Communities Committee

Transcription

1 Communities Committee Item No Report title: Finance monitoring Date of meeting: 16 November 2016 Responsible Chief Tom McCabe - Executive Director of Community Officer: and Environmental Services Strategic impact This report provides the Committee with information on the budget position for the Committee for It provides information on any forecast over and underspends and the forecast use of reserves. Executive summary The approved net revenue budget for this Committee is m. At the end of September, period 6, we are forecasting a balanced budget. The Capital budget for this committee is 6.467m. We are currently anticipating full delivery of the programme. The balance of Communities unspent grants, contributions and reserves at 1 st April 2016 was m. The current planned use of reserves are 4.712m and the details are reflected in the report. Recommendations: Members are invited to discuss the contents of this report and in particular to note: a) The revenue budget for b) The current risks being managed by Services. c) The capital budget for the capital programme. d) The balance and current forecast of reserves as shown in section 4 of this report and that if proposals for any further use of reserves in will be highlighted to this committee if the resulting forecast level of reserves falls below the 31 March 2017 balances anticipated at the time the budget was set. e) Members are asked to approve the current Public Health savings plan as set out in Appendix A. 1. Proposal 1.1. Members have a key role in overseeing the financial position of Communities services, including reviewing the revenue and capital position and reserves held by the service. Although budgets are set and monitored on an annual basis it is important that the ongoing position is understood and the previous year s position, current and future plans and performance are considered This monitoring report reflects the budgets and forecast position as at the end September 2016, period 6.

2 2. Evidence 2016/17 Revenue Monitoring 2.1. The table below summarises the budgets relevant to this committee as at September 2016 Table 1: Communities as at September, Period 06, /17 budget Forecast Variance '000 '000 '000 Community and Consultation Cultural Services 13,465 13,465 Active Norfolk* Cultural Services Management Norfolk Art Service Norfolk Community Learning Services Norfolk Libraries and Information Service 9,701 9,701 Norfolk Museums Service 2,422 2,422 Norfolk Records Office Customer Services 5,616 5,616 Public Health (1,330) (1,330) FIRE: Service Delivery 27,857 27,857 Resilience Trading Standards 1,872 1,872 Registrars (187) (187) Variance % Total for Committee 47,800 47,800 *Active Norfolk is wholly funded from grants and contributions including public health funding There are currently no forecast variances to the net budgets for the services however there are a number service risks that are being monitored and managed that could have an impact on the forecasts Public Safety - The major budget risks relate to the 0.100m grant reduction for USAR which is still forecasting a full year operational spend, water rescue including dive team 0.080m and Youth Development trading unit at 0.040m We have reported to members previously the risk around the anticipated funding gap for flood response capability from 2017/18 onwards, further details of the costs of those activities are shown below: Current flood response provision is comprised of the following elements: Water Awareness. Awareness training allowing emergency responders to develop an effective Dynamic Risk Assessment to establish safe systems of work, to operate in low level flooding and respond to water rescue as the first pump work. The cost is incidental and is captured within the 34,000 Flood First Responder costs below.

3 Flood responder training for crews to operate in and be competent to act in and around water and in flood emergencies. The training costs of 34,000 pa to maintain crew skill levels. Swift water rescue team (SRT): fast boat response for Norfolk s rivers and broads: in year acquisition and maintenance of competency training for our swift water operatives is 14,000 to 20,000 per annum. Every three years there is an additional 51,900 (aggregated 17,500 pa) spend on reaccreditation training for our surface rescue boat operators. This capability also forms part of the national response. These figures do not include capital requirements for specialist equipment, which would be subject to a separate corporate capital funding request to be considered as part of the budget setting process. Underwater search and recovery team / Dive Team: dedicated response to allow for underwater rescue at 3-10m. Costs of 110,000 pa with 35,000 income net cost of 75,000 to run To enable the service to continue to support communities in the event of a flooding incident, the service would need to provide the flood responder training to relevant crews supported by the swift water rescue team at an annual cost of 71,000 It is proposed that this could be funded from Fire Service reserves within 2017/18 whist the service continues to speak to Government in relation to additional funding. This would mean the cessation of the Underwater search and recovery/ dive team Library Services The Library service is closely monitoring the levels of sound and vision income, which are lower than historic trends. The service will continue to review the position and if required will report to committee any management action required Public health Public Health activities are currently funded via a ring fenced public health grant and is used to deliver a range of activities, some of which span financial years and will be managed through the use of reserves. The 2016/17 budget included a number of assumptions around the planned use of the reserves carried forward. Currently there are a number of forecast in year underspends, due to efficient management of contracts and provisions made for planned expenditure that are no longer required, which mean that the required amount of funding that needs to be drawn down from reserves will be reduced. This impact is shown in section 4 of this report Public Health continue to work with other parts of the organisation to support common objectives and public health outcomes. 3. Capital Programme The overall capital budget for the services reported to this Committee is 6.467m 3.2. The capital programme is shown in the tables below:

