Agenda item

Resolved: the committee agreed to refer its views to the Public Accounts Select Committee.

Tom Brown (Executive Director for Community Services) introduced the budget cuts report and the following key points were noted:

1.1  The council continues to do everything it can to support residents and business during the pandemic and despite prudent financial management we are forced to confront a huge budget gap.

1.2  This is the result of a decade of government cuts and underfunding which has seen the council’s budget reduced by 50%. Across the country the local government funding gap is more than £4bn.

1.3  The proposals being discussed aim to prioritise protection of frontline services and transforming the way the council works, but there will be reductions in some services and deletion of some posts.

1.4  Over the next 3 years the majority of cuts will be delivered by continuing to transform the way the council works.

1.5  The local government settlement was marginally better than expected, but the council still needs to find around £28m of cuts in the coming financial year. The Round 1 cuts agreed in December provide £15m of the £28m needed. The cuts being considered in this round provide £13m and if accepted in full would close the budget gap for the coming financial year.

1.6  Covid continues to cast uncertainty on local government finances. Although the government has confirmed that some income losses will be funded the council remains very concerned about the ongoing pressures of the pandemic. There have been no assurances from government about funding into 2021/22.

1.7  There are significant concerns about the impact on the economy with many local businesses currently relying on grants and rate relief. The end of the furlough scheme may also see a rise in unemployment and more demand for council services. There will also be a significant impact on our partners, in particular health and social care providers and schools.

1.8  Deputy Mayor and Cabinet Member for Health and Adult Social Care, Councillor Best, commented that the government’s austerity agenda has continued to get worse and that continuing to increasing the adult social care precept is not fair or sustainable solution. Cllr Best said that the government urgently needs to fix the funding model for adult social care.

Tom Brown (Executive Director for Community Services) introduced each of the budget cuts. The committee discussed each of the proposals and the following key points were made:

B-11 - Improved usage of BCF Funding across partners

1.9  The Better Care Fund is being reviewed to get best value. The fund itself won’t go down, but the way it is deployed will allow cost pressures elsewhere to be offset and release some savings.

1.10      A progress update on the review will be brought the next meeting of this committee.

The committee also asked to discuss and comment on a number of Round 1 cuts proposals.

B04 – smoking cessation service (Round 1)

1.11      It was confirmed that the Southeast London CCG has agreed to pay for this service going forwards.

1.12      The Chair asked for it to be made clear in the public communications that the service will continue to be funded just not by the council. 

1.13      B05 – recharging OT and housing officer costs to the Disabled Facilities Grant (Round 1)

1.14      The committee noted this proposal without further comment.

B08 – review of the power of attorney service (Round 1)

1.15      The committee noted that the power of attorney service is extremely important to the small number of people who are supported by it, who often have no one else to look after their affairs and rely on the council as a last resort.

1.16      The committee said that the council should be able to provide a quality fit-for-purpose services at a fair price and recommended the council continues to provide the service in house at a charge.

B09 – reduction in discretionary award of concessionary fares (Round 1)

1.17      The committee noted this proposal without further comment.

1.18      The committee queried the process around the equalities analysis of the cuts and how it relates to the refreshed equalities process approved by Mayor & Cabinet in November.

1.19      David Austin (Director for Corporate Resources) explained that managers are asked to consider the equalities for each individual proposal and that from this a high level aggregation is drawn that highlights the key characteristics concerned. Potential cumulative impacts are also identified and mitigations considered. The council is also currently working to bring together a stronger policy and strategy framework for equalities.

1.20      The committee noted that it might be helpful to get service user input or third party assurance of future equalities impact assessments.

C-02 – adult learning and day opportunities (Round 1)

1.21      The committee said that adult learning should consider operating all year round in order to meet the needs of service users. The service should also be joined up with the council to make sure there are appropriate job opportunities available following training and education.

1.22      Deputy Mayor and Cabinet Member for Health and Adult Social Care, Councillor Best, also suggested that the council consider developing a corporate approach, as an employer, to employing more people with disability, particularly learning disability. The council should also reach out to other partners, in particular health, to find out about their approach.

E-04 – introduce charging for certain elements of self-funded care packages (Round 1)

1.23      The committee stressed the importance of monitoring this change carefully to ensure that there continues to be financial benefit for users from using the bulk purchasing power of the council compared to approaching a provider as an individual.

1.24      The committee noted this proposal without further comment.

F-06 – adults with learning difficulties and 14-25yrs transitions costs (Round 1)

1.25      Cllr Jacq Paschoud (under standing orders) noted that given the options available in Lewisham many parents are forced to seek education for their child or young person outside of London. The council should develop the services available, particularly college and sixth form education, so that parents aren’t pushed to looked elsewhere.

