The Adult Social Care & Health Overview and Scrutiny Committee was scheduled to discuss the draft budget and financial plans for 2026/27, alongside plans to tackle health inequalities in North Bexley and expand the council's reablement offer. The committee was also set to review its work programme for the upcoming year.

Draft Budget and Financial Plans 2026/27

The committee was scheduled to consider the draft budget and financial plans for the Adult Social Care and Public Health Directorate for the 2026/27 financial year. This report highlighted proposals for investment in services, including contract inflation, growth, and pay inflation, totalling £23.815 million. It also detailed the current forecast for Adult Social Care and Public Health, which showed an overspend of £3.621 million as of November 2025. The report outlined savings expected from the Future Bexley programme, including customer experience and commercialisation initiatives. Service reviews were also conducted, with a focus on growth and inflation requirements for the directorate. The report detailed proposed changes to address these, including growth and contract inflation, alongside savings and mitigations. A significant portion of the budget is allocated to funding inflation uplifts for external providers, with £3.762 million set aside for Adult Social Care and Public Health. The report also touched upon key policy and legislative changes impacting the sector, such as the Employment Bill 2025 and the NHS 10-year plan, and outlined the capital programme and bids for Adult Social Care and Public Health, detailing planned expenditure and funding sources. Finally, the report addressed fees and charges, noting that Bexley has lower income from these compared to neighbouring authorities, and proposed an increase to reflect RPI.

Tackling Health Inequalities in North Bexley

This report was scheduled to provide an update on the North Bexley locality's Health Inequalities Fund Project, focusing on raising awareness of breast cancer and prostate cancer screening. Key population health headlines for North Bexley indicated it is the largest Local Care Network, with a diverse population and a high proportion of deprived neighbourhoods. The area experiences significantly lower cancer screening coverage than the Bexley average, particularly for Asian and Other ethnic groups regarding cervical screening. North Bexley also has higher cancer mortality and incidence rates than the England average. The report detailed the North Bexley Local Care Network's aim to improve health and care outcomes through integration and early intervention. It also explained that the Bexley Wellbeing Partnership received £536,000 from NHS South East London Integrated Care Board to tackle health inequalities, with North Bexley Local Care Network allocated £177,153. The project focused on improving screening uptake for breast and prostate cancer, with initiatives targeted at Black men and women. The report outlined the communication and engagement campaign, including the use of community cancer promotion champions and events in various locations. It also highlighted the strengthening of relationships between healthcare providers and local communities. The report was expected to present data indicating overall improvements in bowel and breast cancer screening uptake, alongside a slight decline in cervical screening. Lessons learned included the challenges of overcoming cultural and language barriers, the impact of limited resources for sustained outreach, and addressing misconceptions and fear related to cancer. The next steps proposed the commissioning of three Community Health & Wellbeing Coaches for socially deprived communities in North Bexley.

Plans to Develop an Expanded Reablement Offer and Approach

This report outlined proposals to expand Bexley's Reablement offer, detailing what would change, why expansion is required, and how it would be delivered. Reablement is described as a short-term, intensive, and person-centred intervention designed to help residents regain independence following illness, injury, or hospital discharge. The current Bexley service works in partnership with commissioned providers and an integrated Reablement Team. In 2024/25, the service delivered 1,743 episodes, with nearly 70% of those completing Reablement requiring no ongoing care. The proposed expansion aims to increase activity to approximately 2,000 episodes per annum, with a greater proportion of referrals from community and front-door pathways to prevent escalation into long-term care and reduce avoidable hospital admissions. A new Preparing for Adulthood pathway is planned for young people transitioning to adult services, focusing on life skills and confidence. Additionally, a more structured Mental Health Reablement pathway is to be developed, focusing on functional recovery, routines, and re-engagement with the community. The expansion is to be delivered in phases, aligned with workforce growth, and includes safeguards to ensure outcomes are not compromised. The report detailed the required increase in workforce capacity, estimating a need for 27 full-time equivalent posts to deliver the expanded offer, with an associated cost of £321,000. Financial modelling indicated potential cost savings from 2026/27 onwards, based on an average reduction in weekly care hours and a projected number of Reablement episodes. The expansion aligns with the Council's statutory duties under the Care Act 2014 to prevent, reduce, and delay the need for care and support.

Work Programme

The committee was invited to review and agree its annual work programme for the upcoming year, as detailed in Appendix A. This programme was determined based on alignment with key council and resident priorities, and where scrutiny could add value. The report noted that the programme would be iterative and subject to review as the year progresses. Members were also asked to consider if any further consultation was required on forthcoming policy framework decisions listed in the forward plan. The committee was to review the Bexley Status Report for Quarter 2 (July-September 2025), with a briefing note provided to assist in identifying key issues relevant to the committee's remit. The report also referenced the budget monitoring information, which was attached to the Draft Budget and Financial Plans report. Updates were provided on the work of the SEND Priority Action Plan Scrutiny Sub-Group and the South East London Joint Health Overview and Scrutiny Committee. A summary note of a briefing regarding a review of Prevention and Early Intervention grants to the voluntary sector was also included. Finally, the committee was to note the action tracker document for the committee. The SEND Priority Action Plan Scrutiny Sub-Group last met to discuss progress on SEND improvements, a projection pilot for therapy commissioning, and the use of the case management review system for EHCP reviews. The South East London Joint Health Overview and Scrutiny Committee had considered winter resilience planning and pressures across the SEL system, including primary care, acute flow, mental health trusts, and staff vaccinations. A briefing on the review of Prevention and Early Intervention grants informed members about proposed new 3-year grants from 2026-2029, with a focus on widening access for residents with Autism diagnoses. Members raised queries regarding the process for grant distribution, the challenges of evidencing impact in prevention, and the potential impact of wider cost pressures on small organisations. The committee was also to note planned reality checking visits to care homes and proposed work with adult social care service users to understand their experiences.