The Health and Adult Services Scrutiny Committee of Lancashire County Council met on Tuesday, 3 February 2026, to discuss the Care Quality Commission's (CQC) assessment of adult social care services and the proposed transformation priorities for 2026-27. The committee also debated proposed bed reductions at the Royal Lancaster Infirmary, ultimately deeming it a significant service change requiring public consultation.

CQC Improvement and Adult Health and Wellbeing Services Transformation

The committee received an update on Lancashire County Council's progress in responding to the CQC's 'Requires Improvement' rating for its adult social care services, published in August 2025. Helen Coombes, Executive Director of Adult Health and Wellbeing Services, presented the report, highlighting that while the CQC report confirmed existing knowledge about areas needing improvement, significant work has been undertaken. This includes a re-scoping of the front door service, development of digital self-help tools, and a focus on co-production with service users.

Key areas of focus for improvement include:

• Working with People: Enhancing first-point-of-contact resolutions, maintaining self-directed support and direct payments, and developing new digital self-help tools.
• Providing Support: Strengthening relationships within the care market, mapping care sourcing processes, and developing a co-production approach with the Social Care Institute for Excellence (SCIE).
• Ensuring Safety in the System: Commencing a discovery phase for the Safeguarding Adults pathway, launching a Preparation for Adulthood model for young people, and transforming the offer for residents with Learning Disabilities and Autism.
• Leadership: Merging Adult Services and Public Health into a single directorate, strengthening leadership roles, and holding workforce conferences to address CQC feedback.

Beverley Reid, Head of Risk Management and Business Unit, outlined the transformation priorities for 2026-27, which include commissioning and market shaping, care pathways and prevention, provider services, and transforming intermediate care. These priorities are linked to the council's 2025-27 Improvement Plan and aim to achieve better outcomes, sustain financial stability, improve customer experience, empower the workforce, build market resilience, drive a place-based approach, optimise in-house provision, and strengthen partnership working.

Noel O'Neill, independent chair of the improvement board, commended the positive progress made, particularly in financial improvements and leadership appointments. He noted that while much has been achieved, there is still a long way to go, especially in partnership working with the NHS.

During the discussion, councillors raised concerns about the digital exclusion of some residents and the need for robust data to measure improvements. John Williams, an occupational therapy manager, assured the committee that non-digital access routes would remain available and that efforts were being made to reach those who are not digitally savvy.

The committee also heard from Age UK Lancashire, represented by Alison Reed (Business Development Director) and Donna Studholm (Director of Operations). They highlighted their work in supporting older people in Lancashire, including hospital avoidance, supported discharge, and providing information and advice. They noted that 40% of their clients have internet access, raising concerns about the digital divide for the remaining 60%.

Francesca Dean, a service user with cerebral palsy, shared her positive experience with direct payments and her advocacy for young people with disabilities. She emphasised the need for better housing options and support for mental health within the disability community.

Jody Nolan, representing Home Care Services, spoke about the benefits of collaboration between care providers and Lancashire County Council, particularly in improving communication channels and addressing issues raised in the CQC report. She highlighted the success of the trusted reviewer pilot for care reviews.

Jonathan Tomlinson, Occupational Therapy Manager, and Claire Graves, an OT apprentice, presented a case study of a 99-year-old woman who regained independence through a rehabilitative approach. They discussed the council's initiative to grow its own occupational therapists through apprenticeships.

Councillor Crimmins raised the issue of integration across services, and Helen Coombes responded by detailing efforts to improve relationships with the Integrated Care Board (ICB) and other NHS partners, including a refreshed Health and Wellbeing Board and discussions on joint commissioning.

Proposed Bed Reductions at the Royal Lancaster Infirmary

The committee then considered proposals for bed reductions at the Royal Lancaster Infirmary (RLI). Dr. Helen Skinner, Chief Medical Officer for the University Hospitals Morecambe Bay Trust (UHMBT), and Louise Jones, Director of Communications and Engagement, presented the case for reducing beds by 24, citing financial pressures and the need to right-size hospitals in line with the NHS 10-Year Plan. They highlighted improvements in patient flow, increased virtual ward capacity, and a reduction in patients not meeting the criteria to reside in hospital.

Councillors expressed significant concerns about the safety and impact of these reductions, particularly given the trust's current Operational Pressures Level 4 status and an aging population. Councillor Parker stated, I feel personally that it would be a significant change, a sentiment echoed by several other councillors. The committee ultimately voted that the proposed bed reductions constituted a significant service change, necessitating formal public consultation.

Work Programmes and In-Year Requests

The committee reviewed its work programmes for 2025-26 and considered two in-year requests. Councillor de Freitas requested an item on NHS Never Events, which was agreed to be discussed at the Health Scrutiny Steering Group, with a view to potentially bringing it to a full committee meeting later. Councillor Jewell requested an item on Mental Health Services and integration across other services, which will be added to the work programme for the meeting on 22 April 2026.

Reports from Steering Groups

The committee received reports from the Health Scrutiny Steering Group and the Joint Health Scrutiny Committee on the Shaping Care Together Programme. Discussions around the latter highlighted issues with the accessibility and recording of meetings, with a commitment to explore alternative venues and improved visibility of documents.