The Committee considered a report providing the budget monitoring position for 2022/23 for the Adult Care and Health Portfolio, based on activity up to the end of September 2022.
The Director of Adult Social Care advised there was an error in paragraph 3.3.1 of the report and confirmed that there was a projected underspend of £53k on the controllable budget. Overall this was good news, however it was noted that there had been overspends in the areas of Learning Disabilities and Mental Health and the associated cost pressures were projected to impact in 2022/23 by £1.924m.
The Director of Adult Social Care said that in her update she had highlighted the work being undertaken to maintain performance against the budget. They were aware that pressures around hospital discharge had continued, with people having more complex needs – the figures indicated that this was being contained with people being moved towards move independence rather than needing long-term support.
A Member asked for more information as to how the financial position had been achieved and suggested that it may be beneficial to have a report relating to this presented to a future meeting. It was highlighted that it was quite a turnaround, and the directorate should be congratulated on the work undertaken to achieve this. In response to a question, the Director of Adult Social Care advised that this related to reablement and therapies – it was due to a change of approach and a culture change with staff. Members were advised that a summary of what had been delivered through the Transformation Programme, and the associated savings, could be brought to a future meeting. It was highlighted that this was not due to cutting services, but was instead about working smarter and more efficiently. The Portfolio Holder for Adult Care and Heath highlighted that it was a whole system approach with health partners. For example the changes within the Domiciliary Care contract to encourage a reablement approach.
A Member considered that credit was due to for reporting a net underspend, despite difficult circumstances, and asked for further information relating to the areas of overspend and trends identified. The Director of Adult Social Care advised that pressure was currently being seen within the younger disabled people cohort, those with learning disabilities and mental health needs, and this was reflective of where attention had been placed. Detailed discussions had been held over recent months with care providers, largely in the older people group. This was where attention had been focussed in relation to health, concentrated on people being discharged from hospital. It was considered to be harder to predict spend as there was much less consistency when looking at young adults with learning disabilities or mental health needs, whereas there was a range of costs for care for older people. The pressures within the learning disabilities service related mainly to young people who were coming through transition, and work was ongoing with the 0-25 Service to resolve this at an earlier stage.
In response to questions from another Member, the Director of Adult Social Care advised that work was being undertaken with the Director of Children’s Services and Head of Service – 0-25 Project (Preparing for Adulthood). Part of this was about working with young people and their families earlier. It was felt that having one service that straddled the age groups would be beneficial. It was noted that there was growth built into the budget to fund young adults coming through transition
A Member questioned if the underspend was due to there being less demand for the services than had been forecast. The Director of Adult Social Care said that it was about providing different solutions for people, and they were working closely with partners and using assistive technology. The emphasis was changing to help people to remain independent – the reablement services were working hard to get people “back on their feet” and withdrawing services from them. In response to a further question, the Director of Adult Social Care said they would do their best to balance the budget at year end.
RESOLVED that the Portfolio Holder be recommend to:
i) Note the projected net underspend of £53k on controllable expenditure based on information as at September 2022; and,
ii) Recommend that Executive agree the release of funds from the Central Contingency as set out in section 3.5 of the report.