Agenda item

This report provides an update on the overall preparation and proposals for the 2024/25 revenue budget, risks, financial resilience, and the impact of those proposals. It also sets out the budget proposals for the services covered by the Health and Adult Social Care Policy and Accountability Committee and provides an update on any proposed changes in fees and charges.

The Chair noted that the first part of the item would be devoted to the Council’s corporate budget and the second part would cover the Adult Social Care and Public Health departmental budget proposals.

Corporate Budget

Councillor Rowan Ree (Cabinet Member for Finance and Reform) introduced the item that detailed the proposals for the 2024/25 revenue budget – including the risks, financial resilience, and impact of those proposals.

Councillor Ree noted that it had been a difficult time for local government, with central government grant reductions and high inflation, but despite the constraints, the Council had delivered a balanced budget that protected core services and continued funding for the areas that were unique to borough such as free home care, universal free school breakfasts, and the Law Enforcement Team. He said this had been achieved through ruthless financial efficiency and reforming how services were delivered. He thanked Sukvinder Kalsi, the finance team, officers across departments, and his Cabinet colleagues for making that possible.

Sukvinder Kalsi (Strategic Director of Finance) gave a short presentation on the corporate budget. He highlighted the following:

• The difficulties of the operating environment including high inflation, pressures on household budgets, new legislative burdens, and uncertainty around local government funding.
• The key objectives of the financial plan were to protect statutory services, deliver services valued by residents, ensure people’s safety, promote prosperity, and be a modern and innovative Council with strong financial governance and resilience.
• That council tax would increase by 4.99%, but an estimated 93,000 households in the borough would not pay the full amount due to discounts and exemptions.

The Chair thanked Councillor Ree and officers for delivering a budget that protected the most vulnerable residents.

Jim Grealy asked how sustainable it was to keep finding efficiencies year after year. He also asked how the budget would be communicated to residents. Councillor Ree said local government was not a priority for central government, as they continued to force councils to make savings without taking responsibility. He noted that the financial settlement from central government used to be delivered in November and cover multiple years, to help councils plan ahead. In the past six years the settlement had covered only one year at a time and had been delivered at the end of December, making the budget setting process far more difficult. Regarding sustainability, he said the Council had cut £118m from the budget over the last nine years and that couldn’t continue forever. He felt there needed to be a change in the way in way local government was funded.

Jim Grealy said it was important to find a way of showing residents the challenge of setting the budget and how the Council was managing more duties with fewer resources. Councillor Ree agreed and noted that the Council communicated budget setting through public meetings like the Policy and Accountability Committees, Councillors engaging with residents, and the council tax booklet.

Merril Hammer (Hammersmith & Fulham Save Our NHS) felt the Council could do more to highlight the services unique to the borough such as free home care. Councillor Ree said there was always more that could be done in this area, but noted the Council had to be careful with its resources. Councillor Ben Coleman noted that, often the most effective messaging came from residents themselves and encouraged people who were passionate about these services to post about them on social media.

The Chair noted the uncertainty around the Household Support Fund, a £2.8m central government grant used by the Council for its cost-of-living response, and asked if there was any word of a continuation or replacement. Councillor Ree said it was very important funding, but it would be gone in March. The Council had committed £1m in the budget to put towards the response. He noted there may be additional money in the Chancellor’s Spring Budget, but the detail wouldn’t be released until the 8^th of March 2024 and the Council had to set its budget in February.

The Chair asked for more information on the role of the independent auditors mentioned in the report. Councillor Ree explained that the Council had an external audit process currently delivered by Grant Thornton, who provide a detailed audit report to the Council’s Audit Committee. He noted they had recently said Hammersmith & Fulham was one of the best run councils in London. Sukvinder Kalsi added that the role of the external auditors was to provide assurance to members, residents, contractors, and other businesses the Council works with.

Departmental Budget

Councillor Ben Coleman (Deputy Leader and Cabinet Member for Health and Social Care) introduced the budget proposals for the services covered by the Committee. He noted that it had been a very difficult year due to the lack of support, lack of adequate funding, and problems created by Central Government. He thanked Linda Jackson, Jo Baty, Dr Nicola Lang, Prakash Daryanani and their teams, and said he was impressed by the way they had worked to find additional funding for social care and protect home care.

