Agenda item

(a) Report of the Chief Officer for Communities, Public Health, Environment and Prosperity, attached (Page 1)

(b)  Report of the Chief Officer for Adult Care and Health (ACH/17/74), attached (Page 3)

(a) Public Health

The Committee received the report of the Chief Officer for Communities, Public Health, Environment and Prosperity on how the Council’s strategic objectives were being delivered, the mid-year budget position, and future strategic issues for this service area.

The Chief Officer and Assistant Director of Public Health responded to Members’ questions and/or commented:

·         on the provision of mandated public health services and aim to improve the health and wellbeing of the people of Devon, while reducing health inequalities;  

·         on the re-procurement of sexual health services, substance misuse and domestic and sexual violence services in 2017/18 leading to the commencement of new contracts in 2018, and additionally recommencement of the universal NHS Health Check programme,   as part of the Council’s responsibilities to reduce health inequalities;

·         on targeting towards those families and communities which were in greatest need, with some services such as the Specialist Stop Smoking Service focused wholly on those most vulnerable;

·         on the Public Health Team’s work to commission a number of public health services to support the delivery of its strategic objectives and statutory responsibilities, working collaboratively with the local NHS delivering its statutory function to provide public health expertise to the Clinical Commissioning Groups; 

·         on the success of the Public Health Team in drawing in additional funding to support the delivery of new programmes and services, including funding from NHS England to support the development of Cranbrook as part of the NHS Healthy New Town Programme, Big Lottery funding to support the introduction of a new targeted Diabetes prevention programme and funding from Public Health England for a Making Every Contact Count (MECC) training programme;

·         on the current budget position in keeping within the budget set and published in the Budget Book; 

·         on the future strategic issues for this service area, notably the continued annual reduction in the Public Health Grant, with significant budget reductions from 2016 – 2020 and on the production of a medium term financial plan to ensure affordability over the coming years; and

·         on the future provision of the 0-19 Public Health Nursing Service on which options for the future delivery mechanism for this service were currently being appraised and would be subjected to public consultation prior to any final decision being taken. 

(b) Adult Commissioning and Health:  Position Statement – Budget 2017/18

(Councillor A Leadbetter attended in accordance with Standing Order 25(1) and spoke to this item at the invitation of the Committee)

The Committee considered the Report of the Head of Adult Commissioning and Health (ACH/17/73) on the budget which was forecast to underspend by £4.170 million as at month 6, covering data up until 30th September. The total budget represented approximately 47% of the Council’s revenue budget.

The Head of Service, Assistant Director - Health and Social Care Community, East; and the Cabinet Member for Adult Social Care and Health Services responded to Members’ questions and/or commented:

·         on the total Adult care and health services budget which represented some 47% of the Council’s revenue budget;

·         on the majority of the underspend (£3 millions) which related to better contract negotiation and demand management;

·         on other areas of underspend which included Older People and Physical Disability £1.393 million which related to lower than anticipated care packages (368);  and

·         savings within in-house operated services of forecasted at £439,000 due to lower running costs and staffing vacancies;

·         on the Learning Disability service (including Autistic Spectrum Conditions) which continued to be an area of significant concern and was forecasting an overspend of £1.335 million which was due to an increase in the number of packages which are now 210 above budget;

·         on Adult Commissioning and Health (which included Adult Mental Health services budgets) which was now showing an underspend of £673,000 due to temporary vacancy savings in the commissioning teams and one off savings on projects;

·         on the risks facing the service, the most significant were: pending HMRC action on National Living Wage compliance for sleep in night shifts; children transitioning to adult services, increased autism cost as a result of individuals being moved back into local communities and increasing incidence and diagnosis; the continuation of increased unit costs in residential / nursing care as a result of significant market premiums being paid; and Winter could also be a challenging and volatile time for the service as demand increased  and hospital flow was challenged;

·         on the relatively high turnover of care staff in Devon on which more information would be provided by the Chief Officer;

·         on the strategic aim of promoting independence for Adults with disabilities and health service needs with good information and advice, signposting and by listening, as part of their overall health and wellbeing;

·         on continued lobbying by the lead Member and Cabinet to Government and local Devon MPs about the challenges faced as a result of Devon’s demography and geography. 

It was MOVED by Councillor Randall-Johnson, and SECONDED by Councillor Sanders and

RESOLVED that the Cabinet be requested to lobby Government for ‘fair funding’ in respect of both the County Council’s Public Health Grant and for Adult Social Care and Health Services.