The Health and Adult Services Scrutiny Committee was scheduled to meet to discuss the use of digital technology in adult services, the 10 Year Health Plan, and proposed changes to secondary care orthodontics. The committee was also expected to review its work programme for the year.

Secondary Care Orthodontics Transformation

A report was prepared for discussion regarding a proposed transformation of NHS secondary care orthodontics across Lancashire and South Cumbria. Secondary care orthodontics addresses complex issues with jaw alignment, bites, and tooth straightening, with about 1,400 patients, mostly under 18, accessing the service annually across Lancashire and South Cumbria.

The report noted that a review in November 2023 identified orthodontics as a fragile service both nationally and locally. Services were assessed on workforce, finances, clinical standards and performance.

The report stated that there were several challenges with the current service:

• Workforce: There are only 3.8 full-time consultant orthodontists across all services, leading to failures to meet elective standards, with patients waiting over 65 weeks to start treatment. Blackpool Teaching Hospitals NHS Trust (BTH) and University Hospitals of Morecambe Bay NHS Trust (UHMBT) rely on temporary staff, and there have been times with no consultant cover.
• Inequity in waiting times: There can be a 30-week difference between the longest and shortest referral-to-treatment times. Residents of Blackpool and the Fylde Coast currently have no local service.
• Financial sustainability: The current model, with two providers relying on temporary staff, is not financially sustainable.

The proposed model involves:

• Standardising services: This includes clinic templates and referral processes.
• Creating an advice and guidance service: This would allow primary care providers to consult with specialists before making referrals.
• New commissioning model: Instead of paying all four hospital trusts for services, Lancashire Council would pay one trust, East Lancashire Hospitals NHS Trust (ELHT), to provide all services in multiple locations. All consultants would be employed by ELHT but work in various hospitals.
• New location plan: This would concentrate clinics at fewer sites to maximise staff capacity. There would be two main hub locations, one in East Lancashire (Burnley General Hospital and Royal Blackburn Hospital) and one in Central Lancashire (Chorley and South Ribble Hospital). Two satellite locations would offer clinics one day a week at Blackpool Victoria Hospital and Furness General Hospital.

According to the report, the changes would have the following impacts on patients:

• ELHT: No change to service, with approximately £0.5 million investment in Royal Blackburn Hospital for dental suite reconfiguration.
• LTH: Consultations would take place only at Chorley and South Ribble Hospital, with approximately £1 million investment at the hospital to support additional dental suites. Some patients may have to travel further.
• BTH: Improved service with more reliable and regular access to a consultant and dental therapist.
• UHMBT: Service would no longer be provided at Royal Lancaster Infirmary (RLI) and Queen Victoria Hospital (QVH). Patients may have to travel further to Furness Hospital or Chorley.

The report noted that approximately 256 patients from Morecambe Bay may now access the Central Lancashire Service at Chorley Hospital, and approximately 115 patients who do not live in the East Lancashire catchment area may have to attend the East Lancashire Hub.

The committee was asked to consider whether the proposed transformation constituted a significant change to the service, which would require a formal public consultation before implementation.

Use of Enabling Digital Technologies in Adult Services

The committee was scheduled to discuss a report providing an overview of the use of digital technologies in adult services within the Adult, Health and Wellbeing Directorate. The report covered current work, including digital tools being piloted to improve care delivery and efficiency, and the use of artificial intelligence (AI) in triage¹, risk prediction and care planning. It also covered future plans being designed through the Digital Blueprint, and a consideration of the risks and opportunities of digital transformation.

The report stated that Adult Services was working to align its transformation activity to the six core ambitions of Lancashire County Council's Digital Strategy (2024-2029).

The six ambitions of the Digital Strategy are:

1. Building digital partnerships for the benefit of the county.
2. Providing a great digital experience for residents.
3. Driving innovation from data insights and artificial intelligence.
4. Creating the technical foundations needed as a building block for innovation and transformation.
5. Building digital skills, culture and new ways of working.
6. Leveraging digital in social care.

According to the report, in the first year of delivery against the Digital Strategy, work has been supported under Ambition 6: leveraging digital in social care. Progress to date includes:

• Expanding Digital Social Care: 85% of regulated care providers in Lancashire and South Cumbria are now using a digital social care record. 286 grants have been issued to support care homes in adopting digital solutions.
• Digitising In-House Care Provision: The Nourish app has been rolled out across 16 residential care homes, enabling 1,000 staff to work digitally and flexibly.
• Streamlining Commissioning with eBrokerage: An eBrokerage solution has been introduced to improve the commissioning process between care workers and providers.
• Supporting Transitions from Children's to Adult Services: A new digital solution has been provisioned to support the transition from Children's to Adult social care services.
• Introducing Smart Technology in Care Settings: The council has supported the rollout of the Nobi Smart Lamp to 50 residential care homes with the highest fall rates.
• Migrating to a Preventative Digital Platform: Former Telecare service users across Lancashire and South Cumbria have been migrated by Progress Lifeline to the Universal Monitoring Software (UMO) digital platform.
• A new Video Relay Service (VRS): This service aims to improve access for people who use British Sign Language (BSL) when contacting council services.
• Copilot AI Adoption to Release Practitioner Time: Copilot AI has been deployed to 332 practitioners in Adult Social Care to support tasks such case prioritisation, risk management, report writing and chronology for court reports.
• Digitising Technology Enabled Care Services: Residents and their advocates can now commission or decommission technology enabled care services using a simple webform, removing the need for a social worker assessment.
• Expanding Access to Social Care Services: A new online social care referral service has been established for use by both professionals and residents.
• Improving Care Package Communication: The Care Package Update Request Form has been deployed, enabling providers to notify the council of changes to resident care.
• Digitising Financial Assessments: A digital Online Financial Assessment tool has been deployed, allowing residents to submit financial information in a structured format.
• Automating Financial Processes in Adult Social Care: A new tool is being piloted to integrate provider systems with the Adults Social Care financial system.
• Expanding Use of Digital Social Care Records: The use of digital social care records in all regulated care homes continues to pave the way for future integration with the council's systems and the development of meaningful data insights.
• Introducing the Trusted Reviewer Model: Adult Services has introduced a Trusted Reviewer Model using the delegation portal functionality within the core system.
• Improving Visibility Through Shared Care Records: Adult Services now have access to the Lancashire Shared Care Record via the ICB LPRES solution.
• Enabling Partner Access to Core Systems: Remote access to the Adults Services core application has been enabled for partner agencies involved in short-term planning and assessments.

