Agenda and minutes

The Chair welcomed everyone to the meeting, especially Health Overview and Scrutiny Committee (HOSC) Members and the Lead Scrutiny Member for Crime and Disorder who were all present due to the partnership working of Adult Services and Public Health.

Apologies were received from Mr R C Adams, Mr T Baker-Price, Mr A Fry, Mr P Grove and Ms P Hill.

Two HOSC Members declared an Interest.

Mr C Hotham declared an Interest as his wife was a GP and Mrs F Smith declared an Interest as her husband was the Cabinet Member with Responsibility for Health and Well-being. 

If the subject matter under discussion touched on either Interest, Members were advised not to participate in the debate at that time.

Members of the public wishing to take part should notify the Head of Legal and Democratic Services, in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 13 November 2017). Enquiries can be made through the telephone number/email address below.

None.

Previously circulated

The Minutes of the Meeting held on 27 September 2017 were agreed as a correct record and signed by the Chair.

Attending for this Item were:

Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care

Sander Kristel, Director of Adult Services

Frances Howie, Director of Public Health

Rob Wilson, Senior Finance Manager

Pauline Harris, Senior Project Officer

A presentation was given which gave Members some context, highlighting in particular the need to work with partners in the NHS, private and voluntary sector to support activity for all residents.  In summary:

-       Worcestershire had a higher than average number of residents aged 65+

-       The numbers were predicted to grow by 34% by 2020

-       4,859 residents were on the Dementia register and by 2030 there was a predicted increase of two thirds

-       Life expectancy by 2021 was likely to be higher than national figures (81.8 for men and 85 for women)

-       2,413 people were recorded as having a learning disability.

In Adult Services:

-       1,900 people received Nursing or Residential Care

-       2,600 people received Domiciliary Care

-       1,200 people received Direct Payments

-       2,342 Safeguarding Alerts were received in 16/17, with 65 assessed as High Risk

-       Prevalence of depression was significantly higher in the County than England, at 9%

-       30 Young People with Disabilities transferred into Adult Services each year.

The Adult Social Care and Public Health Net Budget for 2017 -2018 was stated as £131.1m, with services for Older People and for Learning Disabilities taking up £124.2m in total and covering 4,856 service users.

The budget was a particular challenge, in line with the national picture, as the adult social care budget was totally demand-led.  A shortfall in savings delivery targets of £3.3m was due mainly to timing issues and this year had seen an increase in demand and cost for services for Older People.  Directorate Reserves would have to be used but there was a risk of further overspending if growth continued.

The Public Health Ring Fenced Grant was national funding which had clear grant conditions on mandated duties.  Services included sexual health, drug and alcohol services, health visitors and oral health.  The future of the Grant was uncertain, however it was suggested that an extension to 2020/21 was hopeful but with a continued downward trajectory in the amount of grant funding. 

In the ensuing discussion, the following main points were made:

·         The Better Care Fund (BCF) was a national funding stream worth £34.5m to Worcestershire in 2017/18 with the intention of integrating local health and care services.  £11.8m was transferred to the Council in 2017-18 and £4.6m was passported to District Councils to deliver Disabled Facilities Grants.  The reminder was kept by Clinical Commissioning Groups.  Funding was available for a further three years until 2019/20, however, the amount by then was lower.  Projects delivered under this funding stream were signed off by the Health and Well-being Board

·         The overall financial picture for the Directorate was challenging.  With increasing demand and duty to provide services for those residents who were Care Act eligible, it was also difficult to predict when a person would  ...  view the full minutes text for item 258.