Agenda item - BHCC Health & Adult Social Care Budget Pressures

Presentation on plans to meet HASC budget pressures 2023-24 (verbal)

37.1    This item was introduced by Michelle Jenkins, BHCC HASC Assistant Director, Resources; and by Rob Persey, Executive Director, HASC.

37.2    Theresa Mackay (Older People’s Council) asked how HASC would manage future demand. Ms Jenkins responded that there is a statutory duty to provide services to eligible people in need of support, so demand management has to focus on prevention. Mr Persey agreed that a focus on prevention was key, but a longer term funding settlement would be really helpful also.

37.3    Cllr Sankey expressed sympathy for HASC’s budget position and her support for a preventative approach. She asked how confident HASC was in its ability to delivery 2023/24 savings targets. Mr Persey responded that he would not have submitted an unachievable savings target. This said, however, HASC (and children’s care) are demand-led services and financial planning can be undermined by a few additional high cost care packages needing to be provided. It is also the case that service budgets have been shaved for a number of years in anticipation of  a long term funding settlement that has not yet materialised. The scope to make further savings is limited.

37.4    Cllr Sankey asked why life expectancy has started to fall. Mr Persey replied that this is due to a combination of factors, including poor diet, obesity, and substance and alcohol misuse. It is important that young people understand the benefits of a healthy lifestyle and there is consequently a focus of preventative services on young people and on communities experiencing health inequalities.

37.5    Cllr West noted that the Council’s external auditor had flagged significant financial risk, and limited further opportunities to draw on reserves. What has HASC’s budget performance been like across the year? Mr Persey responded that HASC has not made all its in-year savings targets, but is nonetheless expected to come in on-budget. Next year’s savings targets are realistic and are supported by robust programmes of work. Ms Jenkins added that there is limited value in focusing on individual TBM reports across the financial year, as reports can be impacted by a single expensive placement. It is also the case that in-year savings programmes can take a number of months to start generating savings, so early TBMs may look bad even when plans are progressing well and will deliver on target by year end. However, it is not possible to continue cutting services for ever.

37.6    Cllr Sankey noted that plans include a 0% uplift to many block contracts and asked whether this meant workers would not receive a pay rise. Mr Persey responded that a number of contracts are being uplifted by 5-6% and that Living Wage commitments will be unaffected.

37.7    In response to a query from Cllr Sankey about plans to dispose of unused space at Wayfield Avenue, Ms Jenkins replied that this is space in a mental health residential home that was previously used to deliver a now discontinued day service.

37.8    In response to a question from the Chair about the Section 75 agreement with Sussex Partnership NHS Foundation Trust (SPFT), Mr Persey explained that savings have been agreed with the Trust. This will involve pushing some costs back to SPFT.

37.9    The Chair thanked officers for their contributions. Cllr Moonan also noted that members need to recognise that HASC delivers crucial services, and that it can’t sustain more cuts for ever.