Plymouth City Council's Health and Adult Social Care Scrutiny Panel met on 15 July 2025, to discuss performance, finance and risk reports, palliative and end of life care, and NHS reforms and restructures. The panel noted the appointment of Councillor Pauline Murphy as Chair, and Councillor Carol Ney as Vice-Chair for the 2025-26 municipal year. The panel reviewed the progress of the action log and discussed items on the work programme for 2025-26.

Closing Efford and Weston Mill Crematorium Buildings

The panel noted that Plymouth City Council has decided to permanently close the crematorium buildings at Efford Cemetery and Weston Mill Cemetery. According to the decision document, this is because:

It is not cost effective to keep the crematorium buildings at Efford and Weston Mill cemeteries maintained, heated, and with sufficient staffing to be able to open them. This is combined with demand dropping to zero within a few weeks of The Park opening, and the recognised inability of these buildings to offer modern facilities which are inclusive for all.

The decision does not affect the cemeteries themselves, which will remain open for burials and memorialisations. Access to the niche room/columbaria will remain by appointment only.

Adult Social Care Performance

The panel reviewed the Adult Social Care Activity and Performance Report. The report provided an update on key performance measures and service demand. Key discussion points included:

• Waiting Lists: The report highlighted ongoing efforts to reduce waiting times for Care Act assessments[^1], with a Waiting Well policy in place to ensure people are waiting safely. The average time for an assessment to be completed upon allocation to a social worker was 24.3 days. The report noted that Occupational Therapy has been identified as a service area under significant pressure, with demand consistently exceeding available capacity. [^1]: The Care Act 2014 sets out how people should be assessed for social care and support.
• Residential and Nursing Care: Progression from intermediate care following hospital discharge remains the most common pathway into both residential and nursing care placements. Multi-agency discharge work has improved the percentage of Pathway 1 intermediate care discharges from hospital to home from 23% to 55%, with the aim of reaching 75% by August 2025.
• Domiciliary Care: The number of individuals receiving domiciliary care continues to increase each month. Provider fee uplifts for 2025/26 have been communicated and are not leading to a sense of vulnerability within the market.
• Reablement: The average length of time individuals receive reablement care is below the national target, at 4.9 weeks. The percentage of people remaining at home 91 days after discharge is exceeding the target of 80%.
• Direct Payments: After a period of decline, the number of people receiving direct payments is now increasing. Direct Payment training for staff is being developed and will be rolled out to staff in quarter three of this year.

End of Life Care

The panel received an update on the delivery of the End of Life improvement plan. Key points from the End of Life Locality Plan included:

• Consistent use of a tool to identify the end of life phase and embedding a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) End of Life register.
• Ensuring the end of life care service offer is universally understood with a central information point for individuals and system partners.
• Completing a demand and capacity analysis for end of life care.
• Using the National Audit of Care at the End of Life to ensure priorities for individuals are being met and using this audit to evaluate any service improvements.
• Embedding specialist end of life support in the local coordination hub for urgent and emergency care.
• Developing a strategy for working with communities to expand 'death literacy', building on community assets and the Compassionate City programme.

The report also included updates from University Hospitals Plymouth (UHP) and St Luke's Hospice.

Councillor Terri Beer provided a written statement expressing concerns about palliative care and end of life care in Plymouth, describing it as a postcode lottery. Councillor Terri Beer shared examples of cases where patients did not receive adequate care and support.

NHS Reorganisation

The panel received an update on the reorganisation of NHS bodies in the region. NHS England has approved a new 'cluster' covering Devon, Cornwall and the Isles of Scilly, bringing together Integrated Care Boards (ICBs) into 26 clusters across England. The seven current ICBs in the south west will transition into three clusters:

• Devon and Cornwall and Isles of Scilly (two ICBs)
• Bristol, North Somerset and South Gloucestershire (BNSSG), and Gloucestershire (two ICBs)
• Somerset, Dorset, and Bath and North East Somerset, Swindon and Wiltshire (BSW) (three ICBs)

The panel were informed that the Devon Integrated Care System (ICS) submitted a breakeven plan to NHS England on 30 April 2025, which included £53.8m of Deficit Support Funding (DSF) and a further £10.0m of regional support. The plan included £255.8m efficiencies, which is 7.8% of Devon ICB allocation.