2025-26 Budget Monitoring Report Mth10
North Ayrshire Council · 13 March 2026
Back to Integration Joint Board — 13 March 2026 and its agenda
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Integration Joint Board 13th March 2026 Subject: 2025-26 – Month 10 Financial Performance Purpose: To provide an overview of the IJB’s financial performance as at Month 10 (January). Recommendation: It is recommended that the IJB: (a) notes the overall integrated financial performance report for the financial year 2025-26 and the current overall projected year- end overspend of £2.802m reducing to £2.251m after assumed funding for the reduced working week; (b) notes the progress with delivery of agreed savings; (c) approves the budget reduction in para 2.10; and (d) notes the remaining financial risks for 2025-26. Direction Required to Council, Health Board or Both 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 MH Mental Health MDT Child & Adolescent Mental Health Services BRAG Blue, Red, Amber, Green UNPACS UNPACS, (UNPlanned Activities) – Extra Contractual Referrals NRAC NHS Resource Allocation Committee PAC Performance and Audit Committee MHOF Mental Health Outcome Framework MDT Multi-Disciplinary Team 1. EXECUTIVE SUMMARY 1.1 The report provides an overview of the financial position for the Partnership and outlines the projected year-end outturn position informed by the projected expenditure and income commitments; these have been prepared in conjunction with relevant budget holders and services. It should be noted that, although this report refers to the position at the end of January further work is undertaken following the
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month end to finalise projections, therefore the projected outturn position is as current and up to date as can practicably be reported. 1.2 The projected outturn is a year-end overspend of £2.802m (0.8%). This is a favourable movement of £1.677m from month 9. Financial balance will not be achieved in 2025-26, the projected outturn position is summarised below with the residual risk following already identified financial improvement actions: TOTAL Health/ NHS AA Social Care/NAC Projected Overspend @ mth10 2.802 0.861 1.941 Reduced Working Week (RWW) funding assumed (0.551) (0.551) - Residual Projected Overspend 2.251 0.310 1.941 The Integration Scheme describes the required approach where there is a projected overspend on the IJB integrated budget, which includes the requirement to agree a recovery plan to balance the overspending budget. Only if the recovery plan is unsuccessful will the Health Board and Council consider making available interim funds. At month 9 following approval by the IJB, the Chief Officer wrote formally to North Ayrshire Council and NHS Ayrshire and Arran to request additional in-year funding to support the remaining overspend. This was subject to pursuing further recovery actions. The amount requested at month 9 is shown below along with an updated month 10 position: Month 9 Month 10 Health / NHS A&A 1.111 0.310* Social Care / NAC 3.368 1.941 TOTAL 4.479 2.251 *assumes full funding of the RWW 1.3 The movement in the projected outturn position for the 2025-26 financial year is illustrated in the graph below, this illustrates the movement in the gross and net projected overspend and the residual overspend or risk split between NHS and LA funding partners.
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This demonstrates significant progress in reducing the anticipated overspend since this was first projected at £5.187m in at Period 3 to the current projected outturn of £2.251m at Period 10. This has been achieved through tight financial management controls and the implementation of the actions in the financial recovery plan. As in previous years the impact of financial recovery actions is eroded by new demand and pressures, particularly in relation to social care and low volume high cost placements and areas where service occupancy is high and supplementary staffing costs are incurred. 1.4 From the core projections, overall, the main areas of pressure are: care at home, residential placements for children, physical disability care packages, supplementary staff in wards, staff costs in Montrose House and Unplanned Activities (UnPACs) within the lead partnership for mental health. The main areas of movement from Period 9 to Period 10 are: Favourable: • Care at Home • Physical Disability Care Packages • Lead Partnership for Mental Health • Care Experienced Children • Payroll turnover • Transition slippage • Savings inc contractual inflation Adverse: • Various smaller adverse variances
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1.5 The projected IJB outturn position has been adjusted to reflect the impact of Lead Partnership services. The overspend in relation to North Lead Partnership services for Mental Health is not fully attributed to the North HSCP as a share has been allocated to East and South HSCPs, similarly the impact of the outturn on East and South led services has been shared with North, both on an NRAC basis in line with the agreed risk sharing mechanism. There is a requirement for the 3 IJBs to be aware of the position for Lead Partnership services and plans to deliver services from within allocated budge. Note that the information for East and South HSCPs is the previously reported month 9 information as they do not report at month 10. 1.6 Since the setting of the budget in March 2025 the 2025-26 financial position has been adversely impacted by the below factors out-with the control of the IJB. • National Care Home Contract (NCHC) – the increase to the NCHC rate to reflect the impact of the nursing pay award resulted in an additional unfunded cost of £0.175m. • NHS Board allocation for the Employers National Insurance increase confirmed at 60% of funding – full year impact £0.664m • The current allocation for the Agenda for Change costs in relation to the reduced working week are currently being queried with the NHS finance team to ensure we receive our ‘fair share’ of the funding. The current funding allocated is £0.659m, the cost of covering all reduced hours is £1.497m. A recent exercise collated from services on the actual impact and cost indicated that the cost of cover is £1.210m (84% of staff covered) which is £0.551m higher than the current allocation. A request has been submitted to NHS A&A to review the funding allocation on a recurring basis, NHS AA Director of Finance offered a compromise agreement to fund 50% of the shortfall, following the discussion at IJB the Chief Officer has communicated back that this is not acceptable. A response is awaited. • Pay settlements for both NHS and Local Government staff have been agreed for 2025-26. The NHS element has been funded, and the current assumption is that the shortfall between budget planning assumptions and actual settlements will be fully funded for Local Government staff. 