To receive any declarations of interest from Committee members in relation to items on this agenda.

There were three declarations of interest made:

To confirm the minutes of the previous meeting held on 21 November 2025.

The Panel agreed the minutes of the meeting held on 21 November 2025 as a correct record, subject to the following amendment:

1.     Addition to ‘Also in attendance’: Councillor Mary Aspinall

To receive any reports on business which, in the opinion of the chair, should be brought forward for urgent consideration.

There were no items of Chair’s Urgent Business.

Councillor Mary Aspinall (Cabinet Member for Health and Adult Social Care) introduced the Adult Social Care Finance Report, Month 8 24/25 and discussed:

a)     The Adults, Health and Communities directorate had reported an in?year overspend of £4.4 million at Month 8, of which £2.4 million related specifically to Adult Social Care, reflecting sustained financial pressure within care services;

b)    The main pressures remained consistent with the pattern seen throughout the year, particularly a rise in demand for domiciliary care, with increased activity flowing through as waiting lists were reduced and more people entered the system;

c)     The service had been able to offset a proportion of these pressures through additional joint funding and client income, which helped to reduce net expenditure against budget;

d)    Inflationary pressures had arisen following the collapse of the Council’s previous Community Equipment Service provider, and additional funding had been required to stabilise and sustain delivery of that service under new arrangements;

e)     A Budget Containment Group had been activated from the beginning of the financial year, supported by a series of focused work?streams, to identify high?risk budget areas and develop mitigations, including: targeted package reviews, cost?containment activity, and opportunities to increase appropriate income;

f)      Approximately £800,000 additional income from health partners had been identified by reviewing domiciliary care packages;

g)     Despite the mitigations, some risks remained: £500,000 of delivery plans carried forward from previous years were still in progress and required continued oversight to ensure full delivery;

h)    Delivery plans for 2025/26 had generated £2.7 million of savings at the time of reporting. The remainder of the programme continuing to be monitored through the Budget Containment Group;

i)      The Adult Social Care budget for the following financial year was being developed in parallel, with planned growth of £11.1 million in 2026/27 to address National Living Wage increases, wider inflationary pressures and demand growth across the system, recognising that the demand patterns evident in the current year were expected to continue.

Rebecca Sampson (Lead Account) added:

j)      The approach taken sought to distinguish clearly between unavoidable demand?led pressures and those areas where management action, joint working and improved processes could reasonably be expected to mitigate costs;

k)     Work was ongoing with health partners to ensure joint funding arrangements were robust, transparent and consistently applied, so that Adult Social Care did not bear costs that were more appropriately attributable to NHS responsibilities;

l)      The growth of £11.1 million for 2026/27 had been modelled to reflect the confirmed National Living Wage rate, inflation on commissioned care, and known changes in client numbers and complexity, to minimise the risk of in?year volatility;

m)   Lessons learned from previous years’ income forecasts, particularly around client contributions, had been factored into the new budget assumptions, with a view to improving income accuracy and reducing the likelihood of future income?related pressures.

In response to questions, the Panel discussed:

n)    Appreciation for the work undertaken to contain the overspend and concern regarding the sustainability of relying on  ...  view the full minutes text for item 113.

Councillor Aspinall (Cabinet Member for Health and Adult Social Care) introduced the Adult Social Care Performance Monitoring Report and discussed:

a)     The report provided a performance update for Adult Social Care, including demand levels, waiting times, outcomes for people, and key system pressures and improvements;

b)    The report followed the recent Care Quality Commission (CQC) inspection of Adult Social Care, with Plymouth receiving an overall rating of ‘Good’, which was a significant achievement;

c)     Performance information was presented thematically, including front door and triage, Care Act assessment activity, review activity, occupational therapy (OT) waiting times, care?home demand, domiciliary care capacity, reablement outcomes and hospital flow indicators including “No Criteria To Reside”.

