Agenda for Scrutiny Panel on the Budget Proposals on Friday, 9th December, 2011, 2.00pm
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Agenda and draft minutes
PDF 184 KBVenue: Committee Room 1, Hove Town Hall. View directions
Contact: Tom Hook Head of Overview & Scrutiny
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Minutes: 10.1 There were no declarations of substitutes, declarations of interest or declarations of party whip.
10.2 RESOLVED; that the press and public be not excluded from the meeting. |
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Chairs Communications
Minutes: 11.1 Councillor Ken Norman, Chair of the Budget Scrutiny Panel, welcomed everyone and reminded the meeting of the aims of the Panel:
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Witnesses
Draft Budget Proposals People o Cllr Jarrett – Cabinet Member for Adult Social Care o Cllr Shanks – Cabinet Member for Children & Young People o Strategic Director People, Terry Parkin o Director of Adult Social Care, Denise D’Souza o Geraldine Hoban, Chief Operating Officer, CCG
Minutes: 12.1 Councillor Rob Jarrett (RJ) told the meeting that proposed savings were inevitable within Adult Social Care and Health as these service areas represented a large part of the Council’s overall budget.
12.2 The underlying principle was that services remain wherever possible and would be delivered more efficiently. Savings would be sought when contracted out services eg in Home Care were due for renegotiation. The Council relied on having the right in-house expertise; internal structures were being looked at to ensure the right numbers and levels of officers. Savings would be made in external contracts wherever possible.
12.3 The Council had a statutory duty to provide care and Brighton & Hove faced some significant demographic pressures; eg there were relatively large numbers of people aged 85+ many of whom had significant health needs and a rise in the numbers of adults with learning difficulties surviving into old age and a related rise in cases of dementia. So although some significant savings had been identified, this did not mean that the total budget had reduced.
12.4 Raising the service eligibility threshold from ‘substantial’ to ‘critical’ had been considered and judged to be a false economy in that service users then would tend to return with more severe problems later on. It is intended to take a preventative approach.
12.5 Compared with other areas Brighton & Hove is known to have significantly higher than average costs per individual, particularly for learning disabilities.
12.6 There are proposals to make savings on accommodation arrangements. Various parts of the City have relatively inefficient buildings, some of which are small and underused so reducing unnecessarily high overheads is key. This would involve rearranging some locations and potentially cause some dislocation to service users. A suitable consultation period was being planned.
12.7 Other efficiencies were planned by using new technologies eg in Home Care, helping people to stay in their own homes. Telecare can be used to reduce the number of home visits needed to ensure a person is OK, resulting in savings without loss of service. Simplifying the range of payment rates in new Home Care contracts would also bring about some savings.
12.8 Community Meals was another area of potential savings, pending the outcome of the current scrutiny process. The option of a new contract would be explored.
12.9 Councillor Sue Shanks (SS) pointed out the wide service areas covered by schools, early years and youth budgets. She said national funding was increasingly being switched from local authorities to individual schools and academies with cuts to spending on eg education welfare, school improvement and early years training subsidies. Councillor Shanks focussed on some of the key areas.
12.10 Some of the Children’s Centres did not provide a full range of services and had become expensive to run. For the relatively large numbers of looked after children currently in Brighton & Hove, more learning interventions were being planned to help reduce escalation of service needs. In-house fostering would be used more in future and this was less costly.
12.11 Youth services were shown to be effective, especially at traumatic times in people’s lives and the Council would look to protect these; in particular by bringing together commissioning for sports and play services across the City. A small reduction in employability service was being proposed as schools were increasingly taking responsibility in this area and children staying in school for longer. It was planned to bring together employment services in Housing and Supporting People to cover both young people and older age groups.
12.12 Councillor Shanks said she was keen for schools to stay within the local authority however there were national pressures and a school places commissioning group was established.
12.13 Geraldine Hoban (GH), Chief Operating Officer for Brighton and Hove’s Clinical Commissioning Groupgave the background to the changes to commissioning for healthcare within the City. She confirmed that the CCG was working closely with the local authority on both the adult and childrens’ Section 75 and on the Commissioning Strategy and Improvement Strategy. She said that joint governance and decision-making process were in place and the budget proposals were aligned with healthcare processes.
12.14 She confirmed that from an NHS perspective she was confident that the commissioning proposals would not adversely affect health or the local health economy. As with the approach in health, benchmarking had enabled ‘outliers’ to be identified, so that better value for money could be achieved. She noted that within the budget proposal there were also investment areas.
