Agenda item

The Committee is asked to consider and comment upon the tailored performance report for the period April 2022 - March 2023.

Dr Shade Agboola, Director of Public Health introduced this item and gave a presentation to pull out the key messages. The report provided a retrospective summary of the Council’s performance at the year-end against the strategic priorities and areas of focus set out in the Council Plan 2022-2027. This report drew out relevant areas within the Committee’s remit from that presented to Cabinet on 15 June. Sections of the report together with detailed supporting appendices focussed on:

·   Performance against the Performance Management Framework

·   Progress against the Integrated Delivery Plan

·   Management of Finance

·   Management of Risk

The report provided a combined picture of the Council’s delivery, performance and risk. Overall, for the Council’s performance at year-end, there had been a consistently strong performance delivered. There were ten key business measures (KBMs) within the remit of the committee. A table set out the quarterly performance data, with seven of the KBMs assessed as being on track and three were not on track.

The report detailed key emerging themes. These included the impact of capacity and workload issues on service delivery and difficulties in recruiting and retaining staff in a highly constrained national and local labour market. Whilst there were some improvements at the year-end, there remained issues within specific service teams. The report included notable aspects of positive performance and the performance challenges experienced.

The report set out services’ projected performance trajectory. This was positive, in terms of delivery of the 30 Adult Social Care actions set out in the Integrated Delivery Plan, with 80% being on track and 20% completed.

One of the Council’s strategic risks related to Adult Social Care and Health directly and currently had a ‘red’ status. Two other red-rated strategic risks related to inflation and the cost of living, and the economy might impact on service provision and service demand. At the service level, two risks were rated ‘red’, being the risk of care market failure and the risk of an ongoing impact on Public Health resources of responding to Covid-19.

The presentation included slides on:

·   Council Plan 2022-2027: Strategic Context and Performance Commentary

·   Performance relating to this Committee

·   Area of focus: Support people to live healthy, happy, and independent lives and work with partners to reduce health inequalities 

·   Projection

·   Integrated Delivery Plan

·   Financial performance

·   Management of risk

Questions and comments were invited with responses provided as indicated:

• Clarification was provided on the business measures within the remit of the committee and each quarterly report included those where data was available.
• More information was sought about the percentage of people aged over 65, eligible to access adult social care services, who were supported in the community. Figures for this indicator were below the target level. Pete Sidgwick advised that the target was 60% and the level achieved was 59%. This was about the proportion of people going into a care establishment rather than being supported in their own home. The impact of the Covid pandemic was one contributor. The majority of admissions to care homes resulted from hospital discharge, rather than people transferring from community care to a care home. He spoke about the Community Recovery Service which should see more people return home rather than going into a care placement either on a temporary or permanent basis.
• The Councillor didn’t think the 60% target was sufficient but added that a target of 100% of people returning from hospital to home was not viable. Some would need ongoing care in an establishment and were unable to return home to recover. Mr Sidgwick explained that the target was for 60% of people to receive ongoing support at home and the remaining 40% would be supported in a care home placement. This target was for all care home placements purchased by the County Council.
• Context was sought on the 6.1% overspend of the Adult Social Care budget for the previous year. Furthermore, the budget projection for 2023/24 was questioned, together with any planned mitigation measures to avoid future budget overspend. Mr Sidgwick clarified that taking into account the additional monies received during this year, the net overspend was 0.5%. Social Care finance was complex, with individual payments and such things as the hospital discharge grant. It was expected that such additional funding would continue.
• A member sought information about the outcome measures where Warwickshire’s performance was notably behind the national average for school attainment levels for disadvantaged children and greenhouse gas emissions per capita. As this was outside the committee’s remit, officers would arrange for a briefing to be provided.
• Discussion about life expectancy and linked to this healthy life expectancy which for males was 62 years. A point about the low proportion of Warwickshire people using public transport, compared to the data for the region and nationally. This was outside the committee’s remit.
• A member revisited the issue raised at the April Committee, about the successful completion of treatments for opiates and non-opiates. He thanked officers for the subsequent briefing note provided.  The live data via the PowerBI platform indicated that both this area (opiates) and smoking prevalence were increasing. He asked whether this was due to a lack of engagement with the programme, or other causes. Dr Agboola responded with extracts from the circulated briefing. There was evidence that the position was improving. Shade spoke about the targeted grant funding to increase the number of placements into treatment and prescription of medication. The feedback suggested that people were remaining engaged with the treatment. It may take some time but was expected that the position would improve. The member sought an indication of the timescales, which was difficult to assess. An offer was made to seek more information from the service provider, but the member did not want officers to undertake further work on this area.

Resolved

That the Committee considers and comments, as set out above, on the year-end organisational performance, progress against the Integrated Delivery Plan, management of finances and risk.