Julia Brown (Service Director for Adult Social Care), Gill Nicholson (Head of Innovation and Delivery, Adult Social Care) and Ian Lightley (Livewell Southwest) added:

d)    At the ‘front door’, no-one waited more than five days for an initial triage decision. This ensured everyone contacting the service received a timely first response and a clear decision on whether a full Care Act assessment was required, enabling earlier advice, information and signposting;

e)     Significant progress had been made on Care Act assessments. The average number of days to complete an assessment had reduced from over 200 days earlier in the year towards the 100?day target, and the very long waits of over 500 days had reduced substantially;

f)      The ‘waiting well’ arrangements had been fully implemented, including:

                     i.         proactive contact with people on the waiting list and clear updates on expected timescales;

                   ii.         established contact routes so people could notify the service if needs changed or risk increased;

                  iii.          risk?based prioritisation that enabled higher?risk people to be brought forward sooner;

g)     Review activity had shown a slight reduction in total reviews completed, reflecting a deliberate shift toward targeted, proportionate reviews that:

                         i.         focused on those at highest risk rather than solely on length of wait;

                       ii.         ensured reviews were proportionate, avoiding unnecessary full reassessments;

                      iii.         supported safe reductions in care packages where people no longer required the same level of support;

h)    Targeted reviews had identified individuals whose needs were more appropriately funded through NHS Continuing Health Care or other health budgets. This contributed to a realignment of funding responsibilities, ensuring the correct service funded the correct level and type of care and supporting budget sustainability across health and social care;

i)      OT waiting times remained a priority, with the waiting list including both Adult Social Care and health referrals;

j)      The overall picture for OT had improved, although around 18% of people were still waiting more than 300 days, which officers acknowledged remained too long;

k)     To address OT delays, Adult Social Care and Livewell Southwest had initiated a significant review of OT activity, including:

                     i.         development of a clearer shared definition of Adult Social Care OT, distinguishing longer?term care and independence?focused interventions from health rehabilitation;

                   ii.         review of pathways, demand and prioritisation for Section 2 and Section 9 activity to ensure referrals entered  ...  view the full minutes text for item 114.

Gary Walbridge (Strategic Director for Adults, Health and Communities), Julia Brown (Service Director for Adult Social Care) and Louise Ford (Service Director for Integrated Commissioning) presented the Adult Social Care CQC Outcome Update and discussed:

a)     The inspection outcome had been received following a significant assessment process which began in January of the previous year, during which the Council had submitted over 300 documents and 50 anonymised cases to the Care Quality Commission (CQC);

b)    The on?site inspection had taken place over three and a half days in June and had involved approximately 45 formal interviews with staff, partners and people receiving services, including around 180 individuals in total;

c)     The service had been awarded an overall rating of Good, and the presenters expressed strong pride in the outcome, noting the extensive work undertaken by staff, Livewell Southwest, wider Council teams, partner organisations and voluntary and community sector networks;

d)    Plymouth had achieved an Outstanding rating for the domain of ‘equity, experience and outcomes’, one of only a very small number of councils nationally to achieve Outstanding in this area;

e)     The Outstanding rating recognised Plymouth’s proactive approach to identifying and listening to people most likely to experience inequity in services and reflected extensive partnership work across directorates and sectors;

f)      The presenters emphasised the importance of acknowledging the success achieved while also recognising that not everyone experienced services positively, and the report identified clear areas for improvement which would form the basis of ongoing work with Scrutiny;

g)     Inspection documentation, including the full report, had been published on the CQC website and was available for partners and the public;

h)    Assessing People’s Needs had scored 50%, with strengths including person?centred assessments and 90% of callers having their situation resolved at first contact;

i)      Strong examples of joint working and positive feedback on carer assessments had been noted;

j)      Improvements were required in communication with people and carers and in strengthening strength?based practice, with the Principal Social Worker leading training to address this;

k)     Supporting People to Live Healthier Lives had scored 63%, with strong preventative work, effective reablement and strong partnership working across the council and the voluntary sector;

l)      Improvement areas included occupational therapy (OT) pressures and outcomes for those receiving short?term support, though some progress had already been made since the inspection period;

m)   Equity in Experience and Outcomes had scored 88%, reflecting embedded co?production and strong engagement with seldom?heard groups, with further work planned on cultural competency and data quality;

n)    Care Provision, Integration and Continuity, had scored 57%, with strong recognition of the Council’s use of the Joint Strategic Needs Assessment to shape commissioning and the strategic direction provided by the Plymouth Plan;

o)    Strong partnership working with the voluntary and community sector and commissioned providers had been noted, alongside positive examples of how people were offered choice in their care;

p)    Market?shaping work and the co?production commissioning toolkit had been well received, though further work was  ...  view the full minutes text for item 115.