2. CURRENT POSITION 2.1 The report includes an overview of the financial position including commitments against the available resource, explanations for the main budget variances and an update on progress in terms of savings delivery. 2.2 FINANCIAL PERFORMANCE – AT MONTH 10 At month 10 against the full-year budget of £339.487m there is a projected year-end overspend of £2.802m (0.8%). The Integration Scheme outlines that there is an expectation that the IJB takes account of the totality of resources available to balance the budget in year. Following this approach, an integrated view of the financial
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position should be taken, however it is useful to note that this overall position consists of a projected overspend of £1.941m in social care services and a projected overspend of £0.861m in health services. Appendix A provides the financial overview of the Partnership position. The sections that follow outline the significant variances in service expenditure compared to the approved budgets. Appendix E provides information on the costs of bank and agency staff. 2.3 Health and Community Care Services Against the full-year budget of £99.611m there is a projected overspend of £1.978m (2%) which is a favourable movement of £0.979m and the main variances are: a) Care home placements – net projected overspend of £0.298m (£0.026m favourable). This includes an overspend on placements of £0.760m (£0.014m favourable) which includes a provision for an average of 5 interim beds and reflects the recent increase to the NCHC to reflect the impact of the nursing pay award resulted in an additional unfunded cost of £0.175m. The budgeted number of permanent placements was 765 and at month 10 there were 776 placements resulting in a projected overspend of £0.760m. The plan to manage down the number of permanent placements to reach the target is challenging due to the need to respond to referrals from hospital and to continue to support those in critical and substantial need in the community, this has led to a growing waiting list for access. The overspend is partially offset by income recovered from charging orders and gross funded placements which is projected to be £0.460m over recovered (£0.010m favourable). This income is challenging to predict as it depends on the length of the legal process and time taken to sell the property that the charging order is registered to and access to the funds or estate of service users. b) Care at home is projected to be £0.019m overspent (£1.124m favourable). The position reflects the cost of meeting the significant demand and level of provision for care at home support. The favourable movement is due to the action being taken to reduce the overall level of provision and reflects the contribution to specific SDS care packages from the Unscheduled Care funding received by NHS AA. The level of vacancies in the service has increased and whilst favourable it is coupled with increased levels of unmet need. c) Physical Disability Services – projected overspend of £0.230m (£0.096m favourable) split as follows: £0.963m over in residential placements, £0.416m under in direct payments due to increased clawbacks and £0.317m under in community care packages.
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d) Integrated Island Services is projected to overspend by £0.465m (£0.052m adverse). The most significant variance is a projected overspend at Montrose House of £0.358m which relates to the net overspend on agency staff (i.e. net of underspend on employee costs). There is also an under recovery of income and a write off of aged debt. In addition, outwith Montrose House there are overspends across property, continence and medical supplies, admin and transport. The Arran Patient Transfer contract is projected to overspend by £0.035m. e) Specialist Rehab wards – projected overspend of £0.206m (£0.011m adverse) (Redburn ward £0.191m overspend and Douglas Grant £0.015m overspend). The overspend is due to cover costs for vacancies as well as supplementary staffing for patients who require one to one support. f) Wards 1 and 2 – Projected overspend of £0.750m (£0.047m adverse). The overspend is due to increased use of supplementary staffing. All rehabilitation wards are operating at 100% occupancy supporting a high level of patient needs/complexity, which places pressure on staffing levels and the use of bank and agency staff to support additional patient observations. The projection for Health and Community Care services assumes that the allocation of unscheduled care funding will be fully utilised. 2.4 Mental Health Services Against the full-year budget of £118.613m there is a projected overspend of £1.374m (1.2%) which is a favourable movement of £0.346m prior to the re-allocation of the Lead Partnership variance to East and South HSCP. The main variances are: • Learning Disabilities are projected to overspend by £1.188m (£0.011m favourable). This covers for Children and Adults - residential placements, community packages, direct payments, property costs and an under recovery of charging income. • Community Mental Health services are projected to underspend by £0.113m (£0.002m favourable movement). The main reason for underspend in community packages is the availability and capacity of adult community providers to deliver new packages of care. • There is a projected underspend of £0.353m in relation to the cost of Hospital Based Complex Continuing Care (HBCCC), this reflects the impact of change in provision for these services. There were plans to reinvest this in the service, but these plans are on hold as holding the funding was agreed as part of the recovery plan at month 3.
