Agenda item

Ms Sandra Taylor, the Council’s Corporate Director of Adult Social Care (ASC) and Health, noted that the Committee had previously asked for the ASC budget to be benchmarked against other local authorities.  She advised that the use of resources report had been completed and included data from the Adult Social Care Outcomes Framework (ASCOF) which was out of date.  An updated version of the report would be published the following week and would be reviewed for the Committee.  It showed Hillingdon as providing very good value for money and low cost in comparison to other London boroughs, therefore demonstrating the Council’s good use of limited resources. 

Since the Committee’s meeting in September 2025, officers had undertaken a lot of work in relation to demand growth and inflation.  There had been pressure on the placements budget so officers had spent 8-12 months going through this.  However, Ms Taylor was confident that the older people’s placements had started to stabilise and Hillingdon Hospital had managed to work through the elective backlog which had had a positive impact on older people’s services. 

The increase in neuro diverse demand on health services had been reflected in social care.  As a result of the inspection process, there had been some improvements to the number of direct payments being made which provided good value for money as well as giving residents the autonomy to make their own choices.  Mr Martyn Storey, the Council’s Head of Finance – Adult Social Care, advised that the volume of home care had reduced as the number of direct payments had increased.

Mr Matt Davies, the Council’s Director of Strategic and Operational Finance, advised that the Month 6 position showed a £5.1m overspend which the ASC team had been trying to mitigate by making savings to offset the overspend.  The renegotiation of the social care contracts had been flagged as a red risk with a value of £1.7m as a result of increases in NI charges and the rising older people population. 

There had been challenges with regard to the Section 117 funding split with the North West London Integrated Care Board (NWL ICB) with Hillingdon receiving 37% of the funding (whereas other London boroughs received a fairer percentage ranging from 40% to 50%).  Ms Taylor advised that the ICB determined how much the local authority would receive and Hillingdon had received the lowest percentage in NWL since 2019.  As such, discussions were underway with the ICB to try to redress the balance. 

Mr Davies noted that, if a service was looking to achieve a savings target, it could reduce costs or create additional income.  Members were advised that the £5.1m overspend equated to around 2% of the budget.  There were a number of outer London boroughs that had reported an overspend in the second quarter of this year including: Ealing (£2m), Brent (£1.2m), Kingston (£1m) and Havering (£6.57m).  There were a lot of pressures being faced by local government as a result of local and national issues. 

Whilst Members appreciated what other local authorities were doing and the issues that they faced, the Committee was only really concerned about what was happening in Hillingdon.  The amazing service provided by ASC teams at Hillingdon could not be disputed.  In the previous financial year, officers had talked to the Committee about the use of artificial intelligence (AI) in the transformation of ASC services.  A realistic conversation was needed in relation to the analysis as the data modelling had been undertaken for forecasting but needed to include things like the variance from cost to budget and the associated narrative.  Ms Taylor noted that AI had provided a fantastic resource and had been used on the Magic Notes pilot to make a difference by providing high quality recording and translations and putting the information directly onto the system.  The full rollout had just started throughout children’s and adult social care (Ms Taylor advised that she would arrange a demonstration for Members of the Committee).  The new system managed quality and reduced the time needed from social workers to obtain / input the information, therefore delivering staff time savings. 

This was the start of the digital journey with more initiatives like self service and tech-enabled care emerging.  AskSARA (Self Assessment Rapid Access) had been introduced as a needs-based assessment tool, producing a report and making recommendations for potential aids and services that might be beneficial for that individual with their daily living activities.  This work was largely about managing demand (which was relentless) rather than achieving savings, and helped residents to help themselves. 

Ms Taylor advised that the amount of funding needed to meet the demand was based on the number of people using the services and the cost that the Council was charged for these services.  As the price had outstripped the demand, the authority had opened The Burroughs, reducing the need to buy beds from private providers at a higher cost, and was in the process of developing the Civic’s multi storey car park (the Lobster Pot) into a care home.  Hillingdon had a busy care market (with around 1,200 beds) but the Council had been unable to access a lot of these. 

Demand in all areas had been reviewed (as well as growth) and consideration was being given to ensuring that there was enough in the budget to cope with this.  As so much work was being undertaken to get this right, Members would be holding the Corporate Director to account if the service area was overspent next year. 

Members asked that future reports included calculations on the projections.  Mr Davies advised that lessons had been learnt in relation to not delivering on the budget and changes could now only go into the budget setting if a two-page form had been completed.  Growth and savings had been split into categories and it would be important to ensure that the process did not miss next year’s pressures.  The 2026/27 budget would be out for consultation before the end of December 2025 and Members would get the opportunity to comment on it at their next meeting on 20 January 2026.  Members asked if it would be possible to provide them with a briefing session on the budget to talk through what the numbers meant. 

It was suggested that the fairer funding settlement would help to achieve the savings that were needed and that this needed to be discussed at a future meeting.  Processes needed to be in place to help residents access services if they did not quite meet the thresholds, whilst also keeping the budgets in order.  Ms Taylor noted that it was important for ASC to remember that they were dealing with real people.  The resource allocation system recorded an individuals’ needs which were then reviewed by the brokerage service that looked at cost versus allocation.  The Council tried to work with set providers so that quality and cost could be controlled.  There were parameters around costs whereby the Care Act stated that decisions could not be made on cost alone and decisions needed to meet individual needs whilst also delivering best value for money.  The Council currently spent £184.33 per adult on social care (which was less than other local authorities) and was driven by an overarching need to recognise who needed to receive funding.  Ms Taylor advised that the value for money provided by the Council had resulted from effective negotiation with providers. 

It was noted that Hillingdon had been ranked 90^th out of 153 councils with regard to deprivation, despite having several wards that were amongst the most deprived in the country.  Hillingdon had seen an increase in deprivation in some areas (level 2 in Uxbridge and the south of the Borough).  As such, there needed to be a focus on these areas to ensure that these residents’ needs were being met. 

Insofar as fairer funding was concerned, Ms Taylor advised that Hillingdon needed further funding to enable residents to live independently and reduce the pressure on other Council departments.  In the past, it had been cheaper to outsource services than to provide them inhouse.  Work was currently underway to review and manage the stability of the market.  There would also be employer-related legislative changes introduced in the next year and the subsequent impact on costs would need to be monitored.  The Council’s own trading company needed to provide good care and lower costs. 

RESOLVED:  That:

1.    Ms Sandra Taylor arrange for Members of the Committee to receive a demonstration of the Magic Notes pilot;

2.    investigations be undertaken to establish whether it would be possible for Members to have a briefing session on the budget to talk through what the numbers meant; and

3.    the discussion be noted.