The Sub-Committee will receive a presentation on Demand Management in Adult Social Care.
Minutes:
The Sub-Committee received a very in-depth presentation on Demand Management. Demand Management was about reducing and/or slowing down the rise in demand for services to levels that are manageable within the resource envelope that Havering have. The majority of savings attributed to demand arrangement will arise from cost-avoidance, i.e. preventing an increased spend that would otherwise result from more people entering “the system” and using our services.
The officer explained that this was a very big issue for Adult Social Care as the demand would continue to rise given the ageing population and the changing demographic profile in Havering. The Care Act would also have a disproportionate impact on Havering given both the demographic profile and the amount of care home located in the Borough. GP registrations were continuing to rise each quarter with 3,064 additional registrations in the last quarter (Q2 of 2014/15) alone. Members raised concerns about this issue.
It was noted that Havering was seeing more families with large sibling groups and very complex needs from ethnic minorities and demands for services had increased as a result of the Government’s recent welfare reforms.
The Sub-Committee noted the challenges faced by Adult Social Care, given that the directorate alone accounted for 60% of the whole Council budget. The need to dramatically transform the operating models by prioritising early help, intervention and prevention is hoped to be the resolution. Work had already started that focussed on delivering this.
Early Help, Intervention and Prevention (EHI&P) was explained. It was noted that 90% of the systems at present were in the statutory category with very little intervention, early help or prevention. Early demand management is about prevention management and was felt to be the right way to go.
The Sub-Committee were informed that there was lots of focus on demand management within senior staff meeting, working groups, the Care Act as well as many of the strategic documents, priorities and policies. The Demand Management Working Group was established in 2014 and had representation from across the Directorate including Public Health and Corporate colleagues. An Early Help, Intervention and Prevention Strategy had been produced to help tackle demand and prioritise EHI&P services. This had been aligned to the Health and Wellbeing Strategy, the Care Act Programme and the draft Directorate Plan. There were five pilots about the start which would feed into the Implementation Plan. Whilst this was a Directorate Strategy, it was likely to evolve into a Council-wide and partner-wide strategy.
The Sub-Committee noted that Havering performed poorly against national Self-Directed Support targets. Havering was still quite traditional in the service provision, but by moving to a more personalised service would improve those indicators. A case study was shared with the sub-committee which showed where a review had been carried out on the needs of a resident. It was found that some people could do more for themselves, and with a better use of equipment independence could be enabled therefore reducing the dependency on services. It was thought that this would have been a reduction in the personal budget from £11,767 to £8,537, meaning a saving of £3,230.
It was noted that Assistive Technology reduced the admissions to hospital and care homes. This increased independent and again the reduction of demand on services. The types of demand that are put on Adult Social Care were highlighted all of which could be addressed with early demand management.
Members raised concerns about how this would be delivered, given that the population was increasing. Further concerns were raised as to the reduced time that carers would spend with residents given often the carer may be the only person a vulnerable person may see. It was agreed that this item should come back for the Sub-Committee to scrutinise again.