4 Table 2: Communities Capital Programme Scheme or programme of work 2016/17 capital Budget m 2016/17 Forecast capital Outturn m Total Forecast (under)/ over spend m Norfolk Fire & Rescue Service Museums Libraries Customer Services Strategy Committee Total Communities Reserves, Provisions and Unspent Grants/ Contributions 4.1. The committees unspent grants, reserves and provisions as at 1 st April 2016 stood at m The current forecast use of reserves are shown in the table below The use of Public Health reserves is to facilitate the agreed health projects programme and manage the delivery of large programmes over multiple financial years. Table 3: Communities Reserves & Provisions Reserves & Provisions 2016/17 Balance at 1 April 2016 Forecast Balance at 31 March 2017 Forecast movement reserves m m m Norfolk Fire & Rescue Service (0.944) Libraries, Museums, Record (0.397) Office & Arts Trading Standards Norfolk Community Learning (0.163) services Public Health (2.789) Active Norfolk Customer Services (0.165) Registration Services (0.216) Consultation & Community (0.191) Relations Committee Total (4.712) 4.4. The forecast movements include: Norfolk Fire and rescue Service Forecast use to fund planned training costs 0.064m, Equipment Costs 0.172m, planned ICT replacements 0.195m and Pension costs 0.248m. Libraries Forecast use of the monies brought forward from 2015/16 for investment in self-service technology

5 Public Health includes the proposed 2m use of reserves as highlighted in appendix A. The balance of 0.789, is the updated forecast of unspent grant required to fund the current levels of activity. This is a forecast reduction from previously reported to members and reflects a number of savings on contracts and budgeted provisions which are no longer required. 5. Financial Implications 5.1. The financial position for Communities services is set out within the paper. Officer Contact If you have any questions about matters contained or want to see copies of any assessments, e.g equality impact assessment, please get in touch with: Officer Name: Andrew Skiggs Tel No: address: Andrew.skiggs@norfolk.gov.uk If you need this report in large print, audio, Braille, alternative format or in a different language please contact or (textphone) and we will do our best to help.

6 Appendix A The Public Health budget is largely funded by a grant allocated from the Department of Health, along with a small number of sub-contract arrangements. Grant funding for 2016/17 is 41.1m. This is a reduction of about 8.8% below 2015/16. The grant will be further reduced by 2.5% in 2017/18; 2.6% in 2018/19 and again in 2019/ /17 ( m) 2017/18 ( m) 2018/19 ( m) Total Budget PH Grant Other Income Planned use of reserves The Director of Public Health is responsible for activities to: Improve the health and wellbeing of local populations Deliver public health mandated services Carry out health protection functions delegated from the Secretary of State Plan for, and respond to, emergencies that present a risk to public health Support the local Health and Wellbeing Board The local authority s public health response as a responsible authority under the Licensing Act 2003 The Government has made a commitment to retain the ring fence for the public health grant for 16/17 and 17/18 and then to replace the grant and move it to the Council s baseline through the Business Rate Retention scheme. The Government is not proposing to change the statutory prescribed functions for local authorities for 2016/17 or 2017/18. Public Health Budget The public health budget by service line was agreed by committee in January 2016, following the confirmation of the allocated grant in February The table below shows the current plan. 2016/ / /19 Total Net Budget ( m) By service line: Cross cutting subsidy into other directorates 1 Business and Staffing Children and young people Health improvement Sexual health and smoking Localities Drugs and alcohol Information & intelligence This is the additional cross cutting subsidy agreed by committee in October 2015.

