Integration Joint Boards (IJBs), together with their NHS and council partners, must urgently take decisions on where to redesign, reduce or discontinue services.
Funding to Scotland’s 30 IJBs increased by over two per cent in 2024/25 to more than £12 billion. But this was insufficient to meet rising costs and demands, with many IJBs using dwindling reserves to help meet the almost £450 million gap between demand and available funding. This is not sustainable.
Increasing demand, rising costs and a growing number of people with long-term complex needs are placing mounting financial pressures on IJBs. The boards have reached a critical point, with a significant risk they will become financially unsustainable within the next 12 to 24 months.
Alongside savings and using reserves, IJBs have been relying on substantial additional funding from their partners in the NHS and councils. IJBs need to plan their finances more realistically to reduce this reliance, as health boards and councils face their own significant financial pressures.
Malcolm Bell, member of the Accounts Commission said: “The cost of delivering services is rising faster than available funding.
“Tackling this could include difficult decisions about redesigning or reducing services, and whether new or additional charges need to be made. Whatever decisions are made, service users, their families and wider communities must be consulted.
“But without radical change the services delivered by IJBs can’t be sustained. The gap between funding available and the cost of meeting demand is widening, and the gap of nearly £450 million cannot be bridged with savings alone.”
COSLA Health and Social Care spokesperson, Councillor Paul Kelly, commented: “The Accounts Commission report on Integration Joint Board finances for 2024-25 confirms the stark reality our Health and Social Care Partnerships face: that severe financial challenges continue to pose a risk to the sustainability of social care, which threatens the every day lives of our most vulnerable citizens and communities.
“The challenges also threaten the sustainability of our councils, who have continued to prioritise social care, with an additional £163m invested over and above Scottish Government funding in 2024-25. This level of additional funding is unsustainable for partners, but in many cases the only option given the diminishment of reserves held by Partnerships.
“The report makes clear the validity and need for our budget lobbying ask of an immediate investment of £750m in social care. We will continue to press the Scottish Government for this investment to avoid further cuts, reductions and increased charges in future.”
We recently launched our Scottish Approach to Change Learning Community. Our community aims to support change across health and social care in Scotland. We plan to help members build knowledge, understanding, and confidence when delivering change.
Head to our website to get involved. Link to find out more:
Unpaid carers, disabled people and people with lived experience of social care will have a say on local services after Scottish Parliament regulations come into force.
Social Care Minister Tom Arthur tabled an order giving service users and third sector organisations a vote during integration joint board decision making. This ensures their perspectives carry equal weight in shaping decisions about services, such as care in the community to enable people with disabilities or long term conditions to remain at home.
The 31 boards bring together the NHS and local councils with key community and service representatives to oversee planning and delivery of social care and community health services. Until now only members appointed by the NHS health board and local councils can vote.
The draft regulations will come into force in September after the Scottish Parliament’s Health, Social Care and Sport Committee’s scrutiny of the legislation concluded yesterday.
Mr Arthur said: “I am determined to ensure those who access and support community health and social care services have an equal say in making decisions that affect their communities.
“These regulations extend voting rights to unpaid carers, service users and third sector representatives, collectively representing the voice of lived experience. It is only fair that these voices carry equal weight alongside other members – to help ensure local services are funded properly to meet the needs of people.
“People with lived experience provide valuable insight into challenges and opportunities which should be considered during planning. This change will bring decision making closer to the people we all serve. We expect to see more inclusive, collaborative and improved choices as a result.”
MPs on the cross-party committees will consider what mental health support is available to children and young people up to the age of 25 in community, health and education settings.
Through the inquiry, MPs will consider how this support is integrated with NHS services, such as specialist Child and Adolescent Mental Health (CAMHS) services, and what support is available throughout the education system, including for children with special educational needs and disabilities (SEND).
They will explore how potential reforms to CAMHS could improve children and young people’s access to mental health care and whether support could be provided in the community, such as through the Government’s new Young Futures Hubs.
Around one in five children and young people aged 8 to 25 in the UK has a “probable mental disorder”, according to NHS statistics published in 2023, while the consultancy PwC says that mental health challenges are having a significant impact on young people’s career choices and wellbeing at work. The committees will investigate what factors are driving these changes to children and young people’s mental health.
