Healthwatch Stoke-on-Trent responds to budget consultation

What do we think of the proposals?

Healthwatch Stoke-on-Trent would like to commend the administration for not making further cuts to frontline services. The Equality Impact Assessment proposes that “indirect impacts are possible” from the rise in Council Tax. Healthwatch Stoke-on-Trent believes that the Equality Impact Assessment should also have addressed the potential impacts arising from the proposed “internal efficiencies, improved commissioning and contract management, workforce reforms, service redesign and operational changes” and “ongoing demand management and care package reviews across children’s social care (c£4m) and adult social care (c£2m), staffing structures and reviews (c£1.2m), additional income (c£2.5m) and other efficiencies (c£0.1m).” (page 12). 

Given the financial context within which the 2026/2027 budget is being set, Healthwatch Stoke-on-Trent believes that the proposed ‘reviews’ are more likely to reduce the service an individual receives, than increases it. Healthwatch Stoke-on-Trent is also concerned about the adverse economic impact on the City from the review of staffing structures, should this lead to council employees being made redundant.

Healthwatch Stoke-on-Trent would also like to commend officers for completing an equality impact assessment and would like to suggest that the team responsible supports other departments to do the same. Equality impact assessments are not widely nor consistently completed. If they were, the council would be able to understand the cumulative impact of council activities on its residents. 

Healthwatch Stoke-on-Trent is disappointed that a simplified and more accessible format of the document was not produced and published. This was suggested by the Healthwatch representative when the paper came to the Adult Social Care, Health Integration and Wellbeing Overview and Scrutiny Committee on Thursday 15^th January 2026.

Suggestions for other ways we can make savings or improvements to our services

The Leader’s forward references “Co-designing services with the communities they serve” and “We need to think more creatively about how we use the assets we have.”

Page 15 contains a section entitled “Building thriving neighbourhoods and communities” and references the partnership approach that puts local communities at the heart of decision-making using an Asset-Based Community Development approach. The approach is about “not about imposing top-down solutions. It is about building on what works and tailoring support and services around existing networks and neighbourhoods.”

Section 5 (page 17) entitled “Transforming the Council” makes no reference to the approach outlined above.

Healthwatch Stoke-on-Trent would like to suggest that taking a co-designing, Asset-Based Community Development approach using data from collated equality impact assessments will result in solutions, both area specific and city-wide, that improve health and experience whilst reducing costs through the elimination of waste and duplication and an increase in compliance. 

A number of place-based community forums, with recruitment from the very places where solutions are needed, should be developed to truly work on the broad determinants that impact on wellbeing. Fora such as these are essential in being place and city-focussed, in light of the removal of place as a focus of the larger Integrated Car Board. By starting with the community and working with them on all aspects of their life, as opposed to different teams parachuting in with separate projects, is more likely to solve the council’s wicked problems. 

When embarking on such an approach, mindset is key. Here is a way of thinking about the circumstances within which residents find themselves.

This is a quote from the Staffordshire and Stoke-on-Trent Adult Safeguarding Partnership Board Annual Report 2024-2025, presented to the Adult Social Care, Health Integration and Wellbeing Overview and Scrutiny Committee on Thursday 15th January 2026. Priority one, effective practice, sets out what the board is seeking to achieve and fifth on the list is the following:

“Safeguarding partners commit to improve our response to self-neglect, including that we will explore what experiences led, and sustain, a person to live in this way rather than judge self-neglect and substance use to be a lifestyle choice and we will consider wider social, physical and mental health factors rather than rely on substance use to explain a person’s circumstances. We will recognise the impact of trauma, substance use, and the coercive and controlling effects of addiction, on a person’s mental capacity to make decisions about their self-neglect and substance use.”

Imagine what could be achieved if we truly understood the experiences that impacted on a person’s capacity to make decisions.