Agenda and minutes

Consideration was given to the minutes of the previous meeting held on 14^th March, 2011.

Resolved:-  That the minutes of the previous meeting held on 14^th March, 2011, be approved as a correct record.

- presentation by Jo Abbott, Consultant in Public Health and Sally Jenks, Public Health Specialist.

Jo Abbott, Consultant in Public Health, and Sally Jenks, Public Health Specialist, jointly gave a presentation in respect of the NHS Health Check which aimed to identify an individual’s risk of cardiovascular disease and for this risk to be communicated in a way that the individual understands, and for that risk to be managed by appropriate lifestyle advice, referral and clinical follow-up.  It was explained that this preventative programme had been introduced by the former Prime Minister, Gordon Brown, for people aged 40-74 years, and that the programme had been continued by the present Government.

The presentation covered the following:-

-          definition of the NHS Health Check

-          what the health check included

-          national policy

-          who was eligible in Rotherham

-          involvement of GP practices to deliver this

-          monthly progress chart – number of CVD screens undertaken

-          high performing practices – 9 Rotherham practices had exceeded the 45% threshold

-          regional comparison – Rotherham having performed the highest number of Health Checks

-          what the Health Check tells us:-  16% of screened patients have a CVD risk of > 20%;  of patients with a >20% risk  - 71% were overweight or obese/31% are current smokers and 47% of them had been prescribed statins

-          implications for service planning and provision

-          risk management through lifestyle change – (i) stop smoking advice and referral to smoking cessation adviser;  (ii)  referral to exercise in association with DC Leisure

-          what the Patients say – feedback from use of fitness facilities

-          issues for the future:- quality assurance;  organisation as a screening programme with a 5 year call and recall;  commissioning – local authorities, NHS Commissioning Board or Public Health England?

Members present raised and discussed the following:-

-          effectiveness of the Quit Smoking programme – any follow up after 3/6 or 9 months?

-          incorporating peer support into the Quit Smoking programme

-          cost of leisure club membership and promotion of other forms of free exercise e.g. walking

-          how to monitor participants, assess and evaluate

-          constant changes to the commissioning of services

-          development of links with “Make every contact count” initiative – training issues

-          follow-up after age of 74

-          recent scrutiny review into diabetes

The Cabinet Member thanked the NHS staff for their very informative and interesting presentation.

Consideration was given to a report, presented by the Strategic Commissioning Manager, setting out a proposal for the implementation of Rotherham’s Integrated Local Area Workforce Strategy (InLAWs) 2011-2014.

It was explained that the strategy would deliver the requirement to meet the statutory responsibility of the Director of Adult Social Services (DASS) for the professional leadership of the workforce. 

Also the development and implementation of the InLAWs strategy demonstrated significant progress for Rotherham ahead of other authorities who are yet to fully deliver a comprehensive Workforce approach.

Reference was made to the following six strategic objectives:-

• Leadership and management
• Recruitment and retention
• Workforce remodelling and commissioning
• Workforce development
• Joint and integrated working
• Regulation

An explanation was given of how InLAWS responded to these with a framework for leadership skills, identifying and planning for current and future skills needs (e.g. around dementia) and occupational gaps, establishing effective workforce planning, and identifying and planning for the workforce development needs of the whole social care workforce.

Members present raised and discussed the following:-

-          how and who would provide the training

-          monitoring and evaluation

-          compulsory elements e.g. moving and handling clients; 1^st aid and safeguarding

-          ensuring that the trainers were qualified to deliver training

-          joint approach to commissioning training to reduce costs

-          Rotherham’s preparedness to implement this strategy

Resolved:-  (1)  That the strategic approach for Rotherham’s Integrated Local Area Workforce Strategy (InLAWS) to meet the statutory workforce responsibility of the DASS be agreed.

(2)  That the progress made to achieve InLAWs in Rotherham be noted.

Consideration was given to a report, presented by the Business Finance and Commissioning Manager, setting out a proposal to increase the Resource Allocation System (RAS) to reflect the impact of inflation by 2.32% with effect from April, 2011.

Appendix 1 to the submitted report set out details of the Resource Allocation System Scorecard showing 2010 £ per point together with 2011 £ per point.

Reference was made to the current key cost drivers of:-  (i)  Direct Payments and (ii) cost of independent sector community based services.  It was reported that following discussions with Financial Services it was therefore proposed that the RAS scorecard be increased by 2.32% and a further verbal explanation was given of the way in which this figure had been calculated.

Members present raised and discussed the following:-

-          impact of Direct Payments

-          total budget exposed to RAS

-          situations where clients receive funding through RAS but then do not want to purchase services from the local authority

-          the issue of duplicate funding

-          accuracy of the proposed increase and its significance

-          choice of the individual

-          audit of client spend

Resolved:-  That the Resource Allocation System (RAS) be increased by 2.32% from April, 2011 at the new rates as detailed in Appendix 1 to the submitted report.

