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ITEM CA16

CABINET - 21 MARCH 2006

LEARNING DISABILITY SERVICE PARTNERSHIP

Report by Director for Social & Community Services

1. On 6 December 2005 the Cabinet agreed to the development of an agreement under Section 31 of the Health Act 1999 for services for people with a Learning Disability at its meeting. The arrangements under consideration were for lead commissioning and pooled budgets. The responsibilities that the County Council would have under these arrangements were set out in the December report. The present report outlines the conclusions to this work; summarises the scope and nature of the agreements for lead commissioning and pooled budgets; gives the total value of the pool budgets and the contributions from each of the partners that are being proposed; and summarises the arrangements for the implementation of the agreement.
2. A considerable amount of work has been undertaken to reach this position. Senior representatives of the PCTs and of Social & Community Services have jointly agreed:

• the detail of the functions to be included in the pooled budget;
• the level of contributions they will provide for 2006/07;
• the structure of the Joint Management Group which will formally operate from April with equal representation from the Primary Care Trust and the County Council – and with advice from the Learning Disability Partnership Board;
• the reporting mechanisms for performance management;
• the initial staffing capacity to start the work and the mechanism to further refine the staffing requirements by June;
• to consult with the Learning Disability Partnership Board and with external providers of learning disability health and social care services in Oxfordshire, all of whom support the proposed agreement;
• to carry out informal staff consultation in readiness for the proposed agreement;
• to identify the developments in the Social & Community Services Directorate to facilitate the governance arrangements for the Section 31 Agreement.

3. A high level of agreement between the partners has been evident throughout the preparation work. The consultations on the proposed commissioning and pooled budget arrangements were positive and supportive.

Scope of the Agreement

4. The agreement will cover arrangements for commissioning and for the pooling of budgets. A copy of the proposed agreement has been placed in the Members’ Resource Centre.
5. The commissioning arrangements are for people aged 18 and over. The County Council will be the lead commissioner, and will commission services on behalf of the PCTs in Oxfordshire as well as its own services. This role will be undertaken by the Head of Planning and Partnerships in the Social & Community Services Directorate.
6. The pooled budgets will total £59.4m. The contributions from each of the partners is summarised in the table below. The Social & Community Services line reflects the Directorate gross budget, and therefore excludes external grant income and client income. Contributing the gross figure to the pooled budget will allow the Council to retain the client and grant income.
7. The primary care trusts contributed £16m this year to the County Council as section 28 grant which currently appears in Council budget reports in the gross Social & Community Services budget. For clarity as to funding sources the 2005/06 grant has been included in the table within the PCT contribution and not transferred to the Social & Community Services line.

Contributors	2005/06 Budget £m	2006/07 Budget £m	2006/07 Pooled Fund Budget £m
PCTs	26.6	27.6	27.6
Social & Community Services (gross)	32.3	35.2	31.8
TOTAL (gross)	58.9	62.8	59.4

8. The County Council will establish a Joint Management Group which will be responsible for the management of the pooled budget and the preparation of an annual plan, an annual report and plans for activity and spending levels. The Pooled Budget manager will report to the Joint Management Group. The Section 31 Agreement will replace the existing section 28 arrangements between the Council and the PCTs. The County Council’s contribution does not include Supporting People funds, Adult Placement Service and Employment Service funds, nor the costs of service from the Council’s own Home Support Service. However, these services are all within the overall scope of lead commissioning.

Implementation arrangements

9. The commissioning strategy and the annual plan for 2006/07 will be decided by the Joint Management Group by 30 June 2006. The staffing and other arrangements necessary to ensure the efficient and effective management of the lead commissioning and pooled budget arrangements will finalised at the same time. It should be noted that the pool will cover the costs of any additional staff time necessary for the Lead Commissioner to discharge his responsibilities.

Legal Implications

10. A Section 31 Agreement is a legally binding agreement between local authorities and NHS bodies as described in the report to Cabinet of 6 December 2005. In broad terms the Agreement is similar to previous Section 31 Agreements that the Council has entered into save that arrangements relating to overspends and underspends are set out in greater detail.
11. The Agreement commits the Council to commissioning services on behalf of the PCT using money from the pooled budget. As lead commissioner for both agencies there is a level of risk to the Council on a similar basis to other Section 31 Agreements as set out in the previous report. An extract from the previous report concerning this aspect is attached as Annex 1.
12. The County Solicitor will require that there are appropriate arrangements for monitoring of the budget before authorising completion of the Agreement.

RECOMMENDATIONS

13. The Cabinet is RECOMMENDED to:

1. confirm the arrangements with the Oxfordshire PCTs, as outlined in the report and the report to the meeting on 6 December 2005, for lead commissioning and a pooled budget in relation to services for adults with a learning disability;
2. authorise completion of an agreement with the PCTs for the implementation of the arrangements, subject to the terms of such agreement being to the satisfaction of the Director for Social & Community Services and the County Solicitor.

CHARLES WADDICOR
Director for Social & Community Services

Background Papers: Nil

Contact Officers:
Nick Welch, Head of Service, Planning and Partnerships Tel: 01865 815714
Liz Peretz, Partnership Project Manager Tel: 01865 854466

March 2006

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