1.26      The committee noted this proposal without further comment.

F09 – in house services reductions – adults passenger transport (Round 1)

1.27      As part of a strategic review of transport adult social care are looking at what has happened since Covid and what further changes might come from the adult social care review to consider what services the council might need going forward.

1.28      The committee noted this proposal without further comment.

B-12 - Adult Learning Lewisham – back office efficiencies

1.29      The committee noted this proposal without further comment.

C-12 - weight management

1.30      The committee asked for assurances that the outcomes of this change would be carefully monitored and that members of the BAME community would be involved in co-designing the new offer.

1.31      Officers confirmed that outcomes would be carefully monitored and that BAME people would be involved in co-design.

C-13 - Sexual and Reproductive Health Services in Primary Care

1.32      This proposal includes plans to limit the planned increase in LARC activity in primary care within a new reduced budget and to decommission the “check yourself” online testing service as there is now an online testing service for all ages.

1.33      The committee queried whether there would be any adverse impact of reducing LARC activity noting that Lewisham has historically has high rates of teenage pregnancies.

1.34      Officers noted that there would not be a significant detriment but agreed to monitor the details.

1.35      The committee also queried whether the increase in online testing capacity threatens the viability and capacity of in-person clinics in any way.

1.36      It was noted that there is always the chance that the provider makes a change if people choose not to use one sort of service, but the council is planning to work with LGT to have a block contract for the provision of sexual health services.  It was also noted that people are also entitled to use services across London.

C-14 - Substance Misuse Cuts (Public Health Budget)

1.37      This proposal has three parts: a cut to prescribing budgets through negotiating with Southeast London CCG; a reduction in the number of Tier 4 residential placements provided over the year; and a cut to the training and engagement budget.

1.38      The committee queried whether the reduction in residential placements would add pressure to hospitals.

1.39      Officers explained that residential placements are booked all around the country and that the number of places booked over the year would reduce by around ten.

1.40      Cllr Jacq Paschoud (speaking under standing orders) queried whether the cost of not providing a service would be greater than the saving from cutting the service.

1.41      Officers explained that the council would provide community-based treatment instead and that there is capacity to support the additional numbers. It was also noted that the outcomes are often better in community-based rehabilitation.

1.42      The committee noted this proposal without further comment.

C15 - Integrated Sexual and Reproductive Health Services

1.43      The committee asked for assurances that the change would be monitored and that the communications would be fit for purpose.

1.44      Officers noted that the council has very good links into the community which will help ensure the changes are monitored and communications effective.

1.45      The committee noted this proposal without further comment.

C-16 - Reduction of Management overheads for the Social Inclusion and Recovery Service (SLaM Lewisham Community Services)

1.46      As the council and its partners have developed the mental health alliance teams have been brought together and now needs fewer managers and back office functions allowing resources to go to front line.

C-17 - Re-configuration of MH Supported Housing pay – Social Interest Group

1.47      This proposal is a realignment of the contract to reflect the level of complexity the provider is now dealing with.

1.48      The committee noted this proposal without further comment.

C-26 – Reducing leisure spend – temporary closure of the Bridge

1.49      This proposal is to temporarily close the Bridge Leisure Centre in Sydenham pending the outcome of the new physical activity strategy. The Bridge has been closed since the Covid outbreak last March and due to changes to contracts is costing the council more than £500k a year to run. The centre also requires capital works to make it fit for purpose.

1.50      The committee noted local concerns about the absence of any leisure providers in this part of the borough and in particular the reduction in services such as swimming for children.

1.51      Officers noted that commitments have been made at Mayor & Cabinet to talk to local people and listen to their concerns to make sure their views are fully captured.

1.52      The committee noted this proposal without further comment.

C28 - Supported Housing Services

1.53      This is a proposal to develop alternative provision for parent and child and adult placements by working closely with colleagues across the council to develop a better model at a lower cost.

1.54      The committee noted this proposal without further comment.

F-24 – ASC review

1.55      Adult social care is the biggest single budget in the council and needs to make sure it is using its resources to best effect. Over last three years adult social care has moved towards a much more strength-based and asset-based approach that builds on community resilience and community resources. It has also built up arrangements with health partners which have delivered better outcomes, but there is more work that can be done.

1.56      The committee noted that there have been concerns expressed about the potential for outsourcing services and asked for assurances that any future employees not covered by TUPE would have comparable conditions of service, including receiving London living wage.

1.57      Officers noted that the decision on whether or not to outsource specific services will not be taken until more work has been done on the adult social care review.

1.58      A progress update on the adult social care review will be brought the next meeting of this committee.

Resolved: the committee agreed to refer its views to the Public Accounts Select Committee.