Kate Lattimore (Commissioning Officer), Mark Collings (Strategic Commissioning Manager) and Viktor Keaty?Korycan (Manager of Caring for Carers, Improving Lives Plymouth) presented the Plymouth Citywide All?Age Unpaid Carers Strategy 2025–2027 and discussed:

a)     The strategy had been co?produced across the Plymouth health and social care system, including Plymouth City Council, Livewell Southwest, University Hospitals Plymouth, St Luke’s Hospice, Time 4 U Partnership and Improving Lives Plymouth, and was supported by a detailed implementation plan intended to ensure promises made to carers translated into practice;

b)    Census data from 2021 identified approximately 24,000 unpaid carers in Plymouth, with national estimates of 5.7 million unpaid carers. The school census had identified 730 young carers, although further work with youth services indicated the true figure locally was closer to 1,300;

c)     Unpaid caring was recognised as widespread, with around three in five people becoming carers during their lives. 70% of carers reported long?term physical or mental?health conditions compared to 59% of non?carers;

d)    Young carers faced significant challenges, including reduced school attendance and attainment. National research suggested young carers lost an average of 23 school days per year due to caring responsibilities;

e)     Population change, increasing complexity of need and continuing workforce shortages meant unpaid carers played an increasingly essential role in the wider system;

f)      Development of the strategy had involved extensive engagement with carers, with carers identifying what worked well, what did not and what support they needed. Six priorities had been developed from this engagement:

                        i.         access to support services that worked for carers;

                       ii.         enhanced financial support;

                      iii.         improved health, safety and wellbeing;

                      iv.         early identification and recognition of carers;

                       v.         improved information, advice and communication;

                      vi.         support when caring roles changed, including transition and bereavement;

g)     A cross?partnership implementation group met regularly to oversee delivery of the action plan, with progress reported to the Carers Strategic Partnership Board;

h)    Adult Social Care had introduced a RAG?rated waiting?well tool that ensured people waiting for assessments were supported, informed and signposted appropriately, including checks on carer wellbeing and risk of carer breakdown;

i)      Livewell Southwest had undertaken work to strengthen carer involvement in assessments and decision?making, including reviewing carer support plans and undertaking focus groups;

j)      A cross?system survey had been issued to understand communication gaps between agencies and identify improvements for carers;

k)     Mental?health inpatient units were reviewing discharge processes to ensure carers were included appropriately;

l)      Virtual wards and discharge?to?assess models supported care at home but could increase pressure on carers, so systems were working to ensure appropriate support and communication with carers involved in home?based care;

m)   Adult Social Care teams were piloting the Triangle of Care, a national quality framework, to ensure a therapeutic alliance between services, the cared?for person and the carer;

n)    A programme called Carer Money Matters, funded by Carers Trust, supported income maximisation, benefits navigation and fuel?poverty reduction. More than 500 carers had been supported, with  ...  view the full minutes text for item 116.

Michael Whitcombe (Deputy Chief Operating Officer, University Hospitals Plymouth), Amanda Nash (Head of Communications, University Hospitals Plymouth), Gary Walbridge (Strategic Director for Adults, Health and Communities) and Louise Ford (Service Director for Integrated Commissioning) presented the Winter Pressures Update and discussed:

a)     Winter planning had remained challenging, with the One Plan objective of reducing the number of patients with No Criteria to Reside (NCTR) only partially achieved. Approximately 50% of the intended improvement had been delivered;

