Agenda item - Rob Persey - Health and Adult Social Care

To hear from Rob Persey – the Executive Director for Health & Adult Social Care, Brighton & Hove City Council

289.1  Rob Persey (RP) began by explaining that he had started working for the council in January 2017, after working in Adult Social Care (ASC) for 10 years and prior to that Cultural Services, Town Planning and the Sports Council. He valued culture as well as public health and was concerned that non-statutory services were vulnerable to cuts, but were safer if aligned to the work of ASC and Children & Young People (CYP). There was a focus on the whole population in this city in relation to Public Health and ASC.

289.2  His first impression was of city that was strong on engagement and consultation and engagement. Performance figures revealed that the council was in a broadly strong position, with no service failures or issues to address straight away. It was a positive place to work in which had developed good partnerships, and the siting of the council and the CCG was an opportunity to strengthen their working together. The previous head of ASC had retired last year, along with a number of other key officers, so it was vital to maintain stability at a time of change. Although there had been 10 years of austerity, this was likely to continue.

289.3  There were around 38,000 people aged over 60 in the city, but it was difficult to predict how demand for services would change in the next five years and the factors which would affect demand. They were looking at how service improvements could impact on demand, as well as demand management. The council has a statutory responsibility to provide ASC for those in need, but believed that prevention was also vital.

289.4 RP explained that there were 3 priorities for the service:

•       Maximising resource utilisation – Budget and Performance    

•       Taking forward in partnership Health and Social Care integration

•       Focusing on ‘Wellbeing’ Giving emphasis to prevention                              

Staff were the most important resource. The recent £2bn additional resources for ASC announced by central government was welcomed but this was not the answer, although it would help councils for the next few years. BHCC was in a more positive situation than many other councils. Performance would be a focus in 2017/18 because there was room for improvement, such as in direct payments and delayed transfers of care. 

289.5  The council was working closely with the CCG (including Adam Doyle, the new Chief Accountable Officer) on integration health and ASC and Caring Together was the key way to brand and deliver our services. There was to be an increased push on prevention and well-being. It was a concern that there was greater awareness of the need for a healthy lifestyle but drinking and obesity were increasing.

289.6 An officer was working on consultation and engagement, particularly with carers and ensuring integration. It was vital to have the right consultation at the right stage. The main purpose is to ensure that people understand why things are happening and a person-centred approach was key when the services are for such vulnerable people. The community is part of the solution so we need to be aware of the community assets. Living longer was a challenge for service providers but there was the opportunity to live more healthily.

Questions to Rob Persey

Q: Can we call upon your support for the changing circumstances facing the OPC?

RP: Recognise the important role of the OPC, however in previous job a similar group for Wandsworth/Richmond had their funding withdrawn which they believed was the right thing to happen as had the capacity to continue. There are few locations where the OPC would get the level of support they currently receive.

RP then confirmed that Caring Together was the place-based part of the Sustainable Transformation Plan (STP).

Q: Are you concerned about the assumptions which lie behind the cuts to some of the services, such as those for frail people or excess bed days for people over 75? There would be a £112m cuts in the region’s ASC by 2021.

RP: It will be very challenging for ASC, but the city was not in the same position as the other 7 CCG areas. He emphasised that the STP was a developing process, rather than a plan to be signed off. It had not yet been to the CCG governing body and the focus from the ASC side will be working to deliver their statutory responsibilities.

Q: There are large gaps between the life expectancy of people living in different locations in the city, 25% of pensioners are in receipt of Pensioner Credit and there are increasing numbers of people with dementia. While investment in technology is important, aren’t people based services the answer rather than ICT?

RP: With people living longer and more healthily, those inequalities are reducing. The focus of the Public Health report this year will be prevention, including reducing the life expectancy gap. While ICT is not the answer, it can make a useful contribution.

Q: There should be a public engagement meeting which looks in detail at the STP. Why is a disability workshop, including Remploy (which provides day time activities for people with disabilities), being held by the Children & Young People’s (CYP) service in the council?     

RP confirmed that services for people with learning disabilities have now been transferred to CYP.  There is likely to be joint commissioning of LD services by ASC, CYP and the CCG. He is extremely concerned about employment issues, for example for those with LD or sensory impairment and wants to take a whole council approach to deliver meaningful jobs.

Q: Given the budgetary issues faced by ASC, how many care providers have either closed down or stopped providing services in the city?

RP: The city’s situation was very different from in London, no contractors or providers have closed down or offered their contracts back to BHCC. The future workforce is a key concern and ensuring a career path and workforce development. He had met with colleagues in East and West Sussex and we seemed to have a more sustainable workforce and paid relatively well.

Q: What is the difference between consultation and engagement?

RP: Both are equally important. This meeting was engagement, because not consulting on a specific service issue.

Q: How many staff are you losing and are you consulting with unions? What about the role of the OPC and other voluntary groups?

RP: There were no planned staff reductions at the moment, and had met with both Unison and the GMB in his first month at the council. Had been to the Volunteering Centre and met Possability People too, because volunteers play a vital role as well as organisations such as the OPC – many of whom have continued without direct financial support. Please invite me back in the summer to give a progress update.