The Adult Social Care and Health Overview and Scrutiny Committee met on Monday 02 February 2026 to discuss the draft budget and financial plans for 2026/27, the expansion of reablement services, and initiatives to tackle health inequalities in North Bexley. Key decisions included the approval of the draft budget and financial plans, with a focus on managing inflationary pressures and demand growth in adult social care, and the endorsement of plans to expand the reablement service to improve resident independence and achieve cost savings.

Draft Budget and Financial Plans 2026/27

The committee reviewed the draft budget and financial plans for adult social care and public health for the upcoming financial year. Yolanda Denny, Director of Adult Social Care and Health, presented the plans, highlighting that the adult social care element of the Medium-Term Financial Strategy (MTFS) requires growth due to increased demand and significant inflation on commissioned services. Mitigations of £5.1 million are in place, primarily focused on supporting people to remain independent. A significant portion of the budget pressures is attributed to inflation, with an anticipated £2.5 million overspend this year due to inflation exceeding allocations. This overspend has been covered by the council's central contingencies and will be allocated to the adult social care budget going forward.

Councillor Lisa Moore raised concerns about contract inflation, specifically whether it included the cost of the Employment Bill 2025, and sought reassurance that vulnerable people would not have their direct payments reduced if they were unable to find care staff. Ms. Denny confirmed that contract inflation calculations considered new legislation and market position, and that additional contingency funding would be available. Regarding direct payments, she explained that savings are based on trends and that funds are not recouped without consultation, with checks and balances in place to ensure people's needs are met.

Councillor Rags Sandhu questioned the near 10% increase in the budget for placements, asking for reasons and comparisons with previous years. Ms. Denny explained that demand growth is projected a year in advance, but an unexpected increase in demand has been observed since COVID-19, with some individuals requiring support at a younger age. This trend is being investigated to understand its causes and inform preventative services.

Councillor Peter Reader inquired about the council's fees and charges, noting that they are £200 cheaper per head than neighbouring boroughs. Councillor Lee explained that this statistic is a generic assessment across all services, with adult social care fees being heavily regulated and means-tested. He added that while the council is efficient, comparisons with neighbouring authorities can be misleading due to differing income streams, such as parking charges. Councillor Janice Ward-Wilson, Deputy Mayor of Bexley 2025/26, clarified that adult social care charges are means-tested and follow national procedures, not discretionary.

Councillor Peter Reader also raised a question about the capital programme, specifically the £3.4 million allocated for the conversion of street properties. Mr. Henney explained that these are properties purchased off the market to be converted into supported living arrangements for individuals with mental health needs and physical disabilities, aiming to provide more independent living options.

Councillor Lisa Moore questioned the financial health of delivery partners, such as Transformation Care at Home, and how this is monitored. Ms. Denny stated that the quality assurance team works with all providers to understand their financial sustainability and that no high risks have been identified this year, but this is monitored annually.

Councillor Frazer Brooks asked about the impact of employer National Insurance increases, minimum wage increases, and measures in the Employment Bill on the adult social care budget. Councillor Melvin Seymour, Cabinet Member for Adult Services & Health, expressed concern that government funding is insufficient to cover these costs, placing a burden on council taxpayers. He highlighted the constant flux in adult social care, increasing demand, and the challenges posed by government policies. Councillor Lee echoed these concerns, noting that the national funding for social care is inadequate and that the council is facing significant financial pressures. He also mentioned the upcoming fair pay review and the potential costs associated with Liberty Protection Safeguards, estimated at over £2 million. Both councillors emphasised the importance of prevention as a key strategy to manage future demand and costs.

Tackling Health Inequalities in North Bexley

The committee received an update on the North Bexley Health Inequalities Fund Project, which aims to raise awareness of breast cancer and prostate cancer screening. Nick Aldridge, Principal Population Health Intelligence Analyst, and Sarah Birch, Head of Community Based Care (Bexley) for NHS South East London Integrated Care Board, presented the findings. North Bexley has been identified as the most deprived and diverse local care network, with significantly lower cancer screening coverage and higher cancer mortality rates compared to the England average.

