income relating to the agency arrangement is shown below. 2024 to 2025 £000 Description 2025 to 2026 £000 43,932 Expenditure on Agency Service – Lead Partnership 46,001 43,932 Total agency expenditure 46,001 43,932 Reimbursement for Agency Service – Lead Partnership 46,001 43,932 Total agency income 46,001 0 Net Agency Expenditure Excluded from the CIES 0 Note 10 – Related Party Transactions The IJB has related party relationships with NHS Ayrshire and Arran and North Ayrshire Council. In particular the nature of the partnership means that the IJB may influence, and be influenced by, its partners. The following transactions and balances included in the IJB’s financial statements are presented to provide additional information on the relationships. Transactions with NHS Ayrshire and Arran 2024 to 2025 £000 Transactions with NHS Ayrshire and Arran 2025 to 2026 £000 (244,487) Funding Contributions received from NHS Board (257,665) 0 Service Income received from NHS Board 0 218,087 Expenditure on Services Provided by NHS Board 229,754
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 65 2024 to 2025 £000 Transactions with NHS Ayrshire and Arran 2025 to 2026 £000 67 Key Management Personnel: Non-Voting Board Members 70 0 Support Services 0 (26,333) Net Transactions with NHS Board (27,841) Balances with NHS Ayrshire and Arran 31 March 2025 £000 Balances with NHS Ayrshire and Arran 31 March 2026 £000 147 Debtor Balances: Amounts due from NHS Board 237 0 Creditor Balances: Amounts due to NHS Board 0 147 Net Balances with NHS Board 237 Transactions with North Ayrshire Council 2024 to 2025 £000 Transactions with North Ayrshire Council 2025 to 2026 £000 (135,243) Funding Contributions received from the Council (142,673) 0 Service Income received from the Council 0 163,858 Expenditure on Services Provided by the Council 170,783 67 Key Management Personnel: Non-Voting Board Members 70 0 Support Services 0
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 66 2024 to 2025 £000 Transactions with North Ayrshire Council 2025 to 2026 £000 28,682 Net Transactions with the Council 28,180 Balances with North Ayrshire Council 31 March 2025 £000 Balances with North Ayrshire Council 31 March 2026 £000 3,161 Debtor Balances: Amounts due from the Council 2,585 0 Creditor Balances: Amounts due to the Council 0 3,161 Net Balances with the Council 2,585 There are key management personnel employed by NHS Ayrshire and Arran and North Ayrshire Council; these costs are included in the expenditure on services provided. The non-voting Board members employed by the Council and Health Board include the Chief Officer, Chief Finance Officer, Chief Social Work Officer, representatives of primary care, nursing and non-primary care services, and a staff representative. Details of the remuneration for some specific post-holders is provided in the Remuneration Report. Support services were not delegated to the Integration Joint Board through the Integration Scheme and are instead provided by NHS Ayrshire and Arran and North Ayrshire Council free of charge as ‘services in kind.’ These include services such as financial management, human resources, legal services, committee services, ICT, payroll, internal audit and accommodation. Note 11 – VAT VAT payable is included as an expense only to the extent that it is not recoverable from Her Majesty’s Revenue and Customs. VAT receivable is excluded from income. The VAT treatment of expenditure in the IJB’s financial statements depends on which of the partner agencies is providing the service as these agencies are treated differently for VAT purposes. Where the Council is the provider, income and expenditure excludes any amounts related to VAT, as all VAT collected is payable to H.M. Revenue and Customs and all VAT paid is recoverable from it. The Council is not entitled to fully recover VAT paid on a very limited number of items of expenditure and for these items the cost of VAT paid is included within service expenditure to the extent that it is irrecoverable from H.M. Revenue and Customs.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 67 Where the NHS is the provider, expenditure incurred will include irrecoverable VAT as generally the NHS cannot recover VAT paid as input tax and will seek to recover its full cost as income from the Commissioning IJB. Note 12 – Accounting Standards Issued Not Yet Adopted The Code requires the disclosure of information about accounting changes that will be required by new accounting standards that have been issued, but not yet adopted. At the date of authorisation of these financial statements, the IJB has not applied the following new and revised IFRS Standards that have been issued, but are not yet effective: Amendments to FRS 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (Amendments to Heritage assets) issued in March 2024. The amendments provide further guidance on how to determine whether an asset meets the definition of a heritage asset and the requirements for leases of heritage assets. Amendments to the Classification and Measurement of Financial Instruments (Amendments to IFRS 9 and IFRS 7) issued in May 2024. The amendments relate to settling financial liabilities using an electronic payment system and assessing contractual cash flow characteristics of financial assets. Annual improvements to IFRS accounting standards – Volume 11 issued in July 2024. These include amendments to IFRS 1 First time adoption of IFRS, IFRS7 and IFRS9 Financial Instrument disclosures, IFRS Consolidated Financial Statements and IAS17 Statement of Cash Flows. Contracts Referencing Nature-dependent Electricity (Amendments to IFRS 9 and IFRS 7) issued in December 2024. This amendment is intended to enable better reporting of the effects of nature-dependent electricity contracts. Adoption of the Standards listed above will not impact on the 2025 to 2026 Annual Accounts and it is not anticipated that the adoption of the applicable Standards will have a material impact on the financial statements in future periods.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 68 Glossary of Terms While the terminology used in this report is intended to be self-explanatory, it may be useful to provide additional definition and interpretation of the terms used. Accounting Period The period of time covered by the Accounts normally a period of twelve months commencing on 1 April each year. The end of the accounting period is the Balance Sheet date. Accruals The concept that income and expenditure are recognised as they are earned or incurred not as money is received or paid. Balance Sheet A statement of the recorded assets, liabilities and other balances at the end of the accounting period. CIPFA The Chartered Institute of Public Finance and Accountancy. Consistency The concept that the accounting treatment of like terms within an accounting period and from one period to the next is the same. CNORIS The Clinical Negligence and Other Risks Indemnity Scheme COSLA Convention of Scottish Local Authorities Creditor Amounts owed by the IJB for work done, goods received or services rendered within the accounting period, but for which payment has not been made by the end of that accounting period. Debtor Amount owed to the IJB for works done, goods received, or services rendered within the accounting period, but for which payment has not been received by the end of that accounting period.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 69 Entity A body corporate, partnership, trust, unincorporated association or statutory body that is delivering a service or carrying on a trade or business with or without a view to profit. It should have a separate legal personality and is legally required to prepare its own single entity accounts. IFRS International Financial Reporting Standards. ISA International Standard on Auditing ISD Information Services Division Scotland LASAAC Local Authority (Scotland) Accounts Advisory Committee Liability A liability is where the IJB owes payment to an individual or another organisation. A current liability is an amount which will become payable or could be called in within the next accounting period, for example creditors or cash overdrawn. A non-current liability is an amount which by arrangement is payable beyond the next year at some point in the future or will be paid off by an annual sum over a period of time. NRAC NHS Scotland Resource Allocation Committee (Scottish NHS resource allocation formula) Post Balance Sheet Events Post Balance Sheet events are those events, favourable or unfavourable, that occur between the Balance Sheet date and the date when the Annual Accounts are authorised for issue. Provisions An amount put aside in the accounts for future liabilities or losses which are certain or very likely to occur but the amounts or dates of when they will arise are uncertain. Related Parties Bodies or individuals that have the potential to control or influence the IJB or to be controlled or influenced by the IJB. For the IJB’s purposes, related parties are deemed to include voting members, the Chief Officer and their close family and household members.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 70 Remuneration All sums paid to or receivable by an employee and sums due by way of expenses allowances (as far as these sums are chargeable to UK income tax) and the monetary value of any other benefits received other than in cash. Reserves The accumulation of surpluses, deficits and appropriation over past years. Reserves of a revenue nature are available and can be spent or earmarked at the discretion of the IJB. Revenue Expenditure The day-to-day expenses of providing services. Significant Interest The reporting authority is actively involved and is influential in the direction of an entity through its participation in policy decisions.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 71 Independent Auditor’s Report Appendix A: Proposed Independent Auditor’s Report Independent auditor’s report to the members of North Ayrshire Integration Joint Board and the Accounts Commission Reporting on the audit of the financial statements Opinion on financial statements I certify that I have audited the financial statements in the annual accounts of North Ayrshire Integration Joint Board for the year ended 31 March 2026 under Part VII of the Local Government (Scotland) Act 1973. The financial statements comprise the Comprehensive Income and Expenditure Statement, Movement in Reserves Statement, Balance Sheet and notes to the financial statements, including material accounting policy information. The financial reporting framework that has been applied in their preparation is applicable law and UK adopted international accounting standards, as interpreted and adapted by the Code of Practice on Local Authority Accounting in the United Kingdom 2025/26 (the 2025/26 Code). In my opinion the accompanying financial statements: • give a true and fair view of the state of affairs of the North Ayrshire Integration Joint Board as at 31 March 2026 and of its income and expenditure for the year then ended; • have been properly prepared in accordance with UK adopted international accounting standards, as interpreted and adapted by the 2025/26 Code; and • have been prepared in accordance with the requirements of the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014, and the Local Government in Scotland Act 2003. Basis for opinion I conducted my audit in accordance with applicable law and International Standards on Auditing (UK) (ISAs (UK)), as required by the Code of Audit Practice approved by the Accounts Commission for Scotland. My responsibilities under those standards are further described in the auditor’s responsibilities for the audit of the financial statements section of my report. I was appointed by the Accounts Commission on 1 June 2026. My period of appointment is two years, covering 2025/26 and 2026/27. I am independent of the North Ayrshire Integration Joint Board in accordance with the ethical requirements that are relevant to my audit of the financial statements in the UK including the Financial Reporting Council’s Ethical Standard, and I have fulfilled my other ethical responsibilities in accordance with these requirements. Non-audit services prohibited by the Ethical Standard were not provided to the North Ayrshire Integration Joint Board. I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my opinion.