Here is a summary of the scheduled discussions for the Adults, Wellbeing and Health Overview and Scrutiny Committee meeting on 30 September 2025. The agenda included updates on Shotley Bridge Community Hospital, a review of breast services, reports on financial performance, a performance management report, and a health protection assurance report.

Health Protection Assurance

The committee was scheduled to consider the Health Protection Assurance Annual Report June 2025, a joint report from Michael Laing, Interim Corporate Director of Adult & Health Services, and Amanda Healy, Director of Public Health, detailing health protection arrangements and activities in County Durham. The report noted that local authorities have a mandated responsibility to protect the health of the population, and that the Director of Public Health is responsible for discharging the local authority's public health functions. The report highlighted several key improvements and achievements in 2024/25, including:

• High levels of coverage across all screening programmes, with increased coverage in the breast screening programme (2.7% increase to 72.1%) and the abdominal aortic aneurysm (AAA) screening programme (2.8% increase to 84.5%).
• County Durham ranking highest in the North East and third highest in England for MMR2 coverage (94.2%).
• Regional recognition of the work of the County Durham Immunisation Steering Group.
• An increase in chlamydia testing and access to treatment, and significant work to increase access to HIV testing.
• Ongoing system working with County Durham and Darlington Foundation Trust (CDDFT) and key stakeholders to support high quality infection prevention and control measures.
• A coordinated approach to the management and control of a range of outbreaks of communicable diseases.
• Significant work to progress the inclusion of health in the climate change agenda.

The report also identified areas for improvement and further assurance in 2025/6, including:

• Using the 'What Good Looks Like Health Protection' documents to collectively gain assurance on health protection responsibilities.
• Supporting and providing governance for the delivery of the Childhood Immunisations Project (£81K) to increase vaccination uptake across vaccination programmes.
• Working with Children and Young Peoples Service colleagues to reverse the downward trend in vaccination uptake amongst children in care.
• Working with the County Durham sexual health service and key partners to increase HIV testing to increase uptake and early diagnosis.
• Actively participating in and receiving reports regarding Exercise Pegasus and the development of Local Pandemic Preparedness Plans.

The report recommended that the Adults, Wellbeing and Health Overview and Scrutiny Committee:

• Note the content of the report.
• Note that the report highlights improved performance across a number of health protection programmes.
• Continue to support collaborative system working and review processes and procedures to ensure that these are effective in preventing, detecting, escalating and managing health protection incidents.
• Work collaboratively across system partners to identify, address and mitigate the impacts of the national reconfiguration of NHSE, DHSC and ICBs and the potential impact on health protection assurance.
• Support efforts to address the identified areas for improvement and further assurance, particularly the delivery and uptake of identified vaccination programmes, STI screening and treatment and improvements to infection prevention and control measures.

The report stated that there was a potential that the UK Fair Funding Formula, if applied, could change how funding is distributed as it proposes a move to a model that gives more weight to population size and less to deprivation or specific health needs, and that locally this could mean a reduction in funding for County Durham, potentially impacting services aimed at addressing health inequalities and improving outcomes for residents. The report also noted that the Secretary of State for Health and Social Care announced in March 2025 that NHS England (NHSE) was to be abolished and 50% reductions were to be made to the staffing and running costs of the Department of Health and Social Care (DHSC) and Integrated Care Boards (ICBs).

Adult and Health Services Revenue and Capital Outturn

The committee was scheduled to discuss the Adult and Health Services Revenue and Capital Outturn 2024/25 and Adult and Health Services Revenue and Capital Outturn Q1 2025/26. The report pack included a report from Paul Darby, Corporate Director of Resources and Michael Laing, Corporate Director of Adult and Health Services, which provided details of the 2024/25 revenue and capital outturn budget position for the Adult and Health Services (AHS) service grouping, highlighting major variances in comparison with the budget for the year, and details of the forecast outturn budget position for the Adult and Health Services (AHS) service grouping, highlighting major variances in comparison with the budget for the year, based on the position to the end of June 2025. The report noted that AHS had a cash limit underspend of £2.499 million at the year-end against a revenue budget of £160.882 million, which represents a 1.55% underspend, and that the forecast indicates that AHS will have an underspend of £1.264 million at the year-end against a revenue budget of £161.828 million, which represents a 0.8% underspend. The AHS capital budget for 2024/25 comprised three schemes within Adult Care totalling £0.807 million, and capital expenditure of £0.807 million was incurred during 2024/25. The AHS capital programme for 2025/26 comprises one scheme within Adult Care totalling £33,674, and as at 30 June 2025 no capital expenditure has been reported.

