Agenda item

6.1       The Director of Adult Social Care and Health (ASCH) introduced the report which marked the start of the Committee’s input into the 2024/25 RPPR cycle and provided a stock take of the Council’s position for scrutiny’s consideration ahead of more detailed planning for the 2025/26 financial year. The report contained as appendices relevant parts of the Council’s Year-End Monitoring Report, which highlighted achievements and challenges for services the Committee scrutinised, and the State of the County report which looked ahead at demographic, financial and policy trends and challenges. The Director informed the Committee that the Council was in a period of significant financial challenge, with ongoing pressures impacting on demand led services, and emphasised the important role of scrutiny in the RPPR process, including its input at the upcoming Committee awayday and the December RPPR Board which would consider any savings proposals and the impact of these on service delivery and outcomes, as well as financial implications.

6.2       The Director highlighted the key issues in ASCH, including the Department overspend for 2023/2024 and pressure on the Community Care budget due to an increase in complexity of need; increased pressures on NHS services; an increase in people aged over 65 in the county, and an increase in people aged over 85 who were more likely to need care and support; and increased levels of unsecured debt with people struggling to pay for contributions to their care.

6.3       The Director outlined the key priorities for ASCH in the 2024 State of the County report, including continuing to implement the Adult Social Care Strategy What Matters to You; developing of a new prevention strategy; continuing multi agency work on financial inclusion; and working with the NHS to deliver theintegrated care strategy and shared delivery plan, including the formation of Integrated Community Teams. The Department was also continuing to prepare for an upcoming Care Quality Commission assessment and responding to findings by the Local Government Association Peer Review undertaken in February 2024. Preparation for this visit, and subsequent findings, had identified key priority areas for the Department: prevention; waiting times; safeguarding; quality; and value for money.

6.4       The Director of CSD highlighted the key issues in Children’s Services, including an overspend in 2023/24, due to increased demand for and increased costs of children’s care placements; Home to School Transport; and the increased number of children with an education, health and care plan (EHCP). Although these challenges reflected national increases in demand and costs, the Department was responding locally by targeting early support to families, including through connected coaches and family practitioners, and was starting to see positive outcomes with reductions in the number of children on Child Protection Plans. The Department had increased in-house foster carers and had worked regionally to manage market challenges through a regional care cooperative. To address pressures on Special Educational Needs and Disabilities (SEND) support, the Department was continuing to work with schools to identify and support children with maintained provision in the county. The Director highlighted the challenges with attainment in East Sussex and informed the Committee of targeted support to schools in Hastings and Bexhill to improve outcomes. In response to increases in demand across all areas, the Department was working with partners in the community, and with ASCH, to ensure families were provided with the right offer.

6.5       The Director outlined the key priorities for CSD going forward in the 2024 State of the County report, including continuing to respond to increased demand and complexity across children’s care and SEND support; responding to national policies, such as Stable Homes Built on Love, as well as expected changes to SEND support and Home to School Transport; developing the safeguarding approach; and building on the success of Family Hubs.

6.6       The Chief Finance Officer outlined the key financial outlook in the report which set out a stark financial position, with appendix 2 showing a revenue overspend of £30m due to significant pressures in ASCH and CSD. The updated Medium-Term Financial Plan showed an increased deficit by 2027/28 of £83m, and current unallocated reserves at £16m. The Chief Finance Officer noted uncertainties in planning with a new government, but emphasised the financial situation was unsustainable, and the deficit meant the budget was in an unbalanced position for 2025/26; work therefore was underway with officers to seek opportunities to reduce the deficit. 

6.7       The Committee asked a number of questions regarding the information provided in the report including:

• Home to School Transport – The Committee enquired about work underway to seek savings in Home to School Transport, including the possibility of using the Council Flexibus service, and where appropriate, families making their own arrangements despite national requirements for the local authority to do so. The Director of CSD informed the Committee that Home to School Transport was being reviewed, including looking at route optimisation, the number of single journeys, use of personal transport budgets, and eligibility. The Lead Member or Education and ISEND agreed that this was an important issue to review, but noted the priority was to ensure the needs of children were appropriately met.
• Lobbying – The Committee discussed lobbying opportunities with a new government, including through the County Council Network, on local challenges such as areas of deprivation and areas with low employment in the county.
• Support for Carers – The Committee enquired about the drop in carer referrals to the short-term crisis intervention outlined in the quarter 4 monitoring report and asked if recent national issues with payments to carers was having an impact on carers seeking support. The Director of ASCH emphasised that the report outlined performance for the crisis intervention service which was targeted to carers in crisis such as a health issue, however the Department was working with carers to understand if the drop in referrals was due to improvements to people’s situations or carers needing a different type of support. The Department was also developing a prevention strategy which aimed to raise awareness of support services. The Director clarified that the Government provided carer’s allowance, but that officers did signpost carers to this support.
• Care placement costs – The Committee sought clarification on local authority and NHS funding for children’s and adult’s care where there were health related needs, in particular for high cost placements. The Director of CSD informed the Committee that young people often presented with social and mental health difficulties and challenging behaviours which meant they needed more costly care and noted that greater contributions from health partners to support these care packages would be welcome to improve outcomes for children and young people. There were ongoing discussions with partners on supporting children with complex needs with health funding. The Director also noted a reduction in Tier 4 beds across the county which had resulted in limited access to clinical residential support and that whilst social care would support children, there was a lack of clinical skills required to meet some children’s needs. The Director of ASCH noted increased high cost placements within ASCH, partly due to children with complex needs often needing ongoing, and sometimes intensive support once they became adults. The Director detailed the NHS funding frameworks to support health needs and noted the ongoing work with the NHS to ensure eligible individuals received appropriate funding and develop opportunities for joint funding for adults who did not meet Continuing Health Care eligibility criteria but still presented with complex needs.
• Prevention – The Committee enquired about ways people could be supported to avoid the need for care, including with changes to policy. The Director of ASCH informed the Board of the Council’s priority on prevention to prevent, reduce or delay the need for care and noted that the Department was working on a strengths based approach to identify and meet people’s needs and develop their abilities, including support provided by friends and family and community assets to avoid funded services and promote people’s independence.
• ASCH funding – The Committee discussed the current model for ASCH funding and noted that locally there were increased demands due to a higher number than average of older people in the county which funding should reflect. The Director of ASCH emphasised the increase in demand seen in referrals, assessments and safeguarding enquiries and noted the delays to national funding reforms to social care, which had been due to be implemented in 2025, and was awaiting developments.
• SEND – The Committee asked for more information about the increases in the number of children requiring SEND support. The Director of CSD informed the Committee that this was a national trend in response to lowering the threshold for EHCPs in 2014, and increases in complexity of need since COVID, which had exasperated the needs of children who were neuro diverse and those with social and mental health needs. Whilst East Sussex had lower numbers than other areas of the country, it was expected that these would increase which would put pressure on services including Home to School Transport. The Committee discussed that increases in complex needs would require high cost support which only limited providers would be able to offer.

6.8       The Committee RESOLVED to establish an RPPR Board to meet in December to consider the developing financial position for 2025/26 and draft Portfolio Plans and agree detailed comments on those to be put to Cabinet. The Committee agreed the Membership of the RPPR Board would be the whole Committee.

6.9       The Committee RESOLVED to note the report.