The report by the Accounts Commission said community health and social care finances were ‘increasingly precarious' and called for urgent reform.

Malcolm Bell, member of the Accounts Commission, said: ‘For too long, Integration Joint Boards (IJBs) have been fire-fighting immediate financial challenges. Now they must shift from making one-off savings and relying on reserves to transform how services are delivered if they are to tackle their precarious finances.

‘A stronger focus on prevention is needed, with candid conversations with communities, councils and NHS partners vital around the difficult choices that need to be made.'

The report highlighted the ‘worrying' high turnover chief executives and chief financial officers. Despite an increase in IJB funding in the past year, the report said reserves were being running down and there was reliance on one-off savings.

Reserves were depleted by 40% in 2023/24, with the projected funding gap for services increasing from £357m in 2023/24 to £457m in 2024/25.

COSLA's health and social care spokesperson, Cllr Paul Kelly, said: ‘Given the present challenges facing the system, there needs to be constructive collaboration between local government, Scottish Government, IJBs and NHS partners around the scale of the challenge - and what this means for what people and stakeholders can expect from the system. We are committed to working with all partners to do everything we can to understand the impact the current and projected financial position is having on the system.'