The Committee will receive a report on the Integrated Fund.

The Committee received the Integrated Fund Monitoring Report, introduced by Councillor Mrs Bowyer and presented by David Northey(Plymouth City Council), Carole Burgoyne (Plymouth City Council), Craig McArdle (Plymouth City Council) and Jerry Clough(New Devon CCG) (as attached);

The Committee heard that;

a)    NHS finances were under pressure in all areas. The intent of the integrated fund was to encourage greater collaboration between NHS organisations by setting a control total across all of those organisations rather than a total for each individual organisation. The CCG was working with all of its providers on a joint forecast outturn position;

b)    the decision nationally to change the funding rate for free nursing care had increased cost pressures, there were a number of other cost pressures that could emerge, mitigating actions were in place to offset these pressures;

c)    the system control total for the CCG was not yet set. Although this was an irritant it was not having any detrimental operational effect. The issue was between NHS England and NHS Improvement who needed to agree how the control total was apportioned between them;

d)    a break even position was forecast for the end of the year;

e)    savings of around £25 million were required to be made this year;

f)     there was continued overheating in Children’s placements and adult social care. The department needed to deliver savings of £9.2 million while managing budget pressures of £1.6 million. It was expected that these savings that these savings would be achieved and that the budget pressures were manageable;

g)    it was hard to forecast the volume of pressure on the service but more sophisticated modelling meant this was improving. A number of initiatives were underway to offset the cost pressures of increasing volumes of work and being a part of the Integrated Fund assisted in meeting demand.

In response to questioning the Committee heard that;

a)    payments for commissioned services would not be capped if they are over performing although the rate of pay for visits may change depending on the level of over performance;

b)    the cost of home to school transport had increased following re-tendering but the department was confident that it was able to cover the increased cost pressure that resulted. This service was under constant review;

c)    the £5 million contingency fund held by the CCG had been used up relieving the pressure caused by the new expectation to provide free nursing care. There was no further contingency available to offset additional pressures should they arise this financial year;

d)    it was difficult to pinpoint the reasons that use of minor injuries services was rising. One reason could be pressure on primary care but this would not be the only reason.

The Committee agreed the following recommendations;

a)    a briefing and training session for members of the committee on NHS financing would be provided;

b)    a briefing on guardianship would be provided for members of the committee via email;

c)    figures for the full year cost of the school transport service would be provided to members of the committee via email