Agenda item

Report FSD23011

The Committee considered a report setting out the draft Adult Care and Health Portfolio Budget for 2023/24, which incorporated future cost pressures, planned mitigation measures and savings from transformation and other budget options which were reported to the Council’s Executive on 18^th January 2023. Members were requested to provide their comments on the proposed savings and identify any further action to be taken to reduce cost pressures facing the Local Authority over the next four years. It was noted that there were still outstanding issues and areas of uncertainty remaining and further updates would be included in the 2023/24 Council Tax report to the next meeting of the Executive.

The Head of Finance for Adults, Health and Housing advised Members that a balanced draft budget was proposed for 2023/24. However, there were a number of unknowns in the years ahead, relating to levels of government funding and inflation, and a budget gap of approximately £30m was projected in 4 years’ time. With regards to Appendix 1 (page 44), it was noted that £5.8m had been added to the budget for increased costs (mainly inflation), and £6.2m of growth. There were also savings targets of £2.5m (mitigation) and £1.8m (Transformation Programme). The Head of Finance for Adults, Health and Housing said there were challenges, but echoed the comments made by the Director of Adult Social Care, regarding the plans that were already in place to achieve these savings and, on balance, considered it to be a fair budget for the portfolio.

A Member highlighted that despite Bromley having the sixth largest borough by population, the report noted that it received the second lowest settlement funding per head. The Head of Finance for Adults, Health and Housing advised that this was a historical issue relating to the level of government funding received. These comments were echoed by another Member, who said that this historic issue related to the funding formula and advised that the London Borough of Bromley had been campaigning for fairer funding for a number of years.

A Member highlighted the reference made in the report regarding the borough’s council tax being ‘the average of the four other low grant funded boroughs, our income would increase by £30.2m’. It was noted that this figure was similar to the projected budget gap and queried if the average council tax of these other boroughs was known. The Head of Finance for Adults, Health and Housing advised that this information could be provided to Members following the meeting.

In response to questions, the Head of Finance for Adults, Health and Housing emphasised that the vast majority of savings that were being proposed were not a result of making cuts in services. The Director of Adult Social Care advised that at the last meeting, the transformations made within Adult Social Care had been highlighted. Appendix 2 of the report provided a summary of what had been delivered through the Transformation Programme over the last three years – things were being done in a smarter and more efficient way. However, going forward this would become harder in future years – for example there were significant pressures being seen relating to hospital discharge, which was making it harder to negotiate placements at a realistic rate. With regards to the Local Authority providing the care service themselves, the Director of Adult Social Care advised that this was something that Council’s used to provide, but had increasingly moved away from. This had previously been considered, however the knowledge base and opportunity to provide care had been lost. Figures on an earlier prepared business case indicated that the cost for the Council to deliver its own residential care would result in the charges being even higher, partly due to overheads but also due to there not being the expertise within the Directorate. The Council did provide a small reablement service which was working extremely efficiently and was not a service that could be purchased from elsewhere – they were continuing to focus on the areas that they were good at.

A Member noted the reference made in the report to the Council having ‘delivered savings of over £120m per annum since 2009/10 and the ability to make savings in lower priority areas becomes more problematic’ and enquired if this point had now been reached. The Director of Adult Social Care said that this point had not yet been reached and she was comfortable with the plans proposed for the next financial year – however they may face some difficult decisions in future years. In response to a further question, the Director of Adult Social Care said that by investing in prevention, demand could be reduced. This was something they had been seeking to address locally by using the additional government money for hospital discharge, investing it in more preventative services to prevent hospital admissions.

RESOLVED that:

i)  The financial forecast for 2023/24 to 2026/27 be noted;

ii)  Members’ comments on the initial draft Adult Care and Health Portfolio budget 2023/24 as a basis for setting the 2023/24 budget be noted; and,

iii)  Members’ comments on the initial draft Adult Care and Health Portfolio budget 2023/24 be provided to the February 2023 meeting of the Council’s Executive.