Agenda item - Finance Report at TBM7

Report of Executive Director of Finance & Resources and Chief Finance Officer, Brighton and Hove CCG (copy attached),

(1)       That the financial position for the 2013/14 financial year as reported at TBM7 (October 2013) be noted.

(2)       That the 2014/15 budget strategies for the health and social care arrangements set out for development and agreement by Budget Council and the CCG Governing Body be noted.

50.1    The Committee considered a report of the Executive Director of Finance & Resources and the Chief Finance Officer, Brighton and Hove CCG which set out the revenue and capital financial position on Adult Services, NHS Trust Managed S75 Budgets and Public Health. The report included extracts from the Council’s 2014/15 budget strategy and budget proposals covering Adult Services, and Public Health and provided indicative information on the CCG budget strategy for 2014/15.  The report was presented by the Head of Business Engagement, Financial Services.

50.2    Councillor Bowden raised the issue of prescribing.  He commented that the council had not budgeted for the payment of prescriptions.  He assumed that this would be a long term burden on the CCG rather than the council’s budget. 

50.3    Geraldine Hoban explained that the function and responsibility for prescriptions had transferred to the council, whereas the prescribing costs had stayed with the CCG.  A decision would need to be taken as to whether prescribing costs were transferred to the council or remained with the CCG, with the council making a payment for them.  

50.4    Councillor Bowden asked if costs would be recovered from the local authority if a person was prescribed a course of smoking cessation.  Geraldine Hoban replied that the budget could be transferred or the CCG could keep the budget and pick up the cost of prescribing. 

50.5    Councillor Sykes asked if the spend on the Community Care budget was a blip or part of a trend.  The Head of Business Engagement confirmed that it was a trend. 

50.6    Councillor Summers asked for an explanation of ‘double running’ on page 20 of the agenda.   She further asked for an explanation of the £1m assessed risk against the achievement of savings targets in Adults Provider.   

50.7    The Executive Director of Adult Services explained that double running referred to people in the council’s service who were moving to the independent sector.  Savings had to be shown from the provider service.    The £1m was referring to unachieved savings.  The TBM9 report would show a reduction in the overspend.

50.8    Councillor Meadows was pleased prescribing costs had been sorted out.  This was good news.  However, she was disappointed that the report only related to TBM7.  Councillor Meadows remarked that there was a need to see full year accounts, before budget council.

50.9    Councillor Mears stated that a year ago she had requested to see the full detailed adult care & health budget before budget council and that the Chair had said he would ensure members would have a full detailed budget paper. 

50.10  The Chair replied that opposition members had an opportunity to comment on the agenda and make requests at the Cross Party Pre-meetings. 

50.11  Councillor Meadows remarked that the pre-meetings were private meetings and all the councillors needed information in order to make rational decisions. 

50.12  The Head of Business Engagement explained that TBM9 would be the next report to Policy and Resources Committee.  TBM7 was a forecast for the whole year based on actuals at month 7.  The forecast was subject to change.

50.13The Committee Lawyer explained that the budget was agreed by full Council. Policy and Resources Committee were responsible for monitoring the budget. 

50.14  Councillor Bowden commented that the current report was a snapshot of the current position.  

50.15  Councillor Mears stated that her understanding was that Adult Care & Health Committee was an executive committee and had to agree how the budget was spent.  She asked how decisions could be taken when there was no overview of the full budget. 

50.16  The Chair replied that he would ask for a constitutional ruling on exactly what budget information should be presented to the Committee.  He would request a detailed response for the next meeting.  

50.17  The Head of Business Engagement reported on the projections for TBM9 which are in development and informed members that this latest forecast indicated an improvement of £800,000 over the TBM7 forecast overspend. 

50.18  Janice Robinson asked if there had been discussions with the CCG on future savings that might have to be made.  The Executive Director reported that there had been a growth in mental health funding and there was no change in commissioning budgets. One off resources had been set aside in the light of the changes taking place with the introduction of the Better Care Fund. 

50.19  Councillor Mears referred to paragraph 3.10 of the report in relation to people placed out of the city.   She stated that the Committee had been reassured last year that measures were in place to deal with this matter.  Councillor Mears referred to page 19 in relation to the Community Care Budget – Older People.  Councillor Mears stated that she had informed the Chair two years ago that the options were complex but the overspend had been carried forward.  Councillor Mears stressed that there was an issue around older people and the Director of Public Health had carried out a 10 year project.  There needed to be in depth work regarding the long term. 

50.20  Councillor Mears stated that there was an issue with regard to Craven Vale. The Committee had been assured it was the best option. The Committee was now being told it was not a priority.

50.21  Councillor Mears made some observations on the budget in relation to  anti-social behaviour.  She stressed that when people were discharged from Millview, there needed to be a care package provided, otherwise there could be anti social behaviour patterns. 

50.22  Councillor Mears referred to a Brighton Housing Trust contract for a 20-22 room hostel which had been used for rough sleepers who were now out on the street.

50.23  Councillor Mears made reference to the announcement by the Leader of the Council regarding a proposal for a referendum for a council tax increase of 4.75%.  Funding for adult care & health had been mentioned as one reason for this proposal.  Councillor Mears noted that this matter was not included in the committee papers. 

50.24  The Chair stressed that there had been no radical changes in adult care & health.  Funding had decreased which increased service pressure.  

50.25The Executive Director answered Councillor Mear’s questions.  Firstly, service users had been brought back to the city but this process took time and was complex.  Specialist flats had been built in Poets Corner and officers continued to explore options.  With regard to older peoples’ services, the resource centres received joint funding and officers were looking to increase funding from the NHS.

50.26    The Executive Director explained that the Craven Vale Centre had worked well in terms of short term nursing services, but it was now felt that resources were better spent on extra care.  Meanwhile, Section 75 arrangements were in place with regard to people with mental health issues.  The total care of the person was considered and the Director stated that she would like to hear of any people whose needs were not being met.

50.27  RESOLVED - (1) That the financial position for the 2013/14 financial year as reported at TBM7 (October 2013) be noted.

(2)       That the 2014/15 budget strategies for the health and social care arrangements set out for development and agreement by Budget Council and the CCG Governing Body be noted.