Agenda item

The Cabinet Member(s) will update the Panel on any relevant issues. Panel members may ask questions on the update provided.

Councillor Alison Born, Cabinet Member for Adults and Council House Building addressed the Panel. A copy of the update can be found as an online appendix to these minutes, a summary of the update is set out below.

The health and social care system remains under pressure across B&NES, as it is across the country, with increased demand for services and staff shortages. This is continuing to have a significant impact on our Reablement Service provided by Virgin Care and on mental health services provided by AWP and Oxford Health.

Social Care Plan

The Prime Minister has announced the Government’s reform package for social care, and increased funding for the NHS from 2022-23:

https://www.gov.uk/government/publications/build-back-better-our-plan-for-health-and-social-care

National Insurance Contributions (NICs) for employees and employers will increase by 1.25%.  This new “Health and Social Care Levy” will be “hypothecated in law” and will have to be spent on frontline services.  The increase in employer’s national insurance will cost B&NES £750k next year.

Changes will be introduced from October 2023 and will have an impact on the income that local authorities receive from social care clients.  Lost income is estimated by the Government at £5.4bn and local government will receive funding for these losses.  However, the methodology for distributing the funding will need to be determined.  The White Paper says that, “The Government will consult on its proposals for funding distribution and keep this distribution under review”.  Clearly there is a risk for local authorities that the funding is insufficient to offset the lost income. 

Additional funding raised from the tax increases will be used for the NHS (£25bn over 3 years in England) and to fund the costs of social care reform (£5.4bn over 3 years).  Although the Prime Minister said, “you can’t fix the NHS without fixing social care”, there will be very little additional funding for social care to either close the funding gap or to improve care standards.  Within the £5.4bn for social care, there will be £500m over 3 years to support the social care workforce.

Virgin Care Contract

B&NES, Swindon & Wiltshire Clinical Commissioning Group (BSWCCG) Governing Body and B&NESCouncil, as joint commissioners, have requested a report setting out an options appraisal to help decide whether or not to extend the Virgin Care contract. 

This is a seven-year contract from 2017/18 to 2023/2024 with the option to extend the contract term by three years, taking its term to 2026/2027. The option to extend the contract in this way can only be taken once. Virgin Care will need to be notified of the decision to extend or not by no later than the end of March 2022.

Initial dialogue with Virgin Care has identified their commitment to securing the 3-year extension term and their intention (at this stage) not to renegotiate the financial terms of the funding from BSWCCG and B&NES Council for the 3-year term.

The next Virgin Care commissioning report is due to this panel in October and will concentrate on the key themes of workforce and service user experience. 

Update on Transformation Process

Community health and social care services continue to see increased demand and staff continue to work hard to meet the demand. To ensure that services are sustainable in the future, Adult Social Care are embarking on a significant Transformation Programme focused on delaying the demand for statutory services, ensuring quality service provision, improving outcomes for individuals and reducing spend. 

The Adult Social Care Internal Transformation Group (ASCITG) commenced in July 2021 and is chaired by Claire Thorogood - Head of Contracting and Performance. This meeting is held monthly and reports into the Social Care Transformation Board (SCTB) which also commenced in July 2021.  The monthly Board Meeting is chaired by Amanda George – Director of Business Change and Customer Services.

The Chairman asked if she had received responses from enough Councillors to take part in the Transformation of Adult Care Services Working Group.

Councillor Born replied that she would check and would look to ensure that the group has a political balance.

The Chairman asked if the process was about saving £2m or improving services.

Councillor Born replied that the process was primarily about improving services as some were perceived as being old fashioned. She added that savings should also be made as part of the process.

The Chairman asked if the transformation would mean a degree of technological changes for staff and service users.

Councillor Born replied that the plan is to provide the public with better information to enable them to navigate through our services easier and to make better use of the data available to plan for the future needs of patients.

Councillor Liz Hardman asked how the Council will attempt to delay the demand for statutory services.

Councillor Born replied that they will seek to increase awareness of available preventative services as a better use of resources.

Kevin Burnett welcomed her work for keeping the pressure on Jacob Rees-Mogg over the state of Social Care. He asked if all Social Care Services in the South West doing the same thing.

