Report of the Senior Manager, Financial Services.

The Senior Manager, Financial Services (Andrew Roberts) introduced a report that summarised the initial financial forecast of the pooled fund in 2018/19, as at the end of Month 2 (31 May 2018).  It identified an initial forecast underspend of £0.2m, but also highlighted the risks posed by identified cost pressures brought to the pool of £3.4m.

The report also summarises the financial position of those areas being monitored ‘in shadow’ in 2018/19, against which there was an initial forecast underspend of £1.5m.  However, initial cost pressures of £20.3m had been identified against the shadow pool, predominantly due to the Clinical Commissioning Group’s (CCG) Quality Innovation Productivity and Prevention (QIPP).

This was the first report on Pooled Fund Finance for 2018/19 and Members were informed that regular reports would be provided for the JSCB.  The total funds contributed to the commissioning pool in 18/19 amounted to £131.1m as follows:

The Senior Manager reported that this was the first step to greater integration.  The Better Care Fund contribution to the pool had grown by £5.8m between 2017/18 and 2018/19 due to increases in the iBCF.  The Adult Social Care contribution was comprised of packages of care and income in respect of learning disability (LD) and mental health (MH) service users.  The Public Health contribution consisted of a range of services which were set out in the report. The Children and Young People’s contribution was made up of packages of residential care and long term care in schools for children with LD. The CCG’s contribution comprised packages of care for LD and MH service users as well as children’s Continuing Care and Personal Health Budgets. This figure was £0.8m less than reported at PFEG 10/05/18 due to budget realignments in Adult Social Care, prompted by the full completion of the Month 1 forecast.

The Senior Manager also reported that the initial forecast underspend of £0.2m was due to the Council’s initial income forecast in respect of joint funded income and client charges being slightly greater than had been budgeted for.  This would be monitored on a monthly basis and any significant changes reported as early as possible.

It was noted that all Public Health schemes were initially forecast to spend to budget this year. Children and Young People’s budgets were initially forecast to balance in the pooled fund, although work was continuing to identify any known pressures against these budgets. Both the CCG’s schemes and the Better care fund had an initial forecast to spend to budget in 2018/19.

The JSCB noted that the pooled fund had an initial forecast underspend of £0.2m for 2018/19.  However, a number of cost pressures had been identified in both the CCG and Adult Social Care, which would require mitigation.  They were detailed in the report.  Work was ongoing to quantify the mitigation identified against these pressures.  They would be shared with the JSCB as soon as they were confirmed.

Known mitigations include, but were not limited to:

·  Additional grant funding

·  More cost-effective commissioning

·  Application of the social care precept

·  Reviews of packages of care

The gain share on the pool had been agreed at 50:50.  The risk share to be applied to the pool in FY1 would be based on the cost pressures identified at the start of the year i.e. £1.5m Adult Social Care and £1.9m CCG.

The risk/gain share in FY1 of the pool was therefore confirmed as follows:

·  Risk Share: 56:44, weighted towards the CCG.

·  Gain Share: 50:50.

The total funds contributed to the shadow pool in 18/19 amount to £525.9m, as per the table below:

The JSCB considered the detail of the initial forecast for Month 2 of the shadow pool and noted that it had an initial forecast underspend of £1.5m for 2018/19.  This was comprised of a small overspend (£0.5m) over in Adult Social Care and a planned £2.0m underspend in CCG.  The overspend in Adults was due to an initial forecast of greater-than-anticipated demand for short-term care services, which would continue to be monitored on a monthly basis.

  More CYP/Public Health budget was expected to be added to the pool in 19/20; work was continuing with these departments to establish which services may be in-scope for pooling in future years.  Further details would be provided for the next meeting.

The JSCB was not asked to consider any other options.

A general discussion ensued around the following issues:

·  Inclusion in future of savings target plans.

·  Most of the QIPP is back loaded which brings with it certain risks.

·  The key purpose of the JSCB is to develop a sustainable service.  There is a need to focus on the management of risks and how to eradicate them.

·  There was little mention of Children’s Services in the report.

The NHS Wirral Members and Wirral Borough Council’s three Cabinet Members, sitting as a Committee of the Cabinet

RESOLVED:

That the financial position of the pool at 31 May 2018 be noted.