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Health and Social Care Select Committee – 26 March 2026
Classification: Public
BUDGET & SPENDING REPORT – SELECT COMMITTEE MONITORING
Committee name Health and Social Care Select Committee
Corporate Director(s)
responsible
Sandra Taylor Corporate Director Adult Social Care & Health
Papers with report Appendix A
Ward All
RECOMMENDATION
That the 2025/26 Month 10 budget monitoring position be noted.
HEADLINES
This report provides an update on the 2025/26 Month 10 budget monitoring position relevant to
the Select Committee. The Corporate Director, supported by their Finance Business Partners, will
attend the meeting to provide further details and clarifications.
2025/26 MONTH 10 BUDGET MONITORING POSITION
At Month 10 service operating budgets within the Committee’s remit are forecasting a net
overspend of £ 6.5m against budget. This is a n adverse movement of £0. 8m from the Month 7
position.
Demand for Adult Social Care remains consistently high following the pandemic, with funding
from the Department of Health and Social Care failing to keep pace with increasing client demand
volume and complexity and market pressures.
Adult Social Care & Health is forecasting an overspend of £6.5m for the year, with overall
pressures of £8 .0m offset by a £1.5m underspend against SEND transport and mitigations of
£2.0m achieved through effective vacancy management. The overspend is driven by ongoing
growth in demand for all service areas. Client numbers continue to rise above the budgeted
assumption, particularly in Learning Disabilities and Mental Health services. The underspend in
SEND transport is due to more economical procurement of personal assistants and maximising
efficiencies through the mix of delivery options. The £0.9m adverse movement in month is due to
£0.5m of placement growth as a result of client capital depletions and backdated support plans,
£0.3m being the impact of DfE guidance that disallows the use of DSG for Personal Transport
costs, and £0.1m contingent labour and one to one support in Direct Care Services.
Table 1 provides an overview of the Committee’s Month 10 budget monitoring position. It includes
adjustments for Earmarked Reserves, Provisions and Transformation Capitalisation.
Table 2 provides a detailed breakdown of the Committee’s outturn by service area.
2025/26 SAVINGS
For the services within the remit of this Committee, the savings requirement for 2025/26 is £8.3m.
Health and Social Care Select Committee – 26 March 2026
Classification: Public
At Month 10, £3.7m (44%) of the savings and interventions are recorded as banked or on track
for delivery, with a further £0. 2m ( 2%) being at initial stages of delivery. £4.4m (54%) of the
savings are reported at risk in 2025/26, including £1.7m expected to slip into 2026/27.
Table 3 provides a detailed breakdown of the 2025/26 Month 10 savings position.
PERFORMANCE DATA
Adult Social Work & care provision:
Demand at the Adult Social Care front door remains consistently high and is a contributing factor
of downstream financial and operational pressure.
Front‑door performance data shows that Adult Social Care managed 61,154 contacts over the
reporting period. This equates to an average of over 5,000 contacts per month demonstrating
sustained system pressure rather than isolated spikes in activity. Contacts data covering calendar
year 2025 to March 2026.
This profile illustrates both the scale and intensity of demand being managed through the front
door, with a significant proportion of contacts requiring timely triage, assessment or onward action
to manage risk and prevent escalation.
Analysis of contacts by latest support reason shows that demand is dominated by higher ‑need,
statutory support requests rather than low‑level advice or signposting alone.
Approximately 63% of contacts relate to physical support needs, making this the single largest
driver of demand. This is followed by:
Support with memory and cognition, reflecting increased dementia prevalence
Mental health support
Learning disability support
Social support needs
This demand profile reinforces that front‑door activity is closely aligned with statutory Adult Social
Care responsibilities, with limited scope to divert demand away from funded services once
eligibility thresholds are met.
Front‑door activity functions as a critical demand ‑management mechanism rather than a simple
gateway into services.
Contact outcome data shows that:
A large proportion of contacts are linked to existing referrals, supporting continuity and
avoiding duplication
Many contacts are resolved through information, advice, signposting or preventative
responses
A smaller but significant proportion result in new referrals, safeguarding activity or formal
assessment
This demonstrates that front ‑door processes are actively controlling escalation into higher ‑cost
Health and Social Care Select Committee – 26 March 2026
Classification: Public
services, ensuring that statutory interventions are targeted at individuals with eligible needs and
unmanaged risk.