Councillor Born replied that she was not aware of any other colleagues taking similar action but said she was due to meet with other Adult Social Care leads in the South West on Friday. She added that some colleagues within the South West also have MPs who are members of the government so may have a similar view.

Kevin Burnett asked what her views were on the Government’s Social Care Reform proposals and did the Government consult Local Authorities (LA’s) prior to announcing them.

Councillor Born replied that she found it hard to believe that the Government would have come up with the proposals it did if it had consulted LA’s but she may be wrong.

She said that she thought that there were a number of problems with the proposals which include:

-  The package should be funded from general taxation, not NI as NI disproportionately affects those on lower incomes, is an additional cost to employers, many of whom are struggling due to Covid and the NI payments will further reduce the take home pay of care staff who are already paid less than they should be. The Employers NI requirement also puts significant further pressure on council budgets so it may hinder rather than help.

-  The proposals are targeted at older adults, the majority of our ASC   funding goes on LD, PD and MH with LD having about 50% of funding for about 25% of the caseload, reflecting the complexity of need for this group. The government’s proposals do not impact significantly on these other client groups but change is needed.

-  Whilst the plan to stop self-funders from paying more than council funded clients is welcome, it will require significant investment in council budgets, including in brokerage services and could risk destabilising the care home market.

-  The plan does nothing to address the immediate crisis in home care services and the NI implications may make recruitment even more difficult.

-  The proposals offer very little to unpaid carers who desperately need more support.

-  The proposals do not appear to do enough to address the need for training and career development within care settings. This is essential to addressing the staffing crisis.

She added that whilst the financial proposals will cap care costs for individuals the cap is quite high, particularly as accommodation costs are not included so is unlikely to meet expectations. However, significant additional costs will still fall to local authorities which will need to be funded.

Kevin Burnett asked if the Government has made any comments about the new tax effects (National Insurance) on the Local Authority – which in our case is £750,000. He added that unlike private companies, the LA can’t just pass on these costs to the public.

Councillor Born replied that the Council were yet to receive guidance on this.

Kevin Burnett referred to the Virgin Care Contract and asked when a report on whether to extend the contract or not would reach Panel. He also asked why some services might be removed from the contract if an extension is approved.

Councillor Born replied that an update on the Virgin Care contract performance would be presented to the Panel on the 15^th October 2021.  She added that a report identifying the options for extending the contract or not was due to go to the Cabinet meeting on the 11^th November 2021.

She said that discussions are ongoing with Virgin Care about whether any services may be better provided by the Council and the CCG.

The Chairman asked if members of the Panel had any questions for Councillor Romero based on the written update that she had submitted. A copy of the update can be found as an online appendix to these minutes.

Councillor Liz Hardman said that she welcomed Councillor Romero’s update as she is targeting all the areas I would have asked about, including poverty proofing schools, additional money for those entitled to FSMs during the summer holidays, a new approach to mental health support for schools and also information about the Primary Empowerment Project. 

She asked if any thought had been given to support for those entitled to FSMs during the October half term, this is especially important at a time when the Universal Credit £20 uplift is about to be cut.

The Director of Education & Safeguarding read out a response on behalf of Councillor Romero. He said that she will campaign as hard as possible to have some measures in place for October and that this was partly why she is attending the LGA CYP Board today to make sure it’s on all parties’ agendas.

Councillor Hardman commented that later on the agenda the Panel will be considering a report on complaints and feedback on Children’s Services. She said that in paragraphs 3.8 and 3.9 of that report, we see that complaints relating to SEN have increased significantly, covering issues such as lack of special school places, the content of the EHC Plan and the delivery of provision by the school. She added that we know that behind every complaint is a desperate family and I welcome the additional support that has been provided to the service to increase capacity.  She asked to what extent is SEN a political priority for the administration. 

The Director of Education & Safeguarding read out a response on behalf of Councillor Romero. He said that all children’s matters matter to her, none more so than SEND. She has been raising her concerns on funding widely with Cabinet colleagues as she, and those within Children’s Services are acutely aware the Council is likely to have to meet a shortfall in this funding of around £5million unless government commits to new funding. She added it was quite likely she would bring this up at the LGA meeting today.

