Agenda item

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 of funding and look at what is now needed. This would be considered with the health authorities to provide a service targeted to needs.

To further improve public health in the borough, a focus was suggested on where change is needed along with a smarter approach. A more London-wide approach was also advocated which could help in areas such as smoking cessation. The importance of looking at outcomes was further highlighted as were the advantages of prevention.

RESOLVED that:

(1)  the tabled outcome of consultation be noted; and

(2)  subject to the final outcome of consultation with all stakeholders:

·  Council be recommended to agree that the Public Health grant for 2016-17 and 2017-18 is utilised as proposed in Report CS16002; and

·  subject to Council approval of the above (in context of the overall Council budget), notice be given to relevant contracts.