Safeguarding activity remains a significant component of overall demand and is closely linked to
front‑door contact volumes.
During the most recent reporting presented to the Safeguarding Adults Board in Month 10 was
performance data covering 2025 into January 2026:
Adult Social Care received 13,868 safeguarding contacts
These progressed to 3,783 safeguarding concerns
Resulting in 305 Section 42 enquiries
Performance data demonstrates a strong focus on outcomes and risk management:
Over 80% of completed Section 42 enquiries had a clearly identified desired outcome
Over 96% of those outcomes were fully or partially achieved
Nearly 90% evidenced a reduction in risk for the adult concerned
Safeguarding performance is overseen through the Adult Social Care Power BI safeguarding
dashboard and subject to regular multi ‑agency sc rutiny via the Safeguarding Adults Board,
providing assurance on volumes, timeliness and case progression despite rising demand.
Adult Social Care operates robust financial controls to manage demand ‑led expenditure and
ensure resources are targeted appropriately in line with statutory duties under the Care Act 2014.
A spending control process commenced in June 2025 and this has seen an improvement in the
provisioning of care and an improvement in the strengths-based approach to supporting residents
in the community.
Adult Social Care operates a structured, rolling case audit programme to assure practice quality
and support continuous improvement.
Audits are undertaken monthly across all Operational Adult services, drawing from both open
cases and those closed within the previous six months. A thematic approach is applied on a
regular cycle, including focused audits on safeguarding and mental capacity.
Audit findings are translated into clear actions and tracked through management oversight,
providing Members with assurance that quality, safeguarding and value for money are being
actively managed together.
Improving operational efficiency:
Hillingdon’s Technology Enabled Care (TEC) programme has already delivered significant
improvements by expand ing a diverse range of digital tools —from AskSARA and lifestyle
monitoring apps like Intelligent Lilli to night -time sensors, smart devices, and wearables —that
have strengthened early intervention, improved safety, and helped residents remain independent
at home for longer.
These technologies have enhanced assessment accuracy, reduced reliance on intensive or
residential care, supported carers through remote monitoring and training, and generated staff
efficiencies while maintaining high-quality, person-centred care. Building on strong CQC feedback
and a collaborative, digitally confident workforce, the focus now is on embedding TEC as a routine
part of all care planning, fully transitioning to digital systems by 2027, and expanding early help
Health and Social Care Select Committee – 26 March 2026
Classification: Public
tools, smart home solutions, carer support, and proactive risk management so residents, carers,
and professionals are equipped to deliver and experience outstanding, modern adult social care.
RESIDENT BENEFIT
Regular monitoring of financial performance ensures that spending and savings targets are met,
which supports the efficient delivery of services to residents. By closely tracking expenditure and
identifying variances, the council can take timely corrective actions to address overspending and
mitigate risks. This also enhances public transparency and accountability, providing residents with
confidence that their Council is managing finances prudently and prioritising their needs. Overall,
regular monitoring supports safeguarding the Council's finances and the del ivery of quality
services to residents.
FINANCIAL IMPLICATIONS
This is primarily a finance report, and the implications are set out in the main body of the report
above.
LEGAL IMPLICATIONS
There are no direct legal implications arising from regular monitoring of the council’s finances by
select committees.
Democratic Services advise that effective overview and scrutiny arrangements require access to
the information under the committee’s purview and, in accordance with the 2024 S tatutory
Scrutiny Guidance, such information includes finance and risk information from the Council, and
its partners where relevant.