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• The Lead Partnership for Mental Health is projected to be £0.641m overspent (£0.335m favourable) and the main variances are as follows: • Adult Inpatients – projected overspend by £1.473m (£0.044m adverse) due to very high levels of occupancy, patient mix and complexity and levels of continuous intervention which require additional supplementary staff and enhanced observations (1:1 and 2:1) and use of bank staff. • The UNPACS (Unplanned Activities) budget – projected overspend of £1.103m (£0.079m favourable) based on current placements. UnPACS placements are for individuals with very specific needs that require a higher level of security and/or care from a staff group with a particular skill set/competence. There are no local NHS secure facilities for women, people with a learning disability or people with neurodevelopmental disorder. This can necessitate an UNPACs placement with a specialist provider which can be out-of-area. The nature of mental health UNPACs spend is that it is almost exclusively on medium- or long-term complex secure residential placements which are very expensive so a small change in placements can have a high budgetary impact. Due to the complexity and risk involved, transitions between units or levels of security can take many months. Applications to approve a placement are made to the Associate Medical Director for Mental Health who needs to be satisfied that the placement is appropriate and unavoidable prior to this being agreed. Part of the additional control measures agreed in month 3 was to expand the high- cost care package review group to include all UNPACS placement requests, the projected position includes provision for any new placements approved. • Learning Disability Services – projected to overspend by £0.468m (£0.033m adverse). The overspend relates to the delay in achieving the saving from Ward 7A. Whilst the ward closed there are still legacy costs as the staff are still being redeployed and some patients remain within Woodland View. • Elderly Inpatients – projected overspend of £0.103m (£0.026m favourable) due to the use of supplementary staffing. The elderly mental health wards continue to operate at full occupancy with waiting lists, with several patients who are on enhanced observations and bank costs remain high. • Eating Disorders – projected to overspend by £0.137m (£0.002m adverse) due to the staffing level being higher than the funding
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allocation. This is being considered alongside the overall resource allocation. • Enhanced Mental Health Outcome Framework (EMHOF) – projected underspend of £0.624m (no movement). There was £0.624m of reserves held for EMHOF and the recovery plan approved the draw down of these reserves. • Psychiatry – is projected to overspend by £0.355m (£0.040m adverse) mainly due to junior doctor costs. A mitigation plan is being developed and the rota for junior doctors is being reviewed. A wholescale workforce review has been commissioned to determine longer term solutions for sustainability. • MH Pharmacy/Substitute Prescribing – is projected to underspend by £0.219m (£0.283m favourable). The favourable movement is due a further pharmacy rebate of £0.160m. Prior to this rebate there was an overspend due to increased demand and cost of medicines, and particularly the cost of Buvidal. This position is after investing £0.510m on a Pan Ayrshire basis (£0.170m per HSCP). • Action 15 – is projected to underspend of £0.412m (£0.037m favourable). There was £0.487m of reserves held for Action 15 and the recovery plan approved the draw down of these reserves which is the main reason for the underspend. The projected underspend is after considering the legacy costs from the 2024-25 review of funding. Innovation Fund – projected underspend of £0.021m (no movement) assuming that the posts to be redeployed as part of the EMHOF review are actioned. • The turnover target for vacancy savings for the Lead Partnership is held within the Lead Partnership as this is a Pan-Ayrshire target. There is a projected over recovery of the vacancy savings target of £1.412m (favourable movement of £0.065m) in 2025-26. Further information is included in the table below: Vacancy Savings Target (£1.160m) Projected to March 2026 £2.572m Over/(Under) Achievement £1.412m
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2.5 Children and Justice Services Against the full-year budget of £42.320m there is a projected overspend of £1.413m (3.3%) which is a favourable movement of £0.214m and the main variances are: a) Care Experienced Children and Young People is projected to overspend by £1.996m (£0.150m favourable). Some of these costs are offset by the contribution from the Home Office for Unaccompanied Asylum-Seeking Children which is detailed below. The main areas within this are noted below: • The children’s residential placements are projected to overspend by £2.874m (£0.096m favourable) based 32 placements in month 10. There are several factors leading to this challenging position: o We have 32 places available in our internal children’s houses, due to demand these have been operating at 100% occupancy or over for some time, leading to increased use of external placements where residential care is required. o There remains an acute shortage of foster carers leading to residential care being necessary in emergency placement situations. o The requirement to support Unaccompanied Asylum-Seeking Children (UASC) under the National Transfer Scheme and to support trafficked young people who have been identified in North Ayrshire. o A number of young people in residential care have requested Continuing Care, whereby a young person can remain in their placement until age 21. o Where appropriate young people are placed to meet their educational needs, the cost of Residential School Placements in the most cases is shared 50/50 with Education services. o Contractual inflation has still to be agreed for 4 providers. If this is higher than the assumed contractual inflation and it is likely that this will increase the projected costs of residential places which is outwith the control of the service. o Children’s Services are continuing to work with other services including Education and Housing to address the challenges through the work of the ‘Brighter Pathways’ Programme and associated workstreams. Note that the costs associated with mobilising Boyle Street are being finalised and will be funded by an underspend in the Service Redesign Fund. • Looked After and Accommodated Children (fostering, adoption, kinship etc) is projected to be £0.820m (£0.031m adverse) underspent.
