Lewisham Council is grappling with a significant budget gap of £65 million over the next four years, with adult social care and health services facing a substantial portion of this deficit. The council's medium-term financial strategy forecasts a need for £64.469 million in savings between 2027/28 and 2030/31. The savings requirement is broken down as follows: £20.925 million in 2027/28, £13.985 million in 2028/29, £23.712 million in 2029/30, and £5.847 million in 2030/31.
The Healthier Communities Select Committee met on Tuesday, November 3, 2026, to discuss proposals aimed at addressing this substantial financial challenge. The committee reviewed numerous proposals for savings across various service areas, focusing on service redesign, demand management, prevention, invest-to-save initiatives, and income generation, rather than direct service cuts. The aim is to protect frontline services while striving for greater efficiency and investment to reduce future costs.
Councillor Samantha Gardner, Cabinet Member for Health, Wellbeing and Adult Social Care, and Denise Radley, Executive Director of Adult Social Care and Health, presented the budget reductions report. They highlighted the immense pressure on adult social care, citing national austerity, long-term underfunding, an ageing population with complex needs, and the rising cost of private care packages. The ageing population here with increasingly complex care needs, and the cost of private care packages, it's really leaving councillors across the country on their knees,
she stated. Behind every proposed saving is someone who relies on these services to live safely and independently and with dignity. Balancing the budget is a responsibility, but it's also understanding the human consequence of every decision that we make.
Strategies for Adult Social Care and Health Services
Several strategies are being considered for adult social care and health services. These include supporting adults with learning disabilities to move from residential settings to more independent, community-based accommodation, and reviewing care home placements for individuals with behaviours that challenge linked to dementia to reduce care levels where appropriate. The enablement service aims to improve its impact by increasing access from the community pathway and managing demand in-house. Furthermore, the council is looking to expand the Shared Lives programme to individuals with dementia and those at risk of self-neglect. A joint health and social care initiative will address high-cost mental health placements through systemic reviews, recovery-focused planning, and improved commissioning. Efficiencies are also sought in the community equipment service through improved collection, recycling, and prescriber governance, and by reducing costs associated with vacant units in learning disability supported living and residential schemes.
Other service redesigns include revising the funding model of the Transformation Delivery Unit and delivering efficiencies across the People and Organisational Development function through service redesign, process improvement, and demand reduction. Communications and Engagement aims to increase advertising income and achieve savings through contract reviews, while Customer Service Centre efficiencies are expected due to automation and the use of AI. Adult Learning, Lewisham, plans to increase income through learner fees and room hire, and savings are projected through increased income from a recently awarded 13-year contract for leisure services.
Demand management strategies include managing non-statutory dog surrender requests through clearer triage, earlier advice, and signposting to reduce reliance on external kennelling. The council will cease proactive gully cleansing, moving to a risk-based and reactive response for highway drainage, and reduce investment in proactive and reactive carriageway and footway repairs. Standards delivered through the Green Space Contract will be revised, resulting in fewer routine maintenance activities, and the Parks grounds maintenance budget will be reduced. The General Fund subsidy for the Markets Service will be reduced by improving income generation. In Children and Young People services, there is a plan to reduce reliance on agency staff and accelerate permanent recruitment.
Projected Impacts on Services and Residents
The report emphasises that the proposed savings are focused on greater efficiency and investment to reduce future costs, aiming to limit the impact on residents and frontline services. For example, supporting adults with learning disabilities into more independent accommodation is described as delivering improved outcomes. The continual review of care home placements aims to reduce care levels where appropriate, with a described low impact as reducing 1:1 support is less restrictive. Improving enablement seeks to ensure longer-term care is proportionate to need. The expansion of Shared Lives is described as delivering great outcomes at a lower cost, supporting individuals within family settings. The Complex Care Recovery Programme is intended to positively impact service users by strengthening placement reviews and promoting independence. The Learning Disabilities Supported Living/Residential Voids Reduction aims to improve property standards and accelerate internal placement flows, leading to faster placements and better alignment of accommodation to assessed need. For the community equipment service, the focus is on improving collection and recycling, with no negative impact on service users expected.
However, some proposals acknowledge potential negative impacts. Reductions in highways drainage, carriageway, and footway maintenance are projected to have a high impact over the medium to long term, potentially leading to more blocked gullies, localised flooding, faster deterioration of roads and pavements, and reduced service quality. This could disproportionately affect older and disabled people. The Main Grants Programme 2028/29 acknowledges that funded organisations may be significantly impacted, and service users may experience reduced capacity or availability of activities, with a high risk of negative impact on various protected characteristics. The Home Library Service has a medium risk, with a potential negative impact on older and disabled residents if the volunteer-led model is unsuccessful, leading to loss of access to physical library materials and increased social isolation. The reduction in the Parks Grounds Maintenance budget will affect the overall quality and performance of Parks Services.
Invest-to-Save Initiatives
Several 'invest-to-save' initiatives are being explored. The 'Progression and Next Steps' initiative involves developing further supported accommodation for those with complex needs, with a projected saving of £45,000 for 2029/30. The expansion of the Shared Lives programme requires additional staff but is projected to save £539,000 per annum, net of additional staffing costs. Adult Learning, Lewisham, is undertaking an 'Invest to Save' programme requiring investment in a new pottery studio and classroom, with a projected saving to the general fund of £143,000 in 2027/28.
Addressing Rising Care Package Costs
While the rising cost of private care packages is a significant financial pressure, a specific, overarching strategy for addressing this is not explicitly detailed. However, several proposals indirectly aim to manage these costs by promoting independence, ensuring care is proportionate to need, and optimising existing resources. These include supporting individuals into less restrictive, community-based accommodation, reviewing care home placements to reduce care levels where appropriate, and ensuring longer-term care is proportionate to need. The Complex Care Recovery Programme aims to reduce the cost of high-cost adult mental health placements, and the Learning Disabilities Supported Living/Residential Voids Reduction seeks to reduce costs associated with vacant units.
Staffing Implications
The implications for council staff vary. Several proposals explicitly state that no redundancies are planned, with savings achieved through natural attrition, vacancy management, or reduced reliance on agency staff. Some proposals indicate potential changes to roles or structures that may lead to redundancies, subject to further detailed design and consultation. Other proposals state there will be no direct impact on staff. Some may lead to changes in workload or how staff operate, such as managers taking greater responsibility for people management. Staff consultation will be necessary for proposals involving potential structural changes or service redesign. Some proposals may affect specific teams, such as the deletion of a vacant post.
Identifying Remaining Savings
Officers are continuing to work on developing new proposals to identify the remaining savings needed to close the budget gap. Proposals totalling at least £30 million are expected to be put forward as part of setting the 2027/28 budget. This process is intended to minimise the risk of requiring reserves to set a balanced budget next year. This work is ongoing and will be part of the development of the 2027/28 budget.
The committee agreed to note a report which stated that the level of proposals put forward did not meet the budget gap, and officers would continue to work on identifying further savings. The full report can be found in the Public reports pack.