Agenda item

To consider a report of Leader of the Council and the Executive Councillor (Corporate, Customer and Community Services)

At its meeting on 15 July 2014, the Executive received a Medium Term Financial Forecast that indicated a budget reduction requirement of £22.453m for 2015/16, and forecast a cumulative reduction requirement of £39.419m in 2016/17, rising to £64.5m by 2018/19. In response to those forecasts, and in line with its previous deliberations and statements of intent, the Executive agreed the strategic framework for Investing in Stockport (IIS), a single programme of sustainable growth and public service reform in the Borough over the medium term.

At its most recent meeting on 12 August the Executive brought forward a set of proposals informed by the strategic framework and designed to address the budget reduction requirement.  Executive Councillors agreed that there should be a report to all scrutiny committees in the next cycle outlining the proposals relating to each committee’s remit.  Confirmation of which proposals fall within the remit of which Committee is provided at Appendix 1.

The business case working papers (that will be circulated ‘to follow’) that were made available to the Executive Councillors accompany this report have been updated to include additional information in relation to the potential risks and impacts associated with the proposed changes. 

All scrutiny committees are being requested during this cycle of meetings to comment upon the approach being taken by the Executive to address the need to make substantial savings over the next two years, and the specific proposals brought forward for consultation. 

It is recommended, therefore, that the Scrutiny Committee comments upon both the overall approach being taken by the Executive and the specific proposals detailed in the accompanying documents, where they fall within the remit of that Committee.

Officer contact: Steve Houston / Laureen Donnan; 0161 474 4000 / 3180

A joint report of the Leader of the Council and the Executive Councillor (Corporate, Customer & Community Services) was submitted (copies of which had been circulated) detailing the Executive’s proposals to respond to the Medium Term Financial Forecast considered by the Executive In July 2015. At its meeting in August, the Executive endorsed for consultation a set of proposals, in accordance with the Investing In Stockport strategic framework, that sought to respond to the required budget reductions but also to target investment to ensure the best outcomes for residents in the Borough.

The accompanying documents to the report provided further detail on the following Investing In Stockport proposals:-

·         Preventative Commissioning Strategy

·         Integrated Prevention Service Children and Family Services

·         Integrated Care – Adult Social Care and Health

·         0-25 SEND Review

·         Learning Disability Review.

The Executive Councillors (Adult Care Services), (Children & Young People) and (Health & Wellbeing) and appropriate project leads attended the meeting to present the proposals and to answer questions. The Corporate Director for Corporate and Support Services also attended the meeting to answer questions from the Scrutiny Committee.

The following comments were made/issues raised in relation to the following Proposals:-

Preventative Commissioning Strategy

·         Changes to the indicative savings requirements contained in the report reflected the ongoing discussions within the Council and with partners on the scope of integration.

·         An argument could be made that, in the face of the current financial challenges, investment in prevention was not appropriate since savings may not be realised in the short term, and may not be realised by the Council. In response it was stated that there was clear national evidence of the value of preventative activity, although it in the context of one year budgeting this may not be apparent. It was also the case that some savings made be accrued to organisations other than the Council, but that within the context of an expanding pooled budget with the Clinical Commissioning Group, this would reduce the strength of the argument against preventative investment.

·         The ‘pruning’ of contracts that were no longer fit for purpose was to be welcomed, as was the overall direction of the proposals.

·         It was important to engage with local 3rd Sector organisations in the transformation of these services as they often had valuable local knowledge and experience. There was a danger that recommissioning services and making the specifications more restrictive may price out these local organisations and the market becomes dominated by large national charities. In response it was stated that the Council had engaged the Greater Manchester Council for Voluntary Organisations to ensure that it was reaching as many local 3rd Sector groups as possible to ensure wherever possible their valuable contribution could be protected. The Council was also exploring opportunities for ‘alliance contracting’ to encourage smaller organisations to share the risk associated with contracts so they would not be priced out of the market.

Integrated Prevention Service Children and Family Services

·         It was queried whether the Troubled Families Pathway work provided sufficient evidence that the approach detailed in the proposal.

·         Concerns were expressed about the impact on schools of the renegotiation of Service Level Agreements and whether this amounted to passing the cost of services on to schools. In response it was stated that it was hoped this process would encourage more effective buy back of services from schools, some of which could be aligned to Pupil Premium monies.

·         Clarification was sought on the risk associated with the proposals, particular around the availability of appropriate skills and knowledge in the workforce. In response it was stated that training and awareness-raising in relation to safeguarding was already taking place with front line staff in the Council and partner organisations.

