The Adult Social Care and Public Health Cabinet Committee met on Wednesday, 21 January 2026, to discuss the draft revenue and capital budget for Adult Social Care and Public Health, alongside updates on performance and key strategies. Decisions were made regarding the adoption of the Suicide and Self-Harm Prevention Strategy, the recommissioning of drug and alcohol services, contract extensions for carer support and learning disability services, and proposed fee uplifts for adult social care providers.

Verbal Updates by Cabinet Member, Director of Public Health and Corporate Director

Diane Morton, Cabinet Member for Adult Social Care and Public Health, began by thanking officers and staff for their dedication, particularly highlighting the efforts over Christmas and New Year. She acknowledged the significant pressures on adult social care, including rising demand and complexity of needs, and outlined the draft budget as a responsible plan that meets statutory duties while investing in prevention. Key initiatives mentioned included the Kent enabled a home approach to support independence, piloting technology drop-in sessions in libraries, and strengthening joint brokerage with the NHS for hospital discharge.

Dr. Andrew Ghosh, Director of Public Health, outlined five strategic priorities for public health: prevention, tackling health inequalities, mental health, and refreshing the Health and Wellbeing Board. He highlighted specific areas of focus for the year, including Accident and Emergency pilots, social prescribing, and the public health aspect of Family Hubs investment. Dr. Ghosh also mentioned the upcoming launch of the first coastal Marmot Place in the UK, aimed at addressing health inequalities in coastal communities.

Sarah Hammond, Interim Corporate Director of Adult Social Care, provided an update on efficiencies and market analysis, noting the considerable pressures on adult social care due to increased demand and complexity. She highlighted the draft budget as a responsible plan that meets statutory duties while investing in prevention and long-term change.

Draft Revenue, Capital Budget and Mid-Term Financial Plan for Adult Social Care and Public Health

The committee discussed the draft revenue and capital budget for Adult Social Care and Public Health for the forthcoming year. Brian Collins, Deputy Leader of the Council, presented the overall briefing, noting that the budget proposals aim to set a balanced revenue budget. He detailed spending pressures, savings plans, and income generation, with the net increase funded by central government grants and council tax. The capital programme includes a significant increase funded by external sources or existing planned borrowing.

The majority of spending growth is allocated to adult social care (£89.6 million), children's services (£50.3 million), and environment and transport (£21.7 million). These figures include base budget changes, provisions for future increases, contractual price uplifts, and increased demand on council services. The report acknowledged that spending growth significantly exceeds available funding, necessitating savings and income generation.

Concerns were raised by Councillor Stuart Jeffery regarding the assumption of stabilised demand and costs after a period of unprecedented growth, questioning the empirical evidence for this and requesting backup plans. Officers expressed confidence in reaching a peak in demand and highlighted that cost drivers are partly outside the council's control but can be influenced by fee levels and provider frameworks. The budget was acknowledged to carry significant risks, particularly in adult social care and special educational needs, with mitigation strategies outlined.

Councillor Andrew Kennedy raised concerns about the care sector, questioning the appropriate profit base and the transparency of the re-tendering process for residential care. He also inquired about the potential for care providers to seek judicial review and the implications of smaller care homes closing down. Officers explained that the budget is based on forecasts and that general reserves are held to mitigate risks.

Performance Dashboard

Victoria Tovey, Assistant Director for Integrated Commissioning, presented the Public Health performance for commissioned services for Quarter 2 of the year (July to September). Out of 14 key performance indicators (KPIs), eight were rated green, four amber, and two red. The report highlighted that two key performance indicators were not available at the time of writing due to data return timelines. Positives included exceeding the target for new birth visits delivered by health visiting and a steady increase in substance misuse services. Areas of concern included young people exiting specialist substance misuse services with a planned exit and engagement in deprived areas for the lifestyle service.