Kevin Burnett asked whether with the new changes this term and focus on Ofsted with peer on peer abuse – and the issues raised with the Everyone’s Invited website – is the Council itself seeking ways to change the social culture of dignity and respect for women and will the sexual health training mentioned in the report reflect these ‘cultural issues’.

The Director of Education & Safeguarding replied that Councillor Romero was chairing a workstream in the Council about this issue.

Kevin Burnett asked if the Bath Community Safety and Safeguarding Partnership was carrying out work in this area.

The Director of Education & Safeguarding replied that the Police are the national leads for responding to ‘Everyone’s Invited’ and have been issuing advice on this matter to the BCSSP. He added that The BCSSP has sent a letter to all schools in B&NES with links to advice and support on how schools should review internal Safeguarding policies and where they can seek additional advice and support. He said that the BCSSP will also look at the OFSTED review into peer on peer abuse and consider how the learning from this review can be shaped locally.

Kevin Burnett asked for some examples of the activities supported by the Covid Outbreak Management Fund.

The Director of Children's Services & Education replied on behalf of Councillor Romero and said that in line with grant conditions, examples of proposals approved for funding include: contact tracing posts; staff to take forward universal and targeted testing, vaccination, communications and outbreak management work programmes; communication campaigns on testing and vaccination; Early Years summer holiday childcare sufficiency support fund; continuation of a city centre Covid-19 symptomatic testing site; projects to support populations significantly impacted by covid such as Children and Young People with Special Education Needs; and Covid Marshals.

Kevin Burnett asked if the ‘tone of advice’ provided nationally to schools on their return this term was ‘too reckless’ and would she prefer a more cautious climate to have been created and was she and our B&NES Public Health Teams sending out such a message.

The Director of Education & Safeguarding read out a response on behalf of Councillor Romero. He said that our schools and colleges continue to work extremely hard to make sure their settings remain as safe as possible, and we thank them for all of their dedication and support to our children and families.

He added that in order to prevent Covid-19 circulating as far as possible, schools will continue to encourage regular handwashing, cleaning regimes, and keeping spaces well ventilated. All secondary school pupils have also been asked to take two lateral-flow tests at school at the beginning of term and are encouraged to participate in twice weekly testing going forward. He said that  B&NES Council supports use of these public health measures and has been providing advice to schools and colleges as needed.

He stated that through our joint communications with the NHS, we also encourage all those eligible to take up the vaccine offer as soon as possible. This includes young people aged 16 and 17, and children aged 12 to 15 with specific underlying health conditions, or who live with a person who is immunosuppressed.

He said that it was likely that there will be some increase in cases in schools over the coming weeks, either reflecting higher rates in the wider community, or transmission within schools. Should an increase happen, it’s useful to remember three things:

• For most children and young people, coronavirus infection has no or very mild symptoms.
• There are higher levels of protection in the wider community as by mid-September all adults, including school staff, will have had the opportunity to be double-jabbed.
• Schools will be alert and ready to reintroduce social distancing and other measures to reduce the risk of spread of the virus if that’s needed, in collaboration with public health.

Kevin Burnett said it was exciting to know that finally the Primary Empowerment Project is underway and recalled that the Panel was advised in the Autumn of 2020 that the School Standards Board (SSB) had established a task & finish group re: school performance / narrowing the gap. He said the Panel was advised that this sub-group had met / would meet just before Christmas 2020 and was working with CEOs on how to collect necessary data around the EEF family of schools information. He said that their work had been ‘paused’ given the need for new ‘testing in schools’ etc. He asked if there was any more information on whether this sub-group is now up and running and when they are likely to report back to the SSB / Panel.

The Director of Education & Safeguarding read out a response on behalf of Councillor Romero. He said that the sub-group had held two meetings and has suggested that a strategic approach across B&NES on what works for PP strategies needs to be developed first. He added that officers are meeting with the St Johns Foundation, the RSC and the new Teaching Hub to consider how this project can be moved on to the next stage. 

Kevin Burnett asked if the work of the Inclusion Expert had concluded.

The Director of Education & Safeguarding replied that this work had finished and said that the schools involved had welcomed the input that had been provided.

Councillor Andrew Wait commented that he was pleased to see the Council’s involvement in the resettlement of Afghan families.

The Chairman thanked both Cabinet Members for their updates on behalf of the Panel.