Agenda item

To consider the report of the Director of Public Health, Deputy Chief Executive and Director of Corporate Resources prior to the decision of the Executive Member for Public Health.

The Director of Adults’ Health and Care and the Director of Public Health provided a joint presentation on revenue and capital budgets including the breakdown for Social Care and Public Health.  Members heard:

In the last ten years Central Government funding for Local Authorities has reduced by a significantly greater amount (70% plus) when compared to funding for other Government departments over the same time period.  This has been the primary cause for the level of transformation reductions required by the County Council.

The County Council have continued with the mechanism for delivering savings previously used whereby savings are delivered in 2-year cycles with alternate year loss of funding being met from the Budget Bridging Reserve (formerly the Grant Equalisation Reserve).  The impact of Tt2021 proposals approved in November 2019 were factored into the presented 2020/21 budget.

While reserves may appear as a significant amount, allocations have already been committed with only a minimum reserve amount within guidelines remaining.

Transformation to 2021 programme targets and proposals have been approved and must be delivered alongside delivery of the residual savings required through Tt2019. The concurrent running of two programmes will be a challenge to the department and this is evident through the expected timeline of delivery for Tt2021 with significant saving scheduled to be achieved after 2021/22.  It is forecast that this planned delay in savings can be covered from departmental cost of change and centrally held contingency funds.

Members congratulated officers and the department as the challenges have continued to build.

The Director of Public Health shared departmental challenges and the increased demand for services.  Members heard:

Most Public Health services are commissioned out to NHS and other partners.  Life expectancy is rising but healthy life expectancy is not increasing.  Preventative effort and intervention are the focus with services that help people with smoking, sexual health, healthy weight, etc. 

The Public Health strategy has been signed off by Cabinet.  There is a need to ensure services that are delivered are clinically safe.  There are national, international, and local health protection issues to manager include influenza outbreaks, sexually transmitted infections.  Furthermore, the public health remit includes a system wide role of prevention leadership working alongside the NHS.  There is a new strategic partnership with Isle of Wight (IOW) to maintaining outcomes without detriment to Hampshire and managing Hampshire staff and resource pressures.

More information will be available by April in terms of the ring-fenced grant but currently leaves no clarity in planning budgets, with uncertainty and assumptions around spending Public Health reserves.  Savings are being delivered for lesser reliance on reserves than there have been in the past.  Delivery of new responsibilities will be challenging with reduced funding.

In response to questions, Members heard:

Hampshire faces particularly challenges tackling health inequalities linked to poor health outcomes. 

Public Health responsibilities include health visitor check including universal and more intense interventions for families who need it the most. 

Oral health in children is good in the county and new ways of working will include training nursery workers, supervised toothbrushing, etc. to support good oral health. 

Obesity will need a system approach and healthy weight continues to be a priority alongside smoking cessation, good nutrition, and empower communities for better mental health.  Work with the planning authorities is a key way to support the work being done to address obesity.

Public Health mandated functions are wide and varied, including comprehensive sexual health checks, mother and baby checks – following and pre-birth, oversight of outbreaks of disease, population health management with the NHS, National Childhood measurement program, NHS Health checks drug and alcohol services, etc. 

Members noted that prevention remains key to effective health services.

RESOLVED:

That the Health and Adult Social Care Select Committee consider the detailed budget proposals and -

1. Supported the recommendations being proposed to the Executive Member for Public Health.
2. Agreed any feedback or comments relating to the Select Committee’s recommendations for consideration by the Executive Member when making their decision.