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• Residential respite – placements are overspent by £0.056m (no movement). These short-term placements are used to prevent an admission to full time care or to avoid placement breakdown. • Employee costs – are projected to overspend by £0.055m (£0.059m favourable), largely due to staffing levels in the children’s houses and the outcome of job evaluation for posts. • Care Leavers – projected underspend of £0.046m (no movement) in rent costs. • Section 29 Payments (Throughcare Team) are projected to overspend by £0.130m. b) Head of Service – is projected to underspend by £0.724m (£0.066m favourable). This consists of a projected overspend of £0.158m in relation to the previous staff reconfiguration saving in the children’s houses which was not achieved in 23-24 or 24-25 and this is offset by the grant funding in relation to Unaccompanied Asylum-Seeking Children (UASC), which is projected to amount to £0.779m £0.003m favourable) and which contributes to costs incurred across a number of C&F service areas. c) C&F Health Team – is projected to overspend by £0.127m (£0.010m favourable) mainly in relation to the Band 6 to 7 regrade for Health Visitors and the progression of posts up the Band 7 scale. Part of this recurring cost was incorporated into budget pressures for 2025-26. d) Lead Partnership – Children’s Services – projected underspend of £0.065m as monies carried forward from 2024-25 are being taken towards the overall underspend. In line with the Brighter Pathways Re-Modelling Care Options Plan which was approved by the IJB in November 2025, the budget for care experienced children and young people will be re-aligned moving into 2026-27 with progress monitored in line with the planned reduction and re-alignment of placements. 2.6 ALLIED HEALTH PROFESSIONALS (AHP) The non-employee costs element of the AHP services are projected to be on-line. All underspends in employee costs have contributed to payroll turnover. 2.7 CHIEF SOCIAL WORK OFFICER This is projected to underspend by £0.109m (£0.036m favourable). The favourable movement is due to reduction in spend for young carers.
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2.8 MANAGEMENT AND SUPPORT Management and Support Services are projected to underspend by £1.907m (£0.309m favourable which is primarily due to additional vacancy savings), the overall main areas of variance are: • There is projected slippage on the LD and MH transition funding of £0.631m (£0.098m favourable) due to delays in children transitioning into adult services. This involves complex planning by services with service users and families and can change over time based on assessed need when moving into adult services. • The 2024-25 budget included a budgeted deficit on the social care side of £0.437m which is offset by a budgeted surplus of £0.437m on the health side of the budget. • There is also a balance of overachieved savings of £0.181m (£0.044m favourable) and contractual inflation of £0.268m (£0.268m favourable). • NHS shortfall in savings of £0.124m (£0.106m favourable) which is not coded to specific areas and held centrally until recurring savings can be identified. • The funding for the Reduced Working Week (non-Lead Partnership element) is coded to Management and Support pending final confirming of the allocation. It is projected to underspend by £0.293m as the overspends in relation to these costs are shown on other lines outwith Management and Support. • An over-recovery of payroll turnover of £0.450m (£0.300m favourable) for social care services and an over-recovery of £0.469m (£0.187m favourable) for health services as outlined in the table below. The turnover targets and achievement for the financial year for Health and Social Care services outwith the Lead Partnership is noted below: Social Care Health Vacancy Savings Target (£3.400m) (£1.567m) Projected to be achieved by March 2026 £3.850m £2.036m Over/(Under) Achievement £0.450m £0.469m The areas contributing to the health and social care vacancy savings are spread across a wide range of services with vacancy savings being achieved in most areas. As part of the recovery plan, the vacancy scrutiny group has been enhanced with the Heads of Service and professional leads attending. Each post is scrutinised and filled only where deemed necessary with a recruitment freeze now implemented for all non-essential posts. For 2025-26 there will be a further recruitment delay with vacancy scrutiny approved vacancies being held for four weeks before they are advertised to create more payroll
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turnover. This will be for all vacancies except clinical or registered services vacancies or those which will incur cover costs. The turnover target for the North Lead Partnership for Mental Health services is detailed separately within the Lead Partnership information at section 2.4. 2.9 Savings Progress The approved 2025-26 budget included £4.019m of savings. BRAG Status Position at Budget Approval £m Position at Month 10 £m Red - 1.000 Amber 2.984 1.027 Green 1.035 - Blue - 1.992 TOTAL 4.019 4.019 Appendix B provides an overview of those service changes which do have financial savings attached to them and the BRAG status around the deliverability of each saving. Any shortfall in relation to the red and amber rated savings are already reflected in the projected outturn. 2.10 Budget Changes The Integration Scheme states that “either party may increase it’s in year payment to the Integration Joint Board. Neither party may reduce the payment in-year to the Integration Joint Board nor Services managed on a Lead Partnership basis…. without the express consent of the Integration Joint Board.” Appendix C highlights the movement in the budget position following the initial approved budget. Reductions Requiring Approval: Ref Description Amount (£000) 1 MAT Standards Funding Adjustment 6 2.11 Pan Ayrshire Lead Partnership services and Large Hospital Set Aside Lead Partnerships: - There is a requirement for the 3 IJBs to be aware of the position for Lead Partnership services and plans to deliver services from within allocated budget. East and South HSCP do not report at month 10 so there is not updated pan Ayrshire report.
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Set Aside: - 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 these compare to the NRAC “fair share” of resources. Ayrshire Finance Leads have now agreed a baseline methodology for set aside budgets which involves using the four full years prior to the pandemic, 2016/17 – 2019/20 inclusive. The HSCPs require to agree their final share of the baseline with each other, however the aggregate will remain unchanged. The table below shows the cost of the historic baseline at 2024/25 prices. The 2025/26 actual usage information is not known until later in the year. IJB Baseline at 2024/25 prices (£) East 31.870 North 39.966 South 34.488 Total 106.324 The annual budget for Acute Services is £496.7million. The directorate is overspent by £30.5 million after 10 months including legacy CRES. This was caused by overspends on medical and nursing staff, together non pay overspends on equipment and supplies. These are required due to the level of operational pressure experienced. Unfunded wards contributed an overspend of £5.7m after 10 months. Within the overall £30.5 million overspend Medicine are over by £12.2 million, Emergency Care by £9.9 million, Surgery by £3.8 million, Labs and Diagnostics by £3.4 million and Women and Children by £2.2 million. There is a material underlying deficit caused by: • 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.
