Help shape the future of health and social care services in West Lothian
West Lothian's Integration Joint Board (IJB) is looking for views to help shape the future delivery of local adult health, social work, and social care services.
The IJB has responsibility for planning most health and social care services for adults in West Lothian, and faces an estimated budget gap of over £20 million over the next two years.
It is now looking for residents, service users, carers, staff, and local organisations to take part in a public consultation over potential proposals to bridge the budget gap.
Over £8.9 million in savings were delivered in 2024/25, and the mix of rising costs, increasing demand, and the growing complexity of people's needs makes maintaining current service levels increasingly challenging.
The IJB is legally required to set a balanced budget, and must now make difficult decisions on the necessary steps to achieve this.
A range of options, with the potential to contribute to reducing some of the projected budget gap have been put forward by officers who work in the West Lothian Health and Social Care Partnership. Discussion is also ongoing with NHS Lothian centrally to identify efficiencies to help to address the remainder of the budget gap.
No decisions have been made yet. Members of the IJB will consider all feedback when setting the budget for 2026/2027 on 24 March 2026.
The consultation runs from 28 October to 9 December 2025 and seeks feedback on a range of proposals aimed at:
- Maximising efficiency in service delivery and contracts
- Transforming services through digital innovation and new models of care
- Making difficult choices, including potential reductions in services
Further engagement will take place throughout Autumn 2025 on specific proposals, with a range of engagement sessions, both in person and online, arranged.
We estimate the survey will take between 15 and 20 minutes to complete.
Please note all responses are anonymous, and you can skip questions if you prefer not to answer or you think that they are not relevant to you. Your feedback will help inform decisions about how we prioritise resources and deliver services.
About the West Lothian Integration Joint Board (IJB)
Background
The West Lothian Integration Joint Board (IJB) has responsibility for planning most health social work and social care services for adults in West Lothian.
These services include:
- Community Health Services
- Primary Care
- Adult Social Work and Social Care Services
- Services for people with Physical or Learning Disabilities
- Adult mental health services
- Community Pharmacy Services
- Health Improvement
- Unscheduled Care for Adults
- Housing Support and Adaptions
The board's vision is to increase wellbeing and reduce health inequalities across all communities in West Lothian
The Integration Joint Board's role is to set the strategic direction for functions delegated to it and to deliver the priorities set out in its current Strategic Plan.
Finance
The IJB receives funding allocations from West Lothian Council and NHS Lothian to enable the delivery of local priorities for health and social care for adults and has an annual budget of £334.5 million. The Board gives directions to the council and health board as to how they must deliver their services to secure the delivery of the IJB's Strategic Plan.
Figure 1 below provides an overview of how each £ of IJB funding is allocated.
The largest areas of spend for the IJB relate to staffing costs, payments to care providers for direct service provision and prescribing.
Challenges
In 2025/26, the IJB had a total annual budget of £334.5 million to deliver key services, however this has not been enough to cover the increasing costs of meeting the increasing demand for health and social care services in West Lothian.
The West Lothian Integration Joint Board is faced with unprecedented challenges due to rising demand for services and complexity of support required, as well as the increased cost of delivering these services. This is particularly in relation to services which support adults with learning disabilities, complex needs and mental health complex needs.
The demographic projections for West Lothian show a population where older adults are increasing in number and will form a greater proportion of the population over time. The number of people of pensionable age in West Lothian is expected to increase by 10% by 2028 when compared to the Scottish average of 4%. Over the same time period the number of people aged over 75 in West Lothian is expected to increase by 39% compared to the Scottish average increase of 25%.
Health, social work, and social care services operate within a complex and evolving policy landscape. National programmes, such as Coming Home, are driving significant change, accompanied by considerable implementation and financial costs.
Going forward from 2025/26, the IJB will have to make further significant savings as the funding available will continue to be insufficient to meet the increasing cost of service delivery.
The scale of the savings required to deliver a balanced budget means that we need to fundamentally rethink how and what we deliver, and be transparent about where we will not be able to continue to deliver the same level or range of services. The IJB will aim to maximise the care services that can be provided from the funding it will have available.
The survey is just one part of the IJB's plan to engaged with people who live and work in West Lothian and organisations that deliver services locally. Further engagement will be undertaken on specific proposals for transformation and efficiency measures throughout 2025/26.
Your views will be used to inform the IJB's budget setting process for 2026/27 and beyond and will be very important in shaping the future delivery of health and social care services in West Lothian.
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