The joint meeting of the Health and Adult Social Care Policy and Accountability Committee and the Children and Education Policy and Accountability Committee focused primarily on the proposed 2026/27 revenue budget and the Medium-Term Financial Strategy (MTFS). Key discussions included the financial implications of national policy changes, proposed savings across various departments, and the budget allocations for adult social care and children's services.

2026/27 Revenue Budget and Medium-Term Financial Strategy (MTFS)

The committees reviewed the proposed revenue budget for 2026/27 and the associated Medium-Term Financial Strategy (MTFS). The report detailed the strategic context, including the Chancellor's Budget Statement and the impact of the Fair Funding Reforms 2.0. It outlined the budget proposals, strategy, and objectives for the upcoming financial year, alongside the HRA, Capital, and Treasury Budgets.

The national financial context presented challenges, with eased inflationary pressures but persistent demand-led pressures in Adult Social Care and Children's Services. The Fair Funding Review 2.0 and the reset of the Business Rates Retention System from April 2026 were highlighted as significant factors impacting the council's funding. The council proposed a balanced budget for 2026/27, including £9.5 million in efficiencies, and a 2.99% increase in Council Tax, plus the adult social care precept, to generate an additional £4.4 million.

Key aspects of the budget proposals included:

• Savings Proposals: Across departments, savings totalling £9.5 million were proposed. For the People's Directorate, this included £4.2 million in savings, with specific proposals for Adult Social Care transformation (£3.2 million) and a Homelessness Reduction Strategy (£1.2 million). The Place department proposed £2.8 million in savings, including waste disposal efficiencies and increased recycling targets. Finance and Corporate Services proposed £0.6 million in savings, and centrally managed budgets accounted for £0.7 million.
• Adult Social Care and Public Health Budget: The proposed net budget for Adult Social Care and Public Health for 2026/27 was £82.028 million. This included £74.413 million in controllable expenditure and £28.139 million in ring-fenced Public Health grant. Significant financial pressures were noted, including demographic demand growth, complexity of need, and pressures within the care market. Savings proposals within this area included £1 million for redesigning provision and transforming practice to enable greater choice and control for residents, and £1.75 million for a stretch target to improve the range of local services.
• Children's Services Budget: The proposed net budget for Children's Services for 2026/27 was £67.96 million. The largest portion of controllable expenditure, £31.88 million (56%), was allocated to Children and Young People's Services. Savings proposals included £380,000 for service efficiencies through greater integration and joint working, and £150,000 for efficiencies in education and SEND.
• Council Housing (HRA): A balanced budget was proposed for 2026/27, with a £0.94 billion investment planned for repairs and home improvements. The HRA reported no structural deficit and proposed a rent increase of 4.8% (CPI + 1%) plus £2. Efficiencies of £2.8 million were identified.
• Capital Investment: A four-year investment programme from 2026/27 to 2029/30 was outlined, totalling £452 million, comprising £135 million for the General Fund and £317 million for the HRA. Key schemes included £5 million for schools maintenance and £30 million for transport, climate, and green investment.
• Treasury Management: The council's approach to managing cash balances and external debt was presented, with external borrowing of £426 million and cash balances ranging from £40 million to £100 million.

The committee noted the report and was invited to make recommendations to the Cabinet.

Hammersmith and Fulham Health and Care Partnership Update

The committee received an update on the Hammersmith and Fulham Health and Care Partnership, focusing on integrated care efforts and the development of the Integrated Community Access Point (ICAP). ICAP is designed to support adults with complex needs by bringing together clinicians and professionals from across different organisations. Concerns were raised by Jim Grealy, a co-opted member, about the professional-centric nature of the report and the need for greater patient involvement and awareness of the scheme. Caroline Farrar, Managing Director of the Hammersmith and Fulham Place Partnership, explained that co-production had been incorporated into the development of the plan and that a prototyping approach was being used. Councillor Lydia Paynter highlighted the national shift towards neighbourhood health centres, emphasizing the importance of GPs knowing patients well. Victoria Brignell shared her experience of varying quality of care from health professionals and suggested that patients should have the option to request a change of professional in community settings, similar to Martha's Law in hospitals. The committee noted the report.

H&F Safeguarding Adults Board Report 2024/25

Fiona Bateman, Independent Chair of the Safeguarding Adults Board, presented the annual report. The report detailed the board's statutory duties, including Safeguarding Adults Reviews and progress on its three key priority areas: effective systems and processes, creating a culture of learning and communication, and partnership. Jim Grealy commended the report and drew attention to an increase in racial abuse reported by GP practices, particularly concerning staff members' country of origin. He called for a strategy to support staff and a strong statement on the matter. Fiona Bateman acknowledged a rise in hate crime and mentioned ongoing work with the charity Hope Not Hate. Councillor Alex Sanderson, Deputy Leader and Cabinet Member for Children and Education, noted the pressure this would place on the SAB to produce evidence. The committee noted the report.

Charing Cross Hospital Co-Production

Matt Ayres, Hospital Director at Charing Cross Hospital, along with Jenny Parker and Jack Hill from Action on Disability (AoD), presented findings from co-production work at the hospital. Key issues identified included poor signage, long waiting times, lack of quiet areas, physical barriers, and limited wheelchair access. Staff were generally receptive to feedback, with the radiotherapy team receiving praise for person-centred care. Suggestions included improved signage, sensory-friendly waiting areas, disability awareness training for staff, and ongoing involvement of disabled residents in redesign. Victoria Brignell thanked those involved. Councillor Genevieve Nwaogbe noted that some staff mistakes stemmed from good intentions, such as tidying away pull cords to address trip hazards. Jenny Parker stressed the importance of involving patients from the outset and commencing training early in staff careers. Jim Grealy suggested that AoD share their learnings with the Acute Board. Councillor Alex Sanderson queried the governance of co-production and its links to other Imperial sites. The committee noted the report.

Drug Strategy

Elizabeth Eagle, Substance Misuse Lead, and Dr Mayada Abu Affan, Director of Public Health, introduced the upcoming Hammersmith and Fulham Drug Strategy. The strategy is built around three themes: breaking drug supply chains, providing world-class treatment services, and achieving a generational shift in the demand for drugs. Jim Grealy suggested introducing the strategy into schools and colleges, including through the Youth Parliament. Councillor Jackie Borland raised a question regarding the approach to cuckooing, and Elizabeth Eagle explained enhancements to the existing cuckooing risk panel. The committee noted the report.

The meeting also noted the dates of future meetings and included a welcome to Dr Mayada Abu Affan as the new Director for Public Health, and a farewell to Katharine Willmette.