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Agenda item

2019/20 Finance And Performance First Quarter Report - Health And Adult Social Care

The Committee will receive the above report which analyses the latest performance for 2019/20 and forecasts the financial outturn position by reference to the service plans and budgets for the relevant health and adult social care services falling under the responsibility of the Corporate Director of Health, Housing & Adult Social Care.



Members considered the report which analysed the latest performance for 2019/20 and forecasted the financial outturn position for all of the services falling under the responsibility of the Corporate Director of Health, Housing & Adult Social Care.  Sharon Houlden, Michael Wimmer, and Terry Rudden were in attendance to present the report and to respond to questions.


The following information was provided in response to questions from committee members:


Regarding the likelihood of receiving additional funding during the year to meet the financial challenges within ASC, the Corporate Director of Health, Housing & Adult Social Care reported that the Better Care Fund would continue and that there was a strong possibility that the CYC could expect Government funding in this year’s allocation.  The council would want to allocate funding towards invest to save allocation to produce more sustainable long-term programmes.  If a Green Paper is received, trends indicate that it would be unlikely to address the funding shortfall.   The service area would consider solutions that relate to assets within York, such as the high proportion of self-funding ASC, capitalising on that and generating an income.  There were several different ways to do that which would include considering investment in additional allocation. 


Regarding NHS Checks to prevent heart disease, stroke, diabetes and kidney disease, it was reported that 0.7% of York’s eligible population received a check which is a lower rate compared with the regional (1.9%) and national (2.0%) averages.  This was due to staffing issues.  Geographic information system (GIS) mapping work had been undertaken to identify wards with higher rates of cardiovascular disease but with no immediate health check venue within the ward.  Officers reported that additional health staff had been appointed to deliver this service at locations within the city.  This reduction in figures would appear in the next quarter and improvements would show in quarters three and four.  Postal code data analysis had shown that it tended to be older males in wards with higher deprivation, with health check venues in their wards, who were not coming forward.  They received a request to attend a health check via text or letter.  Officers would consider ways to re-invite them. 


Regarding placing people in nursing or residential care and whether or not insourcing, having and staffing nursing or residential care in York had been considered, officers explained that this current administration aspires to deliver the support required in the community or preferably in customers’ home, even for high dependency care.  Results from surveys undertaken in the city on older people’s needs had shown that the vast majority of people do not want residential care and would prefer support within their home.  There were a range of models for delivering and supporting care. This had include institutionalised care if that was the only option for that customer.  Officers clarified that there was no direct correlation between the closure of private care homes or residential nursing care homes and overspend in that aspect of the budget.  At the same time, the number needing to be placed is greater than the number of places available in York.  It would not be viable to run nursing homes that were empty.  The issue is beyond that of take-up, as some care homes close as the care is inadequate.


Officers reported that there was a slight reduction in the number of women smoking during pregnancy.  The number of ladies that smoke during pregnancy were very low, however, there was some inconsistency between wards.  An officer visits midwives and hospital based midwives to support them in understanding this issues.  There had been a considerable increase of referrals from midwives sending pregnant ladies to the smoking cessation clinic.  Where there was a high number in a particular ward, an officer worked within that community to build trust.  Officers were working with our partners in the Tobacco Alliance.  A members asked for data by ward which would support the committee in work to mitigate this. It was agreed that the officer would contact that member directly with the relevant information.


This committee had previously received a report on the Learning Disabilities Health Plan, delivered by the Vale of York (VOY) GPs. Previously uptake of health checks for those of any age with a learning disability who have an annual health and medication check had been low.  This had significantly improved from 40% to 60% .


Officersreported that CYC figures were just below the national average in respect of uptake of the 2 year early years progress check.  All eligible parents were offered a review, the up-take was 3 out of 4 parents.  To address this a pilot would commence which would combine the two and a half year review with the two year old early years progress check to be delivered in Local Authority nurseries.  A review would consider whether or not this improves the uptake of this measure. 


Regarding the percentage of opiate users in treatment who successfully completed drug treatment (without representation within 6 months) it was reported that opiate and alcohol user numbers had reduced, however, there were a large number of people not accessing treatment.  The committee were to receive a report for consideration at its next meeting in October.


Resolved: That the Committee considered and noted the 2019/20  Finance  And  Performance  First  Quarter  Report for Health  And  Adult  Social Care.


Reason:     So that the committee is updated on the latest financial and performance position for 2019/20.

Supporting documents:


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