Agenda and minutes

Consideration was given to the minutes of the previous meeting held on 10^th October, 2011.

Resolved:-  That the minutes of the previous meeting held on 10^th October, 2011, be approved as a correct record.

- http://www.rotherham.nhs.uk/files/Organisational/Comissioning/JSNA%20Report%202011.pdf

Please note this is a large document and has not been included in the agenda pack

The Director of Health and Wellbeing presented, on behalf of the Strategic Commissioning Manager, the refreshed Joint Strategic Needs Assessment which had been produced by the Joint Commissioning Team working in collaboration with various key partners in Local Authority, Health and the Voluntary and Community sector.

The design and format of the refreshed JSNA would act as an up-to-date platform to support the development of the Borough-wide strategic needs assessment.  It was sufficiently versatile to support ongoing updates and addition of new areas of assessment. 

The emerging needs were:-

-        Rotherham’s ageing population – growing pressure on health, social care, informal care and supported housing

-        Growing ethnic diversity which had changed the community and customer profile particularly for Children and Young People’s Services

-        Growing gap between the most deprived areas of Rotherham and the rest of the Borough

-        Maintenance of existing housing stock and major structural repairs required – the poorest housing conditions tended to be in the private sector

-        Energy efficiency in housing

-        High levels of unemployment and long term sickness

-        Lifestyle risk factors – promotion of healthier lifestyles

-        Second highest rate of Accident and Emergency admissions in the region

-        Above regional and national averages for cancer deaths

-        Need for Mental Health Services to work in partnership

-        Development of an effective community service which promoted independent, maintained cognitive function and prevented secondary conditions whilst supporting carers

-        Reduce health inequalities in terms of mental health related hospital admissions where deprivation and unemployment may be a factor

-        Respond to the increasing demand proposed by people living with learning disabilities for longer

-        Season flu immunisation

-        Essential Uptake of Long Acting Reversible Contraceptives for reducing teenage pregnancy rates

-        Develop public and patient engagement so both NHS Rotherham and the Council could maintain a regular dialogue with Service users

-        Support for parents of disabled children in making the best possible choices for their child’s health and social care needs

-        Need to increase the skill  base of Rotherham’s school leavers

The document was available through the Council and NHS Rotherham internet and intranet sites.

Discussion ensued on the document with the following comments made:-

o       This should be one of the key documents which informed and guided the strategy not just for the local authority but Health and other partners, it should have reference to the wider strategic framework, including Adult Social Care outcomes

o       There had been no Elected Members involvement

o       The report was submitted for endorsement but was already available on the NHS website

o       The JSNA informed PCT Operational Plans but should refer to the current agendas e.g. Public Health, Health and Wellbeing Board

o       No mention of Adult Services outcomes, the Armed Forces Protocol etc.

o       Should be far greater involvement by Elected Members and should be considered by the Cabinet.

Resolved:-  That due to the Cabinet Member being of the opinion that the document was not complete and, in light  ...  view the full minutes text for item 29.

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, 2012 based on actual income and expenditure to the end of September, 2011. 

It was reported that the forecast for the financial year 2011/12 was a balanced budget against an approved net revenue budget of £76.725M.

It was explained that there were a number of underlying budget pressures which were at present being offset by a number of forecast underspends:-

The underlying budget pressures included:

·        an overall forecast overspend within Older Peoples’ Home Care Service mainly due to increased demand for maintenance care within the independent sector

·        pressure on independent home care within Physical and Sensory Disability Services due to continued increase in demand

·        shortfall in respect of income from charges within in-house residential care

·        additional employee costs due to high dependency levels and cover for vacancies and long term sickness within older people inhouse residential care

·        an overall forecast overspend on Direct Payments across all client groups due to increase in demand was being reduced by savings on independent and voluntary sector contracts as clients in those schemes moved to Direct Payments

·        recurrent budget pressure on Learning Disabilities Day Care transport including income from charges

These pressures had been offset by the following forecast underspends:-

·        Forecast net underspend on Older People independent sector residential and nursing care due to an increase in the average client contribution and additional income from property charges

·        Underspend on employee costs within Transport Unit plus income from increased activity

·        Slippage on developing Supported Living Schemes within Physical and Sensory Disabilities

·        Review of care packages within Learning Disabilities Supported Living resulting in efficiency savings with external providers and additional funding from health

·        One off slippage on vacant posts as part of restructure/reviews including voluntary early retirements

·        Underspend on Rothercare Direct due to slippage on vacant posts and a reduction in expenditure on equipment including leasing costs

·        Slippage on recruitment to vacant posts within Older People’s Assessment and Care Management Teams

Total expenditure on Agency staff for Adult Services so far was £201,283 compared with an actual cost of £217,048 for the same period last year.  The main costs were in respect of residential care and assessment and care management staff to cover vacancies and sickness.  There had been no expenditure on consultancy to date.

Careful scrutiny of expenditure and income together with close budget monitoring remained essential to ensure equity of service provision for adults across the Borough within existing budgets.  Any future reductions in continuing health care funding would have a significant impact on residential and domiciliary care budgets across Adult Social Care.

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