Agenda item

Report CS18179

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 September 2018.

The controllable budget was forecast to be in an overspend position of £333k with a full year cost pressure of £1,915k, 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 overspend had been offset by the reallocation of Better Care Funding that had resulted in a one-off reduction in expenditure of £369k for Adult Social Care.  It was requested that the Council’s Executive agree the release of funding held in contingency or reserves comprising £500k of Improved Better Care Funding to offset in-year costs across Social Care, and £1.5M from the Clinical Commissioning Group Reserve to support the continued delivery of transformational changes to reduce acute hospital activity.

The Head of Education, Care and Health Services Finance reported that management action used to help contain cost pressures within adult social care services included the work undertaken by the Invest to Save team, as well as ongoing discussions with health partners to ensure that the cost of meeting the health and social care needs of service users was met by the appropriate partner.

In response to a question from a Member, the Head of Education, Care and Health Services Finance advised that a range of work was underway to more accurately project future costs relating to the transition of service users from child to adult social care services; however this could be difficult as it did not account for the changing care needs of some service users or the move of new service users into the Borough.  The Director: Adult Social Care confirmed that families were provided with support during the transition to adult social care services which included work to manage expectations about the adult social care offer.  The Chairman asked if a more effective modelling tool was available to support the Local Authority in projecting future costs relating to the provision of adult social care, and the Head of Education, Care and Health Services Finance agreed to investigate this following the meeting.  The Director: Adult Social Care noted that the Association of Directors of Adult Social Services was working to develop a more accurate model to project future demand for adult social care services. 

In considering a number of other issues, a Co-opted Member noted the work underway to increase uptake of Direct Payments and queried whether this would reduce cost pressures impacting the Adult Care and Health Portfolio.  The Head of Education, Care and Health Services Finance confirmed that some savings might be realised through the increased use of Personal Assistants and reduced administration costs for the Local Authority.  A Member queried a projected underspend on Learning Disabilities Care Management of £78k and was advised that this related to the cost of agency staff working within the Care Management team.  An underspend in the budget for day care services was related to a reduction in the use of the service. 

The Chairman noted that this was the final budget monitoring report that the Head of Education, Care and Health Services Finance would be presenting and thanked him for the excellent support he had provided to the Committee.

RESOLVED that the Portfolio Holder be recommended to:

1)  Note the latest projected overspend of £333k forecast on the controllable budget for 2018/19, based on information as at September 2018;

2)  Note the full year effect of cost pressures of £1,915k for the Adult Care and Health Portfolio budget for 2018/19;

3)  Agree to the request to release contingency and reserve funding from the Improved Better Care Fund and Clinical Commissioning Group Reserve and refer to the Council’s Executive for approval;

4)  Note the comments of the Department in Section 8 of Report CS18179; and,

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