The Health and Adult Services Scrutiny Committee of Lancashire County Council met on Tuesday 03 February 2026 to discuss improvements to adult health and wellbeing services, proposed bed reductions at the Royal Lancaster Infirmary, and to review work programmes. The committee decided that the proposed bed reductions at the Royal Lancaster Infirmary constituted a significant service change requiring public consultation.

CQC Improvement and Adult, Health and Wellbeing Services Transformation

The committee received an update on the progress made by Lancashire County Council's Adult Social Care services following a 'Requires Improvement' rating from the Care Quality Commission (CQC) in August 2025. Helen Coombes, Executive Director of Adult Health and Wellbeing Services, presented the report, highlighting that while there were many positives, improvements were still needed across all nine quality statements. The report detailed ongoing work in four key themes: Working with People, Providing Support, Ensuring Safety in the System, and Leadership. Specific initiatives included re-scoping the front door service for better initial contact, developing digital self-help tools, strengthening relationships with the care market, and redesigning safeguarding pathways. The committee was also updated on the transformation priorities for 2026-27, which aim to improve resident outcomes, financial stability, customer experience, workforce empowerment, market resilience, and partnership working. Noel O'Neill, the independent chair of the improvement board, provided an overview of the progress made, noting significant financial savings achieved and the ongoing efforts to improve partnership working with health organisations. Guest speakers from Age UK Lancashire, Francesca Dean (a service user), Jody Nolan from Home Care, and frontline workers Jonathan Tomlinson and Claire Graves shared their experiences and perspectives on the services and the impact of the ongoing improvements.

Proposed Bed Reductions at the Royal Lancaster Infirmary

The committee discussed the University Hospitals Morecambe Bay Trust's (UHMBT) proposal to reduce beds at the Royal Lancaster Infirmary (RLI) by 24, representing 7.4% of the general and acute bed base. Dr. Helen Skinner, Chief Medical Officer for UHMBT, and Louise Jones, Director of Communications and Engagement, presented the proposal, explaining it was part of a wider strategy to right size hospitals in line with the NHS 10-Year Plan and improve financial sustainability. The Trust highlighted that many patients currently occupy beds unnecessarily, leading to deconditioning and poorer outcomes. Proposed solutions included increasing virtual ward capacity, improving board round processes and criteria-led discharge, and working with partners like Lancashire County Council to reduce delays in reablement. The committee engaged in a detailed discussion, raising concerns about the impact on patient safety, particularly given the current OPEL 4 status (Operational Pressures Escalation Level 4) and the aging population. Despite assurances from the Trust regarding safety measures and ongoing monitoring, the committee ultimately voted that the proposed bed reductions constituted a significant service change that would require formal public consultation.

Health and Adult Services Scrutiny Committee and Steering Group Work Programmes 2025/26, Recommendations and In Year Requests

The committee reviewed its work programme for 2025/26 and noted the rescheduling of the January meeting to 3 February 2026. Two in-year requests were considered: one from Councillor Thomas de Freitas regarding Never Events and another from Councillor Mark Jewell concerning Mental Health Services and integration across other services. It was agreed that the Never Events request would be discussed within the Health Scrutiny Steering Group, with a potential for further review by the full committee later in the year. The request regarding mental health services and integration was scheduled to be addressed in the committee's meeting on 22 April 2026, as it aligns with the planned discussion on adult mental health.

Report of the Health Scrutiny Steering Group

The committee received the report of the Health Scrutiny Steering Group's meeting on 6 January 2026. Discussions included an update on the Public Health Service, highlighting the alignment with the Adults, Health and Wellbeing Directorate to enhance prevention-led services and long-term health planning. The development of a Prevention Plan following CQC findings was also discussed, alongside the confirmation of the Public Health grant settlement and an upcoming Department of Health peer review. An update on the NHS Health Checks Programme across Lancashire was also presented, detailing its role in identifying early risks of cardiovascular disease and other conditions. The committee noted the progress and endorsed continued work to reduce inequalities in uptake, while also discussing concerns about digital exclusion and access to GP appointments.

Joint Health Scrutiny Committee - Shaping Care Together Programme

An update was provided on the Joint Health Scrutiny Committee with Sefton Council, established to review the Shaping Care Together programme. The committee noted that the programme had been confirmed as a substantial variation of service provision, necessitating formal public consultation. The first meeting of this joint committee had taken place on 20 January 2026, where the Chair and Deputy Chair were confirmed, and terms of reference were agreed. A further meeting was scheduled to discuss the full details of the consultation outcome and final proposals. Councillor Cummins raised concerns about the accessibility of meeting minutes, which were hosted on Sefton's website, and the suitability of venues for meetings. It was agreed that these points would be taken back to the joint committee for consideration.