Agenda and minutes

There were no declarations of interest

To receive the minutes of the meeting held on 24^th January 2012

Resolved – That the minutes of the meeting held on 24^th January 2012 be accepted as a correct record subject to the inclusion of Paul Bearman (PCT)

Claire Allen presented a report concerning the financial position of the Swindon Mental Health aligned budget for the 2011/12 financial year as at 31st January 2012

            The January 2012 position on the Mental Health aligned pool budget is a forecast overspend of £0.087m, a net rise of £0.006m. The pressures on Social Care totals £0.137m and the savings on Health budgets is £0.050m.

            The pressures in the Social Care budgets have increased the outturn forecast in Social Care by £0.059m.  Savings that have materialised on Developments budget has resulted in Health outturn forecast showing an underspend of £0.050m.  

Resolved – That the financial position as at January 2012 for the aligned budget be noted, together with any recommended actions contained in the report.

The Board received a report demonstrating AWP performance against the targets set out in the balance scorecard. The report highlighted key performance target issues and actions taken by AWP to improve performance where required in Month 11 (February) 2012. The report advised on those standards where performance had altered since the last report and those that had remained static, categorised as green, amber or red status. The report also highlighted the specific actions that had been undertaken or were proposed, to continue to seek improvements in overall achievement. The report showed direction of travel arrows against each performance indicator. The Quality Dashboard reports on all 49 indicators included in the Swindon AWP balanced scorecard at the end of Month 11 (February) 2012. Of these 16 were reported as red.

The indicators are presented in a series of categories and within the categories in a service specific section.

Resolved – That the Board notes the performance to date, together with the areas of improvement and the actions required.

Angela Plummer, Acting Deputy Director of Commissioning, submitted a report concerning the financial position as at 31st January 2012 for s75 Adult Commissioning – Adult Community services aligned budget 2011/12.

The outturn position 2011/12 is an underspend of £0.303m, a reduction of £0.097m on the £0.400m November position. This forecast assumes that savings of £0.171m are achieved through management actions in the last two months of 2011/12. The Health budgets are forecast to breakeven.  Any net underspending on Adults pool (social care side) will be used to meet additional commitments on Learning Disability and Mental Health pool.

            The additional commitments on Reablement project have assisted in realising savings in costs of care packages but not at the level required in 2011/12. The impact and effectiveness of Reablement project are to be reviewed to see if the long term gains in 2012/13 exceed costs in 2011/12. 

  Actions being taken to bring current spend down from existing levels and to meet remaining savings targets include the following.

•          Introduce new front door arrangements ensuring that people get right support first time and limiting inappropriate care support.

•          Workforce re-modeling

•          Review of individual domiciliary care packages and implement standardised process across joint community teams

•          Review of guidance to care managers regarding cost of care packages

•          Expansion of  re-ablement service

•          Review of all contracts against VFM criteria

•          Implementation of a Living within our Means policy

•          Implementation of Personal Budgets

•          Fully market and role out use of assistive technology to reduce cost of care packages and promote independent living. 

•          Review of Fairer Charging policy

•          Review of day services

•          Introduction of a residential care home accreditation scheme

•          Remodelling of supported employment service and focus on Connect and partnership with voluntary sector

Resolved – That the financial position as at 31st January 2012 of the Adult  Community aligned budget 2011/12 be noted.

Angela Plummer, Acting Deputy Director for Commissioning, submitted a report concerning the financial position as at 31st January 2012 for the s75 Adult Commissioning – Learning Disability services aligned budget for 2011/12.

            The net overspend on Learning Disability aligned budget is £0.311m. This forecast assumes savings of £0.148m are achieved in the last two months of the year. The budget pressure relates to Social Care budgets with Health Care budgets showing a balanced position.

            The actions taken by management have resulted in savings target for Dec-11 and Jan 12 being exceeded by £0.011m.   

            A number of actions are being implemented in 2011/12 to address the financial pressures and reduce the current spending levels in current year and the ongoing level of spend in future years. These are itemised below

•          Implementation of personal budgets.

•          Implementation of Living within our Means policy.

•          Work with community teams to ensure that care packages are the most appropriate for their needs and that person centred plans are fully utilised

•          Improve the role and function of the funding panel through joint working with commissioners across health and social care.

•          Continue to review residential placements and care home placements to ensure alternative supported living services are explored fully.

•          Brokerage use of the LD Fair Pricing tool to challenge prices.

•          Review of residency

•          Review of health placements (including continuing health care) to ensure health and social care plans are being implemented effectively and explore alternative service provision in Swindon in line with the principles of Valuing People.

•          Work with local providers to ensure a high level of knowledge and skills across health and social care is achieved to meet the needs of the individuals of Swindon to avoid costly out of area placements.

•          Review of potential commitments with the aim of looking at alternative ways of meeting the care needs of the clients.

Resolved – That the financial position as at 31st January 2012 for the Learning Disability aligned budget 2011/12 be noted.

The Board considered a joint report of the Cabinet Member for Health, Housing and Adult Social Care and Chief Executive NHS Swindon setting out potential changes to the governance arrangements for the new Health Services Act 2006 Section 75 Agreements.

            Resolved – (1) That Council and the NHS Swindon and Gloucestershire Cluster Board be recommended to approve that:

(a) the changes to the governance arrangements,  Health Services Act 2006 Section 75 Agreements, for the Adult and Children’s Joint Commissioning Boards, as set in the report, be adopted; and

(b) the Terms of Reference for a joint Commissioning Board for Adults and Children’s Services be adopted;