To consider any items which the Chair has agreed to have submitted as urgent.

The Chair introduced an item of urgent business by inviting Councillor Karney to speak to the recent proposal by Greater Manchester Mental Health Trust to close the café facility at the No. 93 Wellbeing Centre, Church Lane, Harpurhey.

Councillor Karney stated that the café at the site offered subsidised food and drink and was an invaluable resource for some of the most vulnerable residents in the community. He said that the closure of this provision would have a significant detrimental impact on the local community in North Manchester. He said the café should not be closed and he called on the relevant decision maker to review this decision. He said that he would be launching a campaign at the café to lobby for the saving of this valuable community resource.

The Executive Member for Healthy Manchester and Adult Social Care made reference to his contribution at the previous meeting where he had articulated his reservations regarding the approach taken by NHS Greater Manchester to funding decisions that impacted the Manchester Integrated Care System (See Minute ref. HSC/25/02 Integrated Care Systems). He stated that he had committed to writing to the Chair of NHS Greater Manchester to articulate those concerns and he would include the proposed closure of Café at No. 93 Wellbeing Centre as an example of those concerns and call for the café to remain open. He added that he would fully support any local campaign to save the café.

In discussing North Manchester a Member commented that he welcomed the recent announcement by the Secretary of State for Health and Social Care regarding the building of a new hospital in North Manchester. The Member paid tribute to the Executive Member for Healthy Manchester and Adult Social Care and the Leader of the Council for their continued lobbying on this important issue.

The Executive Member for Healthy Manchester and Adult Social Care welcomed the comments and placed on record his appreciation to the Leader and her predecessor, and the Chief Executive of Manchester Foundation Trust Hospital for driving this important project over the previous decade. He said delivery of this programme would deliver many social, economic and health benefits to the wider North Manchester area. He said that the Leader chaired the North Manchester Strategy Board that would oversee delivery of the project and North Manchester Councillors would receive regular updates and briefings as this programme of work progressed.

Decision

The Committee recommends that the Executive Member for Healthy Manchester and Adult Social Care and the Chair write a joint letter to the Chair of NHS Greater Manchester to articulate concerns regarding the proposed closure of Café at No. 93 Wellbeing Centre.

To approve as a correct record the minutes of the meeting held on 15 January 2025.

Decision

To approve the minutes of the Health Scrutiny Committee meeting held on 15 January 2025 as a correct record.

Report of the Executive Director Adult Social Care

This report provides the Committee with a summary update on the Manchester Safeguarding Partnership (MSP) Annual report 23/24.

The Committee considered the report of the Executive Director Adult Social Care that provided a summary update on the Manchester Safeguarding Partnership (MSP) Annual report 23/24.

Key points and themes in the report and accompanying presentation included:

·       Providing an introduction and background that described the statutory arrangements that governed the MSP;

·       Describing the Partnership arrangements in Manchester and the wider Greater Manchester network;

·       Information relating to communication and engagement activity;

·       Safeguarding effectiveness and scrutiny arrangements;

·       Safeguarding practice reviews;

·       The approach to learning and improvement;

·       The approach to complex safeguarding;

·       The approach to the issue of neglect; and

·       Summary, noting that the report provided an open and transparent view of the partnership activity for our citizens and practitioners.

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

·       Section 42 rates (Section 42 enquiries related to the duty of the Local Authority to make enquiries, or have others do so, if an adult may be at risk of abuse or neglect);

·       The future financial viability of the MSP;

·       How was adultification of children being addressed;

·       How were the findings of Safeguarding Adult Review used;

·       The importance of professional curiosity, noting that professional curiosity was where a practitioner sought to explore and understand what was happening in someone's life, rather than making assumptions or accepting what they were told at face value;

·       The importance of the Independent Scrutineer function; and

·       The role of General Practitioners (GP) in identifying safeguarding issues.

In response to specific questions the Executive Director Adult Social Care said that Adult Practice Review Panels were important as they assisted in establishing meaningful data and analysis, helped measure and report impact and informed subsequent training and learning. She said that in relation to Section 42 conversion rates, all referrals from the Manchester Adults Multi Agency Safeguarding Hub (MASH) were appropriately triaged. She commented that an audit of all those decisions was undertaken for quality assurance purposes. With regard to the financial viability of the MSP she stated that was a live issue and a regular item for discussion at the Leadership and Accountability Board meetings. She concluded by reiterating the message that safeguarding was everyone’s responsibility.

