About Luton, its local needs and priorities (our prospectus)
Luton Council published its Prospectus 2013 – 2016 in December 2012. Put starkly, Luton’s population is poorer, more deprived, with more rapidly increasing proportion of young children than the national average. Its ‘super diverse’ community brings opportunities (new markets, innovation, and economic impetus) and risks (cohesion, health inequalities, attainment and access to work). Its location is both an advantage (proximity to central London and, via excellent transport links, to the rest of the country and to Europe) as well as a constraint (Luton is a hemmed-in by ‘green belt’, densely populated, urban space with little room for development within its own borders). The three-point plan, put forward in the Prospectus, to set the town on the path to prosperity can be expressed simply: to increase income from business growth; to better equip residents of all ages to get jobs through investment in education and training; and to work efficiently with public, private and voluntary sector organisations to ensure the most vulnerable in Luton are safe and supported. However, making that plan a reality is difficult; the problems we face are often hard to define or agree and the solutions, if they exist, are sometimes unclear.
What we do know is that we have to think holistically, with innovative and flexible approaches creating a ‘learning organisation’. We have to work across organisational boundaries, effectively engaging stakeholders and citizens in understanding Luton’s problems and in identifying possible solutions. And the Council has to develop a better understanding of what influences behavioural changes of its citizens without losing its grip on its regulatory roles and fiduciary duty. We’re not ‘there’ yet, but we can evidence a track record of improvement and clarity of aim.
This self-assessment therefore has to demonstrate that the Council is playing its essential role in the multi-agency responsibilities for the town and that, with its partners and stakeholders, it has a credible, comprehensive strategy for success. As the Prospectus makes clear, it has to do this whilst leading the borough to financial security, delivering essential services that residents rely on, with much less funding from Government than in the previous three years. In cash terms, this means saving £49m or 30% of the 2012/13 net revenue budget.
Luton’s Prospectus was presented to the full Council as a draft plan in November 2012 and agreed by the Executive in December 2012. It is the result of close working at the highest level between elected members and managerial leadership of the Council and senior leadership from all of Luton’s key partners and stakeholders.
Children’s services are not covered in the CPC
This is because they have recently had an Ofsted inspection and they are involved in the eastern region sector-led improvement programme, which includes a peer review of our Children’s Services self-assessment.
What’s the evidence that we’re thinking and acting holistically?
Luton has some important holistic strategies, with a sound basis in the joint strategic needs assessment (JSNA), which cross corporate and organisational boundaries, such as the children and young people’s plan, the health and well-being strategy, the early intervention strategy, the housing strategy, the skills and employability strategy and the social justice framework. Our Prospectus priorities are not the sole responsibility of the Council and require a high level of partnership working and community leadership to deliver. The same is true of our local plan, which requires the cooperation of neighbouring Councils if we are to meet the town’s priority need for additional housing.
We know that achieving good health outcomes come from more than having good health services and that housing, education, work, diet, lifestyle and social activities make a big and sometimes decisive difference to health inequalities. Similarly, we consciously link community cohesion, education success, the environment, transport and community safety with economic success. The Prospectus talks about a virtuous circle where more businesses create more jobs; investment in education and training helps local people to get those jobs and this increases their resilience, improves their health and reduces their need for public services. At the top level Luton gets more income through retained business rates and a reduction in spending as families are more able to rely on their own earning power and resilience, whilst at a service level our investment in the world-class sports facility "Inspire" enables us to run swimming sessions, for example, aimed at improving the health and wellbeing of particular vulnerable groups such as people with learning difficulties. In addition, our award winning ‘new homes for Luton’ initiative, a joint venture with the Luton Learning and Community Partnership, Catalyst Housing Group and Wates Living Space, has delivered more than 150 affordable homes for people in housing need with a further 109 expected this year.
Citizen and stakeholder engagement
From April 2012 to March 2013 the Council undertook a ‘community debate’ with its residents, about its three year requirement for major savings. A parallel exercise with elected members enabled close examination of various options to make the required savings in the medium-term.
16 service change proposals were put to the public during a three-month consultation period. This led to over 5,000 responses which informed the elected and managerial leadership of the Council prior to its decision-making process.
Luton citizens are regularly consulted on a broad range of issues either through bespoke consultation or at area boards and ward forums, which now involve both the CCG and Healthwatch.
LBC’s proposals for the transformation of social care were based on in-depth interviews and focus groups with residents. We are currently consulting the public on the proposal to develop a wellness service by re-commissioning wellbeing services (e.g. stop smoking) and aim to improve health outcomes e.g. by reducing the rate of alcohol related admissions to hospital.
Some health and wellbeing priorities that have come from resident consultation include: projects to encourage healthy lifestyles, improving access to primary care, community health checks, cheap and accessible weight management classes, all age cook and eat classes, opportunities for community food growing and Green Gyms.
