Councillor Mary Aspinall (Cabinet Member for Health and Adult Social Care) introduced the Adult Social Care Finance Report, Month 8 24/25 and discussed:

a)     The Adults, Health and Communities directorate had reported an in?year overspend of £4.4 million at Month 8, of which £2.4 million related specifically to Adult Social Care, reflecting sustained financial pressure within care services;

b)    The main pressures remained consistent with the pattern seen throughout the year, particularly a rise in demand for domiciliary care, with increased activity flowing through as waiting lists were reduced and more people entered the system;

c)     The service had been able to offset a proportion of these pressures through additional joint funding and client income, which helped to reduce net expenditure against budget;

d)    Inflationary pressures had arisen following the collapse of the Council’s previous Community Equipment Service provider, and additional funding had been required to stabilise and sustain delivery of that service under new arrangements;

e)     A Budget Containment Group had been activated from the beginning of the financial year, supported by a series of focused work?streams, to identify high?risk budget areas and develop mitigations, including: targeted package reviews, cost?containment activity, and opportunities to increase appropriate income;

f)      Approximately £800,000 additional income from health partners had been identified by reviewing domiciliary care packages;

g)     Despite the mitigations, some risks remained: £500,000 of delivery plans carried forward from previous years were still in progress and required continued oversight to ensure full delivery;

h)    Delivery plans for 2025/26 had generated £2.7 million of savings at the time of reporting. The remainder of the programme continuing to be monitored through the Budget Containment Group;

i)      The Adult Social Care budget for the following financial year was being developed in parallel, with planned growth of £11.1 million in 2026/27 to address National Living Wage increases, wider inflationary pressures and demand growth across the system, recognising that the demand patterns evident in the current year were expected to continue.

Rebecca Sampson (Lead Account) added:

j)      The approach taken sought to distinguish clearly between unavoidable demand?led pressures and those areas where management action, joint working and improved processes could reasonably be expected to mitigate costs;

k)     Work was ongoing with health partners to ensure joint funding arrangements were robust, transparent and consistently applied, so that Adult Social Care did not bear costs that were more appropriately attributable to NHS responsibilities;

l)      The growth of £11.1 million for 2026/27 had been modelled to reflect the confirmed National Living Wage rate, inflation on commissioned care, and known changes in client numbers and complexity, to minimise the risk of in?year volatility;

m)   Lessons learned from previous years’ income forecasts, particularly around client contributions, had been factored into the new budget assumptions, with a view to improving income accuracy and reducing the likelihood of future income?related pressures.

In response to questions, the Panel discussed:

n)    Appreciation for the work undertaken to contain the overspend and concern regarding the sustainability of relying on recharging additional elements of domiciliary care to the Integrated Care Board (ICB), noting the view that there was limited scope to pass further costs to health partners on a recurring basis;

o)    The importance of ensuring that the “right service paid for the right care”, with Adult Social Care budgets funding social care needs and NHS budgets funding health care needs, and that this principle underpinned the realignment of costs identified through recent reviews of domiciliary care packages;

p)    The specific example of one?to?one support provided to people in the initial days following discharge from hospital, where recent analysis had demonstrated that some support previously funded as social care properly met health needs and had therefore been reclassified and recharged to health partners;

q)    Assurance given by officers that while there remained some further potential to refine and improve joint funding arrangements, the objective was not to shift unreasonable levels of cost to the NHS, but to ensure that funding responsibilities were allocated fairly and consistently in line with national guidance and local agreements;

r)     The expectation that the practice changes underway, including clearer decision?making about the appropriate funding route at the point of discharge and improved governance around joint panels would, over time, reduce large swings in financial responsibility between organisations and provide greater stability for both the Council and health partners, while supporting better outcomes for individuals;

The Panel agreed:

1. To note the Adult Social Care Finance Report, Month 8 24/25 and the forecast overspend position for the Adults, Health and Communities directorate, including the specific pressures within Adult Social Care.