BACKGROUND PAPERS
NIL
APPENDICES
Appendix A – Tables 1-3
Health and Social Care Select Committee – 26 March 2026
Classification: Public
Appendix A – Tables 1-3
Table 1: 2025/26 Month 10 Budget Monitoring
Approved Budget Underlying
Forecast
Earmarked
Reserves Provisions Transformation
Capitalisation Forecast Outturn Forecast
Variance M10
Forecast
Variance M9
Change in
Variance
A1: Staffing Costs 24,665 22,392 - - -101 22,292 -2,373 -1,799 -574
A2: NonStaffing Costs 160,516 171,896 - - - 171,896 11,381 10,420 961
A3: Grants Fees & Other Income -84,287 -86,255 -538 - - -86,794 -2,506 -2,699 193
Sub-Total 100,893 108,033 -538 - -101 107,394 6,501 5,923 578
Month 9 100,893 107,458 -541 - -101 106,816 5,923
Movement Month 9 to Month 10 - 576 3 - - 578 578
R3: Executive Director Adult Services and Health
R3: Executive Director Adult Services and Health
Health and Social Care Select Committee – 26 March 2026
Classification: Public
Table 2: 2025/26 Month 10 Budget Monitoring by Service Area
Approved Budget Underlying
Forecast
Earmarked
Reserves Provisions Transformation
Capitalisation Forecast Outturn Forecast
Variance M10
Forecast
Variance M9
Change in
Variance
A1: Staffing Costs - -4 - - - -4 -4 224 -228
A2: NonStaffing Costs 474 415 - - - 415 -59 -23 -36
A3: Grants Fees & Other Income -332 -328 - - - -328 4 45 -42
Sub-Total 142 83 - - - 83 -59 247 -306
A1: Staffing Costs 7,972 7,648 - - - 7,648 -323 -467 143
A2: NonStaffing Costs 1,517 2,071 - - - 2,071 553 444 110
A3: Grants Fees & Other Income -625 -730 - - - -730 -105 -109 4
Sub-Total 8,864 8,988 - - - 8,989 125 -132 258
A1: Staffing Costs 116 605 - - - 605 489 490 -1
A2: NonStaffing Costs 2 313 - - - 313 311 311 -
A3: Grants Fees & Other Income -93 -430 - - - -430 -337 -337 -
Sub-Total 25 488 - - - 488 463 464 -1
A1: Staffing Costs - 25 - - - 25 25 21 5
A2: NonStaffing Costs 313 511 - - - 511 198 179 19
A3: Grants Fees & Other Income - -44 - - - -44 -44 -393 349
Sub-Total 313 492 - - - 492 179 -194 373
A1: Staffing Costs 316 7 - - - 7 -309 -309 -
A2: NonStaffing Costs 831 1,129 - - - 1,129 298 109 189
A3: Grants Fees & Other Income - - - - - - - -47 47
Sub-Total 1,147 1,136 - - - 1,136 -11 -247 236
A1: Staffing Costs 745 906 - - - 906 161 150 11
A2: NonStaffing Costs 15,269 15,635 - - - 15,635 367 340 27
A3: Grants Fees & Other Income -22,437 -22,426 -538 - - -22,964 -527 -489 -38
Sub-Total -6,423 -5,884 -538 - - -6,423 - - -
A1: Staffing Costs 49 593 - - -101 492 442 444 -2
A2: NonStaffing Costs 1,151 1,508 - - - 1,509 357 378 -21
A3: Grants Fees & Other Income -22,518 -23,089 - - - -23,089 -571 -571 -
Sub-Total -21,317 -20,988 - - -101 -21,088 228 251 -23
A1: Staffing Costs - - - - - - - - -
A2: NonStaffing Costs 686 1,104 - - - 1,104 418 416 3
A3: Grants Fees & Other Income - - - - - - - - -
Sub-Total 686 1,104 - - - 1,104 418 416 3
A1: Staffing Costs 45 44 - - - 44 -1 -1 -
A2: NonStaffing Costs 126,224 134,903 - - - 134,903 8,678 8,082 596
A3: Grants Fees & Other Income -35,315 -35,660 - - - -35,660 -345 -225 -120
Sub-Total 90,954 99,787 - - - 99,287 8,332 7,856 477
A1: Staffing Costs 4,948 3,958 - - - 3,957 -990 -910 -81
A2: NonStaffing Costs 10,806 10,060 - - - 10,060 -746 -755 9
A3: Grants Fees & Other Income -320 -56 - - - -56 264 -61 325
Sub-Total 15,433 13,961 - - - 13,960 -1,473 -1,726 254
A1: Staffing Costs 4,543 4,020 - - - 4,020 -523 -500 -23