An independent commission was set up in 2011 to review the relationship between the Council and the voluntary and community sector (VCS), and to support a vibrant, sustainable and local VCS, working in partnership to deliver a range of advice, information, guidance, advocacy, health and well being, preventative and social care services.
Cross organisational leadership: How do we know that our partners’ plans and our plans are aligned?
Our partnerships span all major areas of the Council’s work and cover everything of importance to Luton’s residents. For business growth the Council has agreed priorities for Luton with businesses and voluntary sector organisations which come together under the banner of Love Luton to lobby successfully for government investment. Luton’s community safety partnership soLUTiONs brings together the police, fire and rescue, NHS, probation and the Council with an agreed set of priorities designed to ensure Luton is a safe place to live and work and an attractive destination for new business. Luton in Harmony celebrates the diversity of the town that promotes cultural and economic benefits. The Council also works closely with Job Centre Plus, the Skills Funding Agency and the National Apprenticeship Scheme to further its aim of equipping residents to get jobs as they become available.
The NHS Clinical Commissioning Group has aligned its priorities with the Council, including Public Health, and its strategy: A healthier Luton draws on the health and wellbeing strategy underpinned by locally agreed outcomes that span both health and social care. Care pathways are being developed across health and social care and patients will experience seamless and personalised care. We are also developing common systems and processes across partner organisations, along with a new structure for the management and co-location of multi-functional health and social care teams based around clusters of GP practices. Work to turn this aim into reality is underway with a programme supported by Ernst and Young and involving senior Children’s, Adults’ and Public Health managers from the Council and local NHS leaders.
Luton’s community cohesion contingency plan provides a partnership framework, with Bedfordshire police and others, to respond to real or perceived tensions in the local community. For example, a neighbourhood meeting has been arranged on 5 June to bring together a range of key local organisations and representatives to discuss cohesion concerns, in partnership, and to draw up a plan to reduce possible community tensions that might arise from a number of serious gun and knife incidents that have happened in Luton over the past six months.
Additionally, Bedfordshire police Safer Neighbourhood team officers work from Luton’s Council housing offices.
The Council has responded to major welfare reform changes by developing a joint training plan for front line staff in organisations across the town; debt advice and welfare benefits advice have been integrated into customer services and a crisis support scheme with local VCS agencies has been set up to ensure commonality of approach in service delivery and referral routes.
We have an active Safeguarding Adults Board, led by a strategic manager and with an independent chair and senior key partner attendance: Police, CCG community health services, ambulance service, the Luton and Dunstable hospital and SEPT (our integrated mental health service provider).
A major attraction for businesses thinking of investing in Luton is its location and good transport links to markets in London, the rest of the country and abroad. The Council has attracted inward public investment (including innovative performance related grant) to pay for large-scale transport projects such as the Luton Dunstable Busway, improvements to junction 10a of the M1 and the town centre transport scheme (inner ring road). By spending £800,000 a year on infrastructure planning the Council has opened the door to £120 million of additional investment that benefits the town and we had the third highest annual growth of business base in UK from 2010 to 2012.
The airport supports 8,200 local jobs and has an annual economic value of £780 million to the local economy. Working with the airport operator, the Council wants to grow the airport and there is a proposal for the airport to increase capacity as well as generating an anticipated 4,500 jobs including 1,700 directly in the airport.
The town centre square, St. George’s Square, has been remodelled with £2.5 million of grant funding, which had the intended effect of encouraging the private sector to invest in the town’s principal shopping centre, the Mall, and a refurbishment of the nearby leisure complex, the Galaxy Centre. This brought an additional £20 million of investment and new businesses into the town centre improving shopping and the night-time economy.
A strategic officer group is tasked with improving Luton's business rate income through better management and business growth. The business growth strategy is in the early stages of being developed and will draw upon expertise from our business partners across the town. As an early step, we have earmarked £150,000 from under-spend as seed corn incentives to encourage new business growth in Luton.
Heath and adult social care
The headline story in Luton is that mental health services, learning disability services and public health are already integrated between the NHS and the Council. In addition plans for both adults with physical disabilities and older people are underway. Further integration is actively being worked on. This section sets out the headline pressures that the Council and its partners face along with our plans to deliver improved outcomes that address these needs, in light of financial constraints.
The NHS clinical commissioning group sees the integration of health and social care as important for the following reasons: The typical user of health services in Luton is elderly, frail, possibly vulnerable and suffering from one or more debilitating long term conditions and who needs coordinated packages of care to allow them to lead fulfilling lives. This cohort of patients represents 29% of the total population but 50% of all GP appointments, 65% of outpatients’ appointments and 70% of all inpatient bed days. Additionally 51% of people receiving social services, 75% of adults in residential care and 91% of people in nursing care are over the age of 65 years.
