Agenda and minutes

There were no declarations of interest made by members.

Section 33 legal agreement for the frailty service.

Context:

The committee were presented with the Gwent Frailty Programme Section 33 Renewal, which informed members on the proposal to review and renew the Section 33 agreement (Health Act 1999) between Aneurin Bevan University Health board and the five local authorities– Blaenau Gwent, Caerphilly, Monmouthshire, Newport and Torfaen.

Sufficient information would be received by the five organisations as part of the collaboration agreement.  S33 was not appended to the report but would be available if required by members.

The report had been considered by the joint partnership and would be subject to the scrutiny and executive process. 

Key Issues:

The Gwent Frailty Programme (GFP) is a transformational programme between the five neighbouring local authorities in the former Gwent area and Aneurin Bevan University Health Board (ABUHB). Its aim is to provide services to frail people across the area in a way that is person centred and focused on the needs of individuals, rather than organisations. It is regarded by the Welsh Government as one of Wales’ iconic projects, and has been backed by repayable Invest to save funding of £6.3 million.

Gwent Frailty has been developed in recognition that many aspects of current models of health and social care provision are unsustainable and that more effective whole system working is necessary to address increasing demand for services which meet frail individuals’ needs.

The five local authorities (Blaenau Gwent, Caerphilly, Monmouthshire, Newport and Torfaen) engaged in the Frailty Programme with Aneurin Bevan University Health Board (ABUHB) agreed a Section 33 agreement from 2011/12 – 2013/14.

The formula for funding agreed was that ABUHB agreed to contribute 77% of the additional investment required, with the other 23% additional investment agreed to be contributed by local authorities.

The formula for I2S payback was in simple terms based on the anticipated savings each of the partners would receive from the investment. For local authorities that was expected to be in terms of reduced packages of care and care home beds. For ABUHB savings were expected from reductions in bed day usage.

The review of the programme has also been guided by two external reviews, the Cordis Bright Review (commissioned by the GJFC in July 2014 and previously reported to Adult Select Committee), and the Wales Audit Office (WAO) review published in December 2015 (and to be reported to Adult Select Committee’s across the whole partnership at a date to be arranged)

The WAO report (Dec 2015) concluded that...’the Programme has demonstrated positive regional cross-sector partnership working to tackle growing community based needs, but it has not evidenced tangible outcomes, which will be important as partners determine the future of the Programme.’

The Cordis Bright review:

The GFJC received and confirmed the report and 4 key challenges emerged from the review:

·         Acknowledgment that cash releasing savings were unlikely, but cost avoidance may have been achieved.

·         The need to shift to a consistent service model across Gwent, based on the most effective evidence based approach.

·         The need for better information and performance capture to  ...  view the full minutes text for item 2.

To scrutinise the financial position for the directorates within the committee’s remit.

Context:

The purpose of this report is to provide Members with information on the forecast revenue outturn position of the Authority at the end of reporting period 3 which represents month 9 financial information for the 2015/16 financial year.

This report will also be considered by Select Committees as part of their responsibility to,

• assess whether effective budget monitoring is taking place,

• monitor the extent to which budgets are spent in accordance with agreed budget and policy framework,

• challenge the reasonableness of projected over or underspends, and

• monitor the achievement of predicted efficiency gains or progress in relation to savings proposals.

Key Issues:

Specific issues were highlighted which were relevant to the Adults Select Committee:

·         A £162k potential overspend needs some further analysis to understand the underlying position. This overspend includes £620k overspend in relation to non-school redundancy costs (which are still subject to member approval). Setting these one off costs aside would reduce the over spend to an underspend of £458k.  However, the position reported above also includes £778k of underspends relating to reserve funded projects which are now going to be deferred to 2016/17. Taking this into account results in an over spend of £320k overall and a £1.096 million overspend in net cost of services.

·         Bulk of overspend is within Childrens Services and addressed at a corporate level.  Adult social care, increased income generation from current vacancies which are being held. 