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 72 Conclusions relating to going concern basis of accounting I have concluded that the use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Based on the work I have performed, I have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the North Ayrshire Integration Joint Board’s ability to continue to adopt the going concern basis of accounting for a period of at least twelve months from when the financial statements are authorised for issue. These conclusions are not intended to, nor do they, provide assurance on the North Ayrshire Integration Joint Board’s current or future financial sustainability. However, I report on the North Ayrshire Integration Joint Board’s arrangements for financial sustainability in a separate Annual Audit Report available from the Audit Scotland website. Risks of material misstatement I report in my Annual Audit Report the most significant assessed risks of material misstatement that I identified and my judgements thereon. Responsibilities of the Chief Finance Officer and North Ayrshire Integration Joint Board for the financial statements As explained more fully in the Statement of Responsibilities, the Chief Finance Officer is responsible for the preparation of financial statements that give a true and fair view in accordance with the financial reporting framework, and for such internal control as the Chief Finance Officer determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the Chief Finance Officer is responsible for assessing the North Ayrshire Integration Joint Board’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless there is an intention to discontinue the North Ayrshire Integration Joint Board’s operations. The North Ayrshire Integration Joint Board is responsible for overseeing the financial reporting process. Auditor’s responsibilities for the audit of the financial statements My objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes my opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the decisions of users taken on the basis of these financial statements. Irregularities, including fraud, are instances of non-compliance with laws and regulations. I design procedures in line with my responsibilities outlined above to detect material misstatements in respect of irregularities, including fraud. Procedures include:
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 73 • using my understanding of the local government sector to identify that the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014, and the Local Government in Scotland Act 2003 are significant in the context of the North Ayrshire Integration Joint Board; • inquiring of the Chief Finance Officer as to other laws or regulations that may be expected to have a fundamental effect on the operations of the North Ayrshire Integration Joint Board; • inquiring of the Chief Finance Officer concerning the North Ayrshire Integration Joint Board’s policies and procedures regarding compliance with the applicable legal and regulatory framework; • discussions among my audit team on the susceptibility of the financial statements to material misstatement, including how fraud might occur; and • considering whether the audit team collectively has the appropriate competence and capabilities to identify or recognise non-compliance with laws and regulations. The extent to which my procedures are capable of detecting irregularities, including fraud, is affected by the inherent difficulty in detecting irregularities, the effectiveness of the North Ayrshire Integration Joint Board’s controls, and the nature, timing and extent of the audit procedures performed. Irregularities that result from fraud are inherently more difficult to detect than irregularities that result from error as fraud may involve collusion, intentional omissions, misrepresentations, or the override of internal control. The capability of the audit to detect fraud and other irregularities depends on factors such as the skilfulness of the perpetrator, the frequency and extent of manipulation, the degree of collusion involved, the relative size of individual amounts manipulated, and the seniority of those individuals involved. A further description of the auditor’s responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website www.frc.org.uk/auditorsresponsibilities. This description forms part of my auditor’s report. Reporting on other requirements Opinion prescribed by the Accounts Commission on the audited parts of the Remuneration Report I have audited the parts of the Remuneration Report described as audited. In my opinion, the audited parts of the Remuneration Report have been properly prepared in accordance with The Local Authority Accounts (Scotland) Regulations 2014. Other information The Chief Finance Officer is responsible for the other information in the annual accounts. The other information comprises the Management Commentary, Statement of Responsibilities, Annual Governance Statement and the unaudited part of the Remuneration Report.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 74 My responsibility is to read all the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or my knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If I identify such material inconsistencies or apparent material misstatements, I am required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work I have performed, I conclude that there is a material misstatement of this other information, I am required to report that fact. I have nothing to report in this regard. My opinion on the financial statements does not cover the other information and I do not express any form of assurance conclusion thereon except on the Management Commentary and Annual Governance Statement to the extent explicitly stated in the following opinions prescribed by the Accounts Commission. Opinions prescribed by the Accounts Commission on the Management Commentary and Annual Governance Statement In my opinion, based on the work undertaken in the course of the audit: • the information given in the Management Commentary for the financial year for which the financial statements are prepared is consistent with the financial statements and that report has been prepared in accordance with statutory guidance issued under the Local Government in Scotland Act 2003; and • the information given in the Annual Governance Statement for the financial year for which the financial statements are prepared is consistent with the financial statements and that report has been prepared in accordance with the Delivering Good Governance in Local Government: Framework (2016). Matters on which I am required to report by exception I am required by the Accounts Commission to report to you if, in my opinion: • adequate accounting records have not been kept; or • the financial statements and the audited part of the Remuneration Report are not in agreement with the accounting records; or • I have not received all the information and explanations I require for my audit. I have nothing to report in respect of these matters. Conclusions on wider scope responsibilities In addition to my responsibilities for the annual accounts, my conclusions on the wider scope responsibilities specified in the Code of Audit Practice, including those in respect of Best Value, are set out in my Annual Audit Report.
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 75 Use of my report This report is made solely to the parties to whom it is addressed in accordance with Part VII of the Local Government (Scotland) Act 1973 and for no other purpose. In accordance with paragraph 108 of the Code of Audit Practice, I do not undertake to have responsibilities to members or officers, in their individual capacities, or to third parties. Louisa Yule, Audit Director Audit Scotland 4th Floor, The Athenaeum Building 8 Nelson Mandela Place Glasgow G2 1BT
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North Ayrshire Integrated Joint Board Unaudited Annual Accounts to 31st March 2026 76 This document is available in other formats such as audio tape, CDF, braille and in large print. It can also be made available in other languages on request. All of our publications are available in different languages, larger print, braille (English only), audio tape or another format of your choice. Comments or questions about this document, including request for support information or documentation, should be made by email to annualaccountsNAHSCP@north-ayrshire.co.uk Follow us on Twitter @NAHSCP For more information, visit the North Ayrshire Health and Social Care Partnership website.
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Appendix B: Letter of Representations (ISA (UK) 580) 25 September 2026 Louisa Yule, Audit Director Audit Scotland 8 Nelson Mandela Place Glasgow G2 1BT North Ayrshire Integration Joint Board Annual accounts 2025/26 Dear Louisa This representation letter is provided in connection with your audit of the annual accounts of North Ayrshire Integration Joint Board, hereafter referred to as "the IJB", for the year ended 31 March 2026 for the purpose of expressing an opinion as to whether the financial statements give a true and fair view and have been properly prepared, and for expressing other opinions on the Remuneration Report, Management Commentary, and Annual Governance Statement. I confirm to the best of my knowledge and belief, and having made such enquiries as I considered necessary, the following representations given to you in connection with your audit of the IJB's annual accounts for the year ended 31 March 2026. General I have fulfilled my responsibilities for the preparation of the 2025/26 annual accounts as set out in your 2025/26 Annual Audit Plan. All the accounting records, documentation, and other matters which I am aware are relevant to the preparation of the annual accounts have been made available to you for the purposes of your audit. All transactions undertaken by the IJB have been recorded in the accounting records and are properly reflected in the financial statements. I confirm that the effects of uncorrected misstatements are immaterial, individually and in aggregate, to the financial statements as a whole. As you have reported, there are no uncorrected misstatements.