The project has focused on targeted communication and engagement initiatives, including a breast screening campaign for women aged 50-70 and a project to improve engagement with men in North Bexley regarding prostate cancer. The initiative has involved community cancer promotion champions and has distributed information through GP practices, pharmacies, and community sites. Data indicates improvements in bowel and breast cancer screening uptake between April 2024 and January 2026, although cervical screening saw a slight decline.

Lessons learned highlighted the challenges of overcoming cultural and language barriers, the need for sustained outreach, and addressing misconceptions and fear surrounding cancer and screening. Future plans include commissioning three Community Health & Wellbeing Coaches for North Bexley to focus on identifying and preventing health inequalities through place-based working.

Councillor Rags Sandhu highlighted the importance of considering the Sikh community and mentioned an upcoming health check event at a Sikh temple in Belvedere on February 15th, which will offer blood pressure and diabetes checks, as well as health advice. He suggested this could serve as a pilot for reaching other community groups.

Plans to Develop an Expanded Reablement Offer and Approach

The committee reviewed proposals to expand the Reablement Service in Bexley, with the aim of increasing access to early intervention and therapy-led support. Emma Berry, Service Manager, and Jim Beale, Deputy Director Adult Services, presented the plans. The expansion aims to increase reablement episodes from 1,800 to 2,000 per annum, with a greater focus on community and front-door referrals to prevent escalation into long-term care and reduce hospital admissions.

New pathways are proposed for young people transitioning to adulthood (Preparing for Adulthood) and for individuals with mental health needs, focusing on functional recovery and community re-engagement. The expansion requires an increase in the workforce from 16.6 to 27 full-time equivalent posts, costing £321,000, which is considered an investment to achieve cost avoidance through reduced long-term care packages. Financial modelling suggests savings of £0.406 million in 2026/27, rising to £0.815 million in subsequent years.

Councillor Wendy Perfect expressed concern about recruiting occupational therapists, particularly within the first quarter, and the potential impact on the £406,000 savings. Ms. Berry assured the committee that Bexley is attractive to occupational therapists, with a high conversion rate from temporary to permanent staff, and that an apprentice scheme has been launched.

Councillor Peter Reader asked about the services available for people with mental health issues, such as dementia and depression. Ms. Berry explained that the reablement service groups individuals with similar interests for activities like bowling and cinema trips, personalising support and working closely with local care networks and providers. Mr. Beale added that the focus is on community footprint and supporting voluntary sector providers to reduce isolation and improve well-being.

Councillor Peter Reader also inquired about the steps taken to support the 45% of residents who do not remain fully independent after reablement. Ms. Berry clarified that the 55% figure represents those who become fully independent, while others experience reduced dependency. For those requiring ongoing care, the council provides support through its care-at-home service or direct payments, with a focus on promoting independence.

Councillor Rags Sandhu highlighted the importance of prevention and early intervention grants and praised the One Bexley initiative for its community-based approach. He also raised concerns about isolation among older people but noted the council's efforts to create an age-friendly community through initiatives like fitness MOTs and walking groups.

Work Programme

The committee reviewed its work programme for the upcoming year. Councillor Rags Sandhu drew attention to an upcoming prostate cancer screening event at a Sikh temple in Belvedere on February 15th, highlighting the need to consider language barriers and cultural sensitivities when engaging with diverse communities. He suggested using this event as a pilot for reaching other community groups.

The committee also discussed performance data from the Bexley Status Report for Quarter 2 (July-September 2025). Concerns were raised about the proportion of people finding it easy to access information about services, with the latest figure at 65.88% against a target of 68%. A significant drop was noted in the proportion of planned reviews completed within three months, falling from 70.64% to 48.74%. The removal of the indicator for first assessments completed within four weeks was discussed, with assurances that reablement and triage teams are ensuring timely initial assessments.

A briefing note on the progress of the Autism Strategy was noted, outlining actions taken over the past 12 months. The committee also received a summary of a briefing on the review of Prevention and Early Intervention grants to the voluntary sector, which proposed new three-year grants from 2026-2029, with a focus on widening access for individuals with autism. Finally, the committee noted the ongoing reality checking work with adult social care service users to understand their experiences.