Agenda item

Report FSD24007

The Committee considered a report setting out the draft Adult Care and Health Portfolio Budget for 2024/25, 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 17^th January 2024. Members were requested to consider the initial draft budget being proposed and also identify any further action that might be taken to reduce cost pressures facing the Council over the next four years. It was noted that there were still outstanding issues and areas of uncertainty remaining further updates would be included in the 2024/25 Council Tax report to the next meeting of the Executive.

The Head of Finance for Adults, Health and Housing advised Members that the 2024/25 budget included significant growth to reflect the full year effect of the budget pressures during 2023/24, less some significant savings and mitigation to offset these pressures. Overall the draft 2024/25 budget totalled just under £95m which was a net increase of £6.7m compared to the previous year’s budget.

A Member considered that it would be beneficial for the table provided in Appendix 1 to include a column with projected costs for 2023/24. The Head of Finance for Adults, Health and Housing said that the Q2 2023/24 Budget Monitoring report had a projected overspend of £1.5m. The 2024/25 budget looked to address the previous in-year pressures and included growth. The Director of Adult Social Care advised that the planning of the 2024/25 budget was based on the position at the end of Q2, which was reported at the last meeting. It was hoped that going forward there would be reduced pressure in the budget for this year.

In response to further questions, the Director of Adult Social Care advised that pressures on the Learning Disabilities service were in three areas: growth in the numbers using the service as people were living longer; the higher cost of purchasing services; and a significant increase in the number of young people transitioning from Children’s to Adult Services. It was noted that the transition figures were based on Q2, however there was often an increase in demand at the end of the school year. With regards to the reference made that ‘there may need to be a reduction in the scope and level of services’, the Director of Adult Social Care said that the department would not stop providing any statutory services but would look at how they could be delivered more efficiently. The change of approach was outlined in the Adult Social Care Transformation Programme report provided to the meeting. The Director of Adult Social Care confirmed that work to identify any working age adults/older people whose care and support was currently being paid for by Bromley, but were the responsibility of another local authority, was undertaken on a regular basis. However it had been recognised that some were slipping through, particularly when people left hospital and those with mental health needs. These pressure points had been identified and were being tightened up – the criteria itself was not being changed.

A Member enquired if there were plans to review the provision of stop smoking and weight management programmes. The Director of Public Health advised that an obesity service for adults had been funded from the public health grant, and would continue next year. It was noted that a 1-year pilot to deliver a smoking cessation service had been procured and a provider had been appointed. This was in preparation for the government funded smoking cessation programme from April 2024, which it was hoped would significantly increase the offer across the borough.

In response to further questions, the Head of Finance for Adults, Health and Housing said that the reduction in the budget for the Placement and Brokerage service area was due to the delivery of savings made through the Transformation Programme. The slight increase in the budget for the Information & Early Intervention service area was due to the growth allocated. With regards to the utilisation of the public health reserve to mitigate against inflation increases, the Head of Finance for Adults, Health and Housing advised that the public health grant supported a number of services across the Council and £263k would be used to address the inflationary pressures in these areas. It was noted that the cost of salary uplifts in the Public Health team had previously been funded from the general fund, rather than the public health grant. The Director of Public Health confirmed that the inflationary uplift had been significant – this related to staffing and services that Public Health funded, such as Children’s Centres.

A Member noted that a national increase in rates of sexually transmitted diseases (STIs) had been reported in the media and enquired if this was being monitored locally. The Director of Public Health said that the borough had seen an increase in STI rates over a number of years, however this had slowed down. As part of the Public Health transformation programme, a new online testing provision had been implemented a couple of years ago, and the spend on hospital appointments had been significantly reduced. In addition to this, a London sexual health tariff programme had been introduced so all providers charged the same rate. The area of sexual health was a good example of reducing spend by having transformed the service.

In response to a question regarding the mental health budget, the Head of Finance for Adults, Health and Housing said that the full year effect of the 2023/24 overspend on Mental Health services was £529k and this had been funded in the 2024/25 budget. The Director of Adult Social Care confirmed that no additional money had been drawn down during 2023/24, the existing money had just been used in a different way.

RESOLVED that:

i)  The financial forecast for 2024/25 to 2027/28 be noted;

ii)  Members’ comments on the initial draft Adult Care and Health Portfolio budget 2024/25 as a basis for setting the 2024/25 budget be noted; and,

iii)  Members’ comments on the initial draft Adult Care and Health Portfolio budget 2024/25 be provided to the February 2024 meeting of the Council’s Executive.