Issue - meetings

Report CS16002

There had been an in-year 6.1% reduction to the Public Health Grant (announced by the Department of Health in July 2015) amounting to £919k for L B Bromley and a proposed mechanism was outlined to manage the grant reduction in 2016-17 and 2017-18.

Proposals to reduce the Council’s Public Health budget were included in the Draft Budget report considered by Executive on 13th January 2016 and full Council were recommended to agree the proposals as part of the Council’s 2016/17 budget setting process.

To achieve the necessary saving it was proposed to:

• focus on the provision and commissioning of statutory and mandated Public health services;
• re-prioritise the use of some elements of the Public Health grant to focus on addressing wider determinant of health; and
• achieve further general efficiencies. 

These proposals would be implemented over a two-year period (2016-17 and 2017-18) due to the nature of different contractual arrangements and other constraints to achieve savings earlier.

Report CS16002 listed the Public Health services to be commissioned or provided in 2016-17and 2017-18 along with services where commissioning and provision would either reduce or cease.

Further efficiencies within the Public Health Division were also proposed with restructuring necessary to reflect the revised priorities. Formal consultation with staff and trade unions commenced on 15th January 2016 with the consultation period ending on 15th February 2016. A summary of feedback was tabled as were dates of consultation meetings. The Council would endeavour to avoid or minimise redundancies wherever possible by seeking to redeploy staff to alternative roles.  

Noting that the consultation period was due to end on 15^th February the Leader expected that a full update and brief would be available on consultation outcomes at the Council meeting.

It was currently uncertain how much Public Health Grant would be provided over the next two years. Councillor Angela Wilkins (Crystal Palace) expressed concern for the public health service predicting problems for society with a reduced level of services which could ultimately prove costly. Councillor Wilkins was particularly concerned about cessation of a commissioned service for school nursing in 2017-18 and alternative funding being considered to cover the service for 2016-17. She felt that any loss of school nursing (in 2017-18) was an important issue.

On services where commissioning and provision would be either reduced or ceased, the Leader suggested that progress was being made in smoking cessation and obesity, particularly in view of past hard hitting messages.

The Director of Public Health indicated that services needed to focus on significant issues and what is statutorily required and cost effective. Obesity was a sizeable problem, not solely confined to weight management for which there is an action plan (the obesity programme for children would continue in 2016-17 but cease as a commissioned service the following year).

Although School Nursing was not a statutory responsibility, it was proposed to have a new modernised service model for children’s services to 2019. It was not proposed to cut the service but consider a new source  ...  view the full minutes text for item 352

Report CS16002

The Committee considered a report setting out the proposal for the Public Health Budget for 2016/17 and 2017/18.

In July 2015, the Department for Health announced an in-year reduction in the Public Health grant of 6.1%, which equated to a reduction of £919,000 for the London Borough of Bromley.  In considering how Public Health services could best be delivered in future years following the reduction in grant funding, it was proposed that the provision and commissioning of key statutory and mandated Public Health services be prioritised, and that there be a reduction or cessation of provision and commissioning of non-statutory and non-mandated services.  It was also proposed that there should be a reprioritisation of the Public Health grant to address wider determinants of health, and that work be undertaken to achieve further general efficiencies across the Public Health division.

For 2016/17, it was proposed that the commissioned activity of sexual health and the commissioned and provided activity of NHS Health Checks be reduced, and that there be a cessation of the commissioned services for adult weight management and adult exercise referral scheme.  For 2017/18, it was proposed that there be a cessation of the commissioned services for general health improvement, smoking cessation and childhood obesity programme, and that there also be a cessation of the commissioned service for school nursing, although alternate funding for this service would be considered for 2016/17.  It was also proposed that there would be further general efficiencies across the Public Health Division including reduction or cessation of all non-statutory activities and costs.

Consultation on the proposal for the Council’s Public Health budget 2016/17 and 2017/18 had commenced with staff, trade unions and other stakeholders on 15^th January 2016 and would conclude on 15^th February 2016.

The Portfolio Holder for Care Services noted that the Public Health Budget for 2016/17 and 2017/18 was indicative as the Public Health grant had not yet been confirmed for 2016/17, but that the draft budget had been developed based on the expectations that further cuts of at least 3.9% would be made.  A Member reported that the Health and Wellbeing Board would be considering the proposal for the Council’s Public Health Budget 2016/17 as part of the full range of health services, and that there was scope to identify if some non-statutory and non-mandated services could be delivered in alternate ways, such as through voluntary organisations.

In considering the report, the Director of Public Health was pleased to advise Members that there had been a levelling off in the amount of childhood obesity in Bromley in 2015/16 whilst the national trend continued to increase. 

In response to a question from a Member, the Director of Public Health confirmed that the general efficiencies to be made across the Public Health Division would include wide ranging savings, such as making more effective use of online information and library services.  Work was also being undertaken to consider how some elements of non-statutory services could be delivered in a different  ...  view the full minutes text for item 74