Proportionally, Luton has fewer older people than the national average for England. However, within south Asian and African Caribbean communities there is a higher and rising proportion of people with longer-term conditions including diabetes, cardiovascular diseases, high blood pressure and strokes. This is likely to place greater demand on services within the next five years with predicted increases in the ethnic minority populations. Additionally, the number of people who are 85 years and older is set to grow by 55% from 2350 in 2010 to 3650 in 2030. The number of people living with dementia is also expected to rise significantly. The JSNA predicts a 9% increase in prevalence from 2010 to 2014 and a 29% increase to 2020.
Luton’s population has poorer health outcomes than neighbouring populations. Luton is ranked 357 out of 404 local areas for female life expectancy and 276 for male life expectancy. Trend data has shown that female life expectancy in Luton, although rising, has slowed in recent years and therefore the gap with life expectancy in females in England as a whole has widened.
Luton has a relatively high rate of smoking in its most deprived wards, a raised level of obesity and relatively high levels of mental health need compared to the population as a whole.
In 2011/12 our enforcement and public health teams launched a campaign to raise awareness of the health risks of smoking shisha (identified as a major issue in a local needs assessment) and to shut those that were illegally operated. The public health team included volunteers, young health ambassadors, enforcement officers from Bedfordshire and Luton fire and rescue service, HM Revenue & Customs, Luton Council and community groups.
Wellbeing clubs (converted from luncheon clubs) and supported by public health funding will have a focus on community integration, enabling independence and promoting health and wellbeing for older people.
The JSNA identified a shortage of supported living accommodation for people with mental health needs. As a result, two new supported living schemes (the result of a successful joint bid with a housing association to the Housing Corporation) opened in 2012 with independent sector partners providing care and support. 18 people are now able to live independently in their own flats, reducing the Council’s reliance on expensive residential care. Others are now living independently after long stays in inpatient facilities.
The JSNA and the annual public health report highlight poor cancer survival in Luton due to late diagnosis, so we have set up a programme where volunteers are trained by McMillan nurses to raise awareness about the signs and symptoms of cancer and the importance of attending cancer screening programmes. The community development team recruit volunteers in conjunction with public health colleagues and the trained peer educators will work across Luton, focussing initially on wards with the poorest survival rates.
Luton residents with a learning disability have generally poorer health than the population at large and are 50 times more likely to die prematurely. Four years ago, GP health checks were done for 139 people and services were assessed as poor. A local action plan supported by the Learning Disability Partnership Board led to an improvement in completion rates and 286 health checks were offered in 2012/13, 86% of the eligible population. We are also developing a new model of day care for users with high physical and health needs which will include a purpose built facility and a range of community based support and activities for those with a lower level of need. To fund this we are recommissioning and selling the Bramingham centre (learning disability day centre) enabling much needed housing development. Our day-service facilities for adults with a learning disability are old-fashioned and failing to meet the existing and growing demands on the service (96 young people will transition from Children’s Services in the next 5 years). The project will have a focus on community integration, developing independence and health and wellbeing and should be completed by December 2014.
In 2011 we agreed a joint Luton autism strategy (a requirement of the Autism Act 2009) between health and social care and set up a multi-agency implementation group, working with councils and health partners across Bedfordshire. As a result over 600 professionals across Bedfordshire have been trained, a local diagnostic and support service for adults is ready to start in July 2013 and we now have a successful programme to support people with autism towards employment, run by a local voluntary sector partner.
With the NHS we have developed integrated pathways for hospital discharge and we have jointly appointed an integrated discharge manager for health and social care based at the Luton and Dunstable hospital. Jointly commissioned rehabilitation beds and ‘step-up’ flats facilitate hospital discharge and reduce hospital admission as part of ‘care closer to home’ agenda and our community based social care team is aligned to GP surgeries in Luton. Our hospital social work team is now co-located with the community assessment rehabilitation team
Our home care re-ablement service is introducing “step down” rehabilitation flats within extra-care schemes and jointly working and training with health partners such as the ‘Falls Service’ to improve our overall effectiveness and make better use of assistive technology. The integrated stroke service at Chaul End community centre provides an internationally recognised service with specialist gym facilities and training for people recovering from strokes.
A rigorous approach to spending in Luton is achieved by requiring a business case for all projects, having discipline around annual plans, with a strong ‘golden thread’ linking local budgets to corporate budget and service plans to departmental objectives and to the corporate vision and Prospectus. Quarterly delivery and accountability meetings with the chief executive and director of finance hold heads of service to account for performance, financial management and other management issues captured in the quarterly statement of governance.
A robust capital programme ensures that major spending plans are regularly assessed against corporate priorities and are affordable over the medium-term, whilst a prudent approach to reserves allows one-off investments that either save money or provide a good return.
