Resolved: the committee agreed to refer its views to the Public Accounts Select Committee.
Tom Brown (Executive Director for Community Services) introduced the report and noted the following:
1.1 These cuts come at a very challenging time for the council: the financial impact for of Covid for Lewisham is currently £68m and rising. Government support to date has been less than the impact.
1.2 The council also continues to report overspending pressures: £10m this year, mainly in children’s social care, environment services, and technology. The council has managed to make one-off savings of £5.4m to date to help manage these pressures.
1.3 Funding arrangements for local government for next year are still unclear. The financial settlement for local government is not expected to be announced until mid to late December.
1.4 The council’s Medium Term Financial Strategy has identified the need to make cuts of at least £40m over the next three years with the majority (£24m) needed in the next year.
1.5 The draft cuts proposals being presented include £15m of cuts for next year. Further proposals will need to be brought to scrutiny early in the new year.
Tom Brown (Executive Director for Community Services) introduced each of the cuts proposals listed below in turn. There were questions and discussions after each. Key points are noted below.
B-04 - Smoking Cessation service
B-05 - Recharge OT and housing officer costs to the Disabled Facilities Grant
B-09 - Reduction in The discretionary award of concessionary fares
C-02 - Adult Learning and Day Opportunities
E-04 - Introduce charging for certain elements of self-funded care packages
F-01 - Adult Social Care Demand management
F-06 - Adults with learning difficulties and 14 - 25yrs transitions costs
F-07 - Outsource Adults services - Enablement
F-08 - Outsource Adults services - Linkline
F-09 - In house Services reductions - adults passenger transport
1.6 In response to questions on cut B-09 (Reduction in the discretionary award of concessionary fares) regarding communications and engagement with service users, it was confirmed that there would be a full consultation and equalities impact assessment if the proposal is agreed by Mayor and Cabinet.
1.7 The committee raised questions about the phasing of the implementation of cut B-09. A number of potential options were outlined and officers confirmed that they would listen to suggestions from the consultation process.
1.8 The committee also expressed concern about the impact of proposal B-09 on vulnerable people under 60, particularly those whose health conditions may have been exacerbated by Covid-19.
1.9 Officers noted the importance of a thorough Equality Impact Assessment to ensure that the proposal doesn’t disproportionately affect those with less obvious disabilities such as mental health.
1.10 In response to cut proposal C-02 (Adult Learning and Day Opportunities) the committee expressed concern about the availability of day opportunities outside of term time if more is to be provided by Adult Learning Lewisham.
1.11 Officers confirmed that any day opportunities would be personalised for individuals which would include opportunities outside of term time. Ideally this would include volunteering opportunities.
1.12 On cut proposal E-04 (Introduce charging for certain elements of self-funded care packages) the committee noted that self-funders benefit from the council’s management and oversight of care services and the better rates the council is able to negotiate.
1.13 Given the weekly costs that individuals would be expected to pay for brokerage and transports cost under proposal E-04, the committee asked for there be clear guidance and communications on who will be required to pay and how much as this change is phased in – noting that charges for social care has been a significant issue for the Positive Ageing Council.
1.14 Officers stressed that only those who can afford to pay will be asked to do so – in line with the council’s fairer charging policy.
1.15 On proposal F-01 (Adult Social Care Demand management) the committee noted that while an asset-based approach to social care is laudable it is important that there are proper risk assessments and mitigations in place as the council will increasingly be dealing with some very vulnerable people who may need considerable support.
1.16 It was noted that the council would work closely with individuals to understand risk and put in place mitigations where possible in order to help people live as independently as possible.
1.17 The council in not planning to commission additional advocacy services but will be working with voluntary sector partners that support individuals through the process.
1.18 The asset-based approach to adult social care is being phased in incrementally as people approach the council and when care packages are reviewed.
1.19 The committee asked for some examples of how the asset-based approach has led to savings and more detail on how the council is assessing and tracking the impact of the changes it’s making.
1.20 It was noted that officers would monitor the success of this approach by monitoring, among other things, indicators of the overall demand for long-term care, such as care home use.
1.21 On proposal F-01 the committee also asked if there was any further non-financial support the council could provide to voluntary organisations as they take on more, given the impact Covid has had on the sector and the number of organisations vulnerable to failing.
1.22 Officers noted that the voluntary sector is primarily being asked to help keep people social connected to avoid loneliness and depression. It would not be appropriate for the voluntary sector to be responsible for hands-on care. The council is also working with the voluntary sector to help consolidate and share some facilities.
1.23 On proposal F-07 (Outsource Adults services – Enablement) in response to questions about involving service users in the design and monitoring of outsourced services, officers said that the council would make sure service users are involved in setting out the service specification.
1.24 On proposal F-08 (Outsource Adults services – Linkline) the committee noted the vulnerability of these service users and asked whether there would be more information coming forward about the different agencies and services available from the market, including what sort of checks and monitoring would take place, so that the committee can feel confident about the proposed changes.
1.25 Officers noted that the council’s commissioning teams are very experienced in specifying and monitoring contracts and that a bigger concern to the council will be the immediate loss of workforce and the flexibility that comes with having an in-house service.
1.26 On proposal F-09 (In house Services reductions - adults passenger transport) the committee queried whether it would be economically viable to continue with children’s transport services in-house if the fleet was no longer to be used for adult transport services.
1.27 Officers agreed that this was something that they would need to build in to ensure that proposal F?09 is a real saving.
Resolved: the committee agreed to refer its views to the Public Accounts Select Committee in the following terms:
Given that a number of the proposed budget cuts considered by this committee involve outsourcing services to external providers, the committee seeks assurances that the council has the capacity and ability to effectively manage and monitor these outsourced contracts and ensure services are being provided to the agreed standards.
The committee would also welcome more information about the market for the proposed outsourced services so that members can better understand the quality of services available and feel more confident in supporting these changes.
The committee also seeks assurances that good engagement and coproduction with service users and stakeholders will be themes that run through all the proposed changes, so that we can have as clear as possible understanding of the effects of the changes on residents. It is important that there is evidence that we are engaging with residents, using multiple channels, and listening to their concerns and suggestions.