Jo Baty (Director of Independent Living, Strategy, Standards and Regulation) gave a presentation on the department’s vision and priorities. She noted the Council’s vision of “working compassionately with residents so that they enjoy independent, healthy and fulfilling lives”. She then highlighted the following areas of focus:

• Quality and assurance of services
• Digitalisation and artificial intelligence
• Better utilisation of assets to meet increasing demand
• Workforce transformation and integrated workforce development
• Collaboration with Children’s Services for transitioning residents reaching adulthood
• Working with Housing Services

Jo Baty then discussed some of Social Care’s key achievements:

• A new co-produced service offering day opportunities for independent living for adults with complex autism.
• Achieving Dementia-Friendly Community status from the Alzheimer’s Society.
• Establishing an all-age Autism Partnership Board to co-produce improvements to services and support for neurodiverse residents and their families.
• Working with Action on Disability and Strategic Co-production leads to launch the new Independent Living Delivery Group.
• Improving transitioning young people into adulthood.
• Receiving 174 compliments since April 2023 from residents.

Jo Baty gave an overview of the pressures on Social Care, including workforce issues caused by Covid-19, the focus on rapid discharges from hospital, delays in elective surgeries, the lack of a long-term funding model, demographic pressures, and issues of sustainability for care providers.

Prakash Daryanani (Head of Finance, Social Care) gave a presentation on the social care spending plan. He noted that the department has a gross budget of £114.08m, and the Council proposed an increase of £7.6m in 2024/25 (£4.8m investment, £3m inflation, £1.4m additional grants and (£1.6m) of savings).

He noted that over the last two years there had been significant increases in spend in Home Care and Care Homes due to residents being discharged early from hospital, with greater acuity of need, and uplifts in the minimum living wage. He also noted there had been a steady increase in direct payments year on year.

Dr Nicola Lang addressed the Committee and highlighted recent Public Health achievements, including:

• Procurement of a new integrated drug and alcohol service, co-designed and evaluated by residents.
• The launch of ‘Beat the street,’ an evidence-based programme of physical activity to promote walking in children and reduce childhood obesity.
• Commissioning of The Listening Place to do expert, bespoke suicide prevention work.
• An innovative education and empowerment programme to promote uptake of flu and Covid vaccines in nursing home staff.
• An in-house infection prevention and control nurse, leading on environmental audits, and designing new safety systems.
• Working with mental health trusts and substance misuse services to build an innovative model of bespoke specialist mental health and dual diagnosis expertise for hostels and mental health supported accommodation.

Victoria Brignell asked if keeping council tax relatively low compared with many other authorities had an impact on the support that could be provided to people. She also asked about the sustainability of the Council’s commitment to free home care. Councillor Ree explained that increases in council tax were capped each year at 2.99% and an additional 2% for the social care precept. The Council was increasing council tax by the full amount allowed this year. He noted that the Council had to balance the desired amount of funding with the amount of money residents could afford.

Councillor Coleman said the commitment to free home care required a strong political commitment and careful management of finances. He noted that Hammersmith & Fulham had an advantaged position, with the third highest land values in the country, and the Council used that to benefit residents. He recognised not all councils could do that. He added that H&F Council also provided a subsidised ‘daily meals and a chat’ service – for which it had not increased the price in nine years.

Merril Hammer noted that there was a national campaign for a national support and independent living service which had publicised that H&F offered free home care.

Jim Grealy asked if the NHS were coming back with budget proposals to the Council, given that the Council was saving them money by providing complementary services. Jo Baty said the Council’s partnership with the NHS was developing well. The new neighbourhood model avoided unnecessary meetings and allowed for earlier intervention. She said it was an effective partnership model.

Councillor Coleman noted the point and said if the Council saved the NHS or the police money they would not be compensated. But he noted that since the Covid-19 pandemic, the Council and the NHS had worked better together. There were challenges because the NHS was trying to make operational cost reductions which could have an impact on council services. He felt both parties needed to work to understand each other better.

Jim Grealy asked if the new neighbourhood teams were cost heavy.

Jo Baty said the NHS had funded additional posts – two social workers and a part time post in the Housing team. She explained that housing was a common denominator and said there were further opportunities for joint posts to unblock issues there.

Jim Grealy noted that Imperial College Healthcare NHS Trust had complemented the Council’s approach to discharge and saw it as a model for other councils to adopt.

The Chair asked how complaints were analysed and used to improve services. Jo Baty said Adult Social Care carried out deep dives of service areas then brought officers together to look at data, including quality, risks, trends, and benchmarking with other councils. Complaints were themed and an annual report went to a senior manager meeting. Learning then informed operational practice.

Jim Grealy noted the work some NHS Trusts were doing to identify different communities and asked if the Council could do something similar to see who was being supported and where the gaps were. Prakash Daryanani said officers could look into that. Currently, ethnicity data was requested from users through the case system, but it was not mandatory to provide it.

ACTION: Prakash Daryanani

The Chair brought the discussion to a close and thanked members and officers for their contributions. She then summarised the achievements of the budget, notably that H&F was the only council in the country that provided free home care.

RESOLVED

1. That the Committee considers the budget proposals and makes recommendations to Cabinet as appropriate.

2. That the Committee considers the proposed changes to fees and charges and makes recommendations as appropriate.