The Health and Adult Services Scrutiny Committee of Lancashire County Council met on Wednesday, 5 November 2025, to discuss the development of a prevention strategy for Lancashire and the redesign of adult social care provider services.

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 seeks to establish a neighbourhood health model to foster local service integration and empower residents to maintain their health and independence.

The strategy will focus on three key elements: understanding and managing demand by reducing reliance on traditional council-led support and strengthening the role of the voluntary and community sector; measuring and maximising impact through data-driven insights and collaboration with partners; and smarter use of funding by aligning investment with demonstrable impact. The approach will be phased, starting with council-focused actions, then building the strategy, and finally aiming for a system-wide and sustainable model.

Councillor Mark Jewell expressed excitement about the proposal but sought clarity on whether the strategy would be shaped by existing funding or if funding would be sought to support the strategy's ambitions. Dr. Karunanithi explained that while current funding is a starting point, the ambition is not constrained by it, and various funding sources, including social impact funding, are being explored. He also highlighted the importance of data and lived experiences in shaping the strategy, with a commitment to democratising data further. Councillor M Hindle raised concerns about rural isolation and suicide rates in areas like the River Valley, despite good overall health, indicating that a one-size-fits-all approach would not be effective. Dr. Karunanithi acknowledged this, stating that the strategy would consider the unique challenges of different areas and communities.

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 evaluation framework used to assess services and provided further information on building condition data. The redesign is driven by the Living Better Lives in Lancashire strategy, which aims to support residents in remaining in their homes and communities, and addresses findings from the CQC assessment and an internal review highlighting an overreliance on long-term residential and nursing care.

The proposal includes accelerating the reprovision of five residential care homes and five day services due to significant risks associated with the condition and suitability of the buildings. These services are Favordale, Grove House, Milbanke, Thornton House, and Woodlands care homes, along with associated day centres. The report detailed the investment required for each, with Favordale and Woodlands requiring the most significant investment (£1.419m and £1.390m respectively) to maintain current standards.

Councillor C Church questioned the emphasis on cost-cutting, noting that the business case suggested private sector provision was cheaper and that significant revenue savings could be achieved. He also raised concerns about the quality of care at Favordale, which he believed was highly praised by residents and their families. Councillor County Councillor Jordan Fox, Champion for Mental Health, highlighted the need for a focus on improving quality services for the elderly, not just addressing building conditions. Councillor County Councillor Hamish Mills, Local Councillor Decision - Lancaster South East, raised concerns about transparency regarding Grove House, questioning the discrepancy between the initial condition survey cost and the estimated service needs suitability report. He also questioned whether the process was a rush job and if it aligned with CQC recommendations for increased residential care.

Councillor County Councillor Graham Dalton, Cabinet Member for Adult Social Care, acknowledged the concerns and encouraged members to share their experiences and stories to inform the Cabinet's decision-making process. He stressed that the council is responding to CQC criticisms and that the ageing building stock presents significant challenges for modernisation. He also noted that the council is beholden to CQC recommendations and that modernisation is not cheap. The committee discussed the evaluation framework, which assesses services against four lenses: strategic alignment, service quality, market assessment, and value for money. The weighting for each element was presented, with strategic alignment and market assessment carrying the highest weightings.

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

The committee reviewed the draft work programmes for the Health and Adult Services Scrutiny Committee and the Health Scrutiny Steering Group for the 2025/26 municipal year. The work programmes outline planned scrutiny activities, including reports on integrated urgent care, quality impact assessments, paediatric audiology, and updates on winter planning. Key lines of enquiry were also discussed for upcoming meetings, focusing on areas such as digital and AI opportunities in care, the NHS 10-year plan, and orthodontic secondary care.

Report of the Health Scrutiny Steering Group

The committee received a report on the Health Scrutiny Steering Group meeting held on 14 October 2025. The group considered updates on orthodontic secondary care, winter planning, and speech and language therapy in early years. The proposed reconfiguration of secondary care orthodontics across Lancashire and South Cumbria was discussed, aiming to address fragility in the service, workforce shortages, and long waiting times. East Lancashire Hospitals NHS Trust would become the lead provider, with services consolidated at hub locations in Burnley/Blackburn and Chorley, and satellite clinics in Blackpool and Furness. The report also detailed the winter plan for adult social care and NHS services, highlighting collaboration between various agencies to ensure resilience. An update on the Easy Access Speech and Language Therapy (SALT) Walk-In Clinics initiative was also presented, which aims to improve early identification and intervention for preschool children.