The committees will also scrutinise the implementation and rollout of relevant government policies such as the commitment to expand Mental Health Support Teams to all schools in England by 2029/30.
MPs will also investigate how education staff can support children and young people’s mental health, and whether current Ofsted frameworks or DfE guidance help or hinder mental health provision.
Chair of the Education Committee, Helen Hayes MP, said: “Struggling with mental health should never obstruct a young person’s chance to learn and thrive. Yet for too many, especially those with SEND or experience of the care system, that’s still the reality.
“From the early years through to university, education staff are often being asked to step in where existing support has failed.
“Our inquiry will take a forensic look at the mental health services available to children and young people at every stage of their education, from ages zero to 25.
“We will consider the role teachers can play in supporting children and young people’s mental health and whether they are getting the training they need to do that properly.
“We’ll also look at the full range of government policies and plans affecting young people, from SEND reform to the National Youth Strategy, and ask: are ministers doing enough to protect young people’s mental health?”
Chair of the Health and Social Care Committee, Layla Moran MP said: “For parents and school leaders alike, trying to get mental health support for children can feel like navigating a spaghetti junction.
“Services are frequently overwhelmed and not joined up. Too often the help doesn’t come until a child’s needs are at crisis point. These fundamental problems sit alongside issues that the Health and Social Care Committee documented in 2021 – the need to increase emphasis on prevention and early intervention. We return to these themes now amid deepening concern about the scale of need and questions of how the system can be remade fit for purpose.
“We will try and show Government how it can untangle the knotty problems that stop children getting the help they need and point to where investment should be directed. We’ll see how silos can be broken down between two sectors that should be working hand in glove, because we know that children’s education and wellbeing are intrinsically linked.”
Social Work Scotland is a membership organisation which represents social workers and other professionals who lead and support social work across all sectors.
In October 2025, after reports of reductions to SDS personal budgets (options 1 direct payments), Social Work Scotland facilitated two separate surveys for disabled people and carers and social workers.
Survey analysis was completed by Three Sisters Consultancy (disabled people and carers) and Dr Gillian MacIntyre and Dr Ailsa E Stewart (social workers).
In addition, Social Work Scotland are proud to publish a bridging paper collating both perspectives to discuss the state and future of social work and social care in Scotland, and pleased to be able to bring lived experience and workforce voices together.
This report is published alongside two complementary research studies: one capturing the lived experience of people who draw on social work and social care support, and another exploring the experiences of social workers operating within the current system.
Its purpose is to connect these perspectives – to show how funding decisions, governance arrangements, and policy choices shape both what people experience and what practitioners are asked to do.
By bringing lived experience, workforce reality, and financial analysis into the same frame, this paper aims to support informed, constructive discussion about how Scotland can build a more sustainable, rights-based, and trusted system of care and support. It is intended as a contribution to collective problem-solving, not an attribution of blame to individuals or organisations working within significant structural constraints.
Report 1: The State and Future of Social Work and Social Care in Scotland Part 1 (written by Laura Kerr, Head of Policy and Workforce, Social Work Scotland)
Report 2: Impacts of SDS budget reductions on social workers – Survey analysis (written by Dr Gillian MacIntyre and Dr Ailsa E Stewart)
Report 3: Impacts of SDS budget reductions on disabled people and unpaid carers – Survey analysis (written by Rhiann McLean Three Sisters Consultancy)
COSLA’s Health & Social Care Spokesperson Councillor Paul Kelly said:“This report serves as a collective call to action for meaningful and sustainable change in social work and social care in Scotland, to deliver the system we aspire to have; one centred around human rights and dignity, where both the people delivering and accessing support feel valued. I offer Local Government’s commitment to work with partners on realising change.
“Scotland’s social work and social care sector faces complex funding, policy and system challenges, and this report makes clear the impacts these can have on people, carers and frontline workers. It is deeply troubling that frontline workers talk about the moral and ethical dilemmas they face as a result of having to balance financial considerations with the care that can be delivered to citizens.
“In collectively considering the reports and working through system challenges, we cannot allow further cuts to be inflicted upon vital social care services at this pivotal time. As it currently stands, the Scottish Budget would represent a further cut to social care funding in Scotland, and risks compounding the very real system pressures which will directly impact people and communities.
“Social work and social care are essential to the fabric of Scottish society. We know that by investing in these services, and by working together to change them for the better, we can make a real difference to people’s lives, to local economies and to our communities.”