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Financial Reporting Framework The annual accounts have been prepared in accordance with the Code of Practice on Local Authority Accounting in the United Kingdom 2025/26 (2025/26 Code), mandatory guidance from LASAAC, and the requirements of the Local Government (Scotland) Act 1973, the Local Government in Scotland Act 2003, and the Local Authority Accounts (Scotland) Regulations 2014. In accordance with the Local Authority Accounts (Scotland) Regulations 2014, I have ensured that the financial statements give a true and fair view of the financial position of the IJB at 31 March 2026 and the transactions for 2025/26. Accounting Policies and Estimates All material accounting policies applied are as shown in the note included in the financial statements. The accounting policies are determined by the 2025/26 Code, where applicable. Where the 2025/26 Code does not specifically apply, I have used judgement in developing and applying an accounting policy that results in information that is relevant and reliable. All accounting policies applied are appropriate to the IJB's circumstances and have been consistently applied. The methodology, significant assumptions, and data used in making accounting estimates are reasonable, and have been properly reflected and disclosed in the financial statements in accordance with the 2025/26 Code. Judgements made in making estimates have been based on the latest available and reliable information. Estimates have been revised where there are changes in the circumstances on which the original estimate was based or as a result of new information or experience. Going Concern Basis of Accounting I have assessed the IJB's ability to continue to use the going concern basis of accounting and have concluded that it is appropriate. I am not aware of any material uncertainties that may cast significant doubt on the IJB's ability to continue to adopt the going concern basis of accounting. Assets All assets at 31 March 2026 of which I am aware have been reported in the financial statements.
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Liabilities All liabilities at 31 March 2026 of which I am aware have been reported in the financial statements. Litigation and Claims All known actual or possible legal claims have been disclosed to you and have been accounted for and disclosed in the financial statements in accordance with the 2025/26 Code. Fraud I understand my responsibilities for the design, implementation, and maintenance of internal control to prevent fraud and I believe I have appropriately fulfilled those responsibilities. I have provided you with all information in relation to: my assessment of the risk that the financial statements may be materially misstated as a result of fraud, any allegations of fraud or suspected fraud affecting the financial statements, and fraud or suspected fraud that I am aware of involving management, employees who have a significant role in internal control, or others that could have a material effect on the financial statements. Laws and Regulations I have disclosed to you all known instances of non-compliance or suspected non-compliance with laws and regulations whose effects should be considered when preparing financial statements. Related Party Transactions All material transactions with related parties have been appropriately accounted for and disclosed in the financial statements in accordance with IAS 24, as adopted by the 2025/26 Code. I have made available to you the identity of all of the IJB's related parties and all the related party transactions of which I am aware.
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Remuneration Report The Remuneration Report has been prepared in accordance with the Local Authority Accounts (Scotland) Regulations 2014, and all required information of which I am aware has been provided to you. Management Commentary I confirm that the Management Commentary has been prepared in accordance with statutory guidance, and the information is consistent with the financial statements. Corporate Governance I confirm the IJB has undertaken a review of the system of internal control during 2025/26 to establish the extent to which it complies with proper practices set out in Delivering Good Governance in Local Government: Framework 2016. I have disclosed to you all deficiencies in internal control identified from this review or of which I am otherwise aware. I confirm that the Annual Governance Statement has been prepared in accordance with the Delivering Good Governance in Local Government: Framework 2016 and the information is consistent with the financial statements. There have been no changes in the corporate governance arrangements, or issues identified, since 31 March 2026 which require to be reflected in the Annual Governance Statement or annual accounts. Events Subsequent to the Date of the Balance Sheet All events subsequent to 31 March 2026 for which IAS 10, as adopted by the 2025/26 Code, requires adjustment or disclosure have been adjusted or disclosed. Yours sincerely Eleanor Currie Section 95 Officer
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North Ayrshire Integration Joint Board 2025/26 Annual Audit Report Prepared for North Ayrshire Integration Joint Board and the Controller of Audit September 2026
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North Ayrshire Integration Joint Board: 2025/26 Annual Audit Report | 2 Contents Summary of audit opinions and conclusions 3 Introduction 5 Audit scope, responsibilities, and fee 6 Audit of the annual accounts 8 Wider scope and Best Value audit 12 Appendix 1 28 Appendix 2 34 Accessibility You can find out more and read this report using assistive technology on our website www.audit.scot/accessibility.
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Summary of audit opinions and conclusions | 3 Summary of audit opinions and conclusions Audit of the annual accounts 1 All audit opinions stated that the annual accounts were free from material misstatement. 2 There were no significant findings or key audit matters to report. All audit adjustments required to correct the financial statements were processed by North Ayrshire Integration Joint Board (NAIJB). Wider scope and Best Value audit 3 NAIJB has effective and appropriate arrangements in place for Financial Management; Financial Sustainability; Vision, Leadership and Governance; and Use of Resources to Improve Outcomes. 4 The IJB has effective and appropriate arrangements in place for securing Best Value. 5 The IJB reported a year end underspend position of £2.501 million. £1.805 million was contributed to earmarked reserves in year which has resulted in the IJB having £2.822 million of total reserves. However, only £0.696 million of this balance is not earmarked for specific purposes and this falls below the aspirational targets set out in reserves strategy. 6 Following consultation with stakeholders, the IJB approved a change to the threshold for the funding of adult social care support to critical only. This decision was made to support the IJB to operate within its available financial resources. 7 The 2026/27 budget includes savings proposals of £2.816 million and a further £5.828 million in savings relating to the eligibility criteria for Social Care Services. The IJB recognise that their transformation plan continues to support a programme of change.
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Summary of audit opinions and conclusions | 4 8 The Strategic Plan 2026-30 sets out the vision, values and strategic priorities of the IJB. 9 Performance management arrangements are effective, with regular Partnership Performance reports presented to the Audit and Performance Committee. The 2025/26 Annual Performance report outlined that 73% of the 18 National Indicators were either achieved or performing above their target.
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Introduction | 5 Introduction Purpose of the Annual Audit Report 1. The purpose of this Annual Audit Report is to report the significant matters identified from the 2025/26 audit of North Ayrshire Integration Joint Board annual accounts and the wider scope areas specified in the Code of Audit Practice (2021). 2. The Annual Audit Report is addressed to North Ayrshire Integration Joint Board, hereafter referred to as ‘the IJB’ and the Controller of Audit and will be published on Audit Scotland’s website in due course. Appointed auditor and independence 3. Louisa Yule, of Audit Scotland, has been appointed as external auditor of the IJB for the period from 2025/26 until 2026/27. Louisa Yule and the audit team are independent of the IJB in accordance with relevant ethical requirements, including the Financial Reporting Council’s Ethical Standard. There have been no developments since the issue of the Annual Audit Plan that impact on the continued independence of the engagement lead or the rest of the audit team from the IJB, including no provision of non-audit services. Acknowledgements 4. We would like to thank the Performance and Audit Committee members, Joint Board members, senior management and other staff, particularly those involved in preparation of the annual accounts, for their cooperation and assistance during the audit. We look forward to working together constructively over the remainder of the five-year audit appointment.