7 Cross Cutting subsidies A number of cross cutting arrangements are either in place or proposed: Within the business and staffing service line there is a Shared Services contribution m recurrent, as agreed by committee in October This contribution in based on a KPMG formula and had not yet has not been revised since the reduction in staffing following the Public Health restructure. Given the reduction in the size of the public health department of about 30%, it may be timely to review this service charge. There is approximately 1.55m in 2016/17 and 750k for 2017/18 for cross cutting activity, which was agreed by committee in October This fund is largely spent in children s and adults services. In addition to the 1.55m cross cutting subsidy, a range of activity within service areas is either undertaken collaboratively with other directorates or reflects earlier transfer of funding from other directorates. Across the public health department this is estimated at about 1.1m. The largest beneficiaries are Adult Care and Children s drug and alcohol services. In addition a small amount of the grant is used with external partners: 32k in joint funding with district councils and Active Norfolk receive c 300k. A further 250k recurrently has been offered to Community and Environmental services to support additional savings required in 2017/18. On a non-recurrent basis a 2m contribution to the 2016/17 Council budget is proposed and was agreed by committee on 19 October 2016 Reductions being made/planned Due to the severity of the grant cuts there has had to be significant savings made to the services that Public Health currently deliver. The savings will impact on the Council s priority of supporting vulnerable people and on Public Health s aims and objectives. To deliver the budget for 2016/17 and 2017/18 a number of challenging reductions are proposed to services across the Public Health Directorate. These amount to cumulative savings from the baseline of approximately 8.01m by end 2018/19. The savings proposals must take into account any impact on the statutory duties of the Director of Public Health and on the mandatory functions. None of these savings are risk free as many are dependent on the provision of clinical staff already under contract and/or provided by a limited and specialist number of care providers. Some of the services are activity-based and so in year costs are subject to external demand which can be difficult to influence and accurately forecast. In considering ways to reduce spending a framework agreed by committee in January has been applied:- Seeking to reduce the risk of ill health that people might impose on others Paying special attention to children and young people Promoting health improvement by providing information and advice, and supporting people to make healthy choices Providing services to help people overcome addictions and other unhealthy behaviour Aiming to reduce ill heath by addressing environmental conditions working with district councils To identify specific savings the following strategic principles have been applied:

8 Reducing demand for services a strategic approach to prevention Value for money strategies Absorption, and prioritisation of what is absorbed, from the public health tasks the council already does (cross cutting subsidies) Application of public health technical skills in population needs assessment and data analysis The majority of savings in 2016/17 are in the process of being realised and officers are confident that the proposed savings will be achieved. They are coming from reductions in staffing, efficiencies generated from redesign of services, and tough renegotiation of current contracts, payments and procurement. (See table below for summary of savings and proposals.)

9 2016/ /18 Public Health Budget Net Budget 000's Reduction 000's Net Budget 000's Reduction 000's Comments Business and Staffing 4,020 1,103 3,947 1.The majority of savings came from the Public Health restructure which reduced establishment by approx 20 posts Further savings from staffing costs 2. Reduction in procurement costs 3. Proposed cessation of HIL's service Children and Young People 17, , Working with provider for HCP to identify efficiencies and reduction in incentive payments in first instance. 2. Reduction in Healthy schools staff by 0.8 wte 3. In year savings for activities not progressed 4. Home Start - a befriending service to vulnerable families to cease 5. Enuerisis service - responsibility transferred to CCG HCP - Working with provider to achieve efficiencies through redesign. Healthy Schools programme to cease and create a new specialist practitioner to achieve whole system approach 2. Reduction in Healthy Schools staff - as above 3.Home Start - as above 4. Enuerisis - as above Health Improvement 2,420 1,346 1, Negotiating reduced payment on physical activity with provider 2. Weight management limited service provided 3. Natural contract end of Health Trainer service 4. Health checks payment by results so variable service costs, estimated underspend in this year Reducing spend on campaigns and comms 1. Physical activity reduced payments.as above 2. Weight Management contract ending 3.Health checks payment by results so variable service costs, estimated underspend in this year Sexual Health and Smoking 9, , Working with the provider of the ICASH service to identify efficiencies. Level of proposed reduction agreed, redesign options being finalised to achieve reduction 2. Tobacco control reduced spend against variable costs. 3. Smoking cessation contract renegotiation to reduce spend. 4. Prescribing - Pharmacies/GP's -variable costs, payment by results estimate lower payment and renegotiation of payment by quit rates. 1. Smoking cessation contract coming to a natural end and recommissioning more efficient service with lower contract pricing envelope Localities Efficiency savings identified in current budget and increased joint partnership working reducing costs 1. Joy of Food Programme-increase in income to cover proportion of the cost of service 2. Healthy Living Pharmacies contract coming to a natural end. DAAT 8, , Saving of innovation money due to negotiation with provider 2. Saving in Detox provision due to natural end of contract and reprocurement 3. GP Shared care underspend forecast against current budget 4. Prescribing variable costs, payment by results estimate lower payments Reducing training to front line professionals and bursary for HE. 6. New sign up's to Primary care contract lower than estimated 1. A 6 month saving on existing contract due to reprocurement 2. Reduction of funding for post in NYOT 3. Natural end to contract for the Matrix service Proposed Savings 17/18 : Health Protection 1. Proposal to move the Health Protection and Infection control to CCG's and Infection Control Negotiated a reduction in licence fee for Dr Foster. As above PH Information and Intelligence Totals 41,673 4,665 39,555 2,118

