The Health and Adult Services Scrutiny Committee met to discuss proposals for delivering healthcare closer to home and a new model for adult social care. The committee considered the Right Care, Right Place initiative, which aims to increase community services and reduce hospital bed numbers, and reviewed the proposed Better Care, Better Lives model for adult social care, which focuses on prevention, early intervention, and community-based support.

Right Care, Right Place: Managing Demand in the Community

The committee considered proposals from NHS Lancashire and South Cumbria Integrated Care Board (ICB) and University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) to increase community services in the Lancaster area, which would lead to a reduction in hospital bed numbers. The proposal, titled Right Care, Right Place, aims to deliver care closer to home, aligning with national and local strategies.

Representatives from the ICB and UHMBT presented the rationale behind the proposal, emphasising that it is an ongoing direction of travel rather than a new initiative. They highlighted that the national direction of travel in healthcare is towards providing more care within communities, closer to where people live. This approach is supported by the NHS England Neighbourhood Health Guidelines and the Virtual Wards Operational Framework. Locally, the proposal aligns with Lancashire's Five-Year Strategic Commissioning Plan and the ICB's emerging strategy refresh, which prioritises neighbourhood health.

Significant investment has already been made in primary care, with GP funding increasing from £2.9 million to approximately £10 million. This investment supports local enhanced services, enabling care previously delivered in hospitals to be provided within the community. The proposal involves the phased closure of two 24-bed wards in the Castle View Unit at the Royal Lancaster Infirmary (RLI). It was stressed that bed closures would only proceed if patient safety is assured, alternative services are working effectively, and there is sufficient capacity to meet demand. Approximately 25% of RLI beds were occupied by patients who no longer met the criteria to reside in hospital, indicating that the majority of patients in the Castle View Unit no longer require acute hospital care.

The committee engaged in a detailed discussion about the proposal, with councillors raising concerns about potential impacts on adult social care, the distinction between hospital care and virtual wards, the permanence of ward closures, and the capacity of community and voluntary services to absorb displaced care. The NHS representatives provided assurances that patient safety and quality of care remain paramount, and that any decisions regarding bed closures would be made with the agreement of the Chief Nursing Officer and Chief Medical Officer.

A significant portion of the discussion revolved around the definition of substantial variation and whether the proposal constituted one. While there was general support for the direction of travel towards community-based care, some councillors expressed reservations about the potential strain on adult social care services. The committee supported the ICB's recommendation for continued engagement, indicating their support for the overall direction of travel.

Model of Care: Better Care, Better Lives

The committee also reviewed Lancashire's proposed future Model of Care for Adult Social Care, titled Better Care, Better Lives. This model aims to modernise adult social care services by focusing on prevention, early intervention, and community-based support, with the goal of helping more people remain independent for longer and stay connected to their communities.

The report detailed that the model has been developed through extensive co-production with over 700 individuals, including people who draw on care and support, unpaid carers, families, staff, providers, and community partners. The co-production process identified seven key priorities: contact, communication and navigation; a single point of contact and coordinated support; valuing and supporting carers; choice, control and co-production; community connections and opportunities; independence and living a good life; and a skilled, consistent, and responsive workforce.

The model proposes a shift from a service-led approach to one that is person-centred, strengths-based, and outcome-focused. It emphasises strengthening community capacity, developing neighbourhood-based services, and improving access to personalised support. The council will act as an anchor organisation, bringing partners together, shaping the market, and focusing its own provision on specialist and complex areas of support where public-sector leadership is essential.

Councillors raised several points regarding the financial implications of the model, the funding of the voluntary and community sector, the need for staff training, the use of technology and AI, and the provision of specialist housing. Concerns were also raised about the potential for increased isolation for some individuals and the need for robust advocacy services. The council representatives explained that funding would be re-aligned to prevention and early intervention, and that the voluntary sector would be commissioned collaboratively. They also highlighted ongoing work to develop the workforce, explore technological solutions, and ensure adequate specialist housing provision.

Regarding care homes, assurances were given that there were no immediate plans for closures, and any future changes would be subject to rigorous processes. The committee also discussed the need for improved advocacy services, particularly in light of the proposed model's focus on independence and community living.

Work Programme

The committee reviewed its draft work programme for 2026/27. A significant discussion took place regarding the Shaping Care Together programme, with concerns raised about the lack of scrutiny following a decision made in March. The committee agreed to request written updates from relevant officers on their advice and involvement in the programme. The work programme also includes planned scrutiny of the Mental Health Act reforms, the NHS Winter Plan, and the Better Care Fund.

The meeting also addressed the appointment of Councillor Hamish Mills as Chair and Councillor Thomas de Freitas as Deputy Chair of the Health and Adult Services Scrutiny Committee for the coming year. The minutes of the previous meeting held on 22 April 2026 were confirmed as an accurate record, with a commitment from officers to follow up on outstanding actions and provide updates.