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The IJBs and the Health Board work closely in partnership to maintain service and improve performance. 2.12 FINANCIAL RISKS There are a number of financial risk areas that impact or may impact on the financial position. • Current overspend areas, especially in low volume / high-cost services e.g. Children’s residential placements, UNPACs, and supplementary staffing across community, mental health and learning disability wards. • Growing demand for services. • Staff recruitment and retention challenges across a number of service areas. • 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. • Pay settlements for both NHS and Local Government staff have been agreed for 2025/26. The NHS element has been funded, and the current assumption is that the shortfall between budget planning assumptions and actual settlements will be fully funded for Local Government staff. • 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. • Removal of brokerage for NHS Boards, NHS AA have been asked by Scottish Government to deliver further financial improvement beyond their Board approved financial plan and have now been escalated to Level 4 of the NHS Scotland Support and Intervention Framework. • The overall sustainability of commissioned care providers, with eNICs compounding historic challenges re financial sustainability, there is a heightened risk of provider failure leading to handing back of care and contracts. • The ongoing ability to source packages of care for service users. • 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 re- grade, protected learning time and reduction to the working week.
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• Scotland Excel inflationary increases for children’s services have been significantly higher than assumed. • There is a risk in relation to recovering recharge income in relation to the LD Assessment and Treatment patients from outwith Ayrshire. • Risk related to NHS Reform investment being allocated by Scottish. These risks will continue to be monitored. Audit Scotland’s recent audit of the IJB Annual Accounts concluded that North Ayrshire IJB has effective financial management and reporting arrangements in place. The audit also highlighted success in achieving approved recurring savings. This demonstrates that the current financial recovery situation is not a result of inadequate financial oversight, poor reporting, or an inability to deliver efficiencies. Instead, the ongoing challenge relates to rising levels of need within the North Ayrshire population and the wider, and national, issue of ensuring the long-term financial sustainability of health and social care services. It is essential that the IJB works with all partners to accelerate and resource service redesign and transformation, in order to provide sustainable care for the future. An Internal Audit review of IJB transformation submitted to the September 2025 Performance and Audit Committee gave an opinion of substantial assurance in relation to the governance of the Transformation Plan. The next planned IJB Audit will focus on Financial Sustainability. 2.13 RESERVES The IJB opening reserves position are summarised in the table below. General Fund Reserve Earmarked Reserves Total Unearmarked External Funding HSCP £m £m £m £m Balance – 1 April 2025 - 2.381 0.780 3.161 Anticipated Drawdown - (2.381) (0.780) (3.161) Balance – 31 March 2026 - - - - The £0.780m HSCP earmarked reserve relates to the Service Redesign and Change Fund which is fully committed in 2025-26. Further detail on the reserves is given in Appendix D.
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2.14 Financial Recovery Plan Since the initial recovery plan was agreed in June 2025 there has been a £2.833m 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 £2.168m. This has resulted in a net achievement of £0.665m recovery action per below: Given the proximity to the financial year end there is no new recovery plan action being proposed and instead a focus on continuing to progress the previously agreed actions and enhanced governance, oversight and escalation of spend and approvals. It is anticipated that the management and recovery actions developed during 2024- 25 and 2025-26 will require to continue into 2026-27. PROPOSALS 3.1 Anticipated Outcomes Continuing to closely monitor the financial position will allow the IJB to take corrective action where required to deliver services in 2025-26 from within the available resource, thereby limiting the financial risk to the funding partners. The transformational change programme will have the greatest impact on the financial sustainability of the partnership, the IJB require to have a clear understanding of progress with the delivery of the transformation plan. 3.3 Measuring Impact The final outturn will be reported to the IJB.
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4. IMPLICATIONS 4.1 Financial The outturn is an overall year-end overspend of £2.802m (0.8%) . The report outlines the main variances for individual services. The IJB unearmarked reserve balance is zero. This current position poses a financial risk to North Ayrshire Council and NHS Ayrshire and Arran. 4.2 Human Resources The report highlights vacancy or turnover savings achieved during the year. Services will review any staffing establishment plans and recruitment in line with normal practice when implementing service change and reviews as per agreement with the IJB. Tight vacancy scrutiny management arrangements are in place for the HSCP. 4.3 Legal None. 4.4 Equality/Socio-Economic None. 4.5 Risk Para 2.12 highlights the financial risks. 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. The ‘financial viability of the HSCP’ risk is on our strategic risk register. 4.6 Community Wealth Building None. 4.7 Key Priorities The ability to deliver on our strategic priorities may be compromised due to the greater financial risk faced in 2025-26 and the increased focus required on financial rather than service improvement. This will be kept under close scrutiny throughout 2025-26. If we are unable to successfully develop a financial recovery plan to achieve financial balance, consideration may be given to revising the strategic commissioning plan. 5. CONSULTATION 5.1 This report has been produced in consultation with relevant budget holders and the Partnership Senior Management Team.