If you’ve got a few minutes this weekend, take a look at Pathways to Progress – a new project focused on improving fair work in Scotland’s social care sector.
The project, delivered by Living Wage Scotland at the Poverty Alliance and funded by the Robertson Trust, is exploring how better pay, more secure hours, and improved working conditions can make a real difference for people working in care. [pathwaysto…rogress.uk]
It’s a thoughtful, accessible site with insights into the challenges facing social care – and the practical pathways that could help build a fairer future.
The Scottish Budget represents a cut to social care funding in Scotland, a concerning and disappointing reality for the people who access and work in social care.
In both COSLA’s manifesto and pre-budget lobbying, the voice of Scottish local government, made a clear and urgent ask for significant additional investment of £750m to protect and strengthen social care. The Scottish Budget as it currently stands, fails to deliver on this. There is no dedicated, additional funding for social care, and the £160m allocated for paying the Real Living Wage to adult social care workers falls short of the estimated £175m cost of this policy commitment.
This is not additional investment – it is underfunding of an existing promise.
The consequences of this budget are real. Without significant new resources, people will continue to face unacceptable delays for social work assessments and care packages. Services already under immense strain will be pushed even closer to breaking point, and councils will be forced into impossible choices.
This will directly impact individuals – those who access care and support and those in hospital waiting for care – at a time when our shared ambition should be to shift the balance of care and improve population health. It is for these reasons that COSLA sees this as very poor settlement for local government which fails to address the dire financial situation.
COSLA Health and Social Care Spokesperson, Cllr Paul Kelly commented: “Social care is fundamental to the wellbeing of our communities.
“The Scottish Budget – which COSLA Leaders agree is very poor – undermines the foundations of a fair and sustainable care system and risks reversing progress toward a model that truly meets people’s needs.
“Quite simply, this Budget is not just disappointing for social care, it is damaging.
“COSLA remains committed to improving the design and delivery of social care and we would welcome the opportunity on offer to take forward focused joint working to support our shared ambition of ensuring those with complex needs are supported in the right setting. But without proper investment, that ambition cannot be realised.”
COSLA has set out concerns about the Scottish Government’s Budget settlement for Local Government, warning that while there is a modest increase in uncommitted revenue, the settlement remains insufficient to meet rising demand for essential local services.
Following a meeting of council leaders, it was stressed that the increase of £234 million in uncommitted revenue funding for 2026/27 does not address the scale of pressures facing councils, particularly in social care where demand and complexity continue to rise sharply.
COSLA also highlighted urgent concerns about the continued underfunding of the Real Living Wage policy.
While welcoming the increase in funding for the Affordable Housing Supply Programme, COSLA warned that the capital funding position for local government is becoming increasingly unsustainable, threatening councils’ ability to invest in vital infrastructure and community assets.
Leaders also expressed significant concern about the medium-term outlook set out in the Spending Review, which suggests continued de-prioritisation of local government and further real-terms cuts over the coming years.
Cllr Ricky Bell, COSLA Spokesperson for Resources, said:“While we acknowledge the increase in uncommitted revenue funding for 2026/27, this settlement falls far short of what is needed to sustain essential local services. Councils are facing acute and growing pressures, particularly in social care, and the current level of funding simply does not reflect the scale or complexity of demand.
“We are especially concerned by the continued underfunding of the Real Living Wage across portfolios including social care. COSLA made a clear and urgent ask for significant additional investment of £750m to protect and strengthen social care, which the Budget as announced fails to deliver.
“Further to this, the medium-term outlook paints a worrying picture for local government, with continued de-prioritisation and the prospect of significant real-terms cuts.
“If councils are to continue delivering for communities, we are calling for urgent and meaningful engagement with the Scottish Government to ensure local government is properly funded to continue delivering the essential services communities rely on every day.”
COSLA reiterated its support for the introduction of additional council tax bands as an interim step towards fundamental reform, emphasising that any changes must be taken forward in close cooperation with COSLA and local government.
In addition, it welcomed the Scottish Government’s forthcoming legislation to remove the cap on council tax premiums for second and empty homes, describing it as a positive step in providing councils with greater local flexibility.
