Agenda item

This report provides a detailed view of outturn position for Adult Social Care (ASC) and Public Health (PH) for 2021/22.

The Finance Manager for Adult Social Care and Public Health presented the 2021-22 Finance and Performance Outturn Report.

He reported that there had been a swing of £1.8m from Q3, which had reduced the overspend within the service. He explained that hard work and one off funding were responsible for the reduction and that the one off funding had probably masked underlying issues that would need to be addressed in the current financial year.

Savings from Public Health (PH) salaries, due to staff being redeployed and funded for Covid related work, had led to the transfer of reserves of £483,000. The plan for spending the sum had been agreed by Executive.  Vacancies in the Healthy Child Service had also contributed to the savings.

In response to questions from Members, it was confirmed that:

·        The Healthy Child Service had found it difficult to recruit Health Visitors and School Nurses due to the acute shortage of trained nurses with a PH nursing degree.  There was also a growing pay differential between the Council and NHS salaries.  Creative solutions to the recruitment problem included providing placements for student nurses, funding and training School Nurses and Health Visitors and offering flexible work contracts.

·        There was a 14% vacancy rate across Health Visiting which had placed additional pressures on existing staff.  The posts were funded through ring fenced PH monies, any financial incentives offered to staff needed to be weighed against the impact on PH services.

·        Budgets were set against the figures in February / March and were assumed to remain steady throughout the year.  Inflation increases had been included and for 2021/22 were set at 3%.  Budgets for Learning Disabilities and Mental Health were difficult to set due to the complexities of the care.

·        An increase in the number of safeguarding reports could be viewed as a positive.  Levels of deterioration across the KPI’s were considered to be low and it was important to ensure early intervention services were available in addition to information and advice with the aim to recover the deterioration quickly.

·        Employers in York support employees with severe mental illness in paid employment, the recent dip in employees mental health may be due to Covid.

·        NHS Health Checks was a statutory service aimed at residents within GP Practice boundaries, operationally it had been found that the most effective pathway to deliver the service was through GP practices.

·        There had been an increase in the number of customers for P&SI Supported Living schemes, a new scheme at Wilberforce Trust was expected to take some of the customers who used the supported living schemes. The spend was also considered to be too high in comparison with other local authorities.  It was a live issue and would be addressed this financial year.

·        With reference to staff sickness levels, fewer members of staff were absent due to work related stress, reasons were variable but some absence was due to scheduled operations.  Covid still impacted on the workforce although staff were able to return to work more quickly.

During the discussion, the Director of Public Health welcomed the opportunity to discuss further the implications of the staff shortages in the Healthy Child Service and the methods that could be used to improve the situation.

Officers agreed to seek clarification from the Business Intelligence Unit regarding the KPI – the percentage of adults in contact with secondary mental health services in paid employment.

They also agreed to seek clarification regarding the 2021-22 Survey of Adult Carers in England, paragraph 35 of the report, to establish the breakdown of responses.

Resolved:

                             i.        The report be noted.

                            ii.        The Healthy Child Service to be added to the Committee’s Work Plan.

                          iii.        A clearer description of the KPI ‘percentage of adults in contact with secondary mental health services in paid employment’ to be included in future reports.

                          iv.        A breakdown of the responses regarding the satisfaction levels of Adult Carers in York be circulated to Members.

Reason:          To keep the Committee updated on the financial and performance position for 2021/22.