Quarter One 2025/26 Performance Management Report

The committee was scheduled to receive a report of the Chief Executive, John Hewitt, which provided progress towards achieving the strategic ambitions and objectives set out in the Council Plan 2024-28. The report noted that in the May council elections, Reform UK was elected as the new administration for the council, and that the interim ambitions, objectives and political direction of the administration were set out in a paper to Cabinet on 21 July following the end of quarter one, 2025/26, and that these ambitions have been subject to extensive consultation and the analysis will be presented to Cabinet and Full Council in October 2025. The report stated that the new administration has made several changes that have changed the political direction of the council, including:

scrapping the council's climate emergency pledge, reviewing net zero commitments, introducing article reviewing the council's capital programme and choosing not to upgrade the electric vehicle fleet. The new administration has also declared a 'County Durham Care Emergency' and introduced new rules that make it more difficult for landlords to convert housing into shared accommodation.

The report noted that following the completion of the Adult Social Care Review Project in March 2025, improvements have been seen in the percentage of annual reviews completed within 12 months, with the latest result of 88.8% being an improvement on the previous quarter and above the target of 80%. The report also noted that following an increase in alcohol specific mortality the Health and Wellbeing Board has developed an ambition to reduce the number of alcohol specific deaths by 20% from current levels by 2034, which equates to 23 fewer alcohol specific related deaths annually.

Shotley Bridge Community Hospital Update

The committee was scheduled to receive an update on Shotley Bridge Community Hospital from representatives of County Durham and Darlington NHS Foundation Trust. The update included a project review, critical milestones for 2025/26, and timelines for the redevelopment. The update noted that the Shotley Bridge Community Hospital was adopted into the New Hospital Programme¹ in 2020, and that governmental approval of SBCH as a wave 1 scheme with uplifted budget had been granted. The update also included information on the Urgent Treatment Centre (UTC) at Shotley Bridge Community Hospital, noting that it had been temporarily closed overnight from 14th July 2025 for 3 months due to an ability to maintain safe staffing levels.

Breast Services Review Update

The committee was scheduled to receive a presentation from representatives of County Durham and Darlington NHS Foundation Trust on the Breast Services Review. The presentation noted that two external reviews have highlighted quality and safety issues with the Trust's Breast Surgery Services, and that the Trust's Breast Surgery Service has been highlighted as following outdated practice in some areas, which have resulted in some cases, in excessive surgery, unnecessary invasive surgery and a failure to consider all options (including breast reconstruction). The presentation stated that:

The Board on behalf of the Trust is issuing a formal and sincere apology to colleagues and to our patients, some of whom have not received the standard of care we would expect and that they deserve We are deeply sorry to every person affected

The presentation also noted that the Royal College review has flagged underlying weaknesses in MDT² decision-making arrangements; governance; demand and capacity management and in ensuring up to date clinical skills and best use of team members, and reinforced the concerns from the peer review and found examples of care that reviewers graded as unacceptable . The presentation listed a number of actions and improvements that have been made, including:

• Patient Safety Investigation instigated
• Clinical Reference Group established
• Ongoing look-back of all relevant cases
• Duty of Candour and Being Open processes discharged
• Ceased insourcing and outsourcing activity
• Patient helpline and email put in place
• External review of governance commissioned
• Two new consultants appointed
• External experts appointed to MDTs and reviews
• Governance of the service strengthened
• Clinical roles, skills and equipment updated