Agenda and minutes

To note any apologies for absence from Members.

Apologies for absence were received from Councillor Sam Corcoran. Councillor Dawn Clark was present as substitute.

To provide an opportunity for Members and Officers to declare any disclosable pecuniary interests, other registerable interests, and non-registerable interests in any item on the agenda..

In the interests of openness and transparency, the following declarations were made:

Councillor Nicola Cook declared an interest in Item 8, Drugs and Alcohol Plan – 12 months update, and would leave the meeting for that item.

To approve as a correct record the minutes of the previous meeting held on 26 January 2026.

RESOLVED:

That the minutes of the previous meeting held on 26 January 2026 be approved as a correct record.

In accordance with paragraph 2.24 of the Council’s Committee Procedure Rules and Appendix on Public Speaking, set out in the Constitution, a total period of 15 minutes is allocated for members of the public to put questions to the committee on any matter relating to this agenda. Each member of the public will be allowed up to two minutes each to speak, and the Chair will have discretion to vary this where they consider it appropriate.

Members of the public wishing to speak are required to provide notice of this at least three clear working days’ in advance of the meeting.

Petitions - To receive any petitions which have met the criteria - Petitions Scheme Criteria, and falls within the remit of the Committee. Petition organisers will be allowed up to three minutes to speak.

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There were no public speakers.

To consider the report on the Third Financial Review of 2025-26.

The committee received an update report on the Third Financial Review of 2025-26 and a verbal update on the Forth Financial Review on 2025-26.

It was noted that at FR4, the overall position for Adults and Health for 2025-26 was unchanged and showed a position of a roughly £3,000 overspend. It was noted that there had been a recent increase in both short term and long term bed costs, this links to changes experienced from additional beds purchased by Health to support Discharge to Assess over the winter period, resulting in the Council experiencing additional costs in both short and long term beds. The increased pressure for 2025/26 was being mitigated through grants and internal efficiencies, however this results in a risk of starting 2026/27 with a material opening budget pressure which could be in the region of £4.8 million if bed numbers remained at this level. If there was an opening pressure in 2026/27 it would need to be mitigated in year, which along side the delivery of increased stretch targets in 2026/27 was likely to present a significant financial challenge for the service.

Members were updated that the difference between the best and worst case financial scenario forecasts was narrowing towards the end of the year as more of the projected spend was understood.

It was noted that Cheshire East Council could not fully control the parameters of the BCF, asthe BCF was a pooled budget with partners agreeing how funding was to be used, so the council could make suggestions to the BCF Governance Group on how it thought the spend should be used. It was noted that there may be a change in focus of the BCF towards discharge.

Members were updated that the budget for Public Health was currently showing an underspend in year, however as the Grant was ringfenced the underspend is  ringfenced as part of the Public Health ringfenced reserve. It was noted that the pay award for NHS staff which impacted on PH contracts and services contained with the Public Health remit had been higher than projected, but work was underway with partners to address this. It was noted that the council had been awarded a three-year funding map, instead of the usual one year, which would make it easier to model going forwards.

It was noted that over 60 individuals had died whilst in hospital awaiting an NHS CHC assessment which was very concerning and had been raised with colleagues in health services. It was noted that some of the council’s greatest pressures were from external factors and not within and it was important that partners were aware of this.

Members requested further details of the circumstances surrounding the deaths of individuals who had died whilst awaiting an NHS assessment. Officers committed to provide a written response.

RESOLVED:

That the Adults and Health Committee:

1. Note the overall Council’s Financial position as described within the Executive Summary – Council Financial Position.

2. Scrutinise the latest revenue forecast for Adults and Health Directorate, review  ...  view the full minutes text for item 48.

To consider a report which seeks approval to procure a new contract for the Integrated Community Equipment Service across Cheshire East and Cheshire West.

The committee considered a report which sought approval to procure a new contract for the Integrated Community Equipment Service across Cheshire East and Cheshire West.

