The Adult Social Care and Public Health Cabinet Committee met on Wednesday, 11 March 2026, to discuss performance, risks, and future strategies for adult social care and public health services. Key decisions included the commissioning of new home care services and a commitment to developing a neighbourhood health model, alongside discussions on the sustainability of the social care market and the impact of national health policies.

Adult Social Care Performance

The committee received an update on the Adult Social Care Performance Dashboard for Quarter 3 of 2025-26. While the overall picture was positive, with most Key Performance Indicators (KPIs) in the green or amber categories, there were ongoing concerns about the sustainability of the social care market. Councillor Stuart Jeffery highlighted this as the top risk, noting that the highest risk it could possibly be and questioning what further actions could be taken, particularly regarding funding for care homes and in-home support. Mark Scrivener, Head of Corporate Risk and Delivery Assurance, acknowledged these concerns, stating that risk ratings are determined by risk owners and that ongoing conversations are taking place to assess if current ratings remain appropriate. He indicated that risk ratings might change based on new information and discussions within the Director Management Team.

Public Health Performance

The Public Health Performance Dashboard for Quarter 3 (October to December 2025) was presented, showing a generally positive performance across 14 KPIs. No indicators were in the red category, although data for some indicators, particularly those relating to substance misuse and smoking services, was still pending. The committee was informed of several changes to KPIs as part of a service transformation programme aimed at improving service specifications and outcomes. These refinements include splitting KPIs for substance misuse to better track under and over-18s, and refining health visiting KPIs to target specific cohorts. Smoking quit targets have also been substantially increased to align with national goals and additional funding. Councillor Colin Sefton raised a question about the absence of KPIs for vaccination, noting worrying trends and suggesting their inclusion. The committee was assured that while some KPIs have been tweaked, the focus remains on outcomes and successful completions, with complementary KPIs in place to maintain granularity.

Risk Management

The committee reviewed the Adult Social Care and Public Health Risk Management reports. The most significant risk identified was the sustainability of the social care market, rated at the highest possible level. Councillor Jeffery expressed concern about the lack of increased funding for care homes and in-home support, stating, you refuse to put up the money to support people in their care homes and the care homes themselves. Councillor Sefton echoed these concerns, questioning the effectiveness of current strategies and suggesting that the risk rating might not yet reflect the doubts held by some members. A point of clarification was sought regarding the timeliness of the risk reports, with a member noting that the report presented was not the most recent available. Mr. Scrivener explained that reports are submitted for approval processes, and sometimes the latest data is not available in the pack due to these timelines.

Neighbourhood Health

A significant portion of the meeting was dedicated to discussing the emerging concept of Neighbourhood Health, a national pilot programme aimed at shifting focus from hospital-based treatment to community-based prevention and care. The initiative is aligned with the NHS's 10-year plan, which advocates for a move from hospitals to communities and from treatment to prevention. Dr. Andrew Ghosh and Mike presented the framework, explaining that local neighbourhood teams will be based on primary care networks, with plans for multi-neighbourhood footprints to deliver more complex services. The model utilises the John Hopkins population segmentation model, focusing on individuals with the highest need to prevent hospital admissions through proactive interventions like comprehensive geriatric assessments and structured medication reviews.

However, challenges were raised regarding the NHS's capacity to shift resources from hospitals to communities, particularly given the current focus on reducing waiting lists. Councillor Sefton expressed scepticism about the Integrated Care Board's (ICB) ability to facilitate this financial shift, stating, I don't think there's much opportunity, frankly, for a large-scale shift of resources. Concerns were also voiced about the potential for the model to overlook individuals at high risk of certain conditions, such as strokes, if the focus is solely on those with the greatest current need. Councillor Jeffery questioned the emphasis on a medical model and the apparent lack of focus on wider determinants of health, such as socioeconomic and environmental factors. The committee was informed that while these wider determinants are recognised as crucial, the immediate NHS focus for neighbourhood health is on preventing hospital admissions.

All Age Home Care Services Commissioning

The committee considered a proposal to commission new All Age Home Care Services, with contracts due to expire in March 2027. This commissioning exercise aims to create a clearer separation between regulated and unregulated services and ensure sustainable pricing and workforce support. Demand for these services has increased significantly, with adult home care demand rising by nearly 25% in one year.

Councillor Jeffery stated he would not be supporting the proposal due to a perceived lack of detail regarding changes to the service model and the holism of care. He noted that while the paper mentions new models, they are not clearly articulated, and expressed concern about the growth rate in demand and pricing. Councillor Connie Nolan also voiced strong reservations, stating, I do take deep exception to not understanding the changes that may or may not be there, because I've heard different answers. She indicated she would not be supporting the proposal. Despite these objections, the recommendation was approved with the exception of Councillor Jeffery.

Work Programme

The committee noted the Work Programme for 2025-26. Councillor Sefton requested that a financial report on the first quarter be included in a private session for the July meeting, a suggestion that was agreed to be taken up during agenda setting.