To approve as a correct record the minutes of the meeting held on 12 October 2022.

Decision

To approve the minutes of the meeting held on 12 October 2022 as a correct record.

Report of the Director of Public Health

This year the focus of the Public Health Annual Report continues to be on the City’s response to Covid-19, capturing our response during the second year of the pandemic. This report is a successor to the 2021 Annual Report, The Manchester Difference. The two are designed to be viewed together as a complete reflection on the most acute stages of the pandemic and the beginning of our efforts to recover, from January 2020 to August 2022.

The Committee considered the report of the Director of Public Health that explained that, as part of the statutory role of the Director of Public Health, there was a requirement to produce an annual report on the health and wellbeing of the local population, highlighting key issues.

The Committee were informed that the annual report could either be a broad overview of a wide range of public health programmes or may have a focus on a particular theme. This year the focus continued to be on the City’s response to Covid-19, capturing our response during the second year of the pandemic. This report was a successor to the 2021 Annual Report, The Manchester Difference. The two were designed to be viewed together as a complete reflection on the most acute stages of the pandemic and the beginning of our efforts to recover, from January 2020 to August 2022.

Some of the key points that arose from the Committee’s discussions were: -

·         To place on record their continued confidence, support and appreciation to the Director of Public Health and all of his team;

·         Stating that the report was excellent and was testimony to the importance of public services;

·         Recommending that this report be shared across all directorate leads as an example of best practice when reporting activity;

·         Supporting the person-centred approach evidenced throughout the report;

·         That cuts to public services resulted in increased deaths, adding that it was important that the national enquiry recognised this important point; and

·         Recognising the important decision taken in Manchester to test patients for COVID prior to them being discharged to a care home setting, noting this this important decision taken locally had saved lives.

In introducing his report, the Director of Public Health paid tribute to all those professionals and volunteers across the city who had responded collectively to the pandemic. He commented that the report would be submitted as evidence to inform the national inquiry into the pandemic. 

The Director of Public Health stated that the decision taken locally by Manchester and Trafford to introduce testing prior to a patients discharge from a hospital into care home was captured in Volume 1 of the report, adding that this also would be submitted as evidence to the national inquiry. The Committee were advised that following final sign off, the report would be submitted to the national archives; printed copies made available in public buildings; published online and in different formats, including braille and other languages. 

In response to a specific question regarding the legacy of the Sounding Boards, the Director of Public Health described these as being a positive legacy of the pandemic. He said that resources had been secured to continue these models, adding that these were recognised as an important vehicle to reach different communities on a range of public health issues, such as screening services.

The Executive Member for Healthy Manchester and Adult Social Care welcomed the report and stated that it was excellent both in terms of content, style and  ...  view the full minutes text for item 104.

Report of the Deputy Chief Executive and City Treasurer

This report sets out the financial challenge facing the Council, the latest forecast position, and the next steps. The Council is forecasting an estimated budget shortfall of £44m in 2023/24, £85m in 2024/25, and £112m by 2025/26. After the use of c£16m smoothing reserves in each of the three years, this gap reduces to £28m in 2023/24, £69m in 2024/25 and £96m by 2025/26.

This report sets out the high-level position. Officers have identified potential savings options to reduce the budget gap totalling £42.3m over three years.

Even after these proposals there remains a budget gap of £7m to close to get to a balanced budget in 2023/24 and further savings options will be developed between now and January 2023 and be reported back to Scrutiny committees in February. Each scrutiny committee is invited to consider the current proposed changes which are within its remit and to make recommendations to the Executive before it agrees to the final budget proposals in February 2023.

The Committee considered the report of the Deputy Chief Executive and City Treasurer that set out the financial challenge facing the Council, the latest forecast position, and the next steps.

Key points and themes in the report included:

·         The Council was forecasting an estimated budget shortfall of £44m in 2023/24, £85m in 2024/25, and £112m by 2025/26. After the use of c£16m smoothing reserves in each of the three years, this gap reduced to £28m in 2023/24, £69m in 2024/25 and £96m by 2025/26;

·         Setting out the high-level position;

·         Describing the officer identified potential savings options to reduce the budget gap totalling £42.3m over three years;

·         Noting that even after these proposals there remained a budget gap of £7m to close to get to a balanced budget in 2023/24 and further savings options would be developed between now and January 2023 and be reported back to Scrutiny committees in February; and

·         Each scrutiny committee were invited to consider the current proposed changes which were within its remit and to make recommendations to the Executive before it agrees to the final budget proposals in February 2023.

