Agenda item

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

Following October Scrutiny Committees, the report provides further detail on the budget change proposals, taking into consideration the feedback received to date.

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

The Committee is recommended to comment on the report and the proposals presented within 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 being considered by the Cabinet to address financial and demand challenges, enable longer term transformation, and ensure the delivery of shared strategic partnership ambitions, taking into consideration the feedback received to date.

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:-

·         In relation to the Care Act Application and Demand Management savings, it was queried how confident the service was that these savings could be achieved.

·         In response, it was commented that the Care Act Application required at least annual reviews of people with care and supports needs, and that during those reviews a strength-based approach and opportunities to maximise independence was supported. It was noted that by using resources differently and by investing in a small additional reviewing team, the service was able to see more people and explore independent ways to support people to live in their own homes for longer through the use of technology enabled care including virtual care. In relation to demand management, the service was exploring ways to ensure that the right information was available at the right time to promote early intervention which would reduce or delay demand in terms statutory intervention.

·         Members requested clarification in relation to the contract reduction proposal in public health.

·         In response, it was commented that the demand led contracts were mostly within the statutory sexual health service provision and relate to fitting of long acting, reversible contraception and sexually transmitted infection testing. It was noted that the demand for those services significantly reduced during the pandemic and had not returned to pre pandemic levels so presented an opportunity to reduce the budget, however, should demand increase in the future there would be an option to draw on public health reserves.

·         In relation to the Care Act Application, it was queried how staff were being trained to support this work.

·         In response, it was stated that over the last 12 – 18 months there had been work with staff teams to further the training offer around the strength-based approach including the opportunities of independence building to help people with a learning disability to gain practical skills and the skills for work.

·         Additional information was requested in relation to the saving around the Better Care Fund investment.

·         In response, it was commented that the Better Care Fund was a joint integrated budget between Greater Manchester Integrated Care Stockport and Stockport Council. It was noted that the Better Care Fund received an inflationary uplift each financial year dependant on the award from the NHS and consideration was given to how to invest that inflationary uplift into the wider pressures within services across adult social care such as demand demographics, price inflation and fee uplifts which in turn releases council resources to invest in other areas of adult social care and other council services.

·         Members welcomed the accountancy-based approach to delivering savings, rather than delivering savings from services.

·         In relation to the grant maximisation in public health, it was queried whether the saving would be variable should demand increase.

·         In response, it was stated that the service was in discussions with NHS provider partners around how this saving could be implemented, however there was a risk in terms of those widening inequalities, so opportunities were being explored to ensure that services were delivered efficiently and appropriately targeted.

·         It was noted that Stockport had one of the higher numbers of people in residential placements and queried whether there was a particular reason for this.

·         In response, it was commented that Stockport had a slightly larger proportion of older people than other boroughs in Greater Manchester which was linked to the higher number of residential placements and as such, the focus to mitigate residential placements was around early intervention and promoting independence to support people to stay and life safely in their own homes.

·         In relation to a query around the control of top ups as part of residential care, it was noted that the service had started the process of engagement with providers on the fee setting process as part of the annual exercise and national data around the real living wage and inflationary pressures was being used to help inform that. It was noted that a detailed report identifying the proposed fee setting for the next financial year would be submitted to the February meeting of the Committee.

·         In relation to demand management, the community led support model and technology enabled care, it was queried whether there were examples of areas where the council had previously offered this, whether this had previously delivered savings and what the uptake rate in relation to technology enabled care had been.

·         In response, it was stated that the community led support model involved early intervention through appointments in the community places such as local libraries to support people with the right advice and information to enable them to make better decisions in the future. It was noted that part of this work included ensuring good, accessible commissioned services that was easy to navigate and joined up working. It was commented that proposals were being developed for Technology Enabled Care, including a “Virtual House” that would enable clients and carers to look at options for technology support to improve their independence which would, in turn, ensure adult social care support was available for those in the community with the most complex needs. It was noted that Members of the Committee would have the opportunity to see a demonstration of the “Virtual House” in the future.

RESOLVED – That the report be noted.