Agenda item

Report of Director for Commissioning and Procurement

Sharon Ribeiro, Lead Contact Performance Manager (Care and Support), presented the report, which detailed proposals for fee rates in 2022/23 across Adult Social Care contracted provision, which Nottingham City Council is contractually bound to consider on an annual basis where it has a statutory duty to provide a service.

It was stated that the Council will consult with providers on the proposals and consider responses prior to implementation from April 2022.

In response to a question regarding minimising costs, Ms Ribeiro stated that the Council was constantly reviewing cost vs provision, and there was currently work being undertaken to review all fees etc in time for 2023/24.

Resolved

(1)  to approve:

(a)  the proposals for fee rates for Adult Social Care Services in 2022/23 as outlined in exempt appendix 1, which will be consulted upon with service providers;

(b)  the total spend of £6.299million, including approval to spend against high cost placement provision through the Council’s scheme of delegation for Adults Care Packages;

(2)  to delegate authority to the Director of Commissioning and Procurement, in consultation with the Director for Adult Health and Social Care, and in line with the Council budget,to agree fee rates in accordance with the proposals detailed in exempt appendix 1, subject to the outcome of consultation with providers;

(3)  to note that:

(a)  subject to recommendation 3(b) below, the agreed rates will be implemented from April 2022;

(b)  if upon completion of the consultation the financial impact of any revised proposals exceed the budget available, further approval would be sought from this Committee.

Reasons for recommendations

i.  Nottingham City Council is contractually bound to consider fee rates in respect of services that is has a duty to provide.  This is balanced against budget commitments and pressures for the Council.

ii.  In accordance with the Council’s legal obligation, it is proposed to consult with adult social care providers with regard to these proposals during February – March 2022. The Director of Commissioning and Procurement in consultation with the Director for Adult Health and Social Care will take account of consultation responses and issue variations to existing contracts reflective of the proposals in this report should no significant issue arise. Should the outcome of these consultations require consideration of significant change to the shape and financial consequence of these proposals (with due regard given to the available budget) a further report will be presented through the appropriate governance process.

iii.  These proposals and the associated financial modelling are based on information currently available about service utilisation and demand changes as a result of Covid 19.

iv.  The recommendations presented take account of the implications of the National Living Wage for the market and aim to represent a fair allocation of funding and to support the market across all service areas. It is considered that a balanced, reasoned and informed approach has been taken and that the proposals seek to support a sustainable, efficient and effective market within the available resources.

v.  It is proposed to undertake a full review of costs of ASC pricing during 2022-2023 to determine sustainable rates for the longer term, particularly in the context of forthcoming changes by the Department of Health and Social Care (DHSC) to the arrangements for self-funders. DHSC has announced a new fund, the Market Sustainability and Fair Cost of Care Fund, which will be available in 2022-23 to support local authorities in paying a fair rate for care and preparing local markets for reform. The allocation to Nottingham City Council in 2022-23 is expected to be approximately £1m and this will be used to source a full review of local costs and a sustainable level funding.

Other options considered

i.  Do nothing – the Council is contractually bound to review contract fee rates on an annual basis. Doing nothing would present a risk of legal challenge and for this reason, this option was rejected.

ii.  Offer different fee rate proposals. This option is not recommended as the proposals have resulted from significant work and modelling between finance and contracting, taking into account knowledge of the market and feedback from providers, and the overall budget pressures for Adult Social Care. The final proposals have taken account of the potential impact on service delivery and risk of market failure. Offering different fee rate proposals would place further pressure on the Adult Social Care budget and this is not a feasible option.

iii.  To undertake analysis of individual provider costs and offer fee rates based on factors such as wage rates paid, pension contributions, profit and void levels etc. This option would not be feasible at this time as it would be administratively burdensome due to variations in rates of pay and other costs across the sector.