The Health and Adult Social Care Overview and Scrutiny Panel met to receive an update on the performance of adult social care in Plymouth. Councillors were also due to be provided with an update on the financial position of the NHS in Devon.

NHS Finances

Councillors were scheduled to receive a report on the finances of the NHS Devon Integrated Care Board. The report pack included a report from the Deputy Chief Finance Officer of the ICB, Kirsty Denwood. This reported that the Board had received funding that would allow it to balance its budget for 2024/25. However, it raised concerns about the financial sustainability of the Board in future years, stating that at the planning stage risks of £88m were identified . £17 million of these risks were mitigated through actions taken at the planning stage, but Ms Denwood's report stated that gross risks by month 6 have reduced to £94m . This means that more risks have emerged since the initial budget was submitted in June.

At the planning stage risks of £88m were identified of which £17m were mitigated, resulting in a net risk of £71m. Gross risks by month 6 have reduced to £94m, driven in majority by risks relating to the efficiencies programme resulting in a net risk of £35m which is an improvement of £6.1m on month 5.

- Kirsty Denwood, Deputy Chief Finance Officer, NHS Devon ICB, NHS Devon ICS Finance Update

The report also stated that, despite receiving £80 million of funding to plug a hole in its budget, the Integrated Care Board would still need to make £213.3 million of efficiency savings in 2024/25. By August 2024 only £66.6 million of these savings had been found.

Adult Social Care Performance

Councillors were scheduled to review a report on the performance of Adult Social Care in Plymouth.

Demand for Care

The report pack included a report on the performance of Adult Social Care. This reported that there had been 8,240 requests for support from new clients between April 2023 and March 2024, and that 3,449 people had started receiving long term support from Adult Social Care during this period.

Waiting Lists

The report noted that the number of people waiting for an assessment for care, or for their care to be reviewed, had been increasing since July. Between July and September 2024 the number of people waiting more than 30 days for their initial assessment to be completed increased from 738 to 721. In the same period, the number of assessments waiting to be allocated to a case worker increased from 590 to 620. And the number of people waiting for a review of their care fell from 365 in July to 216 in September. The report stated that Livewell are addressing this and trying to reduce the waiting time with a planned focused day in December 2024 to reduce the number of overdue referrals over the 5-day target .

Residential and Nursing Care

The report pack included data that showed that between April and September 2024 the number of people aged over 65 receiving residential care in Plymouth had increased, and the number of people receiving nursing care had decreased. This is consistent with the Integrated Care Board's stated aim of supporting people to live in their own homes for longer.

Domiciliary Care

The report stated that the number of people receiving domiciliary care in Plymouth had increased slightly. It stated that we have undertaken further analysis to support understanding and have noted that 7.4% of people in receipt of domiciliary care are Intermediate placements . Intermediate care is designed to help people recover after a stay in hospital and regain their independence, and these placements often involve a stay in a residential care home.

We will commence engagement with providers in December 2024 to support our development of plans, for the future commissioning model. This will support maximising our choice for people who use our services and build and understanding of ‘local’ provision.

- Adult Social Care Performance Report

Direct Payments

The report showed that the number of people receiving direct payments to pay for their own care had reduced from 641 in June 2024 to 624 in October. Direct payments give people more control over their care and support, and are a key part of the government's plan for adult social care.

Mandatory direct payment training for all Advanced Practitioners - Livewell Southwest staff will commence January 2025. With the plan to increase the DP numbers and improve the confidence of staff when discussing the option of using Direct Payments.

- Adult Social Care Performance Report

Reablement

The report included information on the performance of the reablement service in Plymouth. It showed that there had been a slight increase in the number of people receiving reablement at home, and that the average length of time people were receiving reablement for was 5.7 weeks. The report noted that Currently the Reablement service only supports people following an admission to hospital, but we have plans to open up the service to community referrals to avoid unnecessary hospital admissions for those who can remain safely at home.

Staff Sickness

The report pack included a report on staff sickness in the Adult Social Care department. This reported that the average number of days lost to sickness per employee in the department in the 12 months leading up to October 2024 was 19.06. This means that on average each employee was off sick for more than 3 working weeks during that period. The report also stated that there had been 188 short term absences of less than four weeks, and 42 long term absences of more than four weeks.

Recommissioning of Care Homes

The committee was scheduled to receive a report on the recommissioning of care homes in Plymouth. The current contracts for residential and nursing care homes in Plymouth are due to expire in December 2025. The council is working with NHS Devon to recommission these services. The report provided an update on the work undertaken so far, including engagement with care home providers, staff and residents. The report highlighted that the quality of Plymouth's care homes is high, with 86% rated good or outstanding. The report also provided details of the council's vision for care homes in Plymouth, which includes:

A care home that is my home, where my family, friends and loved ones are welcomed, where my voice can be heard and is listened to.

- Slides - Recommissioning of Care Homes

Maternity Care at University Hospitals Plymouth NHS Trust

Councillors were scheduled to receive a report on maternity care at University Hospitals Plymouth NHS Trust.

Health and Adult Social Care Policy Brief

Finally, the committee was scheduled to note a report on the government's latest policy announcements and legislation relating to health and social care. This included the government's plans to:

• deliver plans for new neighbourhood health centres
• create a single patient record, summarising patient health information, test results, and letters in one place, through the NHS App
• modernise mental health legislation and give patients sectioned under the Mental Health Act more dignity and say over their care
• phase-out the sale of tobacco products across the UK to anyone aged 15 or younger this year
• clamp down on temporary workers in the NHS
• hold Senior NHS managers who fail to improve patient care accountable
• legally require public bodies procuring goods and services for the NHS to both identify and mitigate risks of modern slavery
• protect NHS whistleblowers
• support unpaid carers
• unlock the secure and effective use of data for the public interest.

The report also provided an update on the government's vision for adult social care, which was set out by the Minister of State for Care at the National Children and Adult Services Conference in Liverpool in 2022.