Suicide and Self-Harm Prevention Strategy 2026-2030

The committee considered the draft Suicide and Self-Harm Prevention Strategy for 2026-2030. The existing strategy (2021-2025) has contributed to a slight fall in local suicide rates while national rates have increased, and the Kent and Medway Suicide Prevention Programme has been nationally recognised. The new strategy, developed in conjunction with the Suicide Prevention Network and based on national guidance, underwent public consultation and received wide approval. The strategy aims to reduce the number of suicides in Kent and Medway to below the national average by 2030. Councillor Oliver Bradshaw raised questions about mandatory referral systems for domestic abuse and concrete plans for referring individuals to secondary health services. Officers confirmed that domestic abuse is a significant factor and that plans are in place to improve coordination.

Kent Drug and Alcohol Services

The committee discussed the recommissioning of the Kent Drug and Alcohol Inpatient Detoxification Service. The service is funded through the Office for Health Improvement and Disparities (OHID)'s Drug and Alcohol Treatment and Recovery Improvement Grant (DATRIG). The recommendation was to recommission the service in its current format, with the possibility of expanding bed nights if demand and funding allow. This approach aims to ensure continuity of service, minimise workforce destabilisation, and align with national and local drug strategies.

Suicide Bereavement Service

The committee considered the non-key decision regarding the Suicide Bereavement Service. The current contract is due to expire on 31 July 2026. An eight-month extension to the existing contract with Listening Ear's Amparo service is proposed to maintain continuity of care and allow time for future commissioning plans and financial security discussions with the Kent and Medway Integrated Care Board (ICB). The service provides emotional and practical support to those affected by suicide.

Kent Carers' Support Service Contract Award

The committee discussed the outcome of the procurement for the new Kent Carers' Support Service Contract, which is split into two lots: East Kent and West Kent. While the procurement for Lot 2 (West Kent) was successful, with Imago Community identified as the winning bidder, the procurement for Lot 1 (East Kent) was unsuccessful. To ensure continuity of service, an extension of the current Community Navigation Services (Part B) and Carers' Short Breaks contracts for up to four months is proposed to allow for a further procurement exercise for Lot 1.

Learning Disability, Physical Disability and Mental Health Contract Extension

The committee considered the extension of the Learning Disability, Physical Disability and Mental Health Needs Residential Care Contract. The current contract, which commenced in June 2020, has an existing two-year extension option. This decision sought to extend the contract for a further two years, from June 2026 to June 2028. This extension is intended to maintain service continuity for individuals with these needs while the Council undertakes recommissioning for a new, integrated Supported Accommodation and Residential Living Service, expected to commence by June 2027.

Adult Social Care Provider Fee Uplifts 2026/2027

The committee discussed the proposed approach to potential fee uplifts for Adult Social Care providers for 2026/2027. The report outlined the Council's statutory duties under the Care Act 2014 regarding market sustainability and the financial pressures faced by providers. A differentiated approach to uplifts was proposed, with varying rates for different service areas, such as Care and Support in the Home Services (CPI), Supported Living Services (2% plus an element for sleep-night provision), and Residential Care for working-age adults (2%). No general uplift was proposed for Older Person's Residential and Nursing Care or Everyday Life Activities. Councillor Oliver Bradshaw raised concerns about potential home closures if fee uplifts are insufficient and questioned the contingency for multiple providers handing back contracts simultaneously. Officers stated that a robust provider failure process is in place.

Exercise Pegasus Update

Dr. Ellen Schwartz, Deputy Director of Public Health, provided an update on Exercise Pegasus, a national four-nations exercise to test the UK's preparedness for a future pandemic. The exercise involved all government departments and local resilience forums, including the Kent and Medway Resilience Forum. The report summarised the exercise phases and core objectives, highlighting the importance of addressing inequalities and testing coordination across different tiers of response. KCC Public Health is leading the development of a KMRF Pandemic Response Framework, which will supplement the KCC Emergency Response Framework and undergo public consultation in early 2026.

Work Programme

The committee noted the work programme for the Adult Social Care and Public Health Cabinet Committee.