Agenda item

Report CS18145

The Committee considered a report setting out the budget monitoring position for the Adult Care and Health Portfolio for 2018/19, based on activity to the end of May 2018.

The controllable budget was forecast to be in an overspend position of £308k with a full year cost pressure of £501k, assuming further management action was taken throughout the year to maintain this position.  This was a result of predicted overspends across a range of services including Assessment and Care Management, Learning Disabilities and Mental Health which was due to a number of reasons including higher than expected demand for services.  The Council’s Executive had recently approved the release of carry forward amounts relating to the Better Care Fund, Improved Better Care Fund and Public Health Grant that had been held in contingency.  These funds totalled £4226k and were related to either unspent grant income or delays in expenditure where cost pressures would follow through into 2018/19.  The Committee was advised that areas of key risk within the Adult Care and Health Portfolio included the impact of the national living wage, increasing numbers of clients with high complexity of need, and potential funding issues with school nursing provision that was funded by the Public Health service.  Housing was no longer part of the Adult Care and Health Portfolio and costs relating to this service area would be reported as part of the Renewal, Recreation and Housing Portfolio budget in future. 

The Head of Education, Care and Health Services Finance confirmed that the projected savings within the budget expected to be realised through further management action during 2018/19, would be adjusted throughout the year to reflect the actual level of savings that were achieved, and that any concerns around projected savings not being realised would be reported to the Committee.  The expectation was that further management action to contain the overspend would not be based on savings derived from staff vacancies, although staff turnover might realise some savings during 2018/19.  A wide range of activity was underway to contain the overspend for 2018/19 which would realise additional savings in future years, including a review of care packages that would support service users to live as independently as possible and enable their changing needs to be met via the comprehensive support available from the Local Authority and its partners. 

Members generally discussed the Adult Care and Health Portfolio Budget.  In response to a question from a Member, the Head of Education, Care and Health Services Finance explained that the Better Care Fund was a ring-fenced grant and could not be used to offset the projected overspend.  The Better Care Fund was also a time-limited grant and this was being taken into account as part of the budget planning process for future years.  The Government’s green paper on care and support for older people was due to be published in Summer 2018 and was expected to provide further clarity on the future model for adult social care funding. 

Another Member was concerned to note that a contribution of £217k towards the joint funding of placements from the Bromley Clinical Commissioning Group remained outstanding, and emphasised the importance of early intervention services in reducing costs associated with the escalation of need.  The Head of Education, Care and Health Services Finance confirmed that the outstanding amount was subject to ongoing discussions with the Bromley Clinical Commissioning Group and that the expectation was that the contribution would be provided by year-end.  The Director: Adult Social Care noted that the Local Authority worked closely with its health partners to meet the needs of service users, but the complexity and changeable nature of the health and social care needs of some service users could make it difficult to identify the appropriate level of contribution from partners.  A Member underlined that many of the statutory services within the Adult Care and Health Portfolio were demand-led which could make it difficult to manage the Portfolio budget.

In response to a question from a Member, the Head of Education, Care and Health Services Finance clarified that the overspend of £151k in Domiciliary Care and Direct Payments for Clients aged 65+ years was due to a contractual issue in which a planned transfer of the service to a new provider had not gone ahead.  The contractual issue had been reviewed at the meeting of Contracts and Commissioning Sub-Committee on 25th June 2018, and the report and minute relating to this agenda item would be provided to Members following the meeting.

RESOLVED that the Portfolio Holder be recommended to:

1)  Note the latest projected overspend of £308k forecast on the controllable budget for 2018/19, based on information as at May 2018;

2)  Note the full year effect of cost pressures of £501k for the Adult Care and Health Portfolio budget for 2018/19;

3)  Agree the release of carry forward amounts held in contingency relating to Better Care Fund, Improved Better Care Fund and Public Health Grant;

4)  Note the comments of the Department in Section 8 of Report CS18145; and,

5)  Approve the Adult Care and Health Portfolio Budget Monitoring Report 2018/19.