Members will consider the progress in delivering the Council’s Financial Strategy and help inform the refresh and any refocus for 2015/16 onwards.

To assist in this work the following documents are attached:

a)    Performance Report and Dashboards relevant to the Health and Adult Social Care Scrutiny Committee’s remit.

b)    Quarter 1 Performance Report and Dashboards [from 15 October 2014 Cabinet meeting]

c)     Financial Strategy [from 30 July 2014 Cabinet]

d)    Quarter 2 Revenue Monitoring Report [from 15 October 2014 Cabinet meeting]

e)    Latest Public Health England Summary for Shropshire

Members may also find it helpful to access the Business Plan and Financial Strategy 2014/15 to 2016/17 document [from 27 February Council meeting] available from the Members’ Library or by using the following link:     

 http://shropshire.gov.uk/committee-services/CeListDocuments.aspx?CommitteeId=125&MeetingId=2605&DF=27%2f02%2f2014&Ver=2

To help inform comments on the progress in delivering the Council’s Financial Strategy Members had before them the following documents and presentations (copies are attached to the signed minutes).

a)    Performance report and dashboards relevant to the Health and Adult Social Care Scrutiny Committee’s specific remit

b)    Quarter 1 performance report and dashboards from 15 October 2014 Cabinet meeting

c)     Financial Strategy report from 30 July 2014 Cabinet meeting

d)    Quarter 2 Revenue Monitoring Report from 15 October 2014 Cabinet meeting

e)    Two page summary from the Director of Adult Services

f)      Public Health England Shropshire Health Profile 2014

Some Members considered that the format of the material provided to the Committee was difficult to interpret and did not facilitate comprehension as too much had been presented and was difficult to navigate. They also considered that the dashboards provided a useful starting point but were only successful to a degree as their generality resulted in a loss of understanding.

The Director of Adult Services referred to a two sheet summary presentation of key messages, stating  what had gone well, what had gone less well and the areas identified by officers to concentrate on in the following year.  The Committee asked him to provide a commentary on each of the charts displayed on performance dashboards.

The Director of Public Health then referred Members to the Public Health England Shropshire Health Profile 2014 and explained the data and information presented within it. 

During the course of the meeting, Members identified the following as areas of concern around finance and delivery of savings:

·       Unpredictable demand, with around 40% of new spend in a month for people leaving hospital who were not previously known to the service;

·       The rising number of older people with more complex needs;

·       The red rated savings in the following areas – voluntary community sector, day services transformation, outsourcing of community living and shared lives, commissioning mental health services under the new partnership arrangement, tender and contract savings, transition, direct payments base cost adjustment; 

·       PFI savings had not been possible to date as assurance about protection of PFI credit had not been forthcoming;

·       Transport savings - Adult Social Care transport savings had already made and should not have to take a further share;

·       Disappointment with Public Health Allocation, which was £1 million less than it should be.

Areas identified by the Committee as of particular interest and priority looking ahead included:

·       Continuation of focus on primary care to prevent people getting to hospital in the first place, eg by providing simple preventative advice;

·       Continued work on discharge from hospitals and operation of Integrated Community Services;

·       Continued monitoring of the implementation of the new operating model;

·       Continued work to understand and address the Implications of the Care Bill;

·       The need to understand better why people have more control through personalised budgets but not a corresponding level of satisfaction;

·       The need to consider whether the needs of people with long term complex needs are met in the optimum way;

·       Continued need to move away from working in silos when providing services to children and adults;

·       Supported accommodation – the need to look at why 80 - 100 units would be needed to make intermediate bungalow developments viable;

·       Continued need to address fuel poverty;

·       Continued work to reduce the gap in premature deaths between different sections of the population;

·       Need to continue lobbying for rural deprivation to be taken into account and properly measured;

·       Consideration of how to focus resources as some areas of poorest performance in Shropshire were related to very low numbers;

·       Difference in public health budget between Shropshire and urban areas

Members also requested future Scrutiny Committee agenda items covering Joint Working and delivery of prevention of hospital admissions, and addressing the needs of Service Users with very complex and ongoing needs in the optimum way.

The Director of Adult Services and Director of Public Health agreed to supply information outside of the meeting on: numbers receiving domiciliary care at home where the cost would exceed that of residential care; the potential of making Helena Lane Centre in Ludlow available for child care purposes; a report circulated to Young People’s Scrutiny Committee on Mental Health and Wellbeing; the most recent Public Health report on Children and a population density and relative deprivation map for Shropshire. 

Members of the Committee also requested that future performance information cover the speed of assessments in Shropshire compared to the national indicator of no longer than 28 days.  They also felt that it would be useful to see Shropshire’s own figures where performance was not obvious due to the requirements of presenting and recording national indicators.

The Committee’s discussion also covered the pressures faced by Officers during a significant period of change.  The Director of Adult Services acknowledged that it had been a difficult year but with the support of the Business Design Team, colleagues now faced less bureaucracy and were more empowered to make decisions and help people earlier on.

The Performance and Design Team Leader explained that a summary of the Committee’s comments would be fed back to the Performance Management Scrutiny Committee on 26 November 2014 when the overarching scrutiny response to the progress made in delivering the Council’s Financial Strategy would be compiled and reported to the forthcoming Cabinet meeting.