The Head of Safeguarding Adult Social Care said that Safeguarding Adult Review findings fed directly into the Safeguarding Effectiveness Group and Learning and Improvement Subgroup who ensured that lessons were learned, good practice shared, and improvements undertaken as appropriate. She also said that professional curiosity was a consistent theme and promoted widely across all practitioners. She also said that significant training and awareness on the issue of Adultification had been delivered and was included in the Child Friendly Policy. She further commented that cultural curiosity was also encouraged and considered, adding that larger organisations tended to have established strategies in regard to this. She said that the learning from Safeguarding Adult Reviews were also used to review equality and access to services.

The MSP Manager advised the Committee that the new Independent Scrutineer was now in post following a successful recruitment exercise,  ...  view the full minutes text for item 8.

Report of the City Treasurer

This report provides a high-level overview of the updated budget position. Each scrutiny committee is invited to consider the proposed changes which are within its remit and to make recommendations to the Executive before it agrees the final budget proposals on 19 February 2025. 

The Committee considered the report of the City Treasurer that provided a high-level overview of the updated budget position.

Key points and themes in the report included:

·       Providing an introduction and background;

·       Reporting that when the Council set its 2024/25 budget in February 2024, it was forecasting a budget shortfall of £29m in 2025/26 increasing to £41m in 2026/27 and £77m by 2027/28;

·       It was now expected that, subject to the outcome of the budget consultation a balanced budget could be set for 2025/26 after the application of savings approved in previous budget rounds of £10.6m, new proposed savings of £18.2m, and the use of c£18m smoothing reserves, alongside grant increases announced in the provisional settlement on 18 December 2024; and 

·       At the time of writing the report the final settlement had not yet been released, any changes between the provisional and final settlement would be reported to the Executive alongside any changes to the proposals outlined as a consequence.

The Executive Member for Finance and Resources addressed the Committee and said the Council was now expected to deliver a balanced budget for 2025/26 after the application of savings approved in the previous budget, new proposed efficiency savings of £18.2m that had been considered at the December meeting, the use of c£18m smoothing reserves, alongside grant increases announced in the provisional settlement on 18 December 2024 and an increase in Council Tax of 4.99%. He commented that whilst there would be a requirement to replenish an appropriate level of general reserves for the city and pressures still existed, particularly in relation to demand across Adult Social Care and Children’s Services, Manchester was in a much more financially stable position when compared to many other local authorities. He also commented that it was anticipated that the planned government Spending Review in the Spring would result in multiple year settlements for local authorities which he welcomed. He commented that following the positive settlement for Manchester that took into consideration factors such as need, deprivation levels and the low Council Tax base the core spending in Manchester had risen by 9.5% compared to the national average of 6%. He said that the government was committed to working with local authorities and reviewing the funding formulas, which he welcomed noting the cuts to public services and finances since 2010 under the previous government.

The Executive Member for Finance and Resources reiterated that the savings proposed were to be achieved through efficiency savings and increased income generation and not through cuts to frontline services. He said that the Council remained committed to making efficiency savings wherever possible. He further paid tribute of his political predecessors who had held responsibility for delivering the budget, the City Treasurer and his predecessor and the wider finance team.

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

·       Noting the significant impact austerity had on public services;

·       Thanking the Executive Member for Finance and Resources for his prudent stewardship of the Council’s budget during an incredibly challenging  ...  view the full minutes text for item 10.

Report of the Director of Public Health

This report provides a further update to members on the priorities for the services in the remit of this committee and details the proposed changes to the budget. Each Scrutiny Committee is invited to consider the proposed budget changes that are within its remit and to make recommendations to the Executive before it agrees to the final budget proposals on 19 February 2025.

The Committee considered the report of the Director of Public Health that provided an overview of services and their key priorities. A draft set of officer proposals to change the budget previously agreed last year in the context of the current financial challenges facing the Council was also included.

