The Adult Social Care and Health Scrutiny Panel met to discuss the Health Determinants Research Collaboration, receive an update on the Care Quality Commission (CQC) report, and to review the 'Healthy Placemaking Across the Life Course with a Focus on Children and Young People' scrutiny topic, with a particular focus on childhood obesity. The panel agreed to develop communication links between themselves and the South Tees NHS Foundation Trust. They also noted that future meetings of the Adult Social Care and Health Scrutiny Panel would commence at 4pm where possible.

Healthy Placemaking

Lindsay Cook, Health Improvement Manager for Public Health South Tees, and Mark Fishpool, Programme Director for 'You've Got This', gave a presentation on 'Healthy Placemaking Across the Life Course with a Focus on Children and Young People'. The presentation highlighted the prevalence of obesity in Middlesbrough, with 25.6% of Year 6 children (aged 10-11) being obese or severely obese in 2023/24, compared to the national average of 22.1%. It was noted that obesity reduces life expectancy and increases morbidity¹, with wider determinants of health, not just individual choices, being key influencing factors.

The presentation also highlighted the need for a whole systems approach to creating healthier environments, addressing three different types of problem: simple, complicated and complex. The presentation noted that people's opportunities for health are influenced by factors outside of the health and social care system, such as the circumstances in which people are born, grow, live, work and age, which are the social determinants of health.

The presentation concluded by noting the importance of leadership in driving forward health and wellbeing, taking a whole system approach, and the role of scrutiny. It also noted conflicting priorities such as the challenges of providing services in a constrained financial environment conflicting with health priorities.

Care Quality Commission (CQC) Update

The Director of Adult Social Care and Health Integration presented the CQC September update. The Local Authority Inspection Return (LAIR) was submitted on 11 June, with an on-site inspection taking place at the end of October 2024. The final report, published on 21 February 2025, rated the council as 'Requires Improvement'.

Areas identified for improvement included:

• Significant waiting times impacting on people's outcomes.
• Large waiting lists and lack of communication for unpaid carers.
• Housing availability, particularly for those presenting as homeless or requiring accessible adapted accommodation.
• Equality, diversity and inclusion not embedded at a strategic level.
• No defined plan around co-production.
• Lack of assurance at CEO level regarding obligations relating to the Care Act² and safeguarding.
• Lack of ownership corporately with regard to Adult Social Care.
• Data development in early stages, with gaps in data noted.

The Directorate Improvement Plan incorporates CQC improvement actions, audit actions, actions from peer reviews, and business as usual (BAU) identified improvements. The plan is underpinned by a robust process for monitoring progress, with key indicators to measure performance.

Health Determinants Research Collaboration

The Senior Organisational Development Business Partner for HDRC South Tees delivered a presentation on 'HDRC South Tees: Embedding a Positive Research Culture in Local Authority'. The Health Determinants Research Collaboration (HDRC) is funded by the National Institute for Health and Care Research (NIHR) to boost research capacity and capability within local government and embed a culture of evidence-based decision making. HDRC South Tees is a collaboration between Redcar and Cleveland and Middlesbrough Councils and Teesside University.

The presentation outlined the research support process and coordination, including a contact form and research co-ordinators. It also detailed organisational development initiatives to embed research and build research capacity, such as sandpits³, training, and HDRC Ambassadors. The presentation also highlighted the Community-based Research Programme, delivered by Redcar and Cleveland Voluntary Development Agency, which trains community-based researchers in research methods to identify research questions of importance to disadvantaged communities.

The presentation included two mental health research cases:

• Routes to Rights: Evaluating a system response to social welfare needs: This proposal aims to make the best use of available services and agencies through a 'shoulder-to-shoulder' peer approach to mobilising a more informed workforce and connecting services through shared learning.
• Dementia Diagnosis: This project works with the South Asian communities in Middlesbrough to explore the reasons for low dementia diagnosis rates, as well as raising awareness and education.

South Tees NHS Foundation Trust

A Member updated the Panel on a meeting between some former Members of the People Scrutiny Panel and representatives from South Tees NHS Foundation Trust which followed the Trust's presentation of its Quality Account at a previous People Scrutiny Panel meeting.

Members had met with the Chief Executive, Director of Communications and the Chairman of the Trust to discuss concerns regarding preventable deaths, patient experience including car parking and various national comparative statistics which were only covered briefly during the Quality Account presentation.

Following a Member's suggestion, it was agreed that the Chair and Democratic Services Officer would look at further developing communication links between the Panel and the Trust.