Wandsworth Council's Adult Social Care and Public Health department is facing a projected overspend of £3.477 million for the 2026/27 financial year, according to a report presented to the Health Overview and Scrutiny Committee.
The significant shortfall, identified at the first quarter of the financial year, is primarily attributed to increased demand for services, the growing complexity of needs among residents, and rising costs within the care market. The report highlights that the increased demand is particularly evident in services for older people and adults with learning disabilities, with a notable rise in home care and residential and nursing care placements. The average cost of new care home placements in 2025/26 was over £150 per week higher than those that ended during the year.
Councillor Melanie Hampton expressed concern over the consistent overspends, urging a greater focus on efficiency and innovation. Jeremy DeSouza, Executive Director of Adult Social Care and Public Health, outlined the council's Transformation Programme, which aims to enhance resident independence, bolster preventative measures, and improve financial sustainability. Initiatives within this programme include technology-enabled care and refined commissioning practices.
To address these financial pressures, the council is implementing various management and transformation actions. These include strengthening care package reviews, improving financial controls, maximizing appropriate health funding through collaboration with NHS partners, and accelerating the delivery of efficiencies. A delivery partner, Newton, has been engaged to help increase the pace of implementation and improve benefits tracking.
Refined Commissioning Practices
Beyond the general mention of 'refined commissioning practices,' specific changes are being made to how care services are commissioned to improve efficiency and cost-effectiveness. Regarding reablement services, the proposal is to move from a mixed in-house and commissioned model to a fully commissioned service. This involves a managed group of commissioned providers working to a common service specification, outcome framework, and performance standards. The council will retain strategic commissioning responsibility, including oversight of quality, capacity, safeguarding, performance, and value for money through contract management and quality assurance. The report also mentions strengthening commissioning arrangements for Learning Disability services to manage demand and improve value from commissioned services.
Collaboration with NHS Partners
The council is also collaborating with NHS partners to maximize health funding. This includes work to identify needs that may fall wholly or partly to the NHS, and to maximize appropriate funding through Continuing Healthcare, NHS-funded nursing care, and jointly funded packages. Specific actions include earlier referral of potentially eligible cases, review of existing high-cost packages, and escalation where funding responsibilities are disputed. The aim is to ensure the council funds only the social care element of support, in line with section 22 of the Care Act 2014.
Furthermore, the council is working with senior figures in the South West London Integrated Care Board (ICB) to establish more effective ways of working. This includes a recently signed-off process for escalation through continuing healthcare to prevent residents from experiencing prolonged uncertainty. Additionally, an investment of £1.6 million from the ICB is expected to be invested in services across the partnership, which should help to speed up services and create efficiencies.
Further details on the council's financial position and the Transformation Programme can be found in the Public reports pack for the Health Overview and Scrutiny Committee meeting on 21st September 2026.