It was noted that this was a statutory service which provided equipment in the home for safe independent living and to assist with reducing long term care costs. The service was currently jointly commissioned by Cheshire East Council, Cheshire West and Chester Council and the Integrated Care Board. It was noted that the current arrangements would come to an end on 31 March 2027. Members were updated that the current model worked well but there were identified areas for improvement, and consultations had taken place. It was noted that demand for the service had increased by around 20% since 2021, which was positive as it was enabling more individuals to live at home independently for longer.

It was noted that the service aims to recycle and reuse as much of the equipment as possible when it is no longer of need, but there will always be a proportion of equipment which is it not possible to reuse. Members were updated that the service was looking to increase its tracking of equipment by checking in with social workers to what equipment a user may no longer require, marketing campaigns with users, and encouraging users to return equipment which was no longer required. It was noted be Members that it can sometimes take a long time for equipment to be collected when no longer required, and this would be factored in to the new contract, along with KPIs.

It was noted that the increase in demand for the service meant that first the next year, a 19% uplift in budget had been agreed, followed by a 17% uplift in for subsequent years across the three funding partners.

Members requested further details on how privately purchased equipment could be donated, and the time taken for equipment to be collected when it was no longer in use. Officers committed to provide written responses.

The Chair suggested an amendment to recommendation 2 to include reference to “and appropriate Members within the Cabinet System”, which was accepted by the committee as a friendly amendment.

RESOLVED: (Unanimously)

That the Adults and Health Committee:

1.    Approve the procurement approach for a new Integrated Community Equipment Service contract, as outlined in this report.

2.    Delegate authority to award the contract, and all related matters, to the Executive Director for Adults, Health and Integration, and appropriate Members within the Cabinet System.

To consider a report to reprocure a new sexual health based service.

The committee considered a report which sought to reprocure a new sexual health based service.

Members were updated that based on engagement and benchmarking, the current arrangements offered Cheshire East Council significant value for money, and that going through an open tendering process may cause the cost of the contract to increase. It was noted that in terms of the cost of the recommission, continued conversations with the current provider would be required regarding the cost of the contract, and following this, if an agreement could not be reached, then the council would look to an open tender.

Members were updated that the intention was to move towards a care community model, which would use outreach clinics within the communities to reach as many people as possible. It was noted that there was a national agreement among sexual health services to allow for residents to engage with services outside of their local area, and for those costs to be reimbursed.

It was noted that the service encouraged the use of PREP and there was a need to target this towards the individuals who were at a higher risk. It was noted that there had been an increase in the use of the service due to factors around the increased usage of dating apps, changes in sexual behaviour and significant cost pressures on local sexual health services. It was noted that the current provider was also working with Cheshire East Council on several specific target areas, such as those Care Leavers who may have missed out on support via the education system.

Members were updated that there was an outreach element to the service which could engage with local youth clubs, etc, if requested.

Members noted the age of the data within the JSNA and requested further details regarding the rates of under 18s pregnancy. Officers committed to providing a written response.

The Chair proposed two amendments to the recommendations which were accepted by the committee as friendly amendments:

1.    To remove the words “Chair and Vice Chair of the Adults and Health Committee (or” and “if the decision takes place after the start of Cabinet” from recommendation two.

2.    To add an additional recommendation to read “Authorise for a progress report to be taken to the relevant Overview and Scrutiny Committee in six months, detailing the outcomes of the service”.

RESOLVED: (Unanimously)

That the Adults and Health Committee:

1.    Approve the procurement of the Cheshire East Integrated Sexual Health Service using the Provider Selection Regime (PSR).

2.    Delegate authority to the Executive Director of Adults, Health and Integration to award the contract in consultation with the relevant Cabinet Member.

3.    Authorise for a progress report to be taken to the relevant Overview and Scrutiny Committee in six months, detailing the outcomes of the service.

Councillor Nicola Cook left the room whilst the committee considered Item 8.

Councillor Rob Moreton left the meeting at 11:48 and did not return.

To receive a report containing an update to the service.

The committee received a report which contained an update to the service which scrutinised the work of the substance misuse services over the last year.