10 Service Impact Some of the reductions proposed or being considered for 2017/18 are potentially contentious and it would be prudent to give wider visibility to these. They are:- Service Description Home The schemes support local families with young children Start by providing them with befriending, mentoring and signposting services, delivered by trained volunteers, who are parents themselves. Children services are lead partner and have decided not to continue to commission the service. This means that savings will be realised within the Public Health budget from our contribution Health Trainers Service HIL s Sexual Health Joy of Food towards this service. Health trainers help their clients to assess their lifestyles and wellbeing, set goals for improving their health, agree action-plans, and provide practical support and information that will help people to change their behavior. The contract is coming to natural end and it is proposed it will not be recommissioned. This decision was made in January and has been widely publicised already. The Health Information Leaflet service distributes public health materials to a range of places including GP surgeries, Pharmacies, hospitals, health centres etc. Consultation required on whether to continue to provide this service. The ICaSH service is an integrated service that provides contraception, sexual health, HIV and psychosexual health. There is a proposed reduction to the amount of the contract value that will impact on level of provision and is likely to require staff reductions. These savings are providing difficult to identify with the provider as they are likely to be difficult to implement. This service provides courses in food skills to increase confidence in budgeting, planning and preparing meals. Deliverability AMBER GREEN AMBER RED AMBER Further service reviews are being considered to deliver that savings required in 2018/19. As these service redesigns are further away the certainty with which they can be realised is lower. Service Description Deliverability 0 19 Healthy c 178k Children programme Two options are being considered, both are likely to be controversial with clinicians: 1. Ceasing the offer of an additional health check at 3.5 years currently delivered in GP surgeries. This is an innovation project that needs evaluated. 2. Reviewing staff and skill mix in the core 0 5 service as the national Call to Action requirements in the number of health visitors is lifted. Smoking Cessation c 500k needs to be identified We have made challenging estimates on the RED RED

11 Drug and Alcohol Services Reprocurement projected activity in stop smoking clinics and nicotine replacement prescribing costs based on falling numbers as e-cigarettes become more popular. C 1.4m needs to be identified either through service re-design with the current provider or a re-procurement of the service. A decision on strategy is planned for autumn AMBER Use of Public Health Reserves Reserves totalling 5.378m were in hand at the beginning of the 2016/17 financial year, based on the current level of forecast costs an estimate of 0.789m will be required to fund activity within 2016/17 leaving a balance of 4.589m. There is potential within the Public Health Grant accrued reserve to fund, on a non-recurrent basis, existing council services that contribute to a public health outcomes to the value of 2m; This is most likely to be within services provided by Children s and Adults (For example Early Help in Children s) to reflect the lag time needed for preventative interventions to have impact. Discussions with the relevant Executive Directors will take place over the coming month and the exact hypothecation of the funds will be reported to committee. The use of this grant money will have the effect of reducing the council s forecast overspend on the General Fund, and further integrating the delivery of Council priorities across committees. This proposal would leave a planned reserve of c 2.589m in 2017/18, depending on 2016/17 outturn. Work is underway to ensure that cost pressures, growth and risks have been adequately identified. There are potential pressures on the budget from national decisions such as responsibility for funding drugs, and within activity based contacts.