The Adult Care and Public Health Scrutiny Committee met on Wednesday, 3 December 2025, to discuss the performance and future of the Integrated Lifestyle Service (ILS), review the Adult Social Care Strategy, and examine the implementation of the Target Operating Model (TOM) for adult social care. Key decisions included noting the performance update of the ILS, supporting the proposed Adult Social Care Strategy, and endorsing the new leadership structure for adult social care services.

Integrated Lifestyle Service - Performance Update

The committee received an update on the Integrated Lifestyle Service (ILS), known locally as One You Lincolnshire. This service, which supports residents to quit smoking, eat well, lose weight, be more physically active, and reduce alcohol consumption, has supported over 75,000 people since its commissioning in 2019. The report highlighted the service's cost-effectiveness, with an estimated social return on investment of £4.26 for every £1 invested. Members discussed the ongoing public consultation on the future of the ILS, with a report on future options due to be presented to the Executive in February 2026. Concerns were raised about the inclusion of substance misuse within the integrated system, with officers explaining that while separate, more intensive services exist for this, early intervention through the ILS can prevent progression to severe addictions. The committee was assured that impact assessments regarding the ILS existed and would be reviewed following the public consultation. The service's success in weight management, particularly through partnerships with Slimming World and Weight Watchers, was noted, with a shift back to face-to-face interactions where possible. The inclusion of vaping cessation under smoking cessation for harm reduction was confirmed, with advice against non-smokers taking up vaping. The ILS's role in reducing demand for adult social care, including a falls prevention programme, was also highlighted. The committee noted that the £1.14 million Smokefree Generation grant from the Department of Health and Social Care is contingent on maintaining current smoking cessation investment.

Adult Social Care Strategy

The committee considered the revised Adult Social Care Strategy 2025-2028, which aims to empower Lincolnshire residents to maintain their independence and reduce the need for adult social care, thereby ensuring sustainable finances for the council. The strategy has been shortened and made more accessible, with further revisions planned following engagement with the new NHS Integrated Care Board (ICB) cluster leadership. Members discussed the strategy's focus on prevention and early intervention through the Target Operating Model (TOM). Reassurance was given that the TOM would improve coordination across services and that the strategy's impact would be measurable through the new Council Plan and the Local Government Outcomes Framework. The proportion of adults receiving Direct Payments (DPs) had fallen below the target, but remained high nationally, with a focus on ensuring DPs are used effectively and appropriately. The committee supported the recommendation to the Executive to approve the strategy and pass on their comments for consideration.

Adult Social Care Target Operating Model (TOM) and Staff Realignment Update

An update was provided on the implementation of the Target Operating Model (TOM) for adult social care, which aims to maximise independence and integrate working with partners. Operational teams have been reorganised into area-based teams, and a streamlined leadership structure has been implemented. The amalgamation of the learning disability team into the three area teams has reportedly improved service delivery, reduced waiting times, and boosted staff morale. The TOM's next steps include developing 'pre-front door' and 'early front door' approaches to intervene earlier and prevent deterioration. Members discussed the importance of addressing digital exclusion and ensuring alternative communication methods are available for those unable to access digital services. The predicted costs and potential cost savings associated with the TOM were discussed, with assurance given that the transformation focuses on efficiency and effectiveness, not service reduction. The impact on unmet need was also addressed, with confirmation that the council remains obligated to meet all eligible needs under the Care Act 2014. The committee endorsed the implementation of the new leadership structure and area-based teams as the foundation for the TOM and supported ongoing workforce development.

Service Level Performance Reporting against the Performance Framework 2025-26 as at Quarter 2

The committee reviewed the service level performance of adult care against the Performance Framework for 2025-26 as at Quarter 2. Key successes included strong performance in hospital discharge outcomes, with 91.8% of adults remaining at home 91 days after discharge, exceeding the target of 85%. Reablement effectiveness was also high, with 99.8% of completed episodes resulting in no or lower-level support. Safeguarding performance was strong, with 100% of cases supported by an advocate where appropriate and 98.8% of concluded safeguarding enquiries achieving desired outcomes. Direct Payments achieved their target at 39.2%, and permanent admissions to residential and nursing care homes for those aged 65+ remained within tolerance. An area for improvement identified was annual reviews of long-term support, where only 74.8% of people had been reviewed against an 85% target, attributed to capacity being diverted to address new demand. Mitigating actions include refocusing review teams and support from the Achieving Better Outcomes Team. In Public Health and Community Wellbeing, the number of alcohol users successfully leaving specialist treatment increased to 314, exceeding the target of 230. The Wellbeing Service also met its target, with 99% of individuals achieving an overall improvement in their outcomes. The NHS Health Check programme continued to meet its target at 56%. However, the number of people supported to successfully quit smoking (PI 111) did not achieve its target, with 675 quits achieved against a target of 897. The reintroduction of Varenicline as a treatment option is expected to support future quit rates. The committee requested further information on the underperformance of the One You Lincolnshire smoking cessation service.

Adult Care and Public Health Scrutiny Committee Work Programme

The committee reviewed its forward work programme. Members discussed the timing of the Integrated Lifestyle Service (ILS) future arrangements report, requesting impact assessments at the earliest opportunity. A suggestion was made to include a report on the health impacts of the solar industry on farmland, covering mental health, electromagnetic radiation, fire risks, and pollution. The issue of bladder scanner use restrictions in nursing homes was raised, with officers advising it was primarily an NHS matter. Members agreed to add an extra meeting in March to manage the workload and avoid an overly long February meeting. The committee agreed to note the report and approve the existing work programme, with the suggested changes.

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