The Executive Member for Healthy Manchester and Adult Social Care introduced this item by giving an account of his personal experience of accessing social care to support a family member. He stated that his experience, both as a resident accessing services and as an elected Member, was that all staff across the service genuinely cared about the residents of Manchester and every decision taken by officers had this as their primary consideration.

The Executive Member for Finance and Resources stated that the reports presented were currently officer proposals only. He stated that the Government’s Autumn Statement and final financial settlement were still to be announced. He stated that the public consultation on the Council’s Budget had commenced and would run until 7 January 2023, adding that difficult decisions would need to be taken and it was important to hear the views of Manchester residents. He commented that the financial situation the Council found itself was not the fault of the Council, adding the Council was a well manged and financially responsible organisation and this could be evidenced. He stated that the fault was the direct result of ideological decisions taken by the government over the previous decade. He stated that the budget cuts imposed on Manchester had been unfair. He stated that since 2010 Manchester had lost £438m from the budget and if Manchester had received the average cuts to funding the city council budget would be £77m per year better off. He stated that it was calculated that the gap in Local Authority funding nationally was in excess of £3bn, adding further that it was estimated that one in six councils could run out of money next year. He called upon the government to protect councils as these drove local economic growth and provided essential services for some of the most vulnerable in society, especially in the context of the worsening cost of living  ...  view the full minutes text for item 105.

Report of the Director Public Health and Interim Deputy Place Based Lead (Manchester)

The Council is forecasting an estimated budget shortfall of £44m in 2023/24, £85m in 2024/25, and £112m by 2025/26. After the use of c£16m smoothing reserves in each of the three years, this reduces to £28m in 2023/24, £69m in 2024/25 and £96m by 2025/26. Officers have identified potential savings options to reduce the budget gap totalling £42.3m over three years.

This report sets out the priorities for the services in the remit of this committee and details the initial revenue budget changes proposed by officers.

Even after these proposals there remains a budget gap of £7m to close to get to a balanced budget in 2023/24 and further savings and cuts options will be required to be worked between now and January and be reported back to Scrutiny committees in February. Each scrutiny committee is invited to consider the current proposed changes which are within its remit and to make recommendations to the Executive before it agrees to the final budget proposals in February 2023.

This item of business was considered in conjunction with the Adult Social Care Budget report.

Report of the Executive Director of Adult Social Services

The Council is forecasting an estimated budget shortfall of £44m in 2023/24, £85m in 2024/25, and £112m by 2025/26. After the use of c£16m smoothing reserves in each of the three years, this reduces to £28m in 2023/24, £69m in 2024/25 and £96m by 2025/26. Officers have identified potential savings options to reduce the budget gap totalling £42.3m over three years.

This report sets out the priorities for the services in the remit of this committee and details the initial revenue budget changes proposed by officers.

Even after these proposals there remains a budget gap of £7m to close to get to a balanced budget in 2023/24 and further savings and cuts options will be required to be worked between now and January and be reported back to Scrutiny committees in February. Each scrutiny committee is invited to consider the current proposed changes which are within its remit and to make recommendations to the Executive before it agrees to the final budget proposals in February 2023.

The Committee considered the report of the Director Public Health and Interim Deputy Place Based Lead (Manchester) and the Executive Director of Adult Social Services that explained that these reports were the first in the cycle for the budget programme 2023-26. They set out an overview of the services within the remit of this scrutiny committee and the key priorities. The budget growth assumptions in the Medium-Term Financial Plan were set out. The report provided a draft set of officer proposals for further savings for 2023-26, developed in the context of the financial challenge facing the Council, for comments by Health Scrutiny.

Key points and themes in the report included:

·         Providing an overview of the service and priorities;

·         A description of the service budget and the proposed changes;

·         Describing the proposed savings programme;

·         Workforce implications;

·         Equality and Anti-Poverty Impact; and

·         Future opportunities, risk and policy considerations.