Luton’s workforce planning strategy provides a clear method for monitoring and reviewing our approach to dealing with change, focussing resources on priority needs for training, development and performance management.
Resources and capacity
The Annual Audit Letter for the year ended 31 March 2012 says that: “The Council made proper arrangements to secure economy, efficiency and effectiveness in its use of resources for the year ending 31 March 2012”and “the Council has continued to show strong performance in identifying and delivering savings, which has continued into 2012/13.” While it indicated concern that the Council had not identified how it would bridge the future budget gap, the Council has worked on this throughout 2012/13 through its citizen and stakeholder engagement, and the development of the Prospectus, which sets the direction, and shows detailed savings proposals that have been prioritised by members in line with the overall Prospectus aims.
The medium term financial plan and the renewed transformation strategy link directly to the Prospectus. The Council has also ensured that its approach to Council Tax and Council Tax discount is consistent with the Prospectus aims of maximising income and protecting the vulnerable, by increasing the tax for those who can afford to pay, but maintaining the Council Tax discount scheme at the same levels as the previous Council Tax Benefit, so not increasing charges for the most vulnerable.
In order to protect Luton’s future resource position as far as possible, the Council successfully bid for resources to improve the town’s infrastructure to enable further development that will generate additional jobs and business rates (without those developments, the Highways Agency has been objecting to planning proposals that will generate additional traffic on the M1 Junction 10 and 10A, for example). Thus transport schemes have been linked to resources and the potential for enabling future business rates. Further, the recent agreement with the London Luton Airport operator has brought forward the prospect of increased development, generating the potential for increased business rates, jobs, and income to the Council via the concession fee agreement with the operator.
The corporate culture sets the tone of the importance of financial control, knowing your business and challenging the accepted ways of doing things – the Chief Executive recently held a series of meetings explaining the financial pressures to staff, encouraging them to challenge back to generate a ‘challenge everything’ culture promoted on the Council’s intranet.
There is a gap of £5.1m in 2015/16 where currently there are no specific approved savings to meet the target (£44m savings are in our plans) and every effort is being made to find more savings. Welfare reform is likely to generate increasing spend pressures across Council services, including homelessness, (however, there is an allowance of £1m each year for new, as yet unidentified growth within the medium term plan). There are no new savings beyond 2015/16; though, many authorities only work to a three-year financial strategy. Luton has received growth in its public health grant, which has been agreed will be spent on delivering the health and wellbeing strategy.
The political leadership of Luton has the extremely difficult job of deciding policy and determining priorities in keeping with the Council’s mission to “put the needs of Luton’s people first in everything we do”. Over the last three years £54m has been taken out of Council budgets, curtailing existing services and limiting room for future ambition. Never-the-less, the leadership has set out a clear case for action that is based on a balanced budget (requiring a further £49m savings) over the medium term. Savings decisions have only been taken following close examination of all of the options, a search for alternatives, public consultation and rigorous political debate. The policy group met on several Saturdays to consider the scale of the budget challenge and possible options for meeting it and managerial leadership was able to provide informed input to aid the debate.
Luton operates a leader and cabinet model with an overview and scrutiny committee chaired by a main opposition party (Liberal Democrat) councillor, with Conservative and Labour vice-chairs. Of the 13 committee members, five are from the majority group. The leader also chairs the important Health and Wellbeing Board.
Neighbourhood governance, “Your Say, Your Way”, promotes the community leadership role of members and gives residents the opportunity to influence local spending priorities (participatory budgeting) through ward meetings.
The three party leaders signed up to the charter for elected member development in 2010 and this has helped build elected member capacity. A skills audit was carried out in Luton shortly after the election, which has enabled a training plan to be developed to meet needs.
Innovation and transformation
In total, £54 million has been saved to 2013/14, 495 projects have been delivered in 30 months only 14% of which came from noticeable service cuts – our aim, so far as is possible, is to meet savings targets from efficiencies and better ways of working. New competency and assessment systems are driving up personal performance; our customer contact centre has cut queue times by 90% and improved call answer rate by 92%; benefit processing has reduced from 31 to 10 days; bulky refuse collection achieved targets of 98%; council tax collection (96.5%) is the best in 20 years; the cost of central finance has reduced by £659k a year; a reduction in office space (agile working) has saved over £2m; £2m has been saved through better procurement; £600k a year has been saved from engineering and highways services; remodelling integrated services for children has saved £650k a year and an early intervention review saved £600k; joint work with NHS saved £400k. 122 live projects are now helping the Council meet its savings targets for the next three years.
Luton Council can legitimately claim to understand the needs of its local community; a robust JSNA informs the health and wellbeing strategy and the new CCG strategy. The Council can also reasonably claim to know itself. We have some excellent, nationally recognised, services as well as some areas for development and improvement. With our partners, we have developed and continue to develop plans and strategies to improve the lives of Luton's residents.