Key points and themes in the report included:

·       Providing an introduction and background, noting that the Department of Public Health led work with a range of partners to improve the health of the population of Manchester, protect residents from threats to their health; prevent and mitigate risks to support better health outcomes; and create the conditions in society and the environment that led to better health and reduce health inequalities;

·       Manchester’s Public Health Department prioritised multiple areas to improve the overall health and wellbeing of its residents;

·       Reporting that Manchester was growing at a rate that was twice the national average, driven in part by a significant rise in net national and international migration, a strong labour market and continued growth in city centre accommodation;

·       Consideration of Making Manchester Fairer, noting this was a broad and ambitious plan that had taken time to become established. In recognition of that, specific schemes were identified to ‘kickstart’ delivery of the plan, with a focus on improving health equity and exemplifying the Making Manchester Fairer principles;

·       Details of the service budget in the context of national and local arrangements;

·       The gross 2024/25 budget was £60.357m and the net budget of £45.129m. Income of £15.228m included use of reserves £1.731m, Better Care Fund £0.960m, contributions from NHS partners £3.327m, from other local authorities £1.414m and grants £7.796m;

·       In line with corporate requirements budget options were developed by officers in Autumn 2024 and proposals discussed at Health Scrutiny Committee on 4 December 2024. At that time the proposed options represented savings of £71k in 2025/26 and £453k in 2026/27;

·       Reporting that given the shift in the financial position and a more positive Local Government settlement, public health savings proposals were no longer being made for 2025/26 and 2026/27 at this stage. The plan for 2026/27 onwards would be reviewed when the detail of the Public Health Grant and Local Government Spending Review was known;

·       Discussion of public health commissioning and procurement priorities and identified risks arising to public health services and budgets from interdependencies with NHS GM finances at Locality level where there were known financial pressures;

·       Noting and welcoming the introduction of the Provider Selection Regime (PSR) that offered a flexible process for healthcare procurement to tailor contracts to local needs; and

·       There were no Manchester City Council workforce implications based on what was set out within the report.

In presenting the report, the Director of Public Health reported that since the report had been written the Public Health settlement for 2025/26 had been announced and this had resulted in an uplift of 5.4%, resulting in the Public Health budget for 2025/26 now reported at £49.43m, adding that due to complex joint NHS funding arrangements  ...  view the full minutes text for item 10a

Report of the Executive Director of Adult Social Services

The report provides an overview of the Adult Social Care Directorate service and budget strategy and the officer work on developing further cashable savings options for 2025-28.

The Committee considered the report of the Executive Director of Adult Social Services that provided an overview of the Adult Social Care (ASC) Directorate service, the budget strategy and the officer work on developing further cashable savings options for 2025-28.

Key points and themes in the report included:

·       Providing an introduction and background;

·       A service overview and priorities, noting that the ASC budget was invested in ensuring that Manchester citizens could stay independent, safe and well;

·       Describing the overall service and budget strategy, with particular reference to Achieving Better Outcomes Together;

·       Noting that the ASC budget strategy was predicated on managing and avoiding demand, and was delivering a combination of cost avoidance alongside cashable savings;

·       The gross 2024/25 budget was £317.066m and the net budget of £251.979m;

·       Income of £65.087m included client fees £33.971m, Better Care Fund Grant £18.872m, contributions from NHS partners of £9.324m and other income of £2.920m which included grants and use of reserves;

·       Detailed information on the 2024/25 In Year Financial Position, noting that the latest revenue monitoring to the end of December 2024 was a projected overspend of £10.654m an increase of £0.670m from the position reported in the December budget report;

·       The overspend was driven by long term care placements, transitions from children’s services and growing cost pressures which were outpacing demand management interventions;

·       Manchester was not an outlier in experiencing these pressures with growth in spend in line with benchmarks, including spend to budget across Core Cities and Greater Manchester authorities;

·       Past investment in preventative services meant that Manchester still spent proportionally less of its budget on ASC than benchmarked authorities;

·       Information relating to Government Grants and other income 2025-28;

·       Growth and pressures 2025-28;