It was noted that the service worked with those who had substance misuse and mental health problems, aimed at tackling the stigma associated with these issues and worked in line with national strategies to try and stop people from taking up substance misuse, and to treat those requiring assistance.

Members were updated that officers were working with schools to keep them up to date with information regarding vaping, and provided support toa pupil referral unit which identified problems with students accessing vapes illegally. The service was also working with the schools which hadn’t chosen to take up the service to find out how best they can be supported. It was noted that there had been a significant increase in the use of ketamine and the service was working in collaboration with Liverpool John Moores University to conduct research into new drugs which were appearing in the system to help address these issues.

It was noted that some mothers were not aware that they were pregnant until late into their pregnancy, so early and continual engagement was essential. It was noted that there were a lot of complexities with regards to scenarios where one or more parents has a significant drug abuse problem, which required collaboration from several services for intervention.

It was noted that regarding death rates from drug and alcohol abuse, Cheshire East had risen slightly above the England average, although the numbers remained low and targeted work was being undertaken to address this.

It was noted that alcohol issues tended to be more prevalent in older people and the services was looking to address the danger of excessive drinking and helping older people realise that their alcohol use may not be safe.

Members requested that a regular update on the progress of the Drugs and Alcohol Plan be added to the Work Programme of the relevant Overview and Scrutiny Committee.

RESOLVED:

That the Adults and Health Committee:

1.    Scrutinise the actions carried out to date to implement the Drugs and Alcohol Plan 2024-2029.

Councillor Nicola Cook returned to the committee following Item 8.

To receive the minutes of the Cheshire East Health and Wellbeing Board held on 20 January 2026.

RESOLVED:

That the minutes of the Cheshire East Health and Wellbeing Board held on 20 January 2026 be accepted and noted.

To consider a report which provides the committee with an update on progress in relation to Care at Home commission, emerging risks and their direct impact on Care at Home services and commissioning work, and the rationale for the recommendation to Direct Award Care at Home contracts to support and maintain market sustainability.

The committee considered a report which provided the committee with an update on progress in relation to Care at Home commission, emerging risks and their direct impact on Care at Home services and commissioning work, and the rationale for the recommendation to Direct Award Care at Home contracts to support and maintain market sustainability.

It was noted that engagement had taken place with residents, carers, operational teams and providers which had identified that a full procurement at this stage would come with several risks. The engagement had identified that the service had a number of providers who have a significant proportion of international employees which could case issues due to upcoming changes to legislation, which could lead to package hand-backs, a loss of workforce, and emergency spot purchasing. Therefore, the intention remained for a recommission which would continue to deliver a stable service to over 1400 residents who currently receive over 22,000 hours per week of care at home.

Members were updated that, since July 2025 officers had met with a number of providers, however, the provider forum had not met for at least 6 months due to low levels of engagement, but engagement days in Crewe and Macclesfield would be held in due course. During Stage 2 of the procurement process, officers would be stating their expectations and requirements and would be working with legal officers to ensure robust wording regarding hand-backs. 

It was noted that there was an aim to work towards a neighbourhood model and microenterprises to assist with care levels in rural areas.

Members were updated that it was not the intention to use the full 36 months extension proposed, however this was added in following procurement and legal advice. It was noted that officers were working alongside the Care at Home Task and Finish Group which was meeting regularly. It was noted that there were a number of changes to process which would take significant time to implement; the growth in the number of international recruits and legislation changes would take time to adapt to.

It was noted that the intention was to carry out a full procurement with a new model at a later stage and that through a reduction of providers, the service was looking to ease contract management and move towards an “outcome based model” with fewer trusted providers and reducing the number of providers would enable the service to make more strategic relationships with providers, and options for consolidated hours. It also provided an opportunity for providers to collaborate. It was noted that there was currently no incentive for providers to reduce their care packages

Members noted concern regarding residents who live on the boarder of Cheshire East, where it may be more beneficial for their care to be provided by the neighbouring authority due to travel and access issued.

Members requested further details on the CQC rating of providers. Officer committed to provider a written response.

The Chair proposed two amendments to the recommendations which were accepted by the committee  ...  view the full minutes text for item 53.