Agenda and minutes

Apologies have been received by Dr Ian Orpen (Bath and North East Somerset Clinical Commissioning Group)

The Panel noted apologies from Dr Ian Orpen (Clinical Commissioning Group representative).

At this point in the meeting declarations of interest are received from Members in any of the agenda items under consideration at the meeting. Members are asked to indicate:

(a) The agenda item number in which they have an interest to declare.

(b) The nature of their interest.

(c) Whether their interest is a disclosable pecuniary interest or an other interest,  (as defined in Part 2, A and B of the Code of Conduct and Rules for Registration of Interests)

Any Member who needs to clarify any matters relating to the declaration of interests is recommended to seek advice from the Council’s Monitoring Officer before the meeting to expedite dealing with the item during the meeting.

Councillor Simon Allen declared an ‘other’ interest as an Employee as AWP.

There was no urgent business.

Councillor Dine Romero asked the Panel to elect a Vice-Chair as she had to leave the meeting at 5.15pm. She proposed Councillor Simon Allen as Vice-Chair, this was seconded by Councillor Andy Furse.

There was none.

To approve the Minutes of the meeting held on 25^th November 2013.

A report is attached on ‘Financial Out-Turn 2013/14 on Partnership Budgets’.

Andy Rothery – Finance Business Partner, Joint Commissioning introduced the report.

Committee members asked the following questions and made the following points:

John Holden – CCG Chair of Audit Committee - asked what budget controls were in place. Jane Shayler - Adult Care and Health Strategy and Commissioning – explained that there are a range of controls in place, there is a single panel process for agreeing individual placement and package funding requests which is chaired by a Council or CCG representative. She further explained that there is a clear set of information requirements for requests put to the Panel including three options for meeting the assessed need, there are also published thresholds in terms of the level of fees and the panel process means that there is practitioner challenge. The officer assured the Committee that this process ensures a consistent approach and value for money.

John Holden asked if a flag is raised when the budget is spent and more money is needed. The officer explained that there are tiered responsibilities regarding budget management and monthly reporting including clear rationale for overspends. There are also review forecasts to help anticipate and plan for the impact of demographic change.

Sarah James – Chief Financial Officer BANES CCG – explained that placements are one of the recognised risks. Andy Rothery added that placements cannot be refused as they are part of a statutory service.

Councillor Andy Furse asked if young disabled learners turning 18 can be predicted as they are already in the system which can inform services of the higher cost that will be incurred once they turn 18. Andy Rothery responded that this is usually built into the budget process but there are still some movement and changes as a result of demographic growth. Jane Shayler added that there is a draw to this area due to the national service at Poolmead. She also informed the Committee that transitions planning has improved over the last four years and the area has moved from the bottom to the top quartile.

The Chair thanked the officers. The Committee noted the report and asked for a six monthly update at the next meeting.

There will be a presentation on ‘Performance Highlights’ at the meeting.

Andy Rothery – Finance Business Partner, Joint Commissioning and Jane Shayler - Adult Care and Health Strategy and Commissioning - introduced the report. The officer explained some of the performance data in the report. In particular, in relation to permanent admissions to care homes, aged 65 and over, this area is an outliner. She briefly explained the reasons that B&NES is an outliner. The profile of people aged 65+ placed in residential and nursing care in B&NES is highly unusual. People are significantly older than the norm when placed in residential care to nursing care count against this national performance measure as a ‘new admission’ whether or not they have moved address or, indeed, into a different room in the care home. It is believed that this overall picture is as a result of the local integrated health and social care strategy, with its focus on preventing or delaying admissions of a population with the increasingly complex and acute levels of need in community settings and, as far as possible in their own homes. She stated, in her view a more meaningful measure would be length of stay. She stated that this  national indicator may change or indeed an additional indicator may be agreed.

Committee members asked the following questions and made the following points:

John Holden stated that is was a useful presentation and asked if it had been to the Health and Wellbeing Board. Jane Shayler explained that it had been to the Health and Wellbeing Board in a different format.

There was some discussion around recycling equipment.

The Chair thanked officers for the useful format of the report. The Committee noted the report.

There is a report attached on ‘Mental Health Budget Pooling Proposal’.

(Note: Councillor Simon Allen took the Chair at 5.10pm. Councillor Dine Romero left the meeting)

Andy Rothery – Finance Business Partner, Joint Commissioning - introduced the report proposing moving to a section 75 arrangement.

Committee members asked the following questions and made the following points:

Councillor Simon Allen said that he agreed on the 75 arrangement.

Tracey Cox – CCG Accountable Officer – asked that if the 75 arrangement is retrospectively applied, what would the impact have been. Andy Rothery agreed that this would be a good exercise.

The Chair thanked officers.

The Committee noted the following:

·  The proposal for entering into a S75 arrangement to form a pooled budget between BANES CCG and BANES Council

·  The proposal for the management, reporting and associated governance arrangements for the pooled budget.

There will be a presentation on ‘Better Care Fund’ at the meeting.

Jane Shayler - Adult Care and Health Strategy and Commissioning - introduced the report. She explained that the submission had been made at the end of September and the confirmation had been received following formal local sign off.

Committee members asked the following questions and made the following points:

Sarah James explained the difference between ‘approved’ and ‘approved with support’, she stated that ‘approved with support’ is useful as key targets can be adjusted if appropriate in the local context.

There will be a discussion around future meetings of the Committee.

The Committee noted that there would be meetings in June/July (informal) and November (public meeting) in 2015. Items would include:

·  Financial Outturn Update

·  Implementation of MH Pool Budget