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Audit scope, responsibilities, and fee | 6 Audit scope, responsibilities, and fee Scope of the audit 5. The audit is performed in accordance with the Code of Audit Practice, including supplementary guidance, International Standards on Auditing (ISA) (UK), and relevant legislation. These set out the requirements for the scope of the audit which includes: • An audit of the financial statements and an opinion on whether they give a true and fair view and are free from material misstatement. • An opinion on statutory other information published with the financial statements in the annual accounts, namely the Management Commentary and Annual Governance Statement. • An opinion on the audited part of the Remuneration Report. • Conclusions on the IJB’s arrangements in relation to the wider scope areas: Financial Management; Financial Sustainability; Vision, Leadership and Governance; and Use of Resources to Improve Outcomes. • Reporting on the IJB’s arrangements for securing Best Value. • Provision of this Annual Audit Report. Responsibilities and reporting 6. The Code of Audit Practice sets out the respective responsibilities of the IJB and the auditor. A summary of the key responsibilities is outlined below. Auditor’s responsibilities 7. The responsibilities of auditors in the public sector are established in the Local Government (Scotland) Act 1973. These include providing an independent opinion on the financial statements and other information reported within the annual accounts and concluding on the IJB’s arrangements in place for the wider scope areas and Best Value. 8. The matters reported in the Annual Audit Report are only those that have been identified by the audit team during normal audit work and may
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Audit scope, responsibilities, and fee | 7 not be all that exist. Communicating these does not absolve the IJB from its responsibilities outlined below. 9. The Annual Audit Report includes an agreed action plan at Appendix 1 setting out specific recommendations to address matters identified and includes details of the responsible officer and dates for implementation. The IJB’s responsibilities 10. The IJB has primary responsibility for ensuring proper financial stewardship of public funds, compliance with relevant legislation and establishing effective arrangements for governance, propriety, and regularity that enables it to successfully deliver its objectives. The features of proper financial stewardship include: • Establishing arrangements to ensure the proper conduct of its affairs. • Preparation of annual accounts, comprising financial statements for the IJB that gives a true and fair view and other specified information. • Establishing arrangements for the prevention and detection of fraud, error and irregularities, and bribery and corruption. • Implementing arrangements to ensure its financial position is soundly based. • Making arrangements to secure Best Value. • Establishing an internal audit function. Audit Fee 11. The audit fee for the 2025/26 audit was reported in the Annual Audit Plan and was set at £35,480 (2024/25: £34,000). There have been no developments that impact on planned audit work required, therefore the audit fee reported in the Annual Audit Plan remains unchanged. National performance audit reporting 12. The Auditor General for Scotland and the Accounts Commission regularly publish performance audit reports. These cover a range of matters, many of which may be of interest to the Integration Joint Board. Details of national and performance audit reports published over the last year can be seen in Appendix 2.
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Audit of the annual accounts | 8 Audit of the annual accounts Main judgements All audit opinions stated that the annual accounts were free from material misstatement. There were no significant findings or key audit matters to report. All audit adjustments required to correct the financial statements were processed by the body. Audit opinions on the annual accounts 13. The IJB’s annual accounts were approved by Integration Joint Board on 25 September 2026 and certified by the appointed auditor on 25 September 2026. The Independent Auditor’s Report is included in the IJB’s annual accounts, and this reports that, in the appointed auditor’s opinion, these were free from material misstatement. Audit timetable 14. The unaudited annual accounts and all working papers were received on 30 June 2026 in accordance with the agreed audit timetable. Materiality 15. The concept of materiality is applied by auditors in planning and performing an audit, and in evaluating the effect of any uncorrected misstatements on the financial statements or other information reported in the annual accounts. 16. Broadly, the concept of materiality is to determine whether misstatements identified during the audit could reasonably be expected to influence the decisions of users of the annual accounts. Auditors set a monetary threshold when determining materiality, although some issues may be considered material by their nature. Therefore, materiality is ultimately a matter of the auditor’s professional judgement. 17. Materiality levels for the audit of the IJB were determined at the risk assessment phase of the audit and were reported in the Annual Audit Plan, which also reported the judgements made in determining materiality levels. These were reassessed on receipt of the unaudited annual accounts.
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Audit of the annual accounts | 9 Exhibit 1 2025/26 Materiality levels for the IJB Materiality £’million Materiality – set at 2% of cost of services £8.014 million Performance materiality – set at 70% of materiality. As outlined in the Annual Audit Plan, this acts as a trigger point. If the aggregate of misstatements identified during the audit exceeds performance materiality, this could indicate further audit procedures are required. £5.610 million Reporting threshold – set at 5% of materiality. £0.400 million Source: Audit Scotland Significant findings and key audit matters 18. ISA (UK) 260 requires auditors to communicate significant findings from the audit to those charged with governance, which for the IJB is the Performance and Audit Committee. In line with the Performance and Audit Committee’s terms of reference the annual report and accounts were presented to the Performance and Audit Committee for approval prior to submission to the IJB Board. 19. The Code of Audit Practice also requires public sector auditors to communicate key audit matters. These are the matters that, in the auditor’s professional judgement, are of most significance to the audit of the financial statements and require most attention when performing the audit. 20. In determining key audit matters, auditors consider: • Areas of higher or significant risk of material misstatement. • Areas where significant judgement is required, including accounting estimates that are subject to a high degree of estimation uncertainty. • Significant events or transactions that occurred during the year. 21. There are no significant findings or key matters to report. Qualitative aspects of accounting practices 22. ISA (UK) 260 also requires auditors to communicate their view about qualitative aspects of the body’s accounting practices, including
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Audit of the annual accounts | 10 accounting policies, accounting estimates, and disclosures in the financial statements. Accounting policies 23. The appropriateness of accounting policies adopted by the IJB was assessed as part of the audit. These were considered to be appropriate to the circumstances of the IJB, and there were no significant departures from the accounting policies set out in the Code of Practice on Local Authority Accounting in the United Kingdom (the Code). Accounting estimates 24. Accounting estimates are used in number of areas in NAIJB’s financial statements. Audit work considered the process management of the IJB has in place around making accounting estimates, including the assumptions and data used in making the estimates, and the use of any management experts. Audit work concluded: • There were no issues with the selection or application of methods, assumptions, and data used to make the accounting estimates, and these were considered to be reasonable. • There was no evidence of management bias in making the accounting estimates. Disclosures in the financial statements 25. The adequacy of disclosures in the financial statements was assessed as part of the audit. The quality of disclosures was adequate, with additional levels of detail provided for disclosures around areas of greater sensitivity. Significant matters discussed with management 26. All significant matters identified during the audit and discussed with the body’s management have been reported in the Annual Audit Report. Audit adjustments 27. No audit adjustments were required to the financial statements greater than the reporting threshold of £0.400 million. Significant risks of material misstatement identified in the Annual Audit Plan 28. Audit work has been performed in response to the significant risks of material misstatement identified in the Annual Audit Plan. The outcome of audit work performed is summarised in Exhibit 2.
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Audit of the annual accounts | 11 Exhibit 2 Significant risks of material misstatement to the financial statements Risk of material misstatement Planned audit response Outcome of audit work Fraud caused by management override of controls Management is in a unique position to perpetrate fraud because of management’s ability to override controls that otherwise appear to be operating effectively. The audit team will: • Evaluate significant transactions outside the normal course of business. • Assess the adequacy of controls in place for identifying and disclosing related party relationships and transactions in the financial statements. • Obtain assurances from the auditors of NHS Ayrshire and Arran and North Ayrshire Council over the completeness, accuracy and allocation of income and expenditure. Audit work performed found: • No significant issues were identified from transactions outside the normal course of business. • The controls in place for identifying and disclosing related party relationships and transactions were adequate. • Assurances obtained from the auditors of NHS Ayrshire and Arran and North Ayrshire Council on the completeness, accuracy and allocation of income and expenditure. • Conclusion: no evidence of fraud caused by management override of controls. Source: Audit Scotland
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Wider scope and Best Value audit | 12 Wider scope and Best Value audit Conclusion The IJB has effective and appropriate arrangements in place for Financial Management; Financial Sustainability, Vision, Leadership and Governance; and Use of Resources to Improve Outcomes. The IJB has effective and appropriate arrangements in place for securing Best Value. The IJB reported a year end underspend position of £2.501 million. £1.805 million was contributed to new earmarked reserves in year which has resulted in the IJB having £2.822 million of total reserves. However, only £0.696 million of this balance is not earmarked for specific purposes and this falls below the aspirational targets set out in reserves strategy. Following consultation with stakeholders, the IJB approved a change to the threshold for the funding of adult social care support to critical only. This decision was made to support the IJB to operate within its available financial resources. The 2026/27 budget includes savings proposals of £2.816 million and a further £5.828 million in savings relating to the eligibility criteria for Social Care Services. The IJB recognise that their transformation plan continues to support a programme of change. The Strategic Plan 2026-30 sets out the vision, values and strategic priorities of the IJB. Performance management arrangements are effective, with regular Partnership Performance reports presented to the Audit and Performance Committee. The 2025/26 Annual Performance report outlined that 73% of the 18 National Indicators were either achieved or performing above their target.
