Agenda item

Future cuts to Local Authority Public Health funding

To consider the report of the Director of Public Health which provides details of the public health grant cuts faced by Leeds and seeking the Boards consideration of how best to minimise the negative impact of the cuts

Minutes:

The Director of Public Health submitted a report providing an update on the recent government announcement to cut Local Authority public health funding from 2016/17 onwards. The report noted how the government Spending Review and Autumn announcement on 25th November 2015 would lead to significant reductions in the public health grant received by Leeds City Council.

 

Dr Ian Cameron, Director of Public Health, presented the report and stated that specific details of Leeds' funding were anticipated by the end of January 2016. Present indications suggested that there be a recurrent reduction of £3.9m from 2016/17 followed by a further £1.1m reduction in 2017/18. This would result in a £5m reduction (10%) by the end of 2017/18 and would be followed by smaller reductions in subsequent years.

 

In context, in June 2015, a £200m in-year cut to the 2015/16 national Public Health budget had been announced and, following a summer consultation, the Department of Health announced on 4th November 2015 that the cut for Leeds would be £2,818,328 (out of a budget of £45.5m).

 

The presentation included outline commissioning figures for Public Health spending for the 2015/16 financial year.

 

The report outlined the need for a two year plan to encompass both the £3.9m reduction in 2016/17 and the £5m reduction in 2017/18.

 

The report set out how, in determining where public health savings could be made, key criteria would be achievability. Other criteria that could inform the decision making process were identified as being likely impacts (on the health & wellbeing of the population, on organisations – directly or indirectly, on demand for services), scale of impact, priorities within the new Health & Well Being Strategy, health inequalities, the burden of conditions, evidence of effectiveness, fairness, mandatory requirements, value for money, wider benefits (e.g. social value), contractual obligations and links to other priorities.

 

Additionally the report highlighted where there were also opportunities for developing stronger links with other commissioners including the Clinical Commissioning Groups (CCGs) and NHS England. The Director of Public Health had already given a commitment to the three CCGS in Leeds to work together on future public health services commissioning.

 

During discussions, the following issues were raised:

 

-  The challenge presented in balancing implementation of service amendments required by the reduced funding from Central Government against the Government's stated priority of prevention services.

-  Recognition for the collaborative working with Board colleagues which had ensured the continued delivery of most services threatened by the in-year cut to local authority Public Health funding. In order to meet the £2.8m in-year cut, planned activities dealing with issues such as oral health, campaigns on cancer awareness, mental health and winter warmth had not taken place. Public Health involvement in emergency planning for the city had also been hit and the department had put a stop on recruitment. A share of PH funding to Leeds Community Health had been withdrawn and the Board noted that HWB partners had supported LCH to continue service delivery. The Board noted that the in-year cut had been anticipated to be a one-off cut, and the stop on services and campaigns had been intended to be until 2016. However in the light of information on the likely budgets, a full review had been required.

-  The impact and potential for increased costs and worse outcomes on other services (e.g. Adult Social Services, Children’s Services, NHS) and service users downstream should funding be saved or ceased from some existing PH services.

-  The comment that the Local Authority could, in its’ consideration of the Council Budget 2016/17, decide to fund the £5m shortfall to cover service provision, but that this would impact on the Council's delivery of other service areas at a time when Leeds City Council is facing a further £34m funding reduction for 2016/17. Similarly, if the CCGs or NHS solely funded a service, that would remove funding from another service area

-  The urgent need for cost analysis of schemes, such as Leeds Let's Get Active, in order to weigh up the current and future benefits of schemes to inform priority setting across the health and care system.

-  Acknowledgement that individual services had a wide reaching positive impact, an example being the services provided by designated School Nurses commissioned by LCH, whose work provided positive outcomes for children, supported the work of local healthcare providers, general practice and education services. The intended and unintended consequences of the withdrawal of support for services must be analysed in the wider context

 

(Cath Roff withdrew from the meeting for a short while at this point)

 

-  Whether discussions had commenced with 3rd Sector providers. The strategic Third Sector Forum would meet for the first time in April 2016

-  The opportunities to address issues - such as streamlining of contracts and joint commissioning

 

The Board received assurance that processes were in place to deal with future commissioning; however discussions were needed on future priorities, future commissioning and future de-commissioning of services.

 

The Board also noted the intention for a report on city-wide financial challenges to be presented at the next meeting. The Board generally agreed that once the funding figures were released for Public Health, CCGs and the NHS, collective discussions on the future priorities for the city and planning for service delivery would follow.

 

(Julian Hartley left the meeting at this point)

 

RESOLVED -

a)  That the Health and Wellbeing Board recognise the scale and potential negative impact for health & wellbeing and the reduction of health inequalities that arise from the public health grant cuts announced in the Spending Review and Autumn Statement.

b)  To recognise that members of the Board will continue to collectively consider how best to minimise the negative impact of the public health grant cut in light of the emerging priorities of the Joint Health & Well Being Strategy, the Best Council Plan and the recent NHS planning guidance.

c)  That the Health and Wellbeing Board support a partnership approach that works collaboratively to respond to these cuts, taking into account the need of the population and the “Leeds pound” as evidenced through the discussions at this meeting and the collective response to the in-year cuts to public health funding

 

Supporting documents: