Thursday March 26th 2026
West Lothian Council headquarters
Written by Local Democracy Reporter, Stuart Sommerville
West Lothian’s health and care budget will top £326m next year, the county’s Integration Joint Board agreed.
With strict savings packages approved it will meet demands for a balanced budget this year, but early indications are that more money will needed to be trimmed to meet the 2027/28 budget, councillors and board members heard.
The Board, which oversees social care in West Lothian, is jointly funded by West Lothian Council and Lothian NHS.
Chief Financial Officer for the Board, Hamish Hamilton told this week’s meeting: “This is the weakest position the IJB has held financially in several years.”
Of the £360m budget the council provides £124m and Lothian NHS £202m. The council has allocated £2.9m to the IJB to fully fund the estimated recurring overspend in Adult Social Care.
A total of £15.2m in savings have been identified for the next two years – £7.8m this year and £7.4m next year. Even with these savings identified only £5m is in place for 27/28. Another £2m will have to be found to balance that budget.
Mr Hamilton told the meeting that the biggest significant development is the complete depletion of the last of the Board’s cash reserves, used up to address savings needed in the current financial year.
He added: “This has major implications. The Board has no buffer. Any overspends must be met by additional savings or relying on partners The position is more critical than it ever was.”
Mr Hamilton said the chances of rebuilding a reserve fund will be “extremely challenging across the medium and short term”.
In his report Mr Hamilton said: “As part of developing the updated budget plan the IJB completed a public consultation during Autumn 2025. The full findings of the consultation were reported to the Board on 4 February 2026.
“A total of 369 responses were received and key feedback was identified which has been taken account of when developing savings measures. For example, responses strongly opposed any measures reducing adult day services and as a result no measures are being proposed in this area.
Proposals have been developed around the following themes:
– Efficiency – Reducing cost of inputs e.g. supplementary staffing, medicines and equipment.
– Transformation – Reducing cost of outputs e.g. care at home, cost per bed day, intermediate care.
– Difficult Choices – Reducing or stopping services.
Mr Hamilton urged the Board: “Given the scale of the financial sustainability challenge it is imperative that the Board focus on the medium-term savings programme required to ensure the ongoing financial sustainability of the IJB.”
“As part of the IJB’s longer term budget strategy it is recommended that officers commence a review of the implications of demographic change across all health and social care services. Feedback from the public consultation will be considered during this review which should consider demand for services as well as opportunities for further redesign of services.”
After the meeting Alison White, the Lead Officer of the IJB told the Local Democracy Reporting Service: “The IJB budget for 2026/27 has now been agreed, and will see over £326million invested in health and social care across West Lothian.
“Both West Lothian Council and NHS Lothian provided a fair settlement this year, which will enable the IJB to deliver our Strategic Plan aimed at improving wellbeing and reduce health inequalities across all communities in West Lothian.
“There remain challenges due to constrained public sector finances and the increasing demand for services, such as adult and older people social care, GP prescribing and increased costs over the peak winter period. Savings are focused on maintaining service provision where possible and, in many cases, are aimed at improving service quality and resilience.
“To bridge this gap and deliver a balanced budget, we will be making savings of £7.8 million and using all £2.1million of our remaining reserves in 2025/26.”
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