Agenda item

Session Two - Health and Social Care


Also in attendance: Councillor Aspinall, Councillor Lowry, Emma Crowther (Interim Head of Commissioning), Julie Frier (Consultant in Public Health Medicine), (Ross Jago (Head of Governance, Performance and Risk), David Northey (Interim Service Director for Finance) and Helen Slater (Lead Accountancy Manager).


Councillor Aspinall gave an overview of the Health and Adult Social Care (H&ASC) budget and discussed: 


a)    The 2023/24 Adult Social Care (ASC) budget was £88.859m including £107m for care packages. Budgets were offset by client income and grant funding; 


b)    The budget had supported 4,713 people in residential and nursing homes, community settings, and through direct payments; 


c)    ASC currently supported 3,620 individuals.Demand for support had approximately returned to pre-pandemic levels however, increased complexity of need and the ‘cost of living crisishad resulted in considerable cost pressures; 


d)    Compared to the previous year, average weekly costs of residential care had risen 8.9%, nursing care had risen 18.6%, and domiciliary care packages had risen 10.7%; 


e)    The 2024/25 draft budget for ASC was £97 MM, which included a growth of £7.99 MM to reflect inflationary and demand pressures.  


f)     £3.448MM had been added to the budget to cover the rise in the National Minimum Wage however, confirmed figures of 11.44 /hr would require an additional £1.99 MM; 


g)    The Local Government Settlement was due on 19 December 2023 however, Government would not be providing financial resources to cover the increase in the National Minimum Wage; 


h)    Packages of care were tailor-made to individual’s needs, and were subject to review;  


In response to questions, the Committee discussed: 


i)     The Local Authorities responsibility for ensuring ASC needs were met; 


j)     The impact of inflation and the cost of living on providers in the care market; 


k)    Close partnership between the PCC commissioning team and care providers to ensure quality and continuity of care; 


l)     The establishment of ‘Caring Plymouth’ to encourage and support people into caring roles;


m)  The Governments’ new restrictions on immigration could negatively affect the sector, particularly as many workers could not bring their families; 


n)    Positive discharge performance for Devon, Cornwall and Plymouth; 


o)    An estimated 6% rise for care fees and charges for those who were financially assessed as required to contribute toward their care; 


p)    The Government’s withdrawal of previous commitments to the development of the Colin Campbell Court, West End Hub; 


q)    The development of a Community Diagnostic Centre on the land at Colin Campbell Court; 


r)    Ongoing communications between PCC and NHS Devon ICB to improve the health outcomes of the city. ICB funding was frozen until 2025; 


s)     The impact of early intervention and treatment, both for long term wellbeing, and financial efficiency; 


t)     A Strategic Needs Assessment had been undertaken to assess the long term future needs of the city; 


u)    The recovery of waiting lists for Domiciliary care to 15 people waiting per week, as opposed to over 200 during the COVID19 Pandemic; 


v)    The ongoing monitoring of performance and safeguarding metrics, and the role of the CQC in providing regulatory oversight; 


w)   An ongoing need to improve ‘No Criteria to Reside’ performance at University Hospitals Plymouth (UHP), particularly for Cornwall which experienced higher delays; 


x)    The expanding use of ‘care in the community’ and virtual wards to reduce pressure on hospital admissions; 


y)    The development of the ‘Caring Plymouth’ programme; 


z)    The need for Plymouth to receive its ‘Fair Shares’ funding from the ICB; 


aa)  Planned zoning for new domiciliary care contract procurement to enable each agency to take the lead for one area within the city; 


bb)Following a rise in adult safeguarding costs due to demand pressures, a review had been commissioned and ongoing training was being provided to staff to ensure referrals were appropriate; 


cc)  Ongoing work being undertaken to identify and address health inequalities within the city. 


Councillor Aspinall concluded by saying that: 


dd)The team and herself were confident that, despite many pressures and ongoing challenges, the budget gap would be closed; 


ee)Next year’s budget was of large concern. PCC were currently awaiting the Local Government Settlement announcement however, the Public Health budget had always been under-financed. Additional funding would be required to meet challenges caused by the rise in the national minimum wage, inflationary pressures, and rising complexity of need.