The Health and Adult Services Scrutiny Committee of Lancashire County Council met on Wednesday, 5th November 2025, to discuss the development of a prevention strategy for Lancashire and the redesign of adult social care provider services. Key decisions included noting the approach to developing the prevention strategy and engaging in its further development, and discussing the proposed Provider Services Redesign following a Cabinet decision.

Developing a Prevention Strategy for Lancashire

Dr Sakthi Karunanithi, Director of Public Health, Wellbeing and Communities, presented the council's plan to develop a unified prevention strategy for Lancashire. The strategy aims to create a coordinated approach across all council services to improve outcomes and manage demand more effectively, particularly within social care. This initiative is partly a response to areas for improvement identified by the Care Quality Commission (CQC) and will focus on a neighbourhood health model to empower residents to maintain their health and independence.

Councillor Mark Jewell expressed enthusiasm for the proposal but sought clarity on whether the strategy would be shaped by existing funding or driven by identified needs, with the aim of self-funding. Dr Karunanithi explained that while funding is a starting point, the ambition for prevention is not constrained. The council is exploring various funding sources, including co-investment with the private sector and social impact funding models. He also highlighted the importance of data and lived experiences in shaping the strategy, and the use of tools like the Public Finances' return on investment toolkit to demonstrate value for money.

Councillor Mark Hindle raised concerns about rural isolation and mental health in the Ribble Valley, asking how the strategy would address these specific issues. Dr Karunanithi acknowledged that a one-size-fits-all approach would not work and that the strategy would consider the unique challenges of different communities, including rural areas. He emphasised the importance of listening to communities and working with the voluntary, community, faith, and social enterprise sectors to support people in supporting themselves.

Adult Social Care - Provider Services Redesign

John Williams, Director of Operations, presented an overview of the Lancashire County Council Provider Services Redesign, following a Cabinet decision in October 2025. The report detailed the condition of ten older people's services (five residential care homes and five day services) that are at immediate risk due to building condition and suitability. The council is consulting on these proposals, which aim to address safety risks and enhance service delivery, while acknowledging the need for careful management of residents' transitions.

Councillor C Whip expressed concerns about the proposed redesign, questioning the number of care home places that might need to be removed and the lack of emphasis on quality within the evaluation framework. He highlighted positive feedback from residents and families regarding the quality of care at Favordale, one of the affected homes. Councillor Whip also questioned the imperative to cut costs, referencing the council's aim to save £50 million from adult social care.

Councillor G Dalton, Cabinet Member for Adult Social Care, acknowledged the concerns and encouraged members to share their feelings and stories to inform the Cabinet's decision-making. He stressed that the proposals would be taken seriously.

Councillor J Snape raised questions about transparency and potential predetermination regarding Grove House, a care home facing significant investment requirements. He questioned the £590,000 difference between the initial condition survey cost and the estimated investment for a service needs suitability report, seeking a breakdown of how this estimate was reached. Councillor Snape also raised concerns about the CQC's assessment that there is insufficient residential care in Lancashire, and the potential for Grove House's closure to contradict this.

Simon Lawrence, Director of Growth and Regeneration, provided context on the ageing care home estate and the pressures due to asset quality and budgets. He noted that the council's Cabinet had agreed a property strategy and that condition surveys from 2020 and 2021 were being reassessed. He stated that the homes currently meet compliance standards and are safe, with established procedures for inspections and maintenance.

Councillor J Tetlow suggested that a sister paper focusing on improving quality services for the elderly in Lancashire was missing, arguing that quality and the current redesign efforts should go hand-in-hand. He also expressed a desire to see criteria for future provision, whether in existing or new establishments, to ensure the best quality care for elderly residents.

The discussion also touched upon the CQC's regulatory expectations for care homes, highlighting the need for modern standards such as en-suite bathrooms, accessible layouts, and strong infection control, which older buildings may struggle to meet. The report detailed the differences between older and modern care home designs, referencing regulations and guidance.

Report of the Health Scrutiny Steering Group

The committee received a report on the Health Scrutiny Steering Group meeting held on 14th October 2025. Key discussions included the proposed transformation of secondary care orthodontics across Lancashire and South Cumbria, which aims to centralise services at East Lancashire Hospitals NHS Trust (ELHT) to address workforce shortages and long waiting times. The report noted that while some areas would see improved access, others, such as Royal Preston Hospital, might require patients to travel further. The group agreed that this item should be presented to the Health Scrutiny Committee for further consideration.

The Steering Group also reviewed the Winter Plan for Adult Social Care and NHS services for 2025/26, which focuses on resilience, collaboration, and workforce stability. Updates were also received on the Easy Access Speech and Language Therapy (SALT) Walk-In Clinics initiative, aimed at improving early identification and intervention for preschool children. Challenges such as limited workforce capacity and venue availability were noted, with plans for further review and expansion.

Health and Adult Services Scrutiny Committee and Steering Group Work Programmes 2025/26

The committee reviewed and confirmed the draft work programmes for the Health and Adult Services Scrutiny Committee and the Steering Group for 2025/26. The proposed items for the Steering Group included updates on Integrated Urgent Care procurement, Quality Impact Assessments, and Paediatric Audiology Services. For the main Committee meeting on 10th December 2025, planned items included policy development on digital and AI/Telecare opportunities, the NHS 10-year plan, and a review of Orthodontic Secondary Care.