The Health and Adult Services Scrutiny Committee met to discuss the Care Quality Commission (CQC) local authority assessment, NHS vascular service changes, and health scrutiny work programmes. The committee agreed that the proposed reconfiguration of vascular services constitutes a substantial service variation and therefore requires formal public consultation. They also approved recommendations for a task group to oversee the CQC action plan and for more detailed population health data to be presented at future meetings.

CQC Local Authority Assessment Update

The committee approved recommendations to act on the CQC local authority assessment report. The report, which was published on 15 August 2025, gave Lancashire County Council an overall rating of 'requires improvement'.

Mairead Gill-Mullarkey, Director of Operations for Adult Social Care, told the committee that the CQC had found that Lancashire had good foundations to build on, a committed and compassionate workforce, effective safeguarding systems, and positive advocacy services. However, the CQC also highlighted areas for improvement, including:

• equity and consistency across all localities
• stronger partnerships with NHS, voluntary sector and the care market
• building a more sustainable workforce and reducing reliance on agency staff
• improving the timeliness of access to assessments and reducing waiting lists

Ms Gill-Mullarkey reported that since the report, there had been a 50% reduction in delays to access to assessments under the Care Act 2014, a 48% reduction in waiting lists for older people and physical disabilities, and an 8% increase in the number of annual reviews completed.

County Councillor Graham Dalton, Cabinet Member for Adult Social Care, said that the CQC report was a challenge that required reflection. He added that staff were not the issue, but that there were structural issues that needed to be addressed. He noted the importance of enabling professionals to do their jobs effectively, and of focusing on outcomes for people.

Councillor Rick Bell asked where the gaps in recruitment were, and what was being done to fill them. Ms Gill-Mullarkey responded that there was only one vacancy in occupational therapy, but that recruitment was ongoing for social workers. She added that the council had developed a centralised recruitment system and was using social media to attract candidates.

Councillor Margaret France raised concerns about delays in discharging patients from hospital due to a lack of staff to carry out assessments and arrange packages of care. She asked that this be prioritised, particularly in the run-up to winter. Councillor Dalton responded that winter planning had already started, and that steps had been taken to improve relationships between adult social care and the NHS.

Following discussion, the committee agreed to:

• establish a task group to provide further oversight and scrutiny of the CQC action plan
• bring more in-depth population health data to future meetings of the committee

NHS Vascular Services Clinical Reconfiguration

The committee agreed that the proposed reconfiguration of vascular services constitutes a substantial service variation and therefore requires formal public consultation.

Dr Andy Curran, Associate Medical Director, NHS Lancashire and South Cumbria ICB, told the committee that the proposal involved centralising inpatient arterial services at Royal Preston Hospital. He said that the proposal would improve clinical outcomes, workforce sustainability, and alignment with national standards. He added that the reconfiguration would affect approximately 670 patients annually and enable better access to specialist support and rehabilitation services.

Dr Steve Canty, Divisional Medical Director for Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, added that Royal Preston Hospital offered integration with major trauma services and met population thresholds required for specialist vascular care.

Councillor M Iqbal MBE asked why the services could not be centralised at Royal Blackburn Hospital instead. Dr Curran responded that 95% of the vascular activity would remain on the Blackburn site, and that the Royal Preston Hospital had other services that the vascular team would work with, most notably the major trauma service.

Councillor T de Freitas asked whether the speakers believed that the changes were a significant service change. Dr Curran responded that he believed that it was the right thing to do clinically, and that he would like to understand what impact it would have on the population and what mitigation would need to be put in place.

Councillor L McInnes raised concerns about accessibility for patients in Rossendale, which does not have a railway station. Dr Curran responded that emergency transport would be available, and that patient transport schemes would still be in place for those who were unable to make their own way to hospital appointments.

Councillor Nikki Hennessy said that the paper only showed the benefits of the proposal, and did not include any negatives. She asked what would happen if there were negative transport impacts. Dr Curran responded that the risks were included in the risk register, and that the biggest risk was about patient outcomes. He added that the trust had experience of this happening in other places, such as Blackpool, where vascular inpatient services had already moved off site.

Councillor Graham Hargreaves asked about average travel time and cost for patients. Dr Curran responded that this had been factored in, and that the North West Ambulance Service had been consulted. He added that patient transport would be covered for those who were eligible.

Councillor M Hindle said that he saw the proposal as a natural and positive evolution of services. He added that the important thing was to explain it in language that people understood.

Councillor S Crimmins observed that east Lancashire patients already have to travel to Preston for neurosurgery.

Councillor M Jewell asked about data metrics around survivability and outcomes when the services from Blackpool and Cumbria moved to Preston in 2013. Dr Curran responded that he did not have the local data, but that the national data showed the benefit from patient outcomes and survivability.

Councillor M France asked whether the staff had been consulted about the relocation to Preston, and whether the proposal would lead to 24 hours seven day a week access to emergency vascular services. Dr Canty responded that staff consultations were ongoing, and that the new model would give an increased amount of theatre activity and extend planned urgent activity across into the weekend.

Councillor L Jackson said that the increase would be greater for the people of Barrow, because of their geographic location and health deprivation. She asked whether there would be greater airlifting facilities. Dr Curran responded that nothing was changing to the current service delivered to the population of Barrow, and that air transport would be considered where appropriate.

Following discussion, the committee agreed that the proposed reconfiguration of vascular services constitutes a substantial service variation and therefore requires formal public consultation. They also requested a report detailing the outcomes and impacts of the previous service relocation when Blackpool vascular services moved to Royal Preston Hospital in 2013, including pre- and post-move data and patient experience.

Report of the Health Scrutiny Steering Group

The committee received the Report of the Health Scrutiny Steering Group. County Councillor Hamish Mills presented a report on the Health Scrutiny Steering Group meeting held on 9 July 2025. The report included an overview of the Steering Group's Terms of Reference and a summary of Health and Care Updates across Lancashire.

It was highlighted that communication with individual NHS Trusts was a priority. To promote consistency and improve the quality of information received, the Steering Group requested that individual Trusts would be invited to future meetings.

Additionally, the Steering Group requested that a report on the NHS 10-year plan be brought to a future meeting. This would support members in understanding long-term strategic priorities and assessing their implications for local service delivery.

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

The committee noted the Health and Adult Services Scrutiny Committee and Steering Group Work Programmes 2025/26. County Councillor Hamish Mills presented a report on the Health and Adult Services Committee and Steering Group work programme for 2025/26. The report followed the work planning session held by the committee on 25 June 2025 and outlined key areas of focus for the upcoming year.

Councillor T de Freitas asked when the committee would have the opportunity to discuss the shaping care changes in Sefton and west Lancashire. Councillor Mills responded that he was hoping to bring that up at the next meeting.

Councillor M Iqbal MBE requested a link to the adult social care health and adult social care dashboard.

Councillor L McInnes said that she was interested to see what the steering group came out with in relation to the challenges around the uptake of childhood vaccinations.

Constitution, Membership and Terms of Reference

The committee approved the constitution, membership and terms of reference. The report provided information on the membership, Chair and Deputy Chair and Terms of Reference of the Health and Adult Services Scrutiny Committee for the municipal year 2025/26.