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

The Deputy Director of Adult Social Services addressed the Committee to inform Members that following a delivery model assessment a 'Decision in Principle' had been taken to return Adult Mental Health statutory functions and duties from Greater Manchester Mental Health Foundation Trust (GMMH) to the Adult Social Care Directorate working with the Manchester Local Care Organisation.  

The Deputy Director of Adult Social Services said that the Directorate continued to work collaboratively with both GMMH and those staff concerned to ensure a safe transfer, and a report containing information on the new delivery model would be submitted for consideration to the 15 January 2025 meeting of the Committee.

The Executive Member for Healthy Manchester and Adult Social Care made reference to the Manchester Evening News article, published 4 December 2024 that reported that the recent Care Quality Commission (CQC) inspection rating of GMMH remained inadequate. He said that the decision in principle had been taken prior to the publication of the most recent CQC inspection report.

The Committee endorsed the proposals described by the Deputy Director of Adult Social Services.

Decision

To note the verbal update.

To approve as a correct record the minutes of the meeting held on 6 November 2024.

Decision

To approve the minutes of the Health Scrutiny Committee meeting held on 6 November 2024 as a correct record.

Report of the Manchester Local Care Organisation

This report presents an update on the progress of the Manchester Local Care Organisation’s Community Health Transformation Programme.

The Committee considered the report of the Manchester Local Care Organisation (MLCO) that provided an update on the progress of the MLCO’s Community Health Transformation Programme.

Key points and themes in the report included:

·       Providing an introduction and background;

·       Noting that this was a multi-year programme focused on reducing variation in and between community health services in Manchester, ensuring equality and equity of access to services to effectively tackle health inequalities and ensure best use of resources directed to population need;

·       The Programme further supported the delivery of the vision for the Manchester Local Care Organisation;

·       Consideration of the delivery of the transformation priorities identified for 2023/24;

·       Discussion of the opportunities to deliver change and enhance service delivery using digital technology;

·       In-year reprioritisation, noting that in year budget pressures being experienced across Manchester Foundation Trust resulted in the MLCO recently reviewing its Value for Patients (VfP) Programme, noting that it set out how savings would be delivered in-year, and recurrently;

·       Discussion of national and local strategies; and

·       Summary.

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

·       Recognising and welcoming the achievements and improvements described; 

·       Consideration needed to be given to the language used in reports to ensure that they were accessible to the lay reader;

·       Any future update reports on this activity need to articulate the improved health outcomes for residents;

·       What were the lessons learnt form the Manchester Royal Infirmary/Central Discharge Pilot; and

·       What was the planned approach to delivering Palliative Care. 

The Chief Executive, Manchester Local Care Organisation said that she noted and accepted the comments expressed in relation to the style of the report. She commented that a report could be submitted to the Committee at the appropriate time that fully described how the Adult Social Care, NHS and VCSE partners and systems were working together to achieve the best outcomes for residents. She commented that there was a significant amount of work ongoing on the issue of digital connectivity, noting that this had been a significant technical challenge, however there existed good working arrangements between health and social care teams across the city. She said that in terms of lessons learnt, she commented that the MLCO continued to reflect and review all activities and referred to the Manchester Royal Infirmary/Central Discharge Pilot as a recent example of where the learning from this was now embedded in improved hospital services.

The Director of Performance & Operations, MLCO commented that the Manchester Royal Infirmary/Central Discharge Pilot was a good example of improved systems achieved by health and social care partners working collaboratively to achieve improved outcomes for residents. He acknowledged the Social Work team who had helped deliver this pilot. He commented that in respect to Palliative Care a report would be submitted to the 5 March 2025 meeting of the Committee that would provide further information on the work to deliver this service in community settings.

The Executive Member for Healthy Manchester and Adult Social Care commented that the report submitted was a strategic  ...  view the full minutes text for item 46.

Report of the City Treasurer

This report provides a high-level overview of the latest budget position for the Council in respect of its 2025/26 budget. Each scrutiny committee is invited to consider the officer developed options which are within its remit and to make recommendations to the Executive before it agrees to the final budget proposals in February 2025.

The Committee considered the report of the City Treasurer that provided a high-level overview of the latest budget position for the Council in respect of its 2025/26 budget. Each scrutiny committee was invited to consider the officer-developed options which were within its remit and to make recommendations to the Executive before it agreed to the final budget proposals in February 2025.