The report also outlined the design of a Digital Blueprint, with the primary focus on improving resident experiences of accessing care, offering digital and technology enabled care provision, improving capacity and productivity of social work teams and supporting data driven decision making.

The ambitions for the design of the Digital Blueprint are aligned to the delivery of excellent social care services to residents and to those outlined in the council's digital strategy:

1. For residents and their carers to be informed and empowered to help themselves through information and tools that drive service and self-sustained support.
2. For the care sector, creating opportunities for greater connectivity and innovation in supporting the delivery of better outcomes, protecting sustainability and delivering Value for Money.
3. For the workforce, improving confidence, information and productivity to create the best conditions for meaningful engagement and high-quality support by upskilling the workforce and providing the right tools.
4. For how the council works with its partners, identifying ways to join up delivery and information sharing to create a better experience through care pathways.
5. For compliance and preparedness, ensuring enabling systems and infrastructure support workflow, talk to each other where required and actions to support a safe transition through to local government reorganisation (LGR) are in place.

The report noted that risks of digital transformation include the fact that not everyone will have the capability or capacity to use digital technologies, and that digital adoption by residents and families relies upon digital adoption by providers and social work teams and may require upskilling.

Year Health Plan

The committee was scheduled to receive an overview of the 10 Year Health Plan and how the plan could shape health services in Lancashire and South Cumbria.

The 10 Year Health Plan was published in July 2025, and was shaped by experiences and expectations of the public, patients, the health and care workforce and partners.

The plan sets out a new course for the NHS, and aims to use new technology, medicines, and innovation to deliver better care for all patients and better value for taxpayers.

The plan is delivered through three shifts:

• From hospital to community: Transforming healthcare with easier GP appointments, extended neighbourhood health centres, better dental care, quicker specialist referrals, convenient prescriptions, and round-the-clock mental health support.
• From analogue to digital: Creating a seamless healthcare experience through digital innovation, with a unified patient record, AI-enhanced doctor services and specialist self-referrals via the NHS app, a digital red book for children's health information, and online booking.
• From sickness to prevention: Shifting to preventative healthcare by making healthy choices easier, offering new weight loss services, introducing home screening kits, and providing financial support to low-income families.

The plan aims to deliver the following by 2028/29:

• Same-day digital and telephone GP appointments.
• A GP led Neighbourhood Health Service with teams organised around groups with most need.
• Neighbourhood Health Centres in every community, increased pharmacy services and more NHS dentists.
• Redesigning outpatient and diagnostic services.
• Redesigning urgent and emergency care, allowing people to book into urgent and emergency care (UEC) services before attending via the NHS App or NHS 111.
• People with complex needs will have the offer of a care plan by 2027 and the number of people offered a personal health budget will have doubled.
• Patient-initiated follow-up will be a standard approach.
• The NHS App will be the front door to the NHS, making it simpler to manage medicines and prescriptions, check vaccine status and manage the health of your children.
• A 'HealthStore' to access approved health apps.
• A Single Patient Record will mean patient information will flow safely, securely and seamlessly between care providers.
• Digital liberation for staff with the scale of proven technology to boost clinical productivity.
• A Health Coach will be launched to help people take greater control of their health, including smoking and vaping habits later this year.
• New weight loss treatments and incentive schemes to help reduce obesity.
• The Tobacco and Vapes Bill will be passed, creating the first smoke-free generation.
• Women will be able to carry out cervical screening at home using self-sample kits from 2026.

The report stated that the Lancashire and South Cumbria Integrated Care Board (ICB) commissioning intentions for 2026-27 are framed in the context of the NHS 10 Year Plan, current ICB Strategic Priorities, NHS Planning Guidance for 26/27, developing ICB Clinical Strategy, and improving strategic commissioning.

Challenges to the plan include a continuing challenged financial position, increasing pressures across the Health System, a proposed reduction in ICB workforce, and the requirement to change the way services are delivered.

Opportunities include Neighbourhood Health Plans, market management, and population health and prevention.

Work Programme 2025/26

The committee was scheduled to review the work programmes for 2025/26 for both the committee and the Health Scrutiny Steering Group. The next meeting of the Health Scrutiny Steering Group was scheduled to include updates on public health and the NHS Health Checks Programme. The next meeting of the committee had been moved from 19 January to 3 February 2026 to incorporate a report on the consultation outcome for the Provider Services Redesign.