Agenda item

Each scrutiny board in January will receive a report outlining the budget proposals identified within their respective portfolios for the period from 2023/24 to 2025/26. Feedback on the budget proposals included within this report will be reported to the Resources and Delivering Value Scrutiny Board and Full Cabinet next month.

The Directors for Adult Social Care and of Public Health presented the report, explaining how, during January, each Scrutiny Board was receiving a report outlining the proposals identified within their respective portfolios, for 2023/24 to 2025/26.

The Directors took Members through the report, which outlined the forecast budget position in regards to the relevant portfolios, detailing the pressures identified up to 2025/26 and the actions proposed to mitigate them. The key pressures highlighted from the report included progress towards fair cost of care, reform of the adult social care charging system, cost of living pressures and bad debt write-offs, as well as demographic and inflationary pressures. The pending introduction of Care Quality Commission (CQC) inspections for Adult Social Care was also highlighted. The main proposals to mitigate these pressures included Government funding where national allocations have been announced, as well as use of contingency reserves.

The Director for Adult Social Care explained that since the production of the report, there have been further national announcements with respect to adult social care funding, primarily via the provisional Local Government Finance Settlement and that the pressures and mitigations will be updated to take account of the new information now available. It was confirmed that the national Charging Reform has been delayed. The Director for Adult Social Care noted there had been a fourth meeting of the Budget Strategy Group in January.

The Directors highlighted the reporting undertaken to the Budget Strategy Group, as well as the Members’ Budget Seminar.

Members raised the following queries:

·  A Member noted how, for the Adult Social Care and Health Portfolio, it was proposed to use capital funding to reduce care expenditure and they requested further detail on this.

• The Adult Social Care and Support Finance Manager explained how there would be focus on capital funding to support initiatives, such as adaptation of buildings, to enable people to live independently for longer and reduce ongoing care expenditure.
• A Member highlighted how the Autumn Statement indicated increased adult social care precept flexibilities, in total 2%. They noted 1% had already been assumed in the MTFS, which enabled the Council to consider an additional 1% and requested clarification on this.
• The Adult Social Care and Support Finance Manager confirmed there was potential for the Council to consider an additional 1%. Following further queries, he explained that Central Government assumes the full precept has been taken, when allocating funding to Local Authorities.
• A Member raised the proposed fees and charges scheduled for 2023/24, noting how some of these were proposed to increase in line with the Consumer Prices Index, at 6%. They queried the proposals for the Minimum Income Guarantee (MIG), an amount set aside to cover an individual’s everyday expenses, when they were in receipt of local authority arranged home care.
• The Adult Social Care and Support Finance Manager confirmed the MIG was set by the Department of Health and Social Care and our policy was to use these rates.
• The Member explained they recognised the MIG for 2023/24 had not been set yet by the Department of Health and Social Care and they noted there was discretion to supplement this locally, if it had not been increased in line with inflation.
• A Member highlighted Government announcements on additional funding for local areas to buy extra beds in care homes, to support hospital discharges. They queried whether there had been any challenges in securing this additional capacity.
• The Adult Social Care and Support Finance Manager confirmed there were some challenges. The focus was upon ensuring people received the right type of care, to support clear improvements in hospital discharges and as this funding was time-limited it was necessary to plan for this funding to end on 31^st March.
• A Member queried whether the monies awarded to support the development of Family Hubs was one-off funding.
• The Director of Public Health explained how the funding had been awarded by the Department for Education for two years, with clear programme goals and outcome measures, to review its effectiveness. The monies had been awarded to support the launch of the Family Hubs and there were ongoing discussions with the Department for Education on longer term funding arrangements. The hubs would co-locate a range of existing services for families, in accessible locations, linking this with a strong digital offer. It was proposed to establish a reserve for the Family Hubs, to support service set up and on-going operational delivery.
• A Member highlighted how the majority of existing non-NHS Public Health contracts that came to an end during the MTFS period were secured on fixed annual prices that did not provide for inflation. They queried the percentage of overall spend these contracts represented.
• The Director of Public Health explained they represented a small percentage of the overall Public Health grant. She detailed how the majority of the Public Health grant was spent on NHS contracts, such as Health Visiting, as well as drug and alcohol services.
• A Member queried the anticipated Adult Social Care directorate reserves, following the use of £1.774m reserves in 2023/24, to enable a balance budget position.
• The Adult Social Care and Support Finance Manager detailed how, at the end of the current financial year, it was anticipated there would be a £7m reserve. Following the proposed use of reserves in 2023/24, as outlined in the report, it was anticipated there would be a reserve balance of approximately £5.3m. 

  RESOLVED

  The Health and Adult Social Care Scrutiny Board:

(i)  Noted the pressures and mitigating actions set out in Appendix A.

(ii)  Supported the schedule of fees and charges proposed for 2023/24, as attached at Appendix B. This was subject to the Member comments in regards to the Minimum Income Guarantee, as outlined in the minutes above, being taken into account.

(iii)  Supported the indicative service budgets proposed for 2023/24, as attached at Appendix C.