The Executive Member for Finance and Resources referred to the points and themes in the report that included:

·       Noting that the Council was forecasting an estimated budget shortfall of £101m in 2025/26, £126m in 2026/27, and £164m by 2027/28;

·       Mitigations approved in previous budget rounds included approved savings of £32m, the use of c£18m smoothing reserves in each of the three years, and a Council Tax increase of 4.99% (c£11m) a year. After these mitigations the gap reduced to £29m in 2025/26, £41m in 2026/27 and £77m by 2027/28;

·       Noting that councils faced a funding gap of £6.2 billion over the next two years, and this needed to be considered in the context of an estimated £24.5 billion in cuts and efficiencies in service spending that councils had made since 2010/11;

·       Noting that over the same period the Council had delivered over £440m of savings;

·       The 2023/24 outturn position reported to Executive 5 June 2024, reported an overspend of £5.3m. The second monitoring report of 2024/25 was considered by Executive on 13 November, reporting a forecast overspend of £20m. The ongoing implications of this overspend must be considered as part of the budget setting process;

·       Consideration of the Government’s Autumn Statement, noting that a key headline for Local Government was that Core Spending Power would increase by 3.2% in real terms in 2025/26;

·       Noting that Ministers had indicated additional funding would be targeted through a deprivation-based approach; and

·       A summary of the budget position, noting that the final budget position for 2025/26 would be confirmed at February 2025 Executive. This would be after the Finance Settlement was received and key decisions confirming the Council Tax and Business Rates tax base to be used to determine the collection fund position had been made in January.

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

·       The ongoing confidence in the Executive Member for Finance and Resources in delivering a balanced budget;

·       Noting that any agreed budget proposals would be subject to Equalities Impact Assessments; and

·       Noting the social determinants of health and that Manchester was committed to being a Marmot City the Chair welcomed any additional funding would be targeted through a deprivation-based approach.

Decision

To note the report.

Report of the Director of Public Health

This report sets out an overview of the services within the remit of this scrutiny committee and their key priorities. A draft set of officer proposals to change budget previously agreed last year in the context of the current financial challenges facing the Council is also included.

The Committee considered the report of the Director of Public Health that provided an overview of the Public Health Directorate service and budget strategy and the officer work on developing further cashable savings options for 2025-28 to contribute to the balancing of the overall Council budget. Final options would be proposed following the announcement of the provisional Local Government Finance Settlement, expected prior to Christmas.

Key points and themes in the report included:

·       Providing an introduction and background;

·       Service overview and priorities, noting that Manchester’s Public Health Department priorities focused on multiple areas to improve the overall health and wellbeing of its residents;

·       Service budget and proposed budget changes;

·       Commissioning and procurement priorities;

·       Making Manchester Fairer, noting that the need to tackle inequalities in the city continued to be a corporate and political priority;

·       Workforce implications;

·       Equality and anti-poverty impact; and

·       Officer-developed options for 2025-2028, noting that these had been developed so that the Directorate could meet its statutory duties and maximise benefits to Manchester’s residents.

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

·       Further information was sought in relation to the additional funding for drug and alcohol treatment and smoking services and support allocated to Manchester by the Department of Office of Health and Disparities (OHID); and

·       How were outcomes and improvements measured in absolute numbers. 

The Director of Public Health said that the additional funding for drug and alcohol treatment and smoking services and support had enabled CGL (Change Grow Live), the commissioned provider to increase their capacity to increase outreach and support services, adding that they had been able to mobilise quickly in response to this grant funding. She commented that this service was a “gold standard” specialist stop smoking service.

The Director of Public Health said in relation to the question regarding performance data and outcomes that the budget report that would be submitted to the 12 February 2025 meeting would contain further details. The Executive Member for Healthy Manchester and Adult Social Care directed the Member to the report that had been considered at the 4 September 2024 meeting that discussed Long Term Conditions and described the work underway in Manchester to improve health outcomes

and address health inequalities in the prevalence and management of long-term health conditions through the work of the Population Health Management Board

and the Long-Term Conditions programme overseen by the Manchester Provider

Collaborative.

The Executive Member for Healthy Manchester and Adult Social Care paid tribute to the Director of Public Health, noting the significant challenges presented in delivering a balanced budget due to the complex joint funding and grant arrangements that existed.

Decision

To note the report.

