Agenda item

Medium Term Financial Strategy 2016/17 - 2019/20

 

The Committee considered a joint report of the Director of Public Health and Director of Corporate Resources which provided information on the proposed 2016/17 to 2019/20 Medium Term Financial Strategy (MTFS) as it related to the Public Health Department. A copy of the report marked ‘Agenda Item ‘8’ is filed with these minutes. 

 

The Chairman welcomed Mr E F White CC, Cabinet Lead Member for Health to the meeting for this item.

 

In introducing the report the Director of Public Health and Cabinet Lead Member advised that the Department’s overall approach was to redesign services where possible to improve outcomes as well as saving money.  The Department had an exemplary track record of delivery in this area which gave confidence that the proposed savings were deliverable, although it was acknowledged that there would also be some risks associated with the projects.  In some cases the work to deliver savings during 2016/17 was already underway.

 

In response to the financial challenge it was facing, the Department was focused on:-

 

• Services that made the biggest impact such as those to improve the health and wellbeing of children;
• Early help and prevention to reduce demand for service and ease the pressure on the health and social care system.

 

Arising from discussion the Committee was advised as follows:-

 

Service Transformation

 

(i)        The Department was keen to encourage community involvement in the delivery of appropriate services, as outlined in the Annual Report of the Director of Public Health for 2015.  It was intended that this approach would sit outside formal voluntary sector arrangements and would empower communities to take responsibility for their own health and wellbeing.

 

Proposed Revenue Budget

 

(ii)       The Committee was disappointed to note that the grant allocation for 2016/17 from the Department of Health had not yet been confirmed.  However, it welcomed the Department’s pragmatic approach to setting its budget using estimates.

 

(iii)      The contribution to other County Council preventative services made by the Public Health Department would be reviewed as part of a comprehensive approach to early help across the Council aimed at bringing all preventative spend together.

 

Savings

 

(iv)      PH2 – Reduction in Health Checks

 

The Health Check programme was statutory; however the fees that the County Council paid to GPs for carrying out Health Checks were at the higher end of the national range.  There was some risk attached to this saving as any reduction in fees would be dependent on the outcome of negotiation with GPs.

 

(v)       PH4 Review of Physical Activity Services and Contracts

 

It was intended that the physical activity service would be focused on delivery; to that end the reduction in funding to district council was expected to cease the funding of physical activity co-ordinators.  It was recognised that this was not an efficient use of funding and district councils were already working to identify alternative service models.  The reduction in funding would not affect high impact services such as exercise on referral schemes or the infrastructure provided by Leicester-Shire and Rutland Sport to support physical activity across Leicestershire.

 

(vi)      PH6 Review of Smoking and Tobacco Services and Contracts

 

It was acknowledged that the increased usage of e-cigarettes and the time-intensive nature of current smoking cessation services meant that there had been a reduction in activity.  The smoking cessation service would therefore be redesigned to be more cost effective and to take international best practice into account.  The intensive services such as one-to-one or group sessions would still be available, but only for targeted groups such as Looked After Children.  These would be supported by universal telephone or web based services which would be less resource intensive and emerging national and international evidence showed that them to be effective.

 

A future service redesign, currently proposed for 2017/18, would involve integrating all lifestyle services, such as substance misuse and obesity services as well as smoking and tobacco services, into a single lifestyle behaviours service.

 

Capital Programme

 

(vii)    The warm and healthy homes scheme was funded through an external grant following a successful bid for funding. The County Council’s spend on the project would be delivered through the Papworth Trust, although the Trust would not provide services.  There were a number of ways in which vulnerable people could access the scheme, including through the Lightbulb Project, in-house service, district council services or those provided by a charity.

 

RESOLVED:

 

(a)  That the report and information now provided be noted;

 

(b)  That the comments now made be forwarded to the Scrutiny Commission for consideration at its meeting on 27 January 2016.