Agenda item

To consider a report of the Cabinet Member for Health & Adult Social Care.

Following the October and November meetings of the Scrutiny Committee, the report provides further detail on the budget change proposals, taking into consideration the feedback received to date.

The appendix to the report outlines the budget proposals being considered by the Cabinet to address financial and rising demand challenges, enable longer term transformation, and ensure the delivery of shared strategic partnership ambitions.

The Scrutiny Committee is recommended to consider and comment on the report and proposals presented that are relevant to the Committee’s remit.

Officer contact: Gill Lawton on 0161 474 3686 or email: gill.lawton@stockport.gov.uk

The Cabinet Member for Health & Adult Social Care submitted a report (copies of which had been circulated) providing further detail on the budget change proposals, taking into consideration the feedback received to date. This followed on from the report presented at the Cabinet meeting on 19 September 2023 and Scrutiny Committees during October and November 2023.

The appendix to the report outlined the budget proposals being considered by Cabinet to address financial and rising demand challenges, enable longer term transformation, and ensure the delivery of shared strategic partnership ambitions.

The Cabinet Member for Health & Adult Social Care (Councillor Keith Holloway) attended the meeting to respond to questions from the Scrutiny Committee.

The following comments were made/issues raised:-

·         It was noted that a large proportion of the efficiencies and savings centred around continuing to care for people in their own homes and whilst this was conducive with the preference of the majority of residents, it was commented that a small minority of older people would prefer the company and support that residential care offered.

·         In relation to patient choice, it was queried whether residential care was an option for residents were this was their preference.

·         In response, it was commented that for these residents were there may be fears in relation to returning to their own homes around risk of falls and isolation, there would be an offer of intermediate care, step-down from hospital into a facility that would support them with their confidence to maximise their independence. It was stated that work was ongoing to offer a wider range of services at a neighbourhood level. It was noted that the Care Act required the service to look at individuals based on their individual need, there was a national criteria for health, care and support and a decision would be made with the individual based on meeting their needs in the best way for them.

·         Additional information was requested in relation to the benchmarking information reference in the report that Stockport had high fee rates compared to other Local Authorities.

·         In response, it was stated that this would feature as part of the Annual Residential/ Nursing Care, Home Care and other Care Management Fee Setting report was due to be considered at the February meeting of the Committee. It was noted that Stockport’s fee rates comparatively with the North West were quite high related to the range and number of provision, land value and level of residents who were self-funders and able to pay higher rates for care. It was noted that it was important to offer different types of provision and ways to support people to stay independent in their own homes because of the cost such as extra care housing.

·         It was queried whether any of the saving proposals included adopting shared services with other Local Authorities or agencies.

·         In response, it was commented that whilst there was nothing actively planned in terms of specific opportunities, a small number of proposals had been considered in the last year including a complex needs facility led by Tameside, however relating to the costs associated and appetite from other Local Authorities it was decided that the proposal would be reconsidered at a future date. It was noted that there were limitations in relation to shared facilities relating to the preference of individuals within their localities being closer to home, however there was potential for efficiencies around sharing back office costs and different models of commissioning.

·         It was noted that the local government financial settlement had been disappointing and there was unity across the council chamber in the response to Government around the inadequate resources that were available to the council.

·         In relation to the Equality Impact Assessment and the impact of the proposals, it was noted that the changes were likely to disproportionately affect residents who required council resources the most including older people, younger people, people with a disability, low income, people living in deprived areas, people experiencing homelessness, veterans, asylum seekers and refugees.  

·         In response, it was commented that financial position of local government constrained the council’s ability to deliver services, however the council were doing as much as possible to protect the most vulnerable residents in Stockport which included an emphasis on preventative services and neighbourhood working across health services.

·         Members commented on the importance of multi-year settlements for local government and noted that most people’s interactions with government was with local government.

·         In relation to managing the external care markets and bringing third party top ups in house, it was queried whether there would be a policy and resource to manage this.

·         In response, it was commented that the service had been working to create the capacity and space for this work through the social care charging team by utilising some of the modules within the client finance more effectively and modest resource.

RESOLVED – That the report be noted.