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Wider scope and Best Value audit | 13 Audit approach to wider scope and Best Value Wider scope 29. As reported in the Annual Audit Plan, the wider scope audit areas are: • Financial Management. • Financial Sustainability. • Vision, Leadership and Governance. • Use of Resources to Improve Outcomes. 30. Audit work is performed on these four areas and a conclusion on the effectiveness and appropriateness of arrangements the IJB has in place for each of these is reported in this chapter. Best Value 31. The duty on auditors to consider the arrangements in place to secure Best Value applies to the IJB as it falls within section 106 of the Local Government (Scotland) Act 1973. 32. Consideration of the arrangements the IJB has in place to secure Best Value has been carried out alongside the wider scope audit. Significant wider scope and Best Value risks 33. Audit work has been performed in response to the significant wider scope and Best Value risks identified in the Annual Audit Plan. The outcome of audit work performed is summarised in Exhibit 3.
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Wider scope and Best Value audit | 14 Exhibit 3 Significant wider scope and Best Value risks Significant risk Planned audit response Outcome of audit work Financial planning and sustainability At month 9 there is a projected year-end overspend of £4.479 million (1.3% of the budget), reducing to £3.276m after Financial Recovery Plan projections. This overall position consists of a projected overspend of £3.368 million in social care services and a projected overspend of £1.111 million in health services. The IJB has approached NAC and NHSAA for additional funding. Current budget scenarios for 2026/27 are a £16.7 million overspend (best-case), £24.1 million overspend (medium-case) and a £25.5m overspend (worst-case). Additional budget savings will require to be identified to achieve a balanced budget position for approval by the IJB in March. The audit team will: • Review the approved 2026/27 budget and any updates to the IJB’s medium-term financial plans developed and assess the appropriateness of the financial plans and any assumptions made. • Review financial monitoring reports to assess the financial position, including progress in realising efficiency savings. • Review updates to financial plans to assess the short and medium-term financial sustainability of the IJB. Audit work performed found: • Reviewed and assessed the appropriateness of assumptions underlying the approved 2026/27 budget and the updates to the medium-term financial plan. • Reviewed the financial monitoring reports which outline the financial position of the IJB, and the progress made to delivering planned efficiency savings. • Reviewed the IJB’s updated financial plans and the underlying assumptions considered for the short and medium term. Conclusion: The IJB have updated and further developed their financial plans. However, significant challenges continue to face the IJB due to the scale of the savings requirements and limited uncommitted reserves. Financial balance remains dependent on successful delivery of significant recurring savings, demand management and service transformation or securing further recurring funding. Source: Audit Scotland
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Wider scope and Best Value audit | 15 Conclusions on wider scope audit Financial Management 34. The audit work performed on the arrangements the IJB has in place for securing sound financial management found that these were effective and appropriate. This judgement is evidenced by the IJB: • having clear and up-to-date policies and procedures, for example, financial regulations and scheme of delegation, in place that ensure effective financial management. • having appropriate arrangements are in place for the prevention and detection of fraud and other irregularities through the arrangements in place at the IJB’s partner bodies of NHS Ayrshire and Arran and North Ayrshire Council. • having suitably qualified and experienced staff leading the finance function, which has sufficient skills, capacity, and capability to effectively fulfil its role. • having effective arrangements in place for the scrutiny of arrangements that support sound financial management, and effective scrutiny and challenge provided by Performance and Audit Committee A balanced budget was set for 2025/26 which included planned savings proposals 35. The IJB set a balanced budget for 2025/26 on 20 March 2025. The budget included £4.019 million of savings but no planned use of reserves. 36. Savings were planned as being delivered from both social care and health budgets. Social care savings of £2.903 million were to be delivered from a variety of sources including reviews of community mental health and day care provision as well as service redesign and increases in charging. The balance of £1.116 million was expected to be met from health services including planned savings from payroll turnover, increased recharges to East Ayrshire IJB for beds at Woodland view as well as Trindlemoss House moving to a social care model. 37. The IJB noted that the planned savings would be delivered alongside the IJB dealing with fluctuating demand for services as well as a number of known pressures as outlined in Paragraph 66. The IJB reported a year end underspend position following financial pressures during the year of £2.501 million 38. The year end budget was underspent by £2.501 million. Following adjustment for earmarked reserves of £1.805 million this left unearmarked reserves of £0.696 million.
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Wider scope and Best Value audit | 16 39. This is an improved position when compared to the overspend projections reported throughout the year and reflects the impact of the IJB’s recovery actions, strengthened financial controls such as greater scrutiny of the financial position and delivery of the financial recovery plan by the Finance Working group (FWG) as well as the use of a recovery plan where an overspend is forecast, in order to bring overall service delivery back into line with available resources; and non-recurring benefits realised during the year. 40. A number of individual savings were only partially delivered, and the impact of these shortfalls were reflected in the outturn. The savings were noted in care at home, telecare, adaptations and physical disability services and unscheduled care within Health and Community Care services as well as underspends in Mental Health Services, Allied Health Professionals, Chief Social Work officer and Management and Support Services. The IJB contributed £1.805 million to earmarked reserves in year which has resulted in the IJB having £2.822 million of total reserves 41. The Audit Scotland Integration Joint Boards Finance Bulletin 2024 to 25 (published 26 February 2026) outlined the wider national context affecting Integration Joint Boards (IJBs) in Scotland and provided background to the scale of the financial challenge and the implications for service delivery. It highlighted that many IJBs have depleted reserves, limiting the ability to absorb in-year pressures and increasing reliance on partner support. 42. At 31 March 2026 total reserves of £2.822 million are held by the IJB. The unearmarked reserves of £0.696 million at 31 March 2026 represents 0.2% of the 2025/2026 budget which is below the recommended reserve level of 2-4% of the budget (£6.88million to £13.76m). The unearmarked reserves of £0.696 million is the balance after the provision of earmarked reserves of £1.805 million. 43. The IJB acknowledges that uncommitted reserves require to be restored to the minimum recommended level. However, in the short-term, service pressures mean that this would not be achievable without implementing further reductions in service delivery that would impact on the levels of care provided and increase the levels of risk for patients and service users. Financial systems of internal control operated effectively 44. The IJB is reliant on the systems of its partner bodies. NHS Ayrshire and Arran and North Ayrshire Council, for its key financial systems, including ledger and payroll. All IJB transactions are processed through respective partners’ systems and all controls over those systems are within the partner bodies rather than the IJB.
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Wider scope and Best Value audit | 17 45. As part of our audit approach, we sought assurances from the external auditors of NHS Ayrshire and Arran and North Ayrshire Council (in accordance with ISA 402) and confirmed there were no weaknesses in the systems of internal control for either the health board or council. The new Programme for Government in September 2026 focuses on improving outcomes and addressing national challenges with wide ranging proposed reform 46. The Scottish Government’s Programme for Government 2026-31 focuses on eradicating child poverty, growing the economy, tackling the climate emergency, and delivering a strong NHS and public services. Within health and social care, it prioritises reducing waiting times, improving access to care, and shifting more services from hospitals into community settings to support prevention and independent living. 47. The Programme proposes modernisation and significant reform including replacing the current 14 territorial health boards with two strategic health boards. For local authorities, the Programme signals potential reform of health and social care governance and delivery arrangements and reducing duplication and increasing efficiency in the delivery of public services. While the direction of travel is towards greater integration, prevention and community-based care, the full implications for local authorities remain uncertain. Greater clarity is expected in the coming months as the Scottish Government undertakes planned consultation and engagement on the future of social care and local governance. Standards of Conduct and arrangements for the prevention and detection of fraud and error were appropriate 48. The IJB does not maintain its own policies relating to the prevention and detection of fraud and error but instead depends on those in place at its partner bodies. We reviewed the arrangements in place at NHS Ayrshire and Arran and North Ayrshire Council through consideration of the work by partner body auditors and found them to be adequate. 49. Appropriate arrangements are in place for the prevention and detection of fraud and error. We are not aware of any specific issues we require to bring to your attention. Financial Sustainability 50. The audit work performed on the arrangements the IJB has in place for securing financial sustainability found that these were generally effective and appropriate. This judgement is evidenced by the IJB: • making appropriate arrangement to develop medium and longer- term financial plans and linking these to its Strategic Plan and priorities.