b)    University Hospitals Plymouth (UHP) had operated under escalation, with a net loss of 54 beds from the beginning of October due to NCTR?related pressures, compared with an anticipated loss of 8 beds after mitigations. The position had stabilised at around 40 beds lost in December and January;

c)     Ambulance handover delays had shown significant improvement, with 2,000 hours lost in December 2025, compared to 6,344 hours lost in December the previous year. Although performance remained below desired levels, meaningful progress had been made, resulting from joint acute and community system working;

d)    The four?hour emergency department standard had deteriorated more than anticipated against the planned recovery trajectory, with actions underway to improve patient flow and movement through pathways;

e)     Vaccination uptake among staff had improved, with UHP exceeding the 5% increase expected across Devon. Particular success was attributed to peer vaccinators and targeted internal communications, with a further rise in uptake immediately before Christmas in response to rising flu cases;

f)      Infection?prevention benefits were evident, with flu and RSV impacts being more controlled and less severe than in the previous winter due to preventative measures and vaccinations;

g)     The winter communications campaign had included a major public awareness initiative for the Urgent Treatment Centre (UTC), which had involved social media, radio, Spotify advertising and physical banners;

h)    Since the start of the campaign, Urgent Treatment Centre (UTC) attendances had risen significantly, with 11 January 2026 recording the highest number of UTC attendances to date. The campaign had helped reduce emergency?department redirects by encouraging patients with minor illness and injury to present directly to the UTC;

i)      Members of the Panel had visited the UTC in November 2025, and positive feedback had been received, with several councillors independently promoting the service following their visit;

j)      The presenters emphasised the importance of ensuring the public understood when and how to use the UTC as a safe alternative to the Emergency Department, which supported improved flow through the hospital;

k)     UHP highlighted positive results from out?of?hospital services showcased during the BBC NHS Day, including the X?ray car, which had supported over 400 patients, with over 95% avoiding hospital conveyance as a result;

l)      Admission?avoidance services remained a priority, with national policy continuing to promote home?based care. Patients typically recovered better in their own environments and were less exposed to infection during winter;

m)   Livewell Southwest continued to develop the community virtual ward, with 55 people on the caseload out of a capacity of 95, alongside the acute  ...  view the full minutes text for item 117.

The Chair introduced the item and discussed:

a)     This was the second occasion the Panel had requested an update on Armed Forces Care, and significant concerns were raised about the quality and appropriateness of the information provided;

b)    The Chair expressed disappointment and frustration that no representatives from the Integrated Care Board (ICB) or NHS partners had attended the meeting to present the report;

c)     There was a need to clarify information on the final page of the submitted papers, which stated that “there are no special provisions for the (Armed Forces) population to be seen faster than the rest of the population”. This appeared to contradict the Armed Forces Covenant, which provided for priority treatment for serving personnel, veterans and their families for service?related conditions, subject to clinical need;

d)    The Panel would revisit the matter at the March meeting, where attendance from the ICB and NHS representatives would be required to provide a full, accurate and Plymouth?specific report.

In response to questions, the Panel discussed:

e)     Members expressed support for the Chair’s comments and noted that the absence of local information undermined the purpose of scrutiny;

f)      Members emphasised the importance of recognising the Armed Forces community in Plymouth, given the city’s significant military presence.

The Panel agreed:

1. To request a full Plymouth?specific report at the March 2026 meeting, with attendance from the ICB and NHS.

For the Committee to review the progress of actions.

The Panel agreed to note the Action Log.

For the Committee to discuss item on the work programme.

The Panel agreed:

1.     To note the Work Programme;

2.     To move the next scheduled meeting due to a scheduling clash with Taxi Licensing Committee;

3.     To request the following reports for the next meeting:

                          i.    Armed Forces Care;

                         ii.    ICB Reforms and Restructures

                       iii.    Electronic Patient Record (EPIC).

To Consider passing a resolution under Section 100A(2) of the Local Government Act 1972 to exclude the press and public from the meeting for the following items of business, on the grounds that they involve the likely disclosure of exempt information as defined in paragraph 1/2/3 of Part 1 of Schedule 12A of the Act, as amended by the Freedom of Information Act 2000.

Agenda