The RCN says the practice must end urgently, as testimony from members shows its damaging effects
Corridor care has become such a permanent fixture in NHS hospitals that nursing staff are in danger of “losing all hope”, with collapsing care standards devastating morale, according to new testimony from nursing staff.
The Royal College of Nursing is reiterating its call for urgent, fully funded action plans to eradicate the practice, including investment in beds, the nursing workforce, community services and social care.
Nursing staff say the lack of action by governments has left them feeling “ashamed”, “angry”, and “embarrassed” about the unsafe, undignified care they are forced to deliver to patients.
The RCN is aware of a worsening picture this week as hospitals declare critical incidents and is encouraging members to raise any concerns about patient or staff safety. Read on to find out how we can offer practical support.
Our members report shocking examples of a patient being left in a chair for four days, while another patient died after choking undetected in a corridor.
Nursing staff have also resorted to holding up sheets to protect patient dignity when performing intimate procedures, with a corridor in one hospital so tightly packed that an elderly patient was left to eat next to someone vomiting.
One nurse in the south of England said: “We would not treat animals like this in a veterinary practice, so why in a hospital?”
Another, working in an NHS board in Scotland, told us: “It’s very stressful and distressing at times. There’s a sense of frustration and hopelessness.”
A mental health nurse in Wales said corridor care is a “regular occurrence”, with staff having to increase monitoring because unsecured corridors contain objects and fittings that raise the risk of self‑harm and suicide.
A nurse in Northern Ireland said: “I’ve had resuscitation attempts in the waiting room and corridor due to no capacity. It is inhuman and undignified.”
Practical support for nursing staff
If corridor care is happening at your workplace, it’s important to raise your concerns. Find out more in our raising concerns toolkit and get information on RCN support available from member support services.
We believe this latest testimony shows the unacceptable practice of corridor care is spreading beyond emergency departments, including acute assessment units, respiratory wards, surgical wards and elderly care wards.
Professor Nicola Ranger, RCN General Secretary and Chief Executive, said: “This new testimony from nursing staff reveals once again the devastating human consequences of corridor care, with patients forced to endure conditions which have no place in our NHS.”
As a result of our pressure, the Westminster government committed to publishing data on incidences of corridor care in England in February 2025, but so far has failed to do so.
The HSSIB – the patient safety investigation body for England – released a report in January 2026 on the widespread and normalised nature of corridor care, highlighting that some trusts are reportedly installing call bells and plug sockets in corridors.
As many as two in 10 (18%) UK adults have witnessed NHS care in non-clinical spaces such as a corridor in the last six months, according to new YouGov public polling. Further RCN analysis shows that when looking at only those who accessed care, the figure is more than one in three (37%).
The polling also shows the public want faster action on the issue, with seven in 10 (69%) of respondents in England saying Health Secretary Wes Streeting’s pledge to eradicate the practice by the end of parliament is “too slow”.
“The fact remains that there can be no safe, dignified care delivered in a corridor, store room or dining room, but that has become the norm,” Nicola added.
“It’s taking a terrible toll on staff, but ministers mustn’t allow them to lose hope. Decisive action can restore care standards and stop staff morale collapsing past the point of no return.
“Now is the time for ministers to stop dragging their feet and publish the data, alongside announcing a fully funded action plan and timeline for eradication.”
We want to thank our members who have raised their voices on corridor care to show why this issue matters and why it demands urgent action.
RCEM: Nurses’ corridor care testimonies ‘distressing, damning’
NURSE: ‘CONDITIONS ARE A TYPE OF TORTURE’
The Royal College of Emergency Medicine (RCEM) has described new testimony from nurses about the state of corridor care across the UK as ‘distressing, damning and exactly what we see every single day in our departments’.
And the College says this reinforces the need to address this crisis.
More than 430 nurses described the conditions they are working in and what patients are enduring in a survey conducted by the Royal College of Nursing (RCN), that has been published today (15 January 2026).
Just some examples shared include how a nurse witnessed a patient left in a chair for four days, a patient dying after choking undetected in a corridor and nurses holding up sheets to try and protect the dignity of a patient while they underwent an intimate procedure.
One nurse went as far as saying the conditions are “a type of torture”.
Their accounts were gathered between 2 January and 9 January 2026, revealing nursing staff are treating patients in cold corridors, dining rooms, staff kitchens and offices.
