Agenda item

To consider a report of the Leader of the Council and the Deputy Leader.

At its meeting on 18 August 2015, the Executive presented a report which included a Medium Term Financial Forecast for the period 2016/17 to 2020/21. That report illustrated the level of resources likely to be available in 2016/17 and the resulting budget position. In response to those forecasts the Executive brought forward the set of proposals for 2016/17 with the relevant proposals being considered by scrutiny committees, including the specific detailed business cases, in September 2015.

This report provides an update on each of the proposals relevant to this committee and reflects completed or ongoing consultation with members, stakeholders and the public. Scrutiny members are invited to consider and comment on the following updated proposals appended to this report:-

(1)       Preventative Commissioning Strategy

(2)       Health & Social Care

            (i)         Integration of Health and Social Care

            (ii)        Redesign of the Mental Health and Support Work Services

            (iii)       Remodelling of Stockport Learning Disability Services

(3)       Locality Working

Following scrutiny, proposals will proceed to the Executive on 16 December 2015 where they are presented for consideration and approval.

The Scrutiny Committee is asked to review the proposals and consultation findings relevant to this Committee and provide comments.

Officer contact: Andrew Webb or Steve Houston, 0161 474 3808 / 4000

A joint report of the Leader of the Council and the Deputy Leader of the Council was submitted (copies of which had been circulated) providing an update on those Investing in Stockport proposals considered by the Scrutiny Committee in September 2015, following completed or ongoing consultation with members, stakeholders and the public. The proposals had been brought forward by the Executive to respond to the financial challenges facing the Council and in response to the forecasts provided by the Corporate Director for Corporate and Support Services.

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

·         Preventative Commissioning Strategy

·         Health & Social Care (including the integration of health and social care, the redesign of the mental health and support work service, and the remodelling of the Stockport Learning Disability Services)

·         Locality Working

The Deputy Leader of the Council (Support & Governance) and the Executive Councillor (Supporting Adults) attended the meeting to present the revised proposals and to respond to questions from the Scrutiny Committee.

The following comments were made/issues raised:-

Preventative Commissioning Strategy

·         The Targeted Prevention Alliance had been running for the past six months, and a further report would be submitted to a future meeting of the Scrutiny Committee detailing how the service had been operating over this period with particular regard to collaborative working with the localities.

·         It was noted that the report identified that there remained uncertainty in relation to the future Public Health Grant and that there were other potential reductions which may impact on the delivery of the Stockport Together programme.  In response it there were a number of factors which may influence the settlement for 206/17 including the recent announcement that Council’s would be able to increase Council tax by up to 2% to provide additional ringfenced funding for adult social care.

·         Clarity was requested on the implications for those 23 organisations from which public health support workers had been withdrawn.

Health & Social Care

(i) Integration of Health and Social Care

(a)       Review of current Care Management Budget including procurement

·         Concern was expressed that additional responsibilities had been imposed on the Council following the enactment of the Care Act at the same time that significant budgetary reductions were being made.  The onerous impact of the Deprivation of Liberty Safeguard assessments in particular was highlighted. 

·         The Care Act had loosened the eligibility criteria for a number of services which was increasing demand and placing increased pressure on budgets.

·         In response to a statement that the Council would be seeking to either reduce the number of people receiving services, or to reduce the provision of services themselves to achieve the required budgetary saving, it was stated that such measures were seen as the last resort and other options were being explored.

·         It was stated that consultation on this aspect of the business case had been problematic as providers had been clear in their view that any reduction in the price paid by the Council may result in work being handed back to the Council.

·         It was difficult to control demand on services in the light of the relaxation of the eligibility criteria under the Care Act.

·         Work was being undertaken to explore the level of savings that could be achieved through an expansion in the use of telecare.

·         In response to a question about the use of reserves to fund services, it was stated that the Council’s approach was to seek efficiencies through the pooling of budgets with the health service rather than exploit finite resources in reserves.  It was nonetheless commented that capital in the form of reserves could employed if the end result was to put in place initiatives that would ultimately produce a balanced budget.