A2: NonStaffing Costs 2,448 3,394 - - - 3,394 946 890 55
A3: Grants Fees & Other Income -2,400 -3,190 - - - -3,190 -790 -728 -62
Sub-Total 4,592 4,224 - - - 4,224 -367 -338 -30
A1: Staffing Costs 5,931 4,591 - - - 4,591 -1,340 -941 -399
A2: NonStaffing Costs 794 853 - - - 853 59 50 9
A3: Grants Fees & Other Income -247 -301 - - - -301 -54 218 -272
Sub-Total 6,477 5,143 - - - 5,143 -1,335 -673 -661
A1: Staffing Costs - - - - - - - - -
A2: NonStaffing Costs - - - - - - - - -
A3: Grants Fees & Other Income - - - - - - 0 -
Sub-Total - - - - - - - - -
A1: Staffing Costs 24,665 22,392 - - -101 22,292 -2,373 -1,799 -574
A2: NonStaffing Costs 160,516 171,896 - - - 171,896 11,381 10,420 961
A3: Grants Fees & Other Income -84,287 -86,255 -538 - - -86,794 -2,506 -2,699 193
Sub-Total 100,893 108,033 -538 - -101 107,394 6,501 5,923 578
Month 9 100,893 107,458 -541 - -101 106,816 5,923
Movement Month 9 to Month 10 - 576 3 - - 578 578
R3B: Immediate Response Service
R3C: Sustained Support Service
R3: Executive Director Adult Services and Health
R3: Executive Director Adult Services and Health
R35: Head of Hospital and Localities Services
R36: Director of Health and Public Health
R37: Director Adult Services and Health
R38: Head of Safeguarding Adults
R39: ASC Placements
R3A: Head of Direct Care Provision CFE
R30: Closed Codes Corporate Director Social
Care
R31: OT Minor Adaptations and Community
Equipment
R32: Head of Direct Care Provision HSC
R33: Head of Child & Family Development CFE
R34: Head of Learning Disability and Mental
Health Services
Health and Social Care Select Committee – 26 March 2026
Classification: Public
Table 3: 2025/26 Month 10 Savings
RAG Rating 2025/26 & B/fwd savings
Total B G A1 A2 R W/O
£'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000
Mortuary - Provision of E xternal T raining (10) (10) (10)
R eview of E arly Y ears Operating Model (130) (130) (130)
Acquisition of Care home (550) (388) (162) (550)
AI Digitisation of Operational S ocial Work Practices (548) (548) (548)
Care Diagnostic E quipment (150) (150) (150)
Child and Family S upport S ervice S taffing R eview (182) (182) (182)
Creation of a care company for temporary staff via an S PV (277) (277) (277)
Implementation of Ask S AR A (150) (150) (150)
Increase MVF by 1% (146) (146) (146)
Lease Income for S exual Health Clinics (250) (250) (250)
Post 16 T ransport (624) (624) (624)
Proposal to decant Lowdell Close R egistered Care home due to safety concerns (200) (200) (200)
R e-negotiation of S ocial Care contracts (1,739) (1,739) (1,739)
R eview and change in the catering services offer for E xtra Care, Day R esources & E arly Y ears services (217) (118) (99) (217)
R eview of E arly Y ears Operating Model (Additional) - Lease Income (93) (93) (93)
R eview of E arly Y ears Operating Model (Additional) - R esidual E Y Budget (94) (94) (94)
R eview of third sector Carers contract value in S ocial Care (172) (172) (172)
R eview of third sector Information, Advice and G uidance contract value in S ocial Care (170) (170) (170)
S ection 117 Funding split with ICB (2,031) (2,031) (2,031)
Use of Disabled Facilities G rant (300) (300) (300)
Vacant Post R eview (283) (283) (283)
(8,316) (3,665) 0 (99) (93) (2,720) (1,739) (8,316)
Description
Total
2025/26
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