Agenda item

(a)       That the Committee notes the progress made on the proactive budget management of outstanding invoices raised by the Council for payment by Betsi Cadwaladr University Health Board; and

(b)       That joint funded care package debt over 90 days is considered as a matter of urgency to understand how this debt can be reduced in a timely manner.  The work to be carried out by the Head of Service and Cabinet Member and reported back to this Committee on a monthly basis.

The Senior Manager (Safeguarding and Commissioning) presented an update on current long-term debt with Betsi Cadwaladr University Health Board (BCUHB) in respect of joint funded care packages of care and support for individuals with complex care needs.

The report referred to the statutory framework put in place by the Welsh Government which set out arrangements for Health Boards to deliver NHS Continuing Health Care (CHC) within Wales, in partnership with Local Authorities and other organisations.  The Senior Manager detailed a number of key challenges such as the different support required for adults and children, and the high volume of CHC packages delivered in Flintshire and Wrexham.  Positive working relationships with colleagues in the health sector had helped to resolve some long-standing issues in the CHC process.  The appointment of a CHC Planning & Development Officer within Social Services had enabled the team to improve internal processes and engagement with BCUHB.

In relation to reported debt levels as at 5 September 2022, a repayment of £46,333 had since been made by BCUHB for unpaid invoices of three years and over, with work continuing to clear the remaining historic invoices.  Over the past six months, work by the team to focus on the prompt resolution of new invoices had helped to considerably reduce short-term debt levels.  Since September 2022, invoices totalling £260,248 were set to be processed, mainly relating to one particular case involving a child.

The Chairman reminded the Committee of the background to the initial report being shared in December 2021.  His concerns were not only about the loss of expected income but also the length of time taken to resolve disputed invoices which was a cashflow issue for the Council.

The Senior Manager explained that recent improvements put in place had resulted in a clearer understanding of processes on both sides.

Paul Carter gave assurance that BCUHB was working closely with Council colleagues to process current invoices in a timely manner and that there was regular engagement with officers at all levels to clarify the reasons for partial or non-payment of historic invoices which had not been subject to the same rigorous process.  Whilst he was hopeful that around £250K of invoices due to be considered by the BCUHB panel would be approved to further reduce the historic debt, there were ongoing discussions to identify supporting information on three outstanding cases totalling £350K and over £400K of invoices relating to children in order that the BCUHB could approve those payments.  In particular, information on two high-cost cases had not been found to date.

Concerns were raised by Councillor Bernie Attridge about the financial implications of the outstanding debt, given the lack of timescales and the Council’s budget forecast for 2023/24.  He said that procedures due to be discussed at a facilitated workshop should already be clearly understood.

Paul Carter stressed that whilst due processes were in place to approve payments, invoices could not be paid without the necessary authority and supporting paperwork.  He was hopeful that matters could be resolved but was unable to set a timescale without the necessary information being provided to support those payments.

As an update on the current position, the Senior Manager reported that outstanding debt from 2016 had been reduced to £1,461 and that work was currently being undertaken to address the £12,518 worth of invoices from 2017.  The current estimate of debt for 2018 was £34,890.

The Chief Executive welcomed discussion on this important issue on which the Committee should be kept updated.  In thanking all those involved for their work on the matter, he spoke about the need to prioritise high-cost cases to impact overall debt levels.

The Chairman thanked the officers for their attendance and proposed an additional recommendation which was seconded by Councillor Bernie Attridge.

RESOLVED:

(a)       That the Committee notes the progress made on the proactive budget management of outstanding invoices raised by the Council for payment by Betsi Cadwaladr University Health Board; and

(b)       That joint funded care package debt over 90 days is considered as a matter of urgency to understand how this debt can be reduced in a timely manner.  The work to be carried out by the Head of Service and Cabinet Member and reported back to this Committee on a monthly basis.