Agenda item

Question from Councillor Robin Stuchbury to Councillor Angela Macpherson, Deputy Leader and Cabinet Member for Health and Wellbeing

“In the Q2 Budget Monitoring Report 2023/24, the Health and Wellbeing portfolio reporting an adverse variance of £3.4m pressures due to the growth in client numbers and the increased cost of care packages, particularly in residential, nursing and supporting living.  Portfolio Action Plan initiatives to improve the budgetary position will look to achieve savings through measures including £1.3m relating to overdelivery.

Could the Cabinet Member please provide an explanation of the variance, on the overdelivery, and the schemes of delegation for future spend in the portfolio, as well as assurance that the resources will be available to meet the needs of the most vulnerable?”

Question from Councillor Robin Stuchbury to Councillor Angela Macpherson, Deputy Leader and Cabinet Member for Health and Wellbeing  

“In the Q2 Budget Monitoring Report 2023/24, the Health and Wellbeing portfolio reporting an adverse variance of £3.4m pressures due to the growth in client numbers and the increased cost of care packages, particularly in residential, nursing and supporting living.  Portfolio Action Plan initiatives to improve the budgetary position will look to achieve savings through measures including £1.3m relating to overdelivery. 

Could the Cabinet Member please provide an explanation of the variance, on the overdelivery, and the schemes of delegation for future spend in the portfolio, as well as assurance that the resources will be available to meet the needs of the most vulnerable?” 

RESPONSE from Councillor Macpherson 

Thank you for your question Councillor Stuchbury. 

The Adults and Health Directorate at Quarter Two is forecasting an adverse variance of £3.4m (£3.9m in Quarter One) The main reasons behind this variance are both a growth in client numbers and an increased cost of care packages. This reflects the national situation facing Adult Social Care Services, where demand is increasing due to demographic growth, an ageing population, and the ongoing health and wellbeing impacts of COVID-19. In addition, the sector has been significantly impacted by inflationary pressures, with energy and fuel price inflation impacting on residential care home and home care providers, respectively. Continued pressures in relation to National Living Wage, Pension enrolment, energy costs plus labour market impacts add to the pressures on the care market. 

Locally this year our Quarter Two position is reflecting pressures in three main areas, Residential Care, Nursing Care and Supported Living. The main drivers of these are: 

• Increases due to demographic growth and an ageing population 
• Increases in the number of people who have been funding their own care but who have depleted their funds, and  
• Increase in the cost of new packages of care due to inflationary pressures on care providers 

The Directorate is working hard to mitigate these pressures and have developed a number of savings and income targets and in year action plans. These include, reviewing care packages, maximization of block contracts, star chambers deep dive into all service budgets (including staffing), implementation of the Home Care Dynamic Purchasing Vehicle and maximisation of grants. The target for all these plans totalled £5.7m and is presently forecast to deliver £7m. The Leadership Team have established a Scheme of Delegation for all Care Packages that provide greater oversight, and a check and challenge mechanism. Thresholds for authorisation have recently been lowered further to provide even greater oversight when agreeing packages of care. The Adult Social Care Improvement Programme is also focussed on delivering a more sustainable local care system. Key elements of the programme include a community prevention offer for adults that helps prevent and delay the need for adult social care, more targeted use of Reablement to work with existing clients to reduce the amount of care they require and longer-term plans to increase the amount of shared lives, supported living and extra care support available. 

Despite the budget pressures facing Adult Social Care, supporting, and protecting the most vulnerable remains a key corporate priority and the Local Authority will continue to meet its Care Act duties.