·         It was requested that a further report be submitted to a future meeting of the Scrutiny Committee with regard to the implications of the announcement in the recent Spending Review that Council’s would be able to increase Council Tax by up to 2% to provide additional funding for adult social care.

(b)       Reduce size of hospital social work team

·         It was stated that the Council maintained the largest social work team at Stepping Hill Hospital of any authority in Greater Manchester, and that in the light of the financial pressures the Council was under this could not be maintained in the long term

·         It was acknowledged that the pressure on the hospital through the number of admissions was such that it distorted the level of staffing resource the Council needed to put in.

·         It was not possible to simply reduce staffing from the hospital as this would serve to overwhelm the community team, or result in people being discharged from hospital without due care.

·         It was proposed that the funding of the service would transfer to the pooled budget which would result in a saving from the Council’s budget and that as demand reduced, the staffing resource would be reduced commensurately.

(c)        Review of current assessment process/ staff efficiencies

·         It was clarified that this proposal sought to make one-off efficiencies around specific posts whose role had diminished and the postholder had expressed a wish to leave.

·         These measures would not necessarily achieve the same level of saving as voluntary redundancies but had the benefit of allowing service areas to retain a portion of the funding associated with the post to allow some of the duties of the post to be redistributed.

·         It was requested that details of those services affected by this proposal be circulated to members of the Scrutiny Committee.

(d)       Review of current in-house services

·         There was a concern that there were too many pathways into the intermediate care service which needed to be simplified to avoid confusion for users and to rationalise the current staffing arrangements.

·         There was a high level of confidence that the required level of savings could be found.

·         It was requested that a report be submitted to a future meeting of the Scrutiny Committee outlining the progress in reviewing the pathways into intermediate care.

·         It was commented that the Council was provider of last resort which meant that the independent sector was able to ‘cherry pick’ profitable services while more complex and expensive cases were retained by the Council.

·         Further clarity was requested on the impact of the proposal relating to the closure of one residential intermediate tier service.  In response it was stated that a report would be submitted to a future meeting of the Scrutiny Committee in relation to this proposal.

(ii) Redesign of the Mental Health and Support Work Services

·         Following the responses received to the consultation it was confirmed that changes were now proposed to the original business case that would achieve a similar level of saving without affecting staff pay and conditions or involving compulsory redundancies. 

·         There would be a loss of some management and front line posts, however these would be achieved either through the deletion of vacant posts or through voluntary redundancy.

·         The saving requirement from Mental Health and Support Work Services was amongst the lowest level of savings proposed and this reflected the priority that was placed on the service.

·         It was commented that a consultation by Pennine Care NHS Trust was ongoing in respect of changes to mental health services provided by them.

(iii) Remodelling of Stockport Learning Disability Services

·         In response to a query about the assumption that the use of alternative providers would save money, it was stated that alternative providers could bring an different perspective to the delivery of services and a level of innovation.

·         In respect of the additional saving requirement of £1.471m that was added in August 2015, it was stated that work as being done around the outsourcing of tenancies to meet this and which would include work being undertaken with families to bring back some very high cost out of borough tenancies where this was acceptable to all parties.

·         It was requested that an update be provided to the Scrutiny Committee in respect of the impact of the withdrawal of the Council’s assisted transport service and the transition to private arrangements through the use of personal budgets.

Locality Working

·         While there we no direct savings associated with this business case, it was commented that there may be some very low cost interventions that could assist with various service areas such as around loneliness.

RESOLVED – (1) That the report be noted.

(2) That the comments of the Scrutiny Committee in relation to the Investing in Stockport proposals be referred to the Executive for consideration.

(3) That the Executive be recommended to re-examine the proposed saving requirement from the redesign of the Mental Health and Support Work Services in the light of the ongoing review by the Pennine Care NHS Trust in respect of mental health services provided by them and the commitments given by the Council as part of the motion passed at the Council Meeting on 3 December 2015 in respect of the ‘Mental Health Challenge’.