12.15 The level of spending on carers would be maintained; there would be changes to how these services are accessed. Mental health was a priority and more funding was being put into this.
12.16 Re-ablement funding was being re-aligned with £3.2 million being passported to the Council including £500k for work on prevention - enabling access criteria to be maintained. Whilst this year there would be a reduction of £130k in this pot she felt confident it could be managed.
12.17 There would be a specific focus on Children’s health within the CCG, and Geraldine Hoban said they would want to work very closely with the Council on proposals around Children’s Centres. Among the aims of the clinically led working group on Children that will be established this year is to improve the relationships and connections between primary care and the Children’s Centres and to ensure community health services are working to keep children out of secondary care whenever appropriate.
12.18 Cabinet Members answered questions from the Panel together with Denise D’Souza, Lead Commissioner Adult Social Care and Health (DD), Terry Parkin, Strategic Director (People) (TP) , James Dougan, Head of Children and Families (JD) and Jo Lyons, Lead Commissioner, Schools, Skills and Learning (JL).
a) MM: No reference to S75 in the ASC Strategic Financial Context (p35)? DD: this will be set out more clearly when the proposals go to the Joint Commissioning Board.
b) MM: Savings in the assessment budget (p36)? DD: Some of the £200k savings would be found within joint arrangements eg some growth in budget for mental health assessment.
c) MM: Bringing ‘in line,’ support for the Learning Disability Partnership Board (p36) ? DD: This budget has been underspent for 2 years. The proposals are adequate to support the LDP Board and consultation.
d) MM: ‘£50k savings’ appears to be a general ‘accountancy’ number – are these reliable figures (p37, p40 )? DD: The figures in such a large budget are ‘rounded.’ There are detailed budget sheets behind each of these.
e) MM: Are these deleted or vacant posts? DD: A review of support services is in progress; more information can be provided following consultation.
f) MM: How many units would be taken out of Housing Stock for ‘extra care’ (p38)? DD: Brighton & Hove is still an ‘outlier’ regarding numbers of older people in residential care. At current rates the numbers will have increased by 700 people by 2013. The Housing Commissioning Group is looking at a range of options for around 15 units locally at present. No decision on providers of housing has been made and other residential social landlords are also being looked at.
g) MM: Concerned about proposals affecting people with disabilities (p40) MM: Details in EIA – question ‘no’ impact eg on transgender, ethnicity groups (p119): ‘no’ impact on older people (p121) EIA ‘to be completed’ (p123). Some comments may be misleading.
h) RJ: This budget has been prepared sooner than usual and the EIAs are still developing. DD: Services would be clear about the potential impact regarding individuals but these EIAs are for budget scrutiny and would be enhanced for budget council.
i) GM: Timescale and achievability for reducing the numbers of people in residential accommodation (p38) ? DD: Despite developing 200 extra places (eg Patching Lodge, Vernon Gardens) we are still short by around 200 units and the number of people aged 85+ is growing. 15 extra people are in care every week; we are working on how to address this and will consult on proposals. RJ: At present we have people placed as far away as Devon and this is extremely expensive per person although only a few individuals are involved. We can manage transition better and by remodelling local provision we know we can accommodate people in Brighton & Hove, but this will take time.
j) GM: All current in-house provider services (bottom box p44) is this deliverable? DD: This is for 2013/14, so there is a year to plan this. TP: This is ‘joining up’ children and adult services better. Transitioning here is not as good as in some other local authorities; this is one of our biggest weaknesses. Significant savings have already been achieved and we’re confident further savings can be made.
k) GM: How will savings be achieved? TP: We know that local provision can bring down costs significantly and improve the offer to the individual.
l) OS: Adults Assessment – meeting VfM target? DD: Community Care is linked with Personalisation which is included in the summary of VFM gains (p29). This spending on Community Care eg on increasing independence via Telecare and other initiatives has been shown to be effective over the last 2 years and there is no reason to change this, but there is still more to do.
m) JM: We welcome protection of spending on prevention and we recognise budget pressures. How can we ensure that the quality of domiciliary care does not decrease? DD: These are proposals covering 2 years; it is not intended to increase the eligibility criteria. Our demographics show that numbers of people over 65+ is not a significant issue, however the number of people aged 85+ is growing. The Community Care budget for older people continues to decrease and quality is an issue. We are moving to real time monitoring of care actually delivered and getting feedback from carers. The proposals are for more but different investment, targetting the most vulnerable. RJ: There are savings planned on Home Care contracts but high quality is still expected. There will be encouragement for training and we are looking at ability to recruit staff at the right pay level. This is a key aim, but not in the budget papers.