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5.2 The IJB financial monitoring report is shared with the NHS Ayrshire and Arran Director of Finance and North Ayrshire Council’s Head of Finance after the report has been finalised for the IJB. Caroline Cameron, Director Author – Eleanor Currie, Chief Finance Officer [eleanorcurrie@north-ayrshire.gov.uk]
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PUBLIC INFORMATION 2025-26 Budget Monitoring Report–Objective Summary as at 31st January 2026 Appendix A Budget Outturn Projected Over/ (Under) Spend Variance Budget Outturn Projected Over/ (Under) Spend Variance Budget Outturn Projected Over/ (Under) Spend Variance £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 COMMUNITY CARE AND HEALTH 78,717 79,578 861 20,894 22,011 1,117 99,611 101,589 1,978 2,957 (979) : Locality Services 32,539 33,267 728 5,789 5,789 0 38,328 39,056 728 747 (19) : Community Care Service Delivery 41,957 41,730 (227) 0 41,957 41,730 (227) 803 (1,030) : Rehabilitation and Reablement 2,093 2,102 9 0 2,093 2,102 9 51 (42) : Long Term Conditions 904 952 48 10,628 11,584 956 11,532 12,536 1,004 944 60 : Community Link Workers 339 338 (1) 0 0 0 339 338 (1) (1) 0 : Integrated Island Services 885 1,189 304 4,477 4,638 161 5,362 5,827 465 413 52 MENTAL HEALTH SERVICES 41,157 42,242 1,085 77,456 77,745 289 118,613 119,987 1,374 1,720 (346) : Learning Disabilities 32,078 33,266 1,188 727 727 0 32,805 33,993 1,188 1,199 (11) : Community Mental Health 7,069 6,956 (113) 1,801 1,801 0 8,870 8,757 (113) (111) (2) : Addictions 2,010 2,020 10 1,879 1,880 1 3,889 3,900 11 9 2 : HBCCC 0 0 0 353 0 (353) 353 0 (353) (353) 0 : Lead Partnership Mental Health NHS Area Wide 0 0 0 72,696 73,337 641 72,696 73,337 641 976 (335) CHILDREN & JUSTICE SERVICES 36,425 37,801 1,376 5,895 5,932 37 42,320 43,733 1,413 1,627 (214) : Irvine, Kilwinning and Three Towns 3,249 3,292 43 0 0 0 3,249 3,292 43 46 (3) : Garnock Valley, North Coast and Arran 3,598 3,690 92 0 0 0 3,598 3,690 92 83 9 :Intervention Services 1,841 1,839 (2) 0 0 0 1,841 1,839 (2) 0 (2) : Care Experienced Children & Young people 22,791 24,787 1,996 0 0 0 22,791 24,787 1,996 2,146 (150) : Head of Service - Children & Families 1,413 689 (724) 0 0 0 1,413 689 (724) (658) (66) : Justice Services 3,101 3,101 0 0 0 0 3,101 3,101 0 0 0 : C&F Health Team 432 403 (29) 5,015 5,117 102 5,447 5,520 73 82 (9) : Lead Partnership NHS Children's Services 0 0 0 880 815 (65) 880 815 (65) (72) 7 CHIEF SOCIAL WORK OFFICER 1,959 1,851 (108) 0 0 0 1,959 1,851 (108) (73) (35) PRIMARY CARE 0 0 0 53,262 53,259 (3) 53,262 53,259 (3) (3) 0 ALLIED HEALTH PROFESSIONALS 0 11,489 11,489 0 11,489 11,489 0 0 0 MANAGEMENT AND SUPPORT COSTS 8,195 6,922 (1,273) 4,038 3,404 (634) 12,233 10,326 (1,907) (1,598) (309) OUTTURN ON A MANAGED BASIS 166,453 168,394 1,941 173,034 173,840 806 339,487 342,234 2,747 4,630 (1,883) Return Hosted Over/Underspends to East 0 0 0 0 (210) (210) 0 (210) (210) (320) 110 Return Hosted Over/Underspends to South 0 0 0 0 (183) (183) 0 (183) (183) (279) 96 Receive Hosted Over/Underspends South 0 0 0 0 33 33 0 33 33 33 0 Receive Hosted Over/Underspends East 0 0 0 0 415 415 0 415 415 415 0 OUTTURN ON AN IJB BASIS 166,453 168,394 1,941 173,034 173,895 861 339,487 342,289 2,802 4,479 (1,677) Over/ (Under) Spend Variance at Period 9 Movement in variance from Period 9 TOTAL Partnership Budget - Objective Summary Council Health 2025/26 Budget
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2025-26 Savings Tracker Appendix B Social Care: Ref Description Deliverability Status at budget setting Deliverability Month 10 2025/26 Saving Previously Agreed Savings (Full year impact) 1 Review of Day Care provision Green Blue 0.100 2 Service redesign (CAAST Team and Corporate Parenting team) Green Blue 0.034 Adjustments 3 Payroll Turnover Green Blue 0.099 Mental Health 4 LD Responder Service Amber Amber 0.150 Children, Families & Criminal Justice 5 Brighter Pathways Amber Red 1.000 Community Care & Health 6 Review of Day Care provision Amber Blue 0.107 7 Care at Home Amber Blue 0.500 8 Care Package Review (all services) Amber Blue 0.200 9 Deletion of vacant posts Green Blue 0.056 10 Increase to charging Green Amber 0.186 11 Admin Post Savings Green Blue 0.114 12 Financial Inclusion Green Blue 0.357 TOTAL SOCIAL CARE SAVINGS 2.903 Cross Service