(The Cabinet Member authorised consideration of the following extra item in order to keep members informed of the current financial position.)

Mark Scarrott, Finance Manager (Adult Services), to report.

Consideration was given to a report, presented by the Finance Manager (Adult Services), which provided a financial forecast for the Adult Services Department within the Neighbourhoods and Adult Services Directorate to the end of March 2011 based on actual income and expenditure to the end of February   2011. 

It was reported that the forecast for the financial year 2010/11 was an overall underspend of £946,000, against the revised approved net revenue budget of £71.3m.

It was explained that a significant part of the forecast underspend was due to the following:-

• an overachievement in the savings associated with the merger of the Wardens and Care Enablers Service
• the higher than anticipated response to voluntary severance
• holding vacancies to facilitate redeployment of staff in support of the various structural reviews
• increasing numbers of residential care clients receiving full funding through continuing health care
• tight financial management within the service

It was also reported that in addition to the forecast underspend of £946,000, additional income from NHSR in respect of 2010/11 funding announced by the Government for the support of social care had been confirmed. Negotiations had now concluded with NHSR to transfer funding under a Section 256 Agreement of £1.1m towards the delivery of Reablement Services and the prevention of hospital admissions, including winter pressures.  

Further details of a number of underlying budget pressures which had been offset by forecast underspends were also set out in the submitted report.

Reference was also made to total expenditure on Agency staff and consultancy during the year, and to actual expenditure on non-contractual overtime for Adult Services.

Those present congratulated the Service on its management of the budget and for the second year bringing in a balanced budget.

Resolved:- (1)  That the latest financial projection against budget for the year based on actual income and expenditure to the end of February,  2011 for Adult Services be noted.

(2)  That the additional funding from NHSR towards the costs of Reablement and the prevention of hospital admissions be noted.

(3) That it be noted that the underspend achieved on the Council’s budget following confirmation of the additional health funding (£1.1m) had been earmarked to support the Council’s 2011/12 budget.

The following items are likely to be considered in the absence of the press and public as being exempt under those paragraphs, indicated below, of Part 1 of Schedule 12A to the Local Government Act 1972 (as amended March 2006)

Resolved:-  That, under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following items of business on the grounds that they involve the likely disclosure of exempt information as defined in Paragraph 3 of Part 1 of Schedule 12A to the Local Government Act 1972 (as amended March 2006) (financial/business affairs).

(Exempt under Paragraph 3 of the Act - information relating to the financial or business affairs of any particular individual (including the Council)).

Further to Minute No. 67 of the meeting of the Cabinet Member held on 28^th February, 2011, consideration was given to a report, presented by the Business Finance and Commissioning Manager, which provided the further information requested in respect of setting in-house residential accommodation charges 2011/12.

Reference was made to:-

• Previous proposed increase of 1%
• Details of when and to whom maximum charges applied
• Number of people required to pay maximum charge
• The freezing of in house residential care pay and non pay budgets for the coming financial year
• Implications of increasing the maximum charge in line with inflation
• maximum charge per week for independent sector residential care

Reference was also made to the impact of three options and these were detailed in the table at 8.1 in the submitted report.

Resolved:-  That the report be received and contents noted.

(Exempt under Paragraph 3 of the Act - information relating to the financial or business affairs of any particular individual (including the Council)).

Consideration was given to a report presented by the Business Finance and Commissioning Manager, relating to decisions taken by the Council, as part of the budget setting process, to increase charges for non-residential services.

It was pointed out that charges were reviewed in 2010 and increased in October following consultation.

Reference was made to Rotherham’s comparatively lower charges when compared to other neighbouring local authorities.

The report set out charging options to contribute to achieving the Directorate’s budget setting savings target over the next three year.

Details of the options and a breakdown of the estimated additional income from the proposed charges were set out in the submitted report.

Appendix 1 to the submitted report set out comparator analysis tables and estimated impact on customers.

Also submitted at the meeting were summaries of two case studies which illustrated (i)  impact of change in Disposable Income Allowance and (ii)  impact of change in hourly rate, together with comparisons with neighbouring authorities.

It was pointed out that the savings assumed a six month consultation exercise would be required and therefore be achieved over a two year period.

Members raised and discussed the following:-

-          charge for transport day centre

-          provision of meal at day centre – provider, cost and quality

-          client choice

-          complexity of the permutations

-          the consultation timescale

Resolved:-  (1)  That the proposed charges set out in Paragraph 7.7 of the submitted report be noted. 

(2)  That commencement of consultation on these proposals be noted.

(3)  That the other revised charges as set out in Paragraph 7.10 of this report be agreed and implemented with effect from April, 2011.