·         Compensated by overspends (Mardy Park and Severn View).  £95k budget mandate to be considered (additional payments), met wholly by Adults select mandate. 

·         Performance against mandate savings, 274k sitting within adults select and have been achieved 100%.

·         One note of caution, over the next 2 years will be required to achieve savings and work over and above existing budgets.   Requirement to look at significant achievements that have been made this year. 

·         Areas relevant to Adults select were moving in the right direction and no areas of concern.

·         In summing up, officers highlighted that the directorate were on track, £136k would be delivered for year end.  All mandate savings had been achieved, however, further savings to be achieved in 2016/17 and 2017/18, this should not detract from the good work that had been undertaken by officers within the directorate. 

Members Scrutiny:  

• Officers were commended in relation to work that had been done and savings that had been achieved. 
• A member requested clarification regarding what reduced income related to due to falling long term clients.  Officers responded that this related to the transformation of Mardy Park and the decreased number of long term paying clients, which had resulted in a direct loss to income streams.

·         A member queried whether work force planning was in place.  Officers confirmed that this was an issue, with an ageing workforce, key employees with significant expertise were planning for retirement.  Succession planning was regularly considered by the directorate, this was a challenge for management and a transition period would be required.  There was recognition for the high calibre of  ...  view the full minutes text for item 3.

To discuss a position update

Context:

The Adults Select committee were presented with a report, the purpose was to update Adults Select Committee members of the on-going development of Mardy Park Resource Centre [MPRC] as set out in the review report and Adult Select Committee report September 2015 and to seek endorsement for the recommendations set out below prior to Cabinet reports in April 2016.

Key Issues:

1.    A brief background to the review, themes and outcomes is given in Appendix 4 of the report.

2.    Following approval from Cabinet in October 2015, work commenced to implement the recommendations of the review (Appendix 1). Individual work streams were established (including staffing, rehabilitation services, short breaks, community development & involvement) with representation from the staff teams, partners, elected members and others to deliver the finalised models of service delivery.  Work to implement the recommendations of the review is progressing well and a brief update will be given in committee.

3.    We are a critical point in implementing the staffing and accommodation work streams and approvals are now required to move forward with implementation.

4.    The staffing at Mardy Park is disproportionate to the needs of the service. It is necessary to reduce the staffing complement to support the new models of service delivery.

5.    Current infrastructure does not support the development of integration and place based services. Accommodation is limited and has an impact on the well-being of staff and their ability to undertake all necessary duties.

6.    Current accommodation places limits on our ability to work with partners in the Aneurin Bevan Health Board and to develop co-located services that provide seamless, rather than disjointed, services to the people of Abergavenny

Member Scrutiny:

Following the presentation of the report Members were invited to comment:

• Members of the committee commended the facility and welcomed the update report on Mardy Park and recognised that helpful engagement meetings had been held over the past 2 years.
• We welcomed that communication and understanding had improved and developed through engagement with the select committee.
• A member highlighted that the service required further promotion.  Officers reassured that this had been done, through newspaper articles and the Communications team.
• Clarification was requested regarding staff implications.  The committee were informed that 7 out of the 9 redundancies were voluntary.  There would be opportunity for redeployment and redundancy would be last resort.
• A member recognised the need to build on the links with end of life care pathway.  Officers confirmed that they were dedicated to develop a specialist support network, which supported the good work delivered by community re-ablement service.
• The committee welcomed further discussion with the Cabinet Member and Leader to progress the issue and dialogue with health board.

Recommendations:

1.    That ASC endorse the on-going development of Mardy Park Resource Centre as a community hub supporting the health and well-being of the Bryn-y-Cwm community.

2.    That ASC support the application for a call on reserves of £105,000 to fund expected redundancies as a result of the service redesign.

3.    That ASC support  ...  view the full minutes text for item 4.

We received the Adults Select Committee work programme.

We noted that the next ordinary meeting of Adults Select Committee would be held on Tuesday 8^th March 2016 and 10.00am.