n) JM: What is the nature of the cuts to the Learning Disabilities Partnership Board? A consultation is planned for next year – so is this a good time to make cuts of more than a half? DD: The Board will still be supported but there will be less spend on infrastructure and funding targeted instead at specific initiatives, consultations and transitioning. RJ: There was a small one-off discretionary grant for a pilot scheme. Individuals will still be supported including moving to employment. No reduction is proposed on advocacy or other support for individuals to participate.
o) JM: The Voluntary Sector has particular expertise in transition. How will integrated Transition be planned; what will be the impact on adult services? JM: The EIAs need strengthening regarding older people. Referring to the questions for EIAs (p19) - have all the risks been identified in the services? RJ: We want to make sure the EIAs work as they should but they are not perfect at this early stage. Any concerns that the Panel has on EIAs can be referred to Councillor Ben Duncan, either directly or at a Panel meeting.
p) KN: How are the Day Services proposals (p40) different from previous years? Any changes to mental health provision planned? DD: There is a continuation in the service for carer relief but there is a relatively low occupancy rate and further reductions are expected in the personalisation budget. More preventive work and a move to more community-based options are expected. GH: There are no firm proposals as yet. We plan to commission Depression services first and then we will look closely at Day Services this year via the Joint Commission Board with the intention of commissioning in 2013/2014. RJ: Day Services will still be there for those who need them. But there are low occupancy rates and we want to reduce high overhead costs where possible, for example by reducing the number of buildings but still providing the service.
q) GM: No indicative savings for Youth Services for 2013/2014? Will these continue to be provided in-house? SS: There are no proposals to reduce funding; the Youth Services Review has been published and we plan to work closely with the voluntary sector. Current staff are anticipated to stay employed by the Council.
r) MM: So Youth Services will continue to be provided in-house and there will be no reduction in funding to the voluntary sector? SS: There is additional funding of £300k to grant aid more groups so there will be increased provision in this area and no reduction in funding. The Youth Services Review indicates area-based work which will bring services together and avoid duplication. Recommendations are being brought to 20 January CMM JD: The CMM report will indicate how coordination is to be planned.
s) JM; How long will rollover last? TP: Officer advice is that holiday schemes should not be put at risk so rollover is needed so that critical schemes can continue. This will take time and we are grateful to all currently involved for their commitment. We plan to stop providing advice on health and safety which most authorities stopped long ago.
t) GM: Does ‘Transport’ or ‘CYP’ subsidise school buses? TP: I can confirm Transport is responsible to subsidise school bus routes and we have looked to ensure there is no double-subsidy. Our home to school policy is inconsistent with neighbouring authorities in that Brighton & Hove children receive funding to travel to schools outside the local authority area but children from elsewhere do not receive funding from their Authority to travel to Brighton & Hove schools. MM: There is a range of different home-to-school subsidies paid, eg SEN and faith schools. TP: Yes this could be made clearer in the papers. There are no hidden subsidies. We are taking a fresh look at bus routes. We are not good at supporting SEN independence and we’re looking at how to improve this. MM: Regarding transport to faith schools, some children outside the City Centre could be disadvantaged. SS: There will be consultation on proposed changes.
u) OS:
How will schools be able to take on more responsibility and can
that be a seamless transition? TP: The national picture is that local authorities will not be working so closely with schools in future, other than taking responsibility as a last resort. JL: We have been working with Head Teachers for a long time, on these changes to support school-school support. There is a national and local push for being self-supporting. The local authority team is refocusing on commissioning and brokering partnerships. TP: It is important to help schools prepare. The pupil premium will rise and school budgets will increase especially for those with high numbers of pupils receiving free school meals. For the local authority this means a large funding reduction for previously grant-supported services eg around ethnic minorities, school improvement and early intervention so the local authority team may need to reduce further.
v) KN:
There has been significant interest in changes to the music service
and the reduction in funding – would you like to comment on
this? JL: We will be focussing on music provision for vulnerable groups including looked after children and youth offenders and for 2012-2013 will be looking to schools to do their own commissioning.
w) GM: How will the music service be protected in this budget? SS: There is free tuition for children receiving free school meals and our Arts Council bid will emphasise vulnerable groups.
