Agenda item

The Committee considered a joint report of the Director of Public Health and the Director of Corporate Resources which provided information on the proposed 2020/21 to 2023/24 Medium Term Financial Strategy (MTFS) as it related to the Public Health Department. A copy of the report marked ‘Agenda Item ‘9’ is filed with these minutes. 

The Chairman welcomed Mr. L. Breckon CC, Cabinet Lead Member for Health, Public Health and Sport, to the meeting for this item.

In introducing the report, the Director informed the Committee that the Public Health Grant for 2020/21 was expected to be increased in line with inflation plus 1%. However, the funding arrangements from 2021 onwards remained uncertain.

The Cabinet Lead Member informed the Committee that the Public Health budget was tight, but he felt that it represented the best value for public money.

Arising from discussion, the following points were noted:-

Proposed Revenue Budget

(i)          It was clarified that the figure for the proposed/provisional budget was calculated by taking the figure for the original budget, adding the budget transfers and adjustments and also adding proposed growth, before subtracting the savings that needed to be made within the department to facilitate spending elsewhere within the Authority.

(ii)         Approximately two thirds of the net budget for 2020/2021 was proposed to be spent on Sexual Health, Children’s Public Health 0-19 and substance misuse.

Savings

(iii)       To achieve the required £665,000 savings for 2020/21 it was planned to increase the capacity of the Programme Delivery Team to enable a reduction in the number of externally commissioned services. A review of staffing and the skills mix within the Public Health department would also take place as a number of Consultants were due to retire.

(iv)       The potential impact on service users as a result of service reductions was considered by the Public Health department and the policy of bringing more services in house had enabled the Public Health Department to better understand the consequences of decisions made. Public Health held joint Departmental Management Team meetings with colleagues from the Adults and Communities and Children and Families departments within the County Council which enabled potential issues to be identified and the impact of service reductions to be assessed. Public Health Consultants also attended a range of meetings with other partners, including Clinical Commissioning Group Governing Bodies, which enabled two-way discussion regarding the impact of service redesign to take place.

(v)        Work had taken place nationally to assess the impact of Public Health transition to local authorities.  Research carried out by the Local Government Association and by the King’s Fund presented a positive picture. The Public Health Outcomes Framework also showed that performance had not been affected by the transition.  However, it was not currently possible to monitor individual patient’s journeys and track their outcomes due to data protection issues.

(vi)       Savings would be made from the 0-19 Health Visiting and School Nursing Service through a freeze on recruitment and by making better use of digital technology, for example the last check on a newborn child could be undertaken electronically. The programme targeted towards high risk parents would no longer be provided by a separate team, which would result in some savings. The Director undertook to circulate details of the redesigned service to members following the meeting.

External Influences and Other funding sources

(vii)     At this stage many of the external funding sources for 2020/21 were assumed rather than confirmed but the ‘green’ rating for all but one of them indicated a high level of confidence that the funding would be received.

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 2020.