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Wider scope and Best Value audit | 18 • having effective arrangements in place for identifying risks to financial sustainability over the medium and longer-term, and understanding medium and longer-term demand pressures that could impact on available resources. • having savings plans in place to manage forecast budget deficits, and a reserves policy in place to manage the use of reserves if the required level of savings cannot be met. The IJB recognises that resources have not kept pace with demand for social care services 51. The Strategic Risk register presented to the April 2026 IJB includes a risk on financial sustainability which recognises that resources have not kept pace with the demand for and cost of social care services. Financial modelling suggests significant ongoing challenges across the medium- term with 2026/2027 being particularly challenging. This results in a greater risk to the financial sustainability of the IJB. 52. The Medium-Term Financial Outlook (MTFO) taken to the December 2025 IJB was used to identify cost and demand pressure points and inform decisions which are required to ensure the Partnership remains financially sustainable. 53. The MTFO identifies that based on current assumptions, there could be a budget gap across the period 2026/27 to 2028/2029 ranging from £27.746 million in the best case to £47.968 million in the worst case if funding levels remain unchanged. Examples of assumptions include a flat cash for social care in 2026/27 with national priorities fully funded as well as assumptions of Scottish government budgets for future years. 54. In the prior year, we recommended that the IJB strengthen its approach to financial sustainability by putting measures in place to address identified budget gaps. The IJB adopted several measures during 2025/26 in response to this recommendation. Given the ongoing challenges around financial pressures, we have assessed that this recommendation remains ongoing. NAIJB has a number of measures in place to support financial sustainability 55. The IJB recognises that in the face of on-going financial pressures and pace of transformation, there is a need for continued focus on strong governance arrangements. As a result, it has continued actions for 2026/2027 to support financial sustainability and ensure governance arrangements remain resilient. 56. The approved IJB internal audit plan for 2025/2026 focused on a review of the IJB’s arrangements in relation to Financial Sustainability. The audit has been concluded and provides reasonable assurance, with six
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Wider scope and Best Value audit | 19 actions for management. It is expected to be reported to the 25 September Performance and Audit Committee. The IJB’s Transformation plan continued to be an important programme of change during 2025/26 57. The North Ayrshire HSCP Transformation Plan 2024 to 2027 was approved by the IJB in March 2024 and has remained under regular review through the Transformation Board; with regular updates on the plan and progress reported to the IJB. The Transformation Plan is designed to improve service quality and support long-term sustainability. 58. During 2025/2026, the Health and Social Care Partnership (HSCP) undertook a refresh of its Transformation Plan to strengthen delivery, improve financial sustainability and respond to audit recommendations. This followed feedback from Audit Scotland and the Council’s Best Value Review, which highlighted the need for clearer alignment between transformation activity, financial planning and demonstrable benefits. 59. An internal review was completed to ensure the Transformation Plan is focused, deliverable and aligned with strategic priorities. This has led to: • the programme being streamlined, reducing the number of projects and removing activity better classified as business as usual. • refreshing and strengthening governance arrangements, including updated Terms of Reference for the Transformation Board. • Introducing a formal Benefits Realisation Framework to improve transparency and accountability. • Ensuring all projects with approved business cases now include benefits trackers, covering financial (cashable), quantitative and qualitative outcomes. The 2026/27 budget includes proposed savings of £2.816 million and a further £5.828 million in savings relating to the eligibility criteria for Social Care Services 60. The IJB annual budget for 2026/27 was approved by the IJB Board on 13 March 2026. The NA HSCP 2026/27 integrated budget is £343.390 million. This includes a set aside budget of £42.670 million. 61. The approved budget includes planned savings of £2.816 million, split between social care services commissioned from North Ayrshire Council and health services from NHS Ayrshire and Arran. When setting the budget, the IJB recognised that continuing pressures including demographic pressures within older people and physical disabilities as well as a historic increase in mental health packages could impact upon the financial outturn and required savings.
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Wider scope and Best Value audit | 20 62. At the time of setting the budget, a savings requirement of £5.828 million was required to be delivered in Social Care services to achieve a balanced position in 2026-27. 63. The “budget consultation and Eligibility Criteria for Social Care Services” report taken to the March 2026 IJB recommended that the budget gap for social Care Services delegated by NAC is met through a resetting of the eligibility criteria for access to funded adult social work and social care services. This led to a further £5.828 million in savings being identified. 64. Following the final 2025/26 outturn position, and the further £5.828 million in savings, a net opening budget gap position of £0.494 million was recognised for 2026/27. This position takes account of funding increases, service pressures from 2025/26 as well as planned savings. The remaining budget gap of £0.494 million is Health/NHS services is smaller in value and primarily reflects current year pressures recurring to an extent next financial year, rather than a significant pressure on core funding. 65. North Ayrshire Council have increased the IJB funding by £11.147 million whilst NHS Ayrshire and Arran’s funding will increase by £4.961m for 2026/27. The increase in council funding reflects the increase in core revenue funding above the assumed 0% flat cash settlement for the Council. 66. In setting the budget, the IJB recognise that there are a number of pressures to manage on an ongoing basis. In developing the budget, pressures that have been assessed as unavoidable are included in the plans. Recognised pressures include pay, demographic, transition, contract inflation, Pan Ayrshire pressures. The IJB agreed a critical only threshold for the funding of adult social care support 67. As part of the 2026/27 budget a range of proposals were considered to support financial balance. In March 2026 the IJB approved a decision to move to the critical care threshold for the funding of adult social care support. 68. The policy took effect from 1st April 2026 and applied to all new community care assessments. No changes would be made to level of support provided to existing service users until an individual review of their care package is undertaken. Vision, Leadership and Governance 69. The audit work performed on the arrangements the IJB has in place around its Vision, Leadership and Governance found that these were effective and appropriate. This judgement is evidenced by the IJB:
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Wider scope and Best Value audit | 21 • having a Strategic Plan in place, supported by Operational Plans, that clearly set out its vision, strategy, and priorities and reflect the pace and depth of improvement required to realise these in a sustainable manner. • involving service users, delivery partners, and other stakeholders in the development of its vision, strategy, and priorities to ensure these align to their needs. • having clear financial and performance reporting in place, both internally and externally, that is linked to its Operational Plans, and effective scrutiny and challenge of performance provided by the Integration Joint Board. • having effective governance arrangements in place in general, as reflected in the Governance Statement included in the accounts. Governance arrangements are appropriate. The IJB has demonstrated a commitment to openness and transparency 70. Openness and transparency in how a body operates and makes decisions is key to supporting understanding and scrutiny. Transparency means that the public has access to understandable, relevant, and timely information about how the body is taking decisions and using resources. 71. In 2025/26 the IJB held its meetings in person, the meetings are open to the public to attend and are live webcast. Whilst the Performance and Audit Committee continued to be held remotely. All meeting papers and minutes for the IJB are available on the website. 72. The 26 June 2026 meeting of the Performance and Audit Committee did not take place due to the committee not being quorate following a number of late and unexpected apologies from members. As a result, there was a risk that agenda items including the draft accounts would not be considered before the statutory deadline of 30th June. A meeting of the Performance and Audit Committee was reconvened on the 29 June 2026. The meeting was quorate and the agenda items were given due consideration and voted upon. 73. The audit team regularly attend the Performance and Audit Committee meetings. Reports and papers presented to the committees provide a sufficient level of detail to enable members to scrutinise and challenge. 74. We consider that governance arrangements are appropriate and support effective scrutiny, challenge and decision making. Strategic Plan 2026-2030 is in place and sets out the IJB’s vison, values and strategic priorities. 75. The Public Bodies (Joint Working) (Scotland) Act 2014 requires the IJB to prepare a plan that sets out the arrangements in place to carry out the integration functions over the period of the plan. The Act also requires