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Health: Ref Description Deliverability Status at budget Deliverability Month 10 2025/26 Saving Adjustments 13 Increase recharge to East Ayrshire for beds at Woodland View Green Blue 0.010 14 Payroll Turnover Green Blue 0.079 Other Savings 15 Admin Savings Amber Blue 0.186 16 Trindlemoss House - move to social care model Amber Amber 0.250 17 EICT/Rehab Amber Blue 0.150 18 Community MH/Wellbeing Review Amber Amber 0.100 19 Ward 7A - Woodland View Amber Amber 0.341 TOTAL HEALTH SAVINGS 1.116 TOTAL NORTH HSCP SAVINGS 4.019
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2025-26 Budget Reconciliation Appendix C COUNCIL Period Permanent or Temporary £'m Initial Approved Budget 137.739 Adjustments to baseline 0.039 Revised Budget 137.778 Resource Transfer 25/26 1-3 25.026 Additional Funding - 24/25 Adult Social Care RLW 1-3 P 0.073 Additional Funding RLW 1-3 P 0.126 Additional Funding - Money Smart 1-3 P 0.094 ICT Transfers 1-3 P (0.005) Additional Funding - Whole Family Wellbeing Funds 1-3 T 0.179 CJSW - S27 1-3 P 3.280 Development of People working in Childrens SW 1-3 P (0.390) Change Fund Allocation - HSCP FIO Team 7 T 0.021 Internal Commerical Waste 7 P 0.009 ICT Transfers 9 P (0.004) CSC Pay Uplift 10 0.163 SRA Kinship 10 0.058 Change Fund Allocation - HSCP FIO Team 10 0.047 ICT Transfers 10 (0.004) Roundings 10 0.002 166.453 HEALTH Period Permanent or Temporary £'m Initial Budget exc set aside 161.934 Month 10-12 Adjustments and adjusting for the full year impact of part years amounts and temporary funding. 8.532 Revised Budget 170.466 Resource Transfer 24/25 24.640 Resource Transfer 25/26 (25.026) NORTH NATIONAL INS 25-26 AMBUS 1 0.997 PRESCRIBING 25-26 AMBUSH 1 2.754 PRESCRIBING CRES 25-26 AMBUSH 1 (0.715) Training Grade Adj - April 1 (0.058) Training Grade Rates Adj - April 1 0.030 MH: Anticipate PDS Dementia (North) 25/26 1 0.094 MH: Anticipate Delivery of Veteran Specific 25/26 1 0.105 Anticipated RWW from SG 1 0.659 Anticipate 20% Tranche 2 ADP 1 0.174 Social Care Budget Reported at Month 10
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HEALTH Period Permanent or Temporary £'m Training Grade Adj - May 2 (0.013) Bwp 25-26 East Chest Heart Stroke 2 0.001 Bwp 25-26 East Nest Expansion 2 0.023 Bwp 25-26 East - Sds Advice Service 2 0.013 Bwp 25-26 East Sub Prescribing 2 0.170 25-26 South Budget Paper - North Substitute Prescribing 2 0.170 25-26 South Budget Paper - Pan Ayrshire Chest Heart And Stroke 2 0.001 25-26 North Budget Paper - Pan Ayrshire (vision Support Service 2 (0.005) 25-26 North Budget Paper - Pan Ayrshire (communitystore) 2 (0.155) HD52: EARLY INTERVENTION PSYCHOSIS 3 0.100 25-26 Pay Award Increase North 3 1.179 Training Grade Adjustment (Dean Funding) 4 0.011 Medical Pay Award - Senior Medical - Additional 1% 4 0.086 Medical Pay Award - Specialty Doctors - Additional 1% 4 0.006 Virement to Medical Directorate from Mental Health Admin 4 (0.028) Transfer MAT Standards Psychiatrist 0.2 WTE 4 0.029 Primary Care Prescribing Tariff Reduction 4 (0.556) BBV transfer from Public Health 4 0.269 Training Grade Adjustment (Dean Funding) - August 5 0.129 Budget transferred to Capital for INV-3395435821 5 (0.006) Transfer from South - ANP contribution 5 0.030 Primary Care Prescribing Budgets reworked 5 0.130 HD157 3% pay award ADP North 5 0.057 North MDT funding to Arran Medical Group (Virement 11) 5 (0.043) Training Grade Adjustment (Dean Funding) - September 6 0.018 Transfer Methadone LES to East GMS 7 (0.008) Post to Medical records 7 (0.037) GP Prescribing