x) GM :Youth Employability savings (p52)?; and could external funding be sought? SS Brighton and Hove Business Enterprise Partnership will be looking at increasing employment across the city; there will be more joined up provision. Joint commissioning will help make savings here. The Foyer is active in this area. TP: This is an example of where early intervention from age 16 can give better outcomes. At present our performance is low - we need to ensure that more young people achieve 5 or more good GCSE grades. y) JM: Are these Youth Employability Services figures the latest available and why are 4 CVSF posts proposed to the lost in 2012-2013 not shown as a saving (p52) ? Has the transitional funding of £200k all gone? JD: The £200k was allocated to the voluntary sector for 2011-2012 as part of the transitional funding from Connexions service.
z) JM: we welcome the £300k new funding – how does this link with other grants programmes? JD: This is a new pot of money for which the precise details are still being developed. MM; What is the position regarding S75 funding and Children and Families Delivery Unit (p45) ? JD: The Cabinet report can be made clearer here.
aa) MM: Numbers of vacant and deleted posts in services for children with disabilities? SS: This could be made clearer in the papers. JD No cuts are proposed to voluntary sector in Youth services.
bb) MM: Reduction of £10k in adaptations? JD: this is a small saving for year 2 (not year 1) in a much larger budget that we think will have least impact. Discussions are on-going via the Partnership Forum TP: New technology will bring down slightly the cost of adaptation; an explanation can be provided. GH: Most adaptations are from S75 funding; I will check this.
cc) AP:
Savings in school Improvement and Inclusion?
dd) JM: What changes will there be to contracting arrangements for Services for Disabled Children (p57)? The £120k proposed savings does not seem to be in line with the needs assessment. Why is the Voluntary Sector singled out for savings here or is there a proportionate reduction in in-house provision? Proposed savings could have a huge impact on staff levels and organisations’ ability to survive. This would disproportionately affect parent carers and disabled children. SS: the move to 2-year commissioning will help contribute to job security including in the voluntary sector, as well as cost reduction. TP: Identified savings amount to only a small percentage of the total budget. Efficiencies will result from multiyear commissioning and joint commissioning with adult provision. New ways of commissioning will lead to improved services.
ee) JM: even relatively small cuts can impact disproportionately; not least because without core funding CV sector organisations cannot attract additional funding. The needs assessment has identified priorities and it should be followed. The service should be looked at as a whole, not just the voluntary sector. JM: Where will the £192k savings on the early intervention fund be made (p49)? Also the £107k cut to CAMHs and TAMHs at a time of a 40% rise in referrals, including children, and the highest suicide rate for under-25s, in the UK SS; At a national level, CAMHs was an initial pilot that was always due to end in March 2012. We have managed to find the money to support the continuation of the service albeit at a reduced level. JD: Commissioning for Disability Services is actively being linked in with the needs assessments and the next stage is to look at targets. This could be made clearer in the Cabinet papers.
ff) JM: But the cuts appear to be prescribed to fall entirely on the voluntary sector, where they will have disproportionately greater impact. JD: The savings are not new and have already been achieved via the EIG review. We can look at how the information is laid out in the table of savings description, impact and risk. (p49) SS: a small funding reduction will be manageable, providing longer-term commissioning and security is achieved.
gg) MM: How many vacant and deleted posts are proposed in ASC and Childrens’ Services? TP: Across ‘People’ there are approximately 90 vacant posts and 45 unfilled vacancies. These are subject to consultation and detailed figures will be provided. HR can provide the corporate picture.
hh) OS: How can savings be achieved on asylum seekers without service impact (p56)? TP: There are fewer asylum seekers and we are working more closely with West Sussex colleagues regarding people arriving at Gatwick airport but then presenting at Brighton.
12.19 Cabinet Members provided a summing up:
12.20 Councillor Shanks said the EIAs did not fully identify all equality issues but could focus on the main matters. She emphasised that it was a challenge to balance targeted work with individuals, with generic services. However she was satisfied with the proposals put forward, including looked after children and play services.
12.21Councillor Jarrett said even though under difficult financial circumstances, the proposals fulfilled the manifesto commitment, protecting the most vulnerable and carers, and recognising the increasing value of community work. Equalities considerations had been applied across services so that wherever possible there was no disproportionate effect on any particular group. Savings would be applied without impacting on services, though the location or means of delivery might change or the profit line of contractors may be affected.
12.22 Councillor Ken Norman the Panel Chair thanked everyone for attending the meeting and answering questions. |
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Any Other Business The next panel meeting will be held at 2pm on 6 Jan 2012 in Hove Town Hall Minutes: 13.1 Members noted that the next Panel meeting will be on 6th January at 2pm in HTH CR1 |