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Wider scope and Best Value audit | 22 that the plan set out how those arrangements are intended to achieve, or contribute to achieving, the national health and wellbeing outcomes. 76. The IJB first published ‘Caring Together 2022 to 2030’ as a long-term plan outlining their ambitions for improving health and wellbeing of residents in North Ayrshire in an uncertain period of recovering from the pandemic. 77. As part of the 2025 refresh of the Strategic Plan, the IJB considered the national Population Health Framework 2025 to 2035 and the Health and Social Care Service Renewal Framework 2025 to 2035. A new Strategic Needs Assessment was also developed to inform the refresh process. Review of the Strategic Plan and supporting documentation confirmed that these frameworks and assessment findings were used to inform the IJB's strategic priorities, with the aim of aligning local service planning and delivery with national objectives to improve population health and support people to remain independent and well. 78. The refreshed Strategic Plan sets out a renewed dual-priority approach to delivering services in line with new Service Delivery Priorities to meet the current needs of communities within an increasingly challenging financial context, and new Strategic Priorities which will consider future needs and how the IJB may need to transform its services to meet the needs of changing demographics. 79. The Strategic plan recognises three Strategic priorities: • Supporting the Improvement of Population Health • Addressing the Changing Needs of an Ageing Population • Tackling the Root Causes of Health Inequality 80. These are supported by priorities for service delivery consisting of prevention, community-based services, life stages, whole person approach, accessibility and communication; and evidence and performance. 81. The refreshed Strategic Plan 2026-30 was approved in December 2025. The Strategic Plan links to medium term projections in the Medium- Term Financial Outlook (2026 to 2028). Following the Scottish Government’s spending review in June 2025, an update covering 2026 to 2029 was approved in December 2025 by the IJB. 82. The IJB’s Strategic Plan covers its main priorities and sets out how these will be achieved as well as linking to its MTFO. The Integration Scheme review has not yet concluded 83. The Public Bodies (Joint Working) (Scotland) 2014, places a legal duty on Councils and Health Boards to review the Integration Schemes at least
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Wider scope and Best Value audit | 23 once every five years to consider whether any changes are necessary or desirable. 84. The Integration Scheme for the IJB was last updated in 2018. The review of the Integration Scheme has been undertaken on a pan Ayrshire basis by the three Councils and the Health Board to ensure a consistent and co-ordinated approach. A project Board was established to oversee the work and various work groups were established. The review of the Integration Scheme through the various workgroups concluded in March 2024. Further work has since been undertaken to consider specific issues and the overall legal competence of the Scheme. 85. It was noted in the 2024/25 Annual Audit Report that it was anticipated that the Integration Scheme review would conclude in 2025. Following this, it will require approval by North Ayrshire Council and NHS Ayrshire and Arran, prior to submission to the Scottish Ministers. The IJB involves communities and stakeholders in strategic and service decisions 86. The Participation and Engagement Strategy 2026 – 2030 sets out how the IJB involves individuals, communities, staff, carers, and partners in shaping the design, delivery, and improvement of health and social care services. 87. The Strategy provides an engagement insight into the range of engagement activities undertaken by the IJB from 2022 to 2025. Engagement was delivered across operational services Mental Health, Health and Community Care, and Children, Families and Justice as well as by wider support teams, including Planning, Performance & Transformation, Commissioning, and Professional Standards. 88. The IJB employed various engagement methods including the use of focus groups with service users, surveys, in-person and telephone interviews, stalls and workshops, lived experience panels and forums, digital engagement and communication networks. Examples of specific service users involved include young people, service users of Alcohol and Drug Partnership (ADP), Carers and families of individuals with lived experience in mental health. 89. Locality Planning is a core engagement mechanism that enables communities to shape services based on local needs and priorities. Each locality hosts scheduled periods of Locality Conversations where members of the community can share their views, raise concerns, and help set priorities for service improvement. Feedback from Locality Conversations is reviewed by the Strategic Planning Group and may be escalated to the IJB for action. This ensures that local voices directly inform strategic decision-making and service development.
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Wider scope and Best Value audit | 24 Use of Resources to Improve Outcomes 90. The audit work performed on the arrangements the IJB has in place around its Use of Resources to Improve Outcomes found that these were effective and appropriate. This judgement is evidenced by the IJB: • being able to demonstrate a clear link between the use of resources and delivery of its priorities. • having arrangements in place to benchmark its performance to identify areas of improvement. • being able to demonstrate improvements in performance against benchmarks and relative to other comparable organisations. Performance management arrangements are effective, with regular Partnership Performance reports presented to the Audit and Performance Committee and Service Improvement Plans supporting delivery of the IJB’s strategic priorities 91. The Performance and Audit Committee has a role in providing oversight of performance reporting against the values and strategic priorities. North Ayrshire Health and Social Care Partnership produces quarterly performance reports which are scrutinised quarterly at the Performance and Audit Committee with a summary report presented to the Integration Joint Board. Directors and heads of service respond to queries arising from members. 92. The report is part of the audit and scrutiny arrangements in place to oversee general performance, financial and budgetary performance, and specific service audit areas. It highlights performance exceptions and achievements. 93. The reports provide a summary of performance against strategic plan measures as well as across financial and workforce areas. Detailed explanations are included within the reports to outline reasons for targets that have not met and have a red status. Quarterly trend analysis is also included along with, actions for improving performance and the timescales for improvement. The 2025/26 Annual Performance report was published and outlined that 73% of the 18 National Indicators were achieved or above target for 2025/26. 94. Integration authorities are required to publish an Annual Performance Report by the end of July each year. The Annual Performance Report for 2025/26 has been published and is available to view on the Partnership’s ‘Performance’ page on its website. 95. The Health and Social Care Partnership has been working to improve indicators set out by the Ministerial Strategic Group for Health and
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Wider scope and Best Value audit | 25 Community Care (MSG). The IJB’s performance against the MSG indicators are shown in Exhibit 4. Exhibit 4 Performance against Ministerial Strategic Group Indicators Source: North Ayrshire IJB Annual Performance report 2025/26 96. The 2025/26 Annual Performance Report shows performance against the Ministerial Strategic Group targets being met in most areas including unscheduled hospital bed days in acute hospital, emergency department attendances and admissions from emergency department, with the IJB achieving or exceeding targets for approximately 72% (2024/205 – 89%) of the indicators. 97. The areas where the IJB has not met the MSG target during 2025/26 include: • % of people seen within 4 hours at emergency department; with 66.2% of people seen in the set timeframe against a target of 95% • Delayed discharge bed days (all reasons) with 3,229 bed days against a target of 1,515 days. The 2025/26 position is 353 days worse than the 2024/25 position.
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Wider scope and Best Value audit | 26 98. When comparing performance to the prior year we noted that whilst targets were shown as met in 2025/26 there were some instances where the performance level was lower than in the prior year. In Exhibit 5, we have compared a number of the measures with the prior year performance. Exhibit 5 National performance measures prior year comparison Measures 2025/26 performance Improving from 2024/25 Emergency admissions to acute hospitals 6% increase No Unscheduled “hospital bed days” in acute hospital 82% decrease Yes Unscheduled “hospital bed days” in geriatric long stay 252% decrease Yes Emergency department attendances (all) 5% increase No Delayed Discharge bed days (all reasons) 11% increase No Source: North Ayrshire IJB Annual Performance report 2025/26; 99. The IJB has established appropriate arrangements for reporting performance against national outcomes through the Annual Performance report. Conclusions on Best Value 100. The audit work performed on the arrangements the body has in place for securing Best Value found these were effective and appropriate. This judgement is evidenced by: • the body having well established and effective governance arrangements in place, with the Best Value being a key aspect of the governance arrangements. • the arrangements the body has in place around the four wider scope audit areas, which are effective and appropriate, contribute to it being able to secure Best Value. • progress the body is making to embed sustainability into corporate and operational plans and enhance reporting arrangements around sustainability. A formal review is undertaken to demonstrate how the IJB is achieving Best Value
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Wider scope and Best Value audit | 27 101. The Code of Audit Practice requires us to consider the adequacy of the arrangements in place to demonstrate how the IJB meets its Best Value duty to secure continuous improvement in the performance of its functions. We expect bodies to demonstrate that they meet the expectations in the Scottish Government, Local Government in Scotland Act 2003 Best Value: Revised Statutory Guidance 2020. 102. Our work on the four wider scope audit areas financial management, financial sustainability, vision, leadership and governance and the use of resources to improve outcomes provides evidence of how the IJB performs in some important areas of Best Value. There is evidence of elements of Best Value being demonstrated by the IJB across a range of areas as documented across this report. 103. There is a mechanism for formally reviewing and reporting on the arrangements to secure Best to the Board. The Best Value statement 2025/26 was approved by the April 2026 IJB. It sets out how the IJB delivered Best Value during the financial year. The IJB intends to review its Best Value Statement annually and incorporate it into the Annual Performance Report. 104. The statement sets out the fact that the IJB places appropriate reliance on the Best Value arrangements of its partner organisations, NAC and NHS Ayrshire & Arran, both of which are subject to independent external audit and scrutiny. The reliance is supplemented by the Partnership’s own governance and assurance arrangements, including performance reporting, financial monitoring, risk management and internal audit. 105. In the 2024/25 Annual Audit Report, we recommended that the IJB formalised a Best Value assurance framework, to set out how annual assurances from the IJB’s partners can be used to provide assurance on Best Value arrangements to the Board. This is now in place.
