The Health and Adult Social Care Policy and Accountability Committee, alongside the Children and Education Policy and Accountability Committee, convened for a joint budget meeting. The primary focus of the meeting was the proposed 2026/27 revenue budget and the Medium-Term Financial Strategy (MTFS), which outlines the council's financial plans and risk management for the coming years. Discussions also included updates on the Hammersmith and Fulham Health and Care Partnership, the H&F Safeguarding Adults Board report, and the Charing Cross Hospital co-production initiative.

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

A significant portion of the meeting was dedicated to reviewing the proposed 2026/27 revenue budget and the council's Medium-Term Financial Strategy (MTFS). The report detailed the preparation and proposals for the upcoming financial year, including anticipated risks, financial resilience measures, and the overall impact of these proposals. The budget plans covered both Health and Adult Social Care, as well as Children and Education services.

The report highlighted the challenging financial environment for local government, with ongoing demand-led pressures in Adult Social Care and Children's Services, alongside the impact of the Fair Funding Review 2.0 and changes to the Business Rates Retention System. It was noted that the council's Council Tax remains among the lowest in the country, and the administration has a record of cutting or freezing council tax multiple times since 2014. The report also detailed proposed savings and efficiencies across various departments, including People, Place, Housing Solutions, and Finance and Corporate Services, totalling £17.9 million for 2026/27.

Key financial elements discussed included:

• Pay and Price Inflation: Provisions for pay inflation at 2.5% and price inflation at 3.2%.
• Essential Pressures: An estimated £3.0 million for essential pressures, such as a reduction in interest receivable and concessionary fares.
• Savings Proposals: A total of £17.9 million in savings and efficiencies were proposed, with £9.5 million from service savings and £8.4 million from collection fund savings.
• Council Tax: A proposed increase of 2.99% for general Council Tax and an additional social care precept, equating to a 92p per week increase for Band D properties, to generate an additional £4.4 million annually.
• Fair Funding Review 2.0: The report detailed the impact of this review, which aims to create a simpler, needs-based system for allocating resources. It was noted that Hammersmith and Fulham would receive transitional funding protection over three years, but the council's core spending power was forecast to decrease by £11.3 million year-on-year.
• Business Rates: The reset and revaluation of business rates from April 2026 were discussed, with the council retaining 10% of the estimated gross rates collectible within the borough.
• Council Housing (HRA): A balanced budget was proposed for 2026/27, with a significant investment of £0.94 billion planned for repairs and improvements to homes. A rent increase of 4.8% (CPI + 1%) plus £2 was proposed.
• Capital Investment: A four-year investment programme of £452 million was outlined, covering general fund and HRA projects, including schools maintenance, transport, climate and green investment, and HRA asset management and development.
• Treasury Management: The management of the council's cash balances and external debt was discussed, with external borrowing of £426 million and cash balances ranging from £40 million to £100 million.

The report also included detailed breakdowns of service pressures to be mitigated within the People and Place departments, as well as specific savings proposals for Children's Services and Adult Social Care. Equalities Impact Assessments (EQIAs) for each budget proposal were provided, aiming to ensure that budget decisions do not disproportionately affect protected groups.

Hammersmith and Fulham Health and Care Partnership Update

An update was provided on the Hammersmith and Fulham Health and Care Partnership, focusing on a refreshed approach to collaborative working to improve health and wellbeing across the borough. This included efforts in integrated care and the development of the Integrated Community Access Point (ICAP). ICAP is an alliance of clinicians and professionals from various organisations designed to support individuals with complex needs, combining physical health, mental health, and social care requirements. The report noted that referrals to ICAP are restricted to health professionals, primarily GPs, and require input from at least two disciplines. Discussions highlighted the importance of co-production and ensuring patient feedback shapes the development of such schemes.

H&F Safeguarding Adults Board Report 2024/25

The Health and Adult Social Care Policy and Accountability Committee received the H&F Safeguarding Adults Board (SAB) Annual Report for 2024/25. The report detailed the SAB's statutory duties, including reviews of safeguarding adults and progress on its three key priority areas: effective systems and processes, fostering a culture of learning and communication, and partnership working. The report highlighted proactive efforts to improve professional responses to adults at risk of abuse and neglect. A concern was raised regarding an increase in racial abuse towards staff, particularly within GP practices, linked to international issues. The report also touched upon information sharing and how safeguarding reviews are conducted to ensure correct identification of abuse and to consider proactive measures.

Charing Cross Hospital Co-Production

The committee received a report outlining work undertaken at Charing Cross Hospital in collaboration with Action on Disability (AoD). This initiative involved AoD representatives providing input on improving the hospital's accessibility. Key findings from their visits included issues with signage and wayfinding, long waiting times, a lack of quiet areas, physical barriers, and limited wheelchair access. While staff were generally receptive to feedback, the radiotherapy team received praise for their person-centred care. Suggestions included clearer signage, sensory-friendly waiting areas, refresher disability awareness training for staff, and ongoing involvement of disabled residents in redesign processes. The importance of involving patients from the outset of any redesign and ensuring staff training is comprehensive was emphasised.

Drug Strategy

The committee was presented with an overview of the upcoming Hammersmith and Fulham Drug Strategy, which is structured around three main themes: breaking drug supply chains, providing world-class treatment services, and achieving a generational shift in drug demand. The strategy aims to disrupt organised crime, treat addiction as a health problem, address underlying issues such as trauma and poverty, and reduce stigma. Discussions included the potential for introducing the strategy into schools and colleges, engagement with the Youth Council, and enhanced work on cuckooing through a dedicated risk panel and the inclusion of a substance misuse worker. The measurement of success was to be assessed through statistics on treatment uptake and rehabilitation access. The strategy also acknowledged the need to consider the specific needs of residents with complex conditions, such as those who use wheelchairs or have mental health conditions.