Agenda item

i.         Adult Social Care and Health Budget Proposals 2026/27

ii.         Adult Social Care and Health Statutory and Discretionary Spending

The Chair introduced the item and invited Cllr Josh Rendall (Lead Member for Adult Social Care and Public Health), and Council officers Visva Sathasivam (Director of Adult Social Care), Anna Raleigh (Director of Public Health), Usman Khan (Deputy Director of Public Health) and Tom Dennerly (Head of Finance – Adult Social Care) to present the report. The Lead Member highlighted:

1.     Savings proposals totalling £3.5m for 2026/27 and the potential for further savings of £3.8m from 2027/28 onwards, but assured the Committee that savings would not affect front line services.

2.     Budget growth pressures were the result of more people accessing adult social care services.

3.     The Council was continuing to invest in Adult Social Care with existing capital projects scheduled to be unaffected by budget savings.

The Chair invited comments or questions from the Committee. Members of the Committee:

4.     Queried whether the total proposed growth of £1.5m to manage demographic pressures was sufficient considering the 12% increase in service users in 2024/25. Officers advised that the 12% increase, whilst unprecedented, was not expected to be repeated based on modelling. Numbers of service users were closely monitored, and this helped project levels of future need. Officers were confident that current data indicated a reversion to 2023/24 growth levels, and therefore the proposed budget growth was sufficient.

5.     Sought assurance that quality, choice and dignity would be maintained for service users despite budget savings and highlighted the importance of maintaining a manageable caseload for front line workers. Officers referred to the Outstanding CQC rating achieved by the service and were determined to maintain a high quality service with prudent financial management. They noted that the budget growth proposal would ensure that the service would continue to provide the right services to the right people at the right time.

6.     Challenged the Council to work with NHS partners and voluntary and community sector organisations to effectively manage long term financial pressures and ensure services remained available to residents.

7.     Noted the in-year outturn position was vulnerable to demand shocks over the winter period and asked whether there was sufficient contingency to ensure a balanced budget at year-end. The Lead Member was conscious that there would be no grant from the NHS to manage winter pressures, with potential knock-on effects on hospital discharge. Officers said they met regularly to monitor demand, pressures and key risks and were confident that the final in-year position would be balanced.

8.     Discussed the Public Health budget, including reasons behind underspends in the 2024/25 and the appropriateness and sustainability of redirecting Public Health Grant funding across the Council to address budget pressures in other departments while contributing to public health outcomes. Officers advised that the Public Health reserve fund had built up over a long period of time and, on the advice of OHID, needed to be drawn down to a level which is more commensurate with managing contingency pressures. Funding was being redirected in accordance with the objectives in the Council Plan and the Public Health Grant’s conditions.

9.     Recognised the budgetary implications of the collapse of the Council’s community equipment provider and asked how risks around external providers were managed. Officers advised that commissioned services were subject to credit checks to ensure financial stability as part of risk monitoring. The directorate also had contingency plans and agreed business continuity practices to ensure continuity of key services.

10.   Noted proposals to introduce self-funder administration charges and asked whether protections would be in place to ensure residents in need were not discouraged from seeking support from the Council. Officers acknowledged  safeguarding concerns but were confident that effective communications and monitoring with providers would aid effective implementation, and ultimately residents would benefit from better care. The Lead Member added that RBKC would not be an outlier, as neighbouring Councils already levied charges to recover the costs of arranging private care.

11.   Asked whether direct payments to residents would be affected by budget pressures. The Lead Member assured the Committee there were no planned changes to the administration of direct payments. Officers urged any residents who felt their needs were not being met with regard to direct payments to contact the Council and a needs assessment would be conducted.

12.   Discussed how the Committee could have better oversight of Adult Social Care and Public Health budget delivery. Officers noted that the Overview and Scrutiny Committee received quarterly financial monitoring reports that could be circulated to the Committee.

The Chair invited comments or questions from other Councillors in attendance. Members:

13.   Expressed concern that savings from redirected public health funding were inadequately presented in the report, with limited explanation and no demonstrated risk assessment.

14.   Suggested the report did not reflect the breadth of transformation work underway across Adult Social Care and Public Health.

15.   Emphasised the importance of tracking service usage to understand return on investment, reach and outcomes of Council investment.

The Chair closed the discussion and recommended that future budget reports include more narrative on transformation and Public Health savings.