The experiences of nurses build on and updates the RCN’s report published this week last year, titled ‘On the frontline of the UK’s corridor care crisis’.
Dr Ian Higginson, President of the Royal College of Emergency Medicine said: “This work by the Royal College of Nursing makes for incredibly tough reading. It’s distressing, damning and exactly what we see every single day in our departments.
“These deeply personal testimonies aren’t just stories – it’s the daily reality for patients and their nurses, who work alongside our members and their colleagues in Emergency Departments.
“Last year, when RCN released their first report on corridor care, we said that it must represent a watershed moment for the government, a line in the sand. Yet, 365 days on, the nurses voices show our patients are still in corridors, and there is no credible plan to get them out.
“So called ‘corridor care’ takes an immense toll on patients, who will be facing long waits in these conditions. And it takes an immense toll on our clinicians who are trying their upmost best to deliver quality care in these conditions.
“Our patients are being forced to endure these conditions, often for hours, if not days, because hospitals are full to bursting. We can’t move patients out of our departments, and into wards, because there are no available beds for them.
“Those beds are often taken up by patients who have experienced delays in their care, and who no longer need to be in hospital, but can’t leave, because of the lack of social care options.”
The new report also contains public polling which found:
As many as two in ten (18%) UK adults have witnessed care being delivered in a corridor or other non-clinical spaces in the last six months.
88% of respondents across the UK said tackling unsafe care is an urgent priority
Meanwhile in England, 69% said Wes Streeting’s pledge to end corridor care by the end of parliament is too slow.
Dr Higginson said: “Nurses have given their verdict loud and clear. So too have our members, and the public – they all want the crisis in EDs tackled with urgency.
“The Health Secretary said this week the government is ‘determined to consign corridor care to the history books’ and has committed to ending corridor care by the end of 2029. We welcome this. This problem can’t be solved quickly. It has been years in the making. But we do need a credible plan that starts now.
“We look forward to working with the government, and healthcare leaders, to implement meaningful solutions, many of which lie outside the walls of our EDs.”
It comes after the All-Party Parliamentary Group (APPG) on Emergency Care last year published a report, compiled by the Royal College of Emergency Medicine, on corridor care. It found almost one in five patients in EDs were being cared for in trolleys or chairs in corridors in England during summer.
Investment creating jobs and providing for communities
Scotland’s Displaced Workers Scheme signals the type of country the government is working to create, according to First Minister John Swinney.
The £500,000 scheme is helping employers recruit international workers who are already in the UK and find themselves without sponsored employment. It also mitigates the loss of international recruitment caused by changes to the UK immigration system.
Ahead of publication of the draft Scottish Budget 2026-27 tomorrow, the First Minister announced that the fund is reopening for applications following positive feedback from providers.
The First Minister met internationally recruited social care employees during a visit to health and social care charity Quarriers.
He said: “The UK Government’s decision to close the adult social care visa route to new overseas applications means this vital sector faces significant recruitment challenges during a time of great need.
“I have heard how our Displaced Workers Scheme is enabling more people to continue to build lives and livelihoods in a welcoming and open Scotland. It signals the type of country we are working to create – one with kindness and fairness at its heart – and ensures we can continue making a difference in the lives of our most vulnerable.
“We have already received 138 expressions of interest in the scheme, with positions expected to be filled over this month and next. But we want many more employers and workers to benefit, so we are reopening the fund and I would urge all eligible social care providers to express an interest in applying.
“This innovative scheme is just one example of how we are increasing capacity and relieving pressure within our health and social care system. This kind of delivery is what the people of Scotland can expect from the government’s Budget for 2026-27, which the Finance Secretary will set out tomorrow. The Scottish Budget will be firmly focused on my priorities: delivering strong and sustainable public services, growing the economy and supporting families.”
Alastair Dickson, Director of People and Wellbeing at Quarriers, said: “We were pleased to welcome the First Minister to our service in Cowdenbeath to meet international care workers and hear directly about their significant contribution to Quarriers. As an employer sponsor, this aligns with our priorities of investment, innovation, and inclusion to strengthen services and support a stable workforce.
“Quarriers is grateful for support through the Displaced Worker Scheme. It is a practical, targeted measure that helps employers like us meet the additional costs of recruiting workers who are already in the UK but have lost sponsorship through no fault of their own. This helps protect continuity of care and workforce capacity.”
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