To provide the Health and Social Care Overview and Scrutiny Committee and the General Overview and Scrutiny Committee with information on the draft budget proposals and to give an opportunity for the committees to comment on the Budget report to be presented to Cabinet on 23 January 2014.

The Chief Finance Officer provided a report on the Budget for 2014/15 and the Medium Term Financial Strategy.  In his presentation he highlighted the following matters:

·         That there had been a zero based budgeting approach to the Adult Wellbeing budget.  The starting point had been the current spending position, and savings had been made against what was happening at the moment.

·         That whilst 2014/15 would be the focus for the budget, a three year budget had been published in order to be able to provide the organisation with confidence for forward planning. 

·         That the budget was predicated on a 1.9% increase in council tax.  This was the position adopted by the majority of councils nationally.  The Secretary of State for Communities and Local Government was rumoured to be considering reducing the existing cap for the need for a council to undertake a referendum on council tax from the present 2% to 1.5%.  This would mean that a lot of councils would face the prospect of a referendum.

The Director of Adults Wellbeing reported that the budget for 2014/15 was designed to sit within the changing Health and Social Care landscape.  There were key areas for support that would focus on the affordable integration of care services and would focus on the design of pathways that would maximise the effectiveness of what was happening in the community.  Savings would be achieved by ensuring that the Council was providing effective and efficient funding for those who met the appropriate criteria.  The following points were highlighted in discussion:

·         that since September 2013, the pathway for assessments had been redesigned, and the case load of every social worker had been reviewed.  From April 2014, a new assessment process would be brought in that would significantly reduce waiting times as it would provide a single assessment of both need and resource.  The number of social workers had been a key blockage in the past, but the teams had been completely redesigned with additional leadership and training in order to help them cope with the new eligibility criteria.

In reply to a question from a Member as to what assurance could be given that the budget was accurate, the Cabinet Member (Health & Wellbeing) said that Committee Members would have seen all of the items against which savings had been delivered.  There were eleven commissioning programmes in place to deliver a renewed programme by the 1 April 2014.  This, combined with greater emphasis on eligibility of services and the next stage integration programme, would deliver more stability for the service.   

In reply to a Member’s question about whether savings from Adult Social Care were achievable in a budget which had consistently overspent, the Chief Finance Officer said that the three year financial plan would provide stability, and more management capacity was being put into Adult Wellbeing, which had been separated out from the Peoples Directorate.  There was now more capacity to deliver on savings targets.

·         That whilst there would be no public funds for those with low or moderate eligibility for services, work was underway with local community based resources to help support people locally and keep them out of the care system.

·         That the virtual ward scheme would provide rapid access to both community and interim residential and nursing support, and thereby improve discharge rates.  This was a short term facility, and would not be appropriate for those with long term are needs.

·         That there were risks associated with the scheme if it was not done correctly, but there were also risks associated why not undertaking such a scheme at all.

In reply to a question, the Chief Finance Officer said that the Public Health grant was ring fenced, but collaborative working would mean that the best use would be made of the available budgets.  The Director for Public Health would undertake additional collaborative working in order to help deliver savings.

·         That the Older people and Adult Mental Health Teams would be integrated in order to provide additional savings.

In reply to a question from a Member, the Director of Adults Wellbeing reported that the budget did not include any assumptions from financial modelling based on the Care and Support Act, as no national guidance had yet been issued.

In reply to questions around the Open Book Review, she went on to say that there was both an appetite for change amongst service users and providers as well as an immediate market for these changes.

·         That the Council would be utilising the voluntary sector to deliver services, but that the definition of the sector should be clarified in this instance, as it referred to voluntary groups which provided a service that the Council paid for. A separate work stream around communities and volunteering was being pursued through the Health and Wellbeing Board.

·         That the Fairer Charging Policy had been approved in 2011 and that the Council was bound by national policy in this area.  The policy would need to be reviewed as part of the Care and Support Bill.  There was a mechanism for clawing back money from direct payments, and it was important that assessments were tighter and that the workforce felt comfortable undertaking this action.

In reply to a question from a Member about the deliverability of the budget, the Chief Finance Officer said that the principle was that the underlying spend was the starting point for the budget and that savings would be made against that.  The monitoring position would change, but there had not been the volatility that had been experienced in previous years.  The Director of Adults Wellbeing concurred, and said that the budget was being scrutinised on a weekly basis, and there was no expectation of a variation in costs for the last twelve weeks of the year. She expected financial performance to be based on actual performance.

In reply to a further question, the Chief Finance Officer said that he was more confident of the first year of the medium term financial plan, as it was unclear how government changes would impact later years.  Further efficiency savings could be considered as contingency measures.

In reply to a question, the Director of Adults Wellbeing said that there was support for direct payments from service users, but not of significance to provide budgetary savings.

The Director of Children’s Wellbeing reported that as well as the dedicated schools grant, there were a number of other grants that the Council received from the Government to make up a total of £7.1m in educational support grants  that had been affected by the numbers of pupils in Free Schools and Academies.  She added that the Care and Support Bill and the Children and Families Bill had implications for the service, but the principle pressures would come from a change in demography, with an increase in the number of children up to the age of eleven, and a reduction of those between eleven and nineteen.

In the ensuing discussion, the following points were raised:

·         That the Children’s Wellbeing had come in under budget, and there was a strong track record for managing budget costs.  There had been pressure areas such as safeguarding.

·         That there was successful recruitment of good newly qualified social workers, but that there was a gap in the number of experienced social workers.  New children’s needs assessments meant that the number of children in the system was increasing.  There were a greater number of premature babies with significant and complex disabilities. Different models of meeting need would have to be considered and introduced.  The Children a Families Act 2014 contained significant changes relating to children with disabilities, including the need for local authorities to work with the Clinical Commissioning Groups and the other elements of the health system in order to ensure all agencies were working together.

·         That the Children’s budget had been broken down to a finer level than the Adult Social Care budget in order to provide a focus on the deliverability of savings.

·         That the Dedicated Schools Grant had not been included in these figures as it was less flexible than other grants and could not be used in alternative ways.

·         That the governments Early Help and Family Support grants had been reduced since 2010, as had the role of the Council in these areas.  All elements of early help would continue to be provided, but not necessarily by the Council.  More effective work would be undertaken across a range of agencies.

RESOLVED

That:

a)    That the final bullet point on paragraph 20.1 of the Cabinet report be amended to ‘The budget proposals will be considered by Health and Social Care Overview and Scrutiny Committee  General Overview and Scrutiny on 13 January 2014.’

b)    That before the budget comes to full Council all of the impacts identified within the equalities impact assessment should be accompanied by the appropriate mitigations.

c)    That the robustness of all equality impact assessments in the budget appendices should be considered. 

d)    That a robust budget monitoring system be put in place, and that exception monitoring reports be submitted to the appropriate Scrutiny Committee where there were deviations from budget of more or less than 5%.  This would be submitted electronically for distribution.