·         Given the interdependency between Council activity and that of other agencies for the delivery of the proposals, clarification was sought on the mechanism for ensuing and monitoring this non-Council activity. In response it was stated that the Children’s Trust brought together the partners involved. It was also clarified that all partners would continue to deliver their statutory responsibilities, but in non-statutory areas they would seek to work differently where this could be more effective.

Integrated Care – Adult Social Care and Health

·         Clarification was sought on how it was proposed to ensure that the remaining locality hubs were fully functioning within the proposed timescale. In response it was stated that the development of the Marple & Werneth hub had provided useful experience that would inform the roll-out to the other localities, but importantly it had proven that it could make a contribution to reducing unnecessary and expensive acute care. It was stressed that the project required changes to the culture of working, not simply co-location, and there may be development needs to address. Robust project planning was also needed to ensure delivery on time, but this needed to be seen within the context of maintaining current levels and models of delivery. It was also commented that the CCG Plan was committed to the development of integrated care teams.

·         In relation to the risk identified about the complexity of the commissioning process a question was asked about whether this was a potential weakness on the part of the Council or the CCG. In response it was stated that further clarification would be sort sought on the detail of this risk, but that this underlined the scale of the challenge and the ambition of the project. The risk was connected to ensuring that there was capacity to deliver the project while at the same time trying to manage the pressures on the budget.

·         Clarification was sought on whether the proposals would mean the tightening of eligibility and access to services. In response it was stated that the proposals were seeking to fund services that were better able to meet the needs of residents, but that it may also involve reviewing why clients were receiving certain services if they were not appropriate to their needs.

·         In response to a question on what the impact of the proposals would be on residents, it was stated that the aim was better outcomes.

0-25 SEND Review

·         The Scrutiny Committee’s last review was in relation to children’s mental health and one of the clear recommendations from that was to integrate services wherever possible and to retain a single point of entry to the system. In light of this it was queried whether this was still likely and whether the impact of the proposals would be to restrict eligibility. In response it was stated that the intention was to tighten the assessment process to ensure there was a stronger link to delivery and to ensure that progress was tracked more effectively. It was also stressed that there was a strong partnership approach to learning disability provision, including the aligning of budgets, which would continue. It was also stressed that the Partnership was committed to a common assessment model.

·         Concerns were expressed about staffing reductions in the Education Psychology service and that this contradicted the stated desire to expand preventative activity. In response it was stated that it was hoped to better target resources to those most in need of this type of intervention and to manage other lower level or temporary need through other mechanism where appropriate.

·         Concerns were expressed that the proposals would reduce access to support. In response it was stated that the service would continue to meet its obligations under the Children’s Act and that support would continue to be provided to those who needed it, but that that monitoring of the impact on the changes in services would be needed.

·         In response to a question about early intervention, it was stated that this was central to the focus of the proposals as early intervention may prevent the need for longer term support.

·         Concerns were expressed that the proposals in relation to SEND transport would be controversial. In response it was stated that in some cases parents were keen to encourage independence of their children. Ensuring contracts were appropriate was also a component of this work.

·         A question was asked about what facilities would be provided to parents who were not able to access the online information hub. In response it was stated that training would be provided to all front line staff in the Council and the Foundation Trust to ensure they could support those parents unable to access the information.

Learning Disability Review

·         Further information was sought on feedback from clients and their families to existing efforts to bring back to Stockport those clients in placements outside of the borough. In response it was stated that the feedback had been very positive as it reduced the isolation of the client and allowed them to be part of their local community. The opening of Heys Court in Edgeley, which was specialist accommodation for clients with learning disabilities, had already been very successful.

·         In relation to the risk of legal challenge, clarification was sought on the likelihood of this. In response it was stated that the risk was low, but some families were concerned about disruption so the Service worked closely with clients and their families to minimise this.

·         In response to a question about the links of these proposals with the SEND Review, it was stated that this work was linked to ensure a smooth transition.

·         The completion of the Heys Court development was welcomed.

The Chair then summarised the key issues/themes to arise from the discussions:-

·         it was recognised that all five of the proposals were seeking to address challenging situations;

·         that there was a challenge in balancing meeting needs and being able to meet demand for services;

·         that many of the proposals were based on assumptions about deliverability; and

·         there remain significant potential risks with implementing the changes contained in the proposals.

RESOLVED – (1) That the report be noted.

(2) That the comments of the Scrutiny Committee be submitted to the Executive for their consideration as part of the feedback on the Investing in Stockport proposals.