Meeting documents

To consider a report by the Director of Public Health and Chief Financial Officer (attached).

The Board considered a joint report by the Director of Public Health and the Chief Financial Officer which explained in detail public health finances and how these were allocated. The Director explained that the revenue budget for Public Health Dorset in 2016/17 was £29.378m, which was based upon a Grant Allocation of £35.154M.  The Section 151 and other executive officers from each of the constituent authorities had been given an opportunity to contribute to the report and all had endorsed it.  The joint report provided an understanding about the outturn forecast for 2016/17, which currently stood at £1.529m underspent. The final outturn was likely to be lower given the delay in delivery of key projects, in particular, health checks.

The Board was informed that recommendations contained in the report included proposals that the reserve and projected savings should be combined for accounting purposes and redistributed along previously agreed lines, with oversight of how this should be allocated being through the respective constituent Health and Wellbeing Boards. The reasoning for these recommendations was set out in the report and expanded upon by officers.

As it was considered important that the Board had greater understanding of the history and future of the grant, a series of tables depicted:-

·  the history of the overall grant including future projection;

·  changes in the grant’s core elements;

·  the spend, by authority, on public health compared with other

authorities and value for money considerations between functions.

The Board appreciated the explanation of the management of the Directorate’s finances, what monies were available, how they were being allocated, comparisons of how outcomes were measures against spend and where it was considered this was being best spent in terms of achieving a return on that investment. In this regard it demonstrated how the optimum benefit could be improved by reallocation within existing NHS service budgets.

The per capita spend for all three authorities was markedly lower than average -  the Board was able to determine that how the finances were being managed and the outcomes being realised was a positive achievement and one which it was hoped would be maintained and that prevention of scale could help in this.

The Board that the report demonstrated that value for money was being achieved in terms of delivering positive health improvements and in achieving national outcomes.

Resolved

1.    That the current and projected budget out-turn position be noted;

2.    That the value for money of public health spend in achieving national outcomes be noted;

3.    That from the accumulated reserve and savings in 2016/17, totalling approximately £3.5m, it be agreed to:-

·         invest £0.4m in further expansion of the Livewell Dorset scheme to include expanding services for other age groups with an improved digital process for all potential service users.

·         invest £0.2m in improving analysis and modelling of patient flow and resource out of hospital care system to better understand the impact of any changes in the system.

·         invest £0.4m in developing services in localities, particularly around improving the engagement of patients and service users by training colleagues from the community and voluntary sector to better signpost people in need of care away from high cost acute services and statutory social care services.

·         redistribute the remaining £2.5m to the three local authorities by the usual formula for their investment in early years’ and health protection services.

·         redistribute any further savings in 16/17 and 17/18  based on discussion at the JPHB. 

·         endorse the principle that the respective Health and Wellbeing Boards provide oversight to ensure alignment with the respective health and wellbeing strategies.

Reason for Decisions

Close monitoring of the budget position was an essential requirement to ensure that money and resources were used efficiently and effectively.