Some of the key points that arose from the Committee’s discussions were: -

·         Welcoming the very personal testimony given by the Executive Member for Healthy Manchester and Adult Social Care, adding that this evidenced how Councillors were aware of, and responding to the challenges experienced by many Mancunians;

·         That budget cuts imposed on the city had detrimental impacts on health outcomes and reduced the life expectancy of many Mancunians;

·         That continued budget cuts had a direct impact on the wider determinants of health outcomes; and

·         The importance of recognising that budget cuts had been imposed each year on the city for over ten years.

In response to a question regarding the savings proposal of £270k in Children’s Public Health the Director of Public Health explained that the commissioning intention was to review and revise the service model and specification. This would be co-designed with stakeholders including the Local Care Organisation and the Strategic Director of Children and Education Services. He stated that the intention was to protect frontline services. He advised that monitoring of all decisions would be undertaken by the Local Care Organisation Accountability Board.

In response to specific savings proposals related to transport services; access to day services and extra care charges, the Executive Director of Adult Social Services stated that any proposed changes would involve conversations with affected individuals and their families and that an Equalities Impact Assessment would be undertaken for each eventual budget decision taken, noting that a further report on the budget proposals would be presented to the Committee at their February 2023 meeting. The Committee further noted that the Better Outcomes Better Lives programme, an invest-to-save programme of service delivery, would continue to be reported to the Committee along with other transformation work.

In response to a comment regarding workforce, the Executive Director of Adult Social Services commented that the importance of this was fully understood, adding that despite the continued challenges there was a strong and positive culture amongst the workforce. She added that the staff were the best asset she had and paid tribute to them. She further commented that Manchester was contributing to the  ...  view the full minutes text for item 107.

Report of the Executive Director of Adult Social Services

This report provides an overview of the adult social care charging reforms and brief progress update on working towards implementation.

The Committee considered the report of the Executive Director of Adult Social Services that described that the social care white paper set out government plans with regard to adult social care funding reform. A revision to charging thresholds and the introduction of a care cap were due to take effect from October 2023. Progress was being made to fully understand the detailed requirements and make preparations covering process, establishment capacity and systems.

Key points and themes in the report included:

·         A Fair Cost of Care programme had been undertaken in accordance with government requirements and the returns submitted accordingly;

·         The results of this exercise would inform the government of the total likely cost;

·         Funding for this change was to be funded from the health and social care levy (National Insurance) increase which had since been reversed by Government. However, they had committed to continue to invest the £13.8bn;

·         The Council had assumed that the reforms would be fully funded from the £13.8bn and was therefore cost neutral;

·         Failure to fully fund the changes from central government resources would present a significant financial risk to the Council with the implementation and transition arrangements impacted; and

·         Further updates would be provided to the Committee into 2023 as the work progressed and specifically to cover the required policy changes.

Some of the key points that arose from the Committee’s discussions were: -

·         Recognising that the work described had been very intensive for officers; and

·         Welcoming the brevity of the report, adding that it was succinct and very informative.

The Deputy Executive Director of Adult Social Services commented that the majority of the work involved had been delivered within existing teams and resources, adding that the exercise had been informative. The Executive Member for Healthy Manchester and Adult Social Care paid tribute to the work delivered by the Deputy Executive Director of Adult Social Services. The Committee were advised that update reports would be provided to the Committee during 2023, adding that any changes to adult social care funding would be communicated nationally and staff appropriately updated as to any changes once finalised. 

Decision

To note the report.

Report of the Governance and Scrutiny Support Unit

The monthly report includes the recommendations monitor, relevant key decisions, the Committee’s work programme and items for information. The report also contains additional information including details of those organisations that have been inspected by the Care Quality Commission.

The report of the Governance and Scrutiny Support Unit which contained key decisions within the Committee’s remit and responses to previous recommendations was submitted for comment. Members were also invited to agree the Committee’s future work programme.

The Chair advised the Committee that a report on Gambling Related Harms would be included on the Work Programme for consideration at the 7 December 2022 meeting.

A Member requested that the report listed for the 7 December 2022 meeting on Learning Disability also provides information on the local response to the recent CQC report that looked at what people with a learning disability and autistic people experienced when they needed physical health care and treatment in hospital. The Committee supported this recommendation.

A Member also discussed the need to scrutinise the provision and delivery of acute health services across a range of activities. The Chair stated that she would discuss the most appropriate way to progress this with the Executive Member for Healthy Manchester and Adult Social Care.

Decision

The Committee notes the report and agrees the work programme, subject to the above comments.