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Appendix 1 | 28 Appendix 1 Action plan 2025/26 No recommendations for 2025/26. Follow-up of prior year recommendations
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Appendix 1 | 29 Matter giving rise to recommendation Recommendation, agreed action, officer and timing Update
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Appendix 1 | 30 1. Financial sustainability There are no approved plans to meet the budget gaps set out in the MTFO. This needs to be addressed as a matter of urgency. An effective long term financial recovery plan needs to be introduced, and decisions about the way services are delivered in the short, medium and longer- term based on information about the cost, impact and quality of all available options. Detailed scenario planning should also be undertaken to provide an understanding for the IJB of the effects of various reform options. Risk: There is a risk that the IJB is unable to deliver the transformational change at the pace that is required. The Chief Officer, Joint Board members and the Finance Working Group need to produce a financial plan that demonstrates how efficiencies from service reform, cost base reductions and transformation will meet the budget gaps outlined in the MTFO. Progress should be reviewed and challenged by the board. Agreed action: Preparation for the 2026/27 budget has commenced. The Transformation Plan is being further developed with a focus on aligning financial impact to areas of service change. A series of meetings is being held with every senior manager to review their services and look at ways of reducing spend through either redesign or cessation of services. Once completed the actions identified will be discussed at the Finance Working Group prior to proposals being presented to the IJB for approval. Proposals will be submitted throughout 2025/26 e.g. Brighter Pathways will be presented in November 2025. Final proposals to bridge any remaining gap will be presented in March 2026 as part of the 2026/27 budget paper. This work will also include savings beyond 2026/27. Chief Officer and Chief Finance Officer March 2026 Action date: March 2026 Work in Progress IJB Update The IJB has taken substantial action to strengthen financial governance, improve budgetary control and support delivery of a more sustainable financial position. This includes regular and detailed financial reporting to the IJB, enhanced scrutiny through the Finance Working Group, implementation of financial recovery arrangements and continued focus on high- pressure areas. The IJB achieved an improved financial position in 2025/26, moving from an anticipated budget gap of £5.259m at the start of the year to a year-end underspend of £2.235m. In addition, projected overspend reduced by £2.833m following implementation of the recovery plan agreed in June 2025. For 2026/27, the IJB has set a balanced budget, supported by agreed savings, further savings proposals and difficult policy decisions, including changes linked to eligibility criteria and care package prioritisation. Management considers that these actions demonstrate substantial progress in strengthening the arrangements supporting financial sustainability.
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Appendix 1 | 31 Matter giving rise to recommendation Recommendation, agreed action, officer and timing Update Details of continuing action – The IJB will continue to monitor delivery of savings, report regularly on financial performance, maintain expenditure controls, update medium-term financial planning and escalate structural funding pressures through partner and national routes as required. It is recognised that, while these actions improve financial management and control, they do not remove the underlying recurring pressures arising from demand, demography, workforce, inflation, commissioned care costs and available recurring funding. Responsible officer: Eleanor Currie Agreed date: March 2027
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Appendix 1 | 32 Matter giving rise to recommendation Recommendation, agreed action, officer and timing Update PY 2. Arrangements to secure Best Value Whilst there is evidence of elements of Best Value being demonstrated by the IJB across a range of areas, the mechanism for formally reviewing and reporting on the arrangements to secure Best Value is not formalised and reported to the Board. Risk: The is a risk that the IJB is not meeting its Best Value duty to secure continuous improvement in the performance of its functions. A formal review of the Best Value assurance framework and an assessment of the partnership’s Best Value arrangements should be completed and reported to the Joint Board. Agreed Action: A Best Value framework will be developed and presented to the IJB, thereafter this will be incorporated into the Annual Performance Report as the mechanism for regular reporting to the IJB. Officer: Chief Officer Action date: February 2026 Implemented. A Best Value statement for 2025/26 has been prepared and was approved by the April 2026 IJB with the aim of completing this annually and incorporating the findings into the Annual Performance Report. PY 3 Unidentified savings At the end of Month 4 (July 2024), the IJB reported a projected year-end overspend of £6.697m. Identified financial improvement actions amount to £3.702m, A further £2.995m of financial recovery improvement actions still require to be identified. The IJB should ensure that savings plans are developed as a matter of urgency, identifying how the required £2.995 million of financial recovery improvement actions in 2024/25 will be achieved. Agreed Action: The IJB set a balanced budget for 2024/25 on 14 March 2024. This did not require any draw on reserves but did include the approval of £10.290 million of savings to achieve financial balance. The 2025/26 budget has a funding gap of £3.069 million and proposed savings of £4.019 million. Implemented Savings plans were developed for 2025/26. The IJB delivered the required level of savings in 2025/26.
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Appendix 1 | 33 Matter giving rise to recommendation Recommendation, agreed action, officer and timing Update PY 4 Uncommitted reserves The IJB Reserves Strategy recommends that the IJB will aspire to hold between 2 and 4% of its annual budgeted expenditure as an uncommitted reserve. The uncommitted reserve balance at 31 March 2024 was £0.357 million (representing only 0.1% of the IJB’S 2024/25 budget) and therefore does not meet the lower target. In addition, uncommitted reserves are forecast to be depleted by 31 March 2025. The IJB must urgently map a clear route to bring uncommitted reserves back up to the minimum level. Agreed Action: At 31 March 2025, the IJB had zero uncommitted reserves balance against the target level for the year of £6.715 - £13.430 million. The absence of any uncommitted general fund reserves seriously limits the IJB’s ability to manage and mitigate future financial pressures and represents a significant financial risk to both the IJB and its partners. The IJB accepts and acknowledge that uncommitted reserves require to be restored to the minimum recommended level. However, it also reports in the Annual Accounts that in the short-term, service pressures mean that this will not be achievable. This will require to be considered as part of the annual budget setting process alongside the funding allocations from both partner bodies. Work in progress The IJB uncommitted reserve balance is £0.7 million at 31 March 2026. This represents an improved position but remains lower than the 2-4% aspirational target set out in the reserves policy. IJB Update The IJB accepts and acknowledge that uncommitted reserves require to be restored to the minimum recommended level. However, it also reports in the Annual Accounts that in the short-term, service pressures mean that this will not be achievable. This will require to be considered as part of the annual budget setting process alongside the funding allocations from both partner bodies. Details of revised action – no revised action in the short term for the reasons above.
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Appendix 2 | 34 Appendix 2 Supporting national and performance audit reports Report name Date published Local government budgets 2025/26 22 May 2025 NHS in Scotland: Spotlight on governance 28 May 2025 Delivering for the future: Responding to the workforce challenge 7 August 2025 Flooding in communities: Moving towards flood resilience 28 August 2025 Adult Disability Payment 18 September 2025 Scotland’s colleges 2025 2 October 2025 Improving care experience: Delivering The Promise 8 October 2025 Local government performance: Spotlight on culture and leisure services 23 October 2025 Financial sustainability and taxes 13 November 2025 NHS in Scotland 2025: Finance and performance 4 December 2025 Delayed discharges: A symptom of the challenges facing health and social care 8 January 2026 Community health and social care: Performance 2025 8 January 2026 Administration of Scottish income tax 2024/25 16 January 2026 Local Government in Scotland: Financial bulletin 2024/25 29 January 2026 The Scottish Budget 2026/24: Supplement to the Financial bulletin 2024/25 12 February 2026 Integration Joint Boards: Finance bulletin 2024/25 26 February 2026 Annual Assurance and Risks Report: A review of 2024/25 local government audits in Scotland 12 March 2026
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North Ayrshire Integration Joint Board 2025/26 Annual Audit Report Audit Scotland, 4th Floor, 102 West Port, Edinburgh EH3 9DN Phone: 0131 625 1500 Email: info@audit.scot www.audit.scot AS.5.0