budget adjustment 7 (1.094) ADP MAT Standards Allocation 7 (0.045) ADP ABI to East 7 (0.010) Drug Death Co-ordinator funding returned to PH (retiral - post funding returned) (0.040) BBV funding returned to PH (reduction in hours) 8 (0.008) Training Grade Adjustment (Dean Funding) - December 8 (0.071) Training Grade Rates Adjustment - December 9 0.086 Early Years funding 0.49 WTE Band 4 - MIN Alloca 9 0.020 GP Prescribing budget adjustment 9 (0.365) Training Grade Adjustment (Dean Funding) - January 10 0.019 Junior Doctors Pay Award - additional 0.25% 10 0.008 MAT Standards Adjustment 10 (0.006) ANTICIPATED BUDGETS INCL HERE (NOT IN LEDGER) 10 (1.150) Roundings (0.001) 173.034 TOTAL COMBINED BUDGET 339.487 Health Budget Reported at Month 10
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25-26 IJB Reserves Position Appendix D Area of Reserves Balance at 31 March 2025 Earmarked Funds £ : Alcohol & Drug Partnership 353 : Mental Health Action 15 135 : Primary Care Improvement Fund 46 : Service Redesign / Challenge Fund 780 : Family Wellbeing Fund 934 : Breastfeeding Network 36 : MH Recovery and Renewal /Enhanced MH Outcome Framework 365 : Early Intervention in Psychosis 92 : LD funding 82 : Donation (Police Scotland) 1 : Primary Care Improvement Fund IP 303 : GP Premises Improvements - tranches 1 and 2 3 : Dental Practice Improvement 29 : Appropriate Adult 2 Total Earmarked 3,161
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Bank and Agency Costs to Month 10 Appendix E 1) NHS 4863 (Registered) 4864 (Unregistered) 4853 (Registered) 4854 (Unregistered) 4865 (Agency Locum Consultant) TOTAL NORTH CORE SLT ADULT 3,098 3,098 WARD 1 WOODLANDS VIEW 47,525 235,032 282,557 WARD 2 WOODLANDS VIEW 25,567 346,633 372,200 ACH REDBURN REHAB WARD NRS 24,251 164,162 188,413 ACH DOUGLAS GRANT REHAB WD NRS 34,699 75,855 110,554 WARD 3 WOODLANDS VIEW NURSING 12,324 328,558 340,882 WARD 4 WOODLANDS VIEW NURSING 1,605 37,804 39,409 NEW CLONBEITH NURSING(JURA) 89,093 144,959 234,052 WVIEW THE GLEN ECT 5,197 11,959 17,156 WVIEW WARD 10 ACUTE MH NRS 5,576 238,505 244,081 WVIEW WARD 8 ACUTE MH NRS 23,316 760,489 783,805 WARD 5 WOODLANDS VIEW 4,033 47,347 51,380 WVIEW WARD 7B REHAB MH NRS 7,419 7,419 NEW DUNURE NURSING(CLONBEITH) 35,937 192,942 228,879 MH BED MANAGEMENT 21,726 21,726 TRINDLEMOSS 60,040 282,690 342,730 ARRAN HOSPITAL NURSING 69,006 41,701 110,707 CAMHS MANAGEMENT 1,944 1,944 CAMHS UNSCHEDULED CARE 1,903 1,903 EARLY YRS-C/F TEAM 1 923 923 EARLY YRS-C/F TEAM 3 974 974 IMMUNISATION NURSING 55,249 17,611 72,860 ARRAN HV 137 137 ARRAN DN 13,862 13,862 PACKAGE OF CARE (P) - AMG 109,773 109,773 PACKAGE OF CARE (P) - LMO 879 879 NC POC TEAM 2 990 990 NC POC TEAM 3 3,843 3,843 THREE TOWNS DN 1,187 1,187 FOXGROVE(NSAIS)ADVANCE RECRUIT 29,246 29,246 NORTH AHP MANAGEMENT TEAM 7,329 7,329 IRVINE DN 16,516 16,516 NORTH WEST COAST DN 31,318 31,318 GARNOCK VALLEY DN 53,541 53,541 LADY MARGARET NURSING 8,467 4,520 12,987 PREVENTION + SERVICES SPT TEAM 4,719 4,719 LD HEALTH CHECKS 12,238 12,238 NORTH CLDT 6,806 164 6,970 LDS MANAGEMENT 2,332 2,332 MHANPS MH UNSCHEDULED CARE 38,721 57 38,778 MHS INPATIENT MGT 15,845 520 16,365 CMHT NURSING-NORTH AYRSHIRE 9,362 5,890 15,252 WVIEW WARD 7C FORENSIC REHAB N 9,224 138,927 371 148,522 INTENSIVE COMMUNITY NURSING TEAM 44,893 3,978 48,871 ADULT MENTAL HEALTH LIASION TEAM 343 343 PCMHT NORTH 4,108 4,108 WVIEW WARD 6 LOW SECURE NRS 53,282 162,602 215,884 WARRIX AVE 110,637 83,409 194,046 ICFN - COMMUNITY PHLEBOTOMY 12,456 12,456 FORENSIC PSYCHOLOGY 3,248 3,248 CHILD HEALTH ADMIN 25,610 1,797 27,407 WVIEW WARD 7A LD A+T NRS 23,436 425,962 1,804 14,532 465,734 WVIEW WARD 9 ACUTE MH NRS 45,418 384,223 226 429,867 WVIEW WARD 11 ACUTE MH NRS 299,680 299,680 ADULT EAST 1,131 1,131 OLD AGE 60,253 60,253 1,063,557 4,605,590 2,401 14,532 61,384 5,686,080 2) SOCIAL CARE Mth 10 Spend 327,922 158,510 15,000 89,483 590,915 Mh Acm Agency Montrose House Brodick Unscheduled Care Funding Ld Acm Bank