To report on the current budget position in Adult Social Care and Strategic Housing.

The Committee considered a report on the revenue budget’s financial position for Adult Social Care and Strategic Housing as at the end of July 2006 and projections to the end of the financial year. 

The Interim Finance Manager presented the report.  This noted that the projected overspend on adult social care at the end of July was £3.3 million.  This was before any use was made of the social care contingency.

She reported that the risk sharing agreement with the Primary Care Trust (PCT) on spending on Learning Disabilities Services had been suspended and the PCT had agreed that it would fund its share of any overspend.  However, variations to government funding for Health Services due to budgetary pressures had resulted in reduction of £205,000 in the Local Delivery Plan.  The overspend on Learning Disabilities would therefore increase. 

Ongoing pressures on the budgets for older people, physical disabilities and for mental health were also outlined.

In relation to strategic housing she noted that the projected overspend for Strategic Housing was £31,000 against a £2.10 million budget, rather than £2.01m as indicated in the report.  Also, the average number of families in temporary accommodation in 2005/06 had been 45 rather than 405 as indicated in the report.  Homelessness remained the main reason for the projected overspend.  This had, however, reduced by £52,000 since the last report.  The use of the homelessness prevention fund had been an important factor in reducing the demand for temporary accommodation.

The report concluded by noting that in adult services there were projected overspends across all service user groups, with the position on Learning Disabilities requiring particularly close monitoring.

 In the course of discussion the following principal points were made:

·          A question was asked about progress on the needs analysis assessing future social care needs and the services to meet them for older people and adults with learning disabilities.  The Director of Adult and Community Services replied that consideration had been given to a range of service delivery models and a report would shortly go to Cabinet setting out options.  An update would be provided to the Committee at its next meeting.  The indications to date were that comparator authorities focused more on preventative measures and that this brought them cost benefits.  However, given the demographics within Herefordshire additional investment would be needed to change to the pattern of service delivery.

·          Clarification was sought on the funding arrangements with the PCT and the respective responsibilities for funding various service areas given the pressure on the PCT to make budget reductions.  The Director commented that in the case of the pooled budget for learning disabilities the PCT could no longer provide the resources it had originally allocated.  Some £178,000 of development monies was being withdrawn due to the funding of continuing healthcare being outside the pooled budget, placing pressure on that budget.  Negotiations were ongoing with the PCT over funding for these cases.  The Council recognised the pressure under which the PCT had been placed by the Government’s decision to top-slice the budgets of all PCTs to help fund the NHS deficit.  However, the Council had to meet its own pressures and negotiations with the PCT over funding were appropriately robust.  He added that the last report to Cabinet had shown some reduction in the projected overspend on the adult social care budget.  However, the position was now being reversed because of the PCT’s predicament.

·          A report on residential placements including an explanation of the budget available to support day activities was requested.

·          The Committee’s attention was drawn to the upheaval in health bodies in Herefordshire noting the departure of the Chief Executives of the PCT and the Hospitals NHS Trust to new posts outside the County and the replacement of the Chairman of the PCT.  It was also noted that the difficulties faced by the PCT in responding to the requirement to top-slice its budget were severe in comparison with those PCTs who could readily identify savings as a result of amalgamation following the recent reconfiguration of NHS bodies. 

·          A question was asked about how the social care contingency fund set aside to fund both adult social care and children’s’ services might be allocated.  In reply it was confirmed that no decision had been taken as to how the sum might be divided between the two services and business cases would have to be presented to justify the release of money from the fund.

RESOLVED:  

That       (a)     the projected 2006/07 financial outturn for Adult Social Care and Strategic Housing be noted but with continuing concern;

                        and

               (b)    a report be made to the Committee on residential placements including an explanation of the budget available to support day activities.