The Adult Care and Public Health Scrutiny Committee met on 28 January 2026 to discuss the Adult Care and Community Wellbeing budget proposals for 2026/27, the future of the Integrated Lifestyle Service, the recommissioning of Home Based Reablement services, and the Director of Public Health's Annual Report. The committee supported passing comments on the budget proposals to the Executive, but voted against recommending the continuation of the Integrated Lifestyle Service in its current form, opting instead to support the Executive's recommendation to dissolve it. They also supported the recommissioning of the Home Based Reablement service and the Director of Public Health's Annual Report.

Adult Care and Community Wellbeing Budget Proposals for 2026/27

The committee considered the proposed budget for Adult Care and Community Wellbeing for the 2026/27 financial year. The report highlighted that increased demand, demographic changes, and rising fee rates for commissioned care were significant cost pressures. While the council anticipated increased funding due to higher council tax projections and fair funding gains, officers noted that this would not fully cover the forecast cost pressures. The budget proposals included a shift towards community-based services and the use of digital technology to improve efficiency.

During the discussion, concerns were raised about potential financial risks, the impact of decommissioning services like the Housing Related Support and Integrated Lifestyle Service, and the realignment of the funding structure. Members expressed disappointment at proposed net funding reductions and questioned the confidence in forecasts for moderating demand for care, particularly given the ageing population and rising complexity of needs. The effectiveness and cost-effectiveness of mental health services were also questioned, with officers acknowledging challenges in service delivery and integration with social care elements. Assurances were given that an Equality Impact Analysis had been conducted.

Ultimately, the committee voted to pass a summary of their comments to the Executive for consideration. The vote was 6 in favour, 1 against, and 4 abstentions.

Integrated Lifestyle Service - Future Arrangements

The committee discussed the future of the Integrated Lifestyle Service (ILS), which provides support for smoking cessation, physical activity, weight management, and alcohol reduction. Officers explained that due to national funding changes, specifically the ringfencing of smoking cessation grants totalling £2.9 million annually for Lincolnshire, the council was proposing to dissolve the ILS. The funding released from decommissioning other elements of the ILS would be redirected to the Best Start Lincolnshire early years and family service, and a standalone falls prevention service would be commissioned.

This proposal generated significant debate. Councillors Lee, Dilks, Woolley, and Young expressed strong opposition, citing the overwhelming support for the ILS in public and stakeholder consultations, the proven effectiveness of the service, and concerns about widening health inequalities for adults. They questioned the financial justification for decommissioning, highlighting the council's reserves and the potential loss of NHS funding. Councillor Lee, a former nurse, spoke passionately about the impact of poor weight management and the need for adult services.

Councillors Bean, Brookes, Cullen, Redfern, Reeve, and Wimhurst voted in favour of the recommendation to support the Executive's proposal. They emphasised the political dimension of resource allocation and the moral imperative to prioritise children's services, citing the long-term benefits of early intervention. The Director of Public Health, Derek Ward, stated that while decommissioning the adult services was not ideal from a purely objective public health perspective, the decision was ultimately political and aimed at optimising resource allocation.

The committee voted 6-5 to support the recommendation to the Executive, with the caveat that a summary of the committee's comments, including the strong opposition from some members, would be passed to the Executive.

Home Based Reablement - Recommissioning

The committee considered the recommissioning of the Home Based Reablement Service (HBRS). Officers presented a report detailing the service's effectiveness in helping individuals regain independence and avoid long-term care needs, noting its strong performance and alignment with national policy. However, increased demand had led to a cost pressure, necessitating an additional £1.9 million per annum to meet anticipated demand and inflationary adjustments. The proposed model includes strengthened eligibility criteria and pathway management to ensure targeted utilisation of resources.

Members expressed support for the service, acknowledging its role in relieving pressure on hospitals. They sought clarification on the funding, which is primarily from the Better Care Fund (BCF), and received assurances that the funding was secure. Concerns about the transition period for service users and staff were addressed, with detailed transition planning and the option for staff to transfer to a new contractor being highlighted. The committee voted to support the recommendation to the Executive Councillor for Adult Care and Health, with the caveat that the additional funding was subject to approval by the full council.

Director of Public Health Annual Report 2025

Derek Ward, the Director of Public Health, presented his Annual Report for 2025, titled The Public Health Case for Quality Employment. The report highlights the critical link between employment and health, arguing that quality employment is a public health intervention. It details the challenges in Lincolnshire, including deprivation, rurality, and an ageing population, and outlines opportunities for inclusive growth. The report recommends expanding supported employment schemes, removing barriers to work, improving health services, encouraging employers to prioritise workforce health, and making employment a core policy consideration.

Members praised the report but expressed concern that the dissolution of the Integrated Lifestyle Service (ILS) would negatively impact the working-age population, contradicting the report's emphasis on employment as a health determinant. Officers responded that the report provided recommendations, and the Executive would make decisions based on various factors, including the consultation feedback. The committee voted to support the recommendation to the Executive to approve the publication of the Annual Report.

Adult Care and Public Health Scrutiny Committee Work Programme

The committee reviewed its current and planned work programme. Members expressed their praise and thanks for the long and dutiful service of the retiring Director of Public Health, Derek Ward. The work programme was agreed.