·       Savings of £2.2m were previously approved for 2025/26 and were detailed in Appendix 1, noting that implementation plans were being developed and at this stage, there were no proposed amendments to this programme;

·       Information relating to additional savings options identified by officers;

·       Reporting that overall, the directorate budget would increase from £251.979m in 2024/25 to £277.068m in 2025/26 and reach £290.193m by 2027/28, reflecting additional demand as described above;

·       Establishment and investment, noting that Adult Discharge Fund in 2024/25 provided c £1m for additional investment with areas under consideration covering next phase of reablement expansion, the Technology Enabled Care offer and support to Carers;

·       Consideration of chargers and income;

·       Consideration of strategic commissioning and procurement priorities;

·       Workforce implications; and

·       Future opportunities, risks and Policy/Strategy considerations.

In presenting the detailed report to the Committee the Executive Director of Adult Social Services stated that every pound spent in Manchester was focused on delivering the best outcomes for Manchester.

The Executive Member for Healthy Manchester and Adult Social Care drew the Committee’s attention to section 3.8 of the report that detailed the Government Grants for 2025/28, adding that this represented a genuine commitment by the government to support local authorities.

Decision

To note the report.

Report of the Deputy Place Based Lead for Manchester, the Executive Director Adult Social Services, the Chief Executive – LCOs Manchester & Trafford and the Director of Public Health

This report describes the current progress in implementation of winter plans and a summary of pressures within the urgent care system.

The Committee considered the joint report of the Deputy Place Based Lead for Manchester, the Executive Director Adult Social Services, the Chief Executive – LCOs Manchester & Trafford and the Director of Public Health that described the current progress in implementation of winter plans and a summary of pressures within the urgent care system.

Key points and themes in the report included:

·       Providing an introduction and background, noting that in September 2024, the Health Scrutiny Committee and Executive had been presented with a forward view of the plans for this winter;

·       Information on winter priorities;

·       Information relating to Urgent and Emergency Care Recovery Funds and its allocation;

·       Discussion of Urgent Care pressures and performance;

·       Discussion of the Greater Manchester System Coordination Centre (GM SCC), the service that enabled oversight and situational awareness of clinical and operational pressures and risks in the Greater Manchester health and social care system and coordinated actions designed to mitigate pressure;

·       Organisational winter deliverables by organisation; and

·       Conclusions.

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

·       Describing a personal positive experience with the North West Ambulance Service when a relative had been taken ill recently and required medical attention;

·       Recognising the breadth of work and collaboration undertaken by all health and social care partners and services to deliver the best outcomes for residents;

·       Noting the relatively low take up of both flu and covid vaccinations and commenting upon the need to address the significant amount of misinformation that continued to be spread via social media;

·       Noting that some residents were having to attend different services to obtain different vaccinations, and this could be a barrier to people taking up the offer;

·       Noting the harms of not taking up the offer of a vaccination;

·       What was being done to reduce the number of mental health patients being placed out of area; and

·       Describing the positive experience at a pop up vaccination service delivered in a community setting.

The Director of Public Health stated that the challenge to increase vaccination uptake was acknowledged, adding that this was a national issue and not unique to Manchester. She said that a significant amount of work was delivered by the Local Care Organisation, Primary Care Network and Pharmacies to promote vaccination take up, including delivering outreach clinics in conjunction with other support services in community settings. She noted the comments regarding obtaining different vaccinations at different services and explained that this was as a result of the commissioning arrangements. The Associate Medical Director, NHS GM (Manchester Locality Team) accepted that these arrangements could be confusing for people and could be a barrier to take up rates and that this needed to be reviewed. She further added that as a practicing GP the approach was to ensure that every patient contact counted, and vaccination take up was a service that was actively promoted and encouraged.

The Director of Public Health reiterated the comments expressed by the Committee regarding the importance of dispelling the many myths and misinformation that were  ...  view the full minutes text for item 11.

Report of the Governance and Scrutiny Support Unit

This report includes details of the key decisions due to be taken that are relevant to the Committee’s remit as well as an update on actions resulting from the Committee’s recommendations. The report also includes the Committee’s work programme, which the Committee is asked to agree.

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.

Decision

The Committee notes the report and agrees the work programme.