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 Directorate service and budget strategy and the officer work on developing further cashable savings options for 2025-28 to contribute to the balancing of the overall Council budget. Final options would be proposed following the announcement of the provisional Local Government Finance Settlement, expected prior to Christmas.

Key points and themes in the report included:

·       Providing an introduction and background;

·       An overview of services and priorities;

·       Providing a description of the ‘Achieving Better Outcomes Together’ strategy;

·       An overview of the budget strategy, noting that the ‘Achieving Better Outcomes Together’ strategy would move us from Strengths-Based practice into a Strengths-Based System;

·       Service budget and proposed changes;

·       Details of the savings plan 2025-28;

·       Discussion of growth and pressures in 2025-28;

·       Information on Government Grants and other income in 2025-28;

·       The implications of the Care Uplift 2025/26 and Market Sustainability Improvement Fund;

·       Charges and income;

·       Establishment and investment;

·       Strategic commissioning and procurement priorities;

·       Workforce implications;

·       Consideration of the Equality and Anti-Poverty impact; and

·       Future opportunities, risks and policy/strategy considerations.

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

·       Noting that the report was very clearly written and presented; and

·       More information was sought in relation to analysis currently underway to understand the financial implications of the Care Uplift.

The Deputy Director of Adult Social Services stated that the consultation on the Care Uplift was ongoing, adding that Manchester was committed to paying the real living wage. She said that work continued with the City Treasurer and colleagues in the finance team to understand and model the implications of the National Insurance contributions changes. She commented that the provisional Local Government Finance Settlement, expected prior to Christmas would further inform this work and further detail would be provided in the budget reports scheduled for consideration at the 12 February 2025 meeting.

The Executive Member for Healthy Manchester and Adult Social Care stated that the spending of every Manchester pound was taken very seriously, and he referred to report that described that the Achieving Better Outcomes Together strategy included a strong focus on demand management and cost avoidance as well as delivering core practice responsibilities to support Manchester residents. He said that he attended regular meetings to review and monitor this activity. He also referred to the section of the report that described that the number of home care packages were increasing whilst residential care was reducing, thus helping people to remain living safely in their homes and neighbourhoods where appropriate to do so.

Decision

To note the report.

Report of the Assistant Chief Executive

This report provides an update on the development of the new Our Manchester Strategy for the city covering the period 2025 to 2035. It builds on a previous report to Scrutiny Committees in July 2024. This report summarises the second round of engagement activity, the findings that are most relevant to the work of the Committee, and includes an overview of the new strategy.

The Committee considered the report of the Assistant Chief Executive that provided an update on the development of the new Our Manchester Strategy (OMS) for the city covering the period 2025 to 2035. It built on a previous report to Scrutiny Committees in July 2024.

Key points and themes in the report included:

·       Providing an introduction and background, noting that the OMS 2025 was the ten-year strategy for the city and was due to expire in 2025;

·       Providing a summary of the second round of engagement activity;

·       The findings that were most relevant to the remit of the Committee;

·       An overview of the new strategy, noting that the OMS would focus on twelve priorities over the next ten years; and

·       Following formal approval, the OMS 2025-20235 would be launched in April 2025.

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

·       Noting the relatively low figures presented in relation to the question asked about the priority about climate change;

·       Was there an opportunity to provide free text when people were responding to the questionnaire and was this recorded;

·       Noting the analysis of the responses provided at section 8.2 of the report, was granular; and

·       ‘Priority 1: Our people will be supported to be happy, healthy and active from childhood to adulthood’ needed to include specific reference to Manchester being an ACE-aware and trauma informed city.

The Assistant Chief Executive stated that the Council had a distinct and unique civic leadership role on the issue of climate change. He said that the Council had made significant progress in reducing its own carbon emissions and that the new Manchester City Council Climate Change Action Plan for 2025-30, that was currently being developed would include specific consideration of communications and resident engagement. He said that appropriate consideration had been given to the wording and framing of the consultation questions, particularly in relation to the issue of climate change. He further commented that the OMS Strategy was a high level strategy that articulated the priorities and ambitions for the city, and this would inform specific Council strategies. He said that an implementation plan would also be devised to accompany the OMS. He further advised that free text had been captured and incorporated into the analysis.

Decision

The Committee recommend that ‘Priority 1: Our people will be supported to be happy, healthy and active from childhood to adulthood’ needed to include specific reference to Manchester’s ambition to be an ACE-aware, trauma informed and trauma responsive city.

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.

Decision

The Committee notes the report and agrees the work programme.