Health and Adult Social Care Overview and Scrutiny Committee - 5 November 2025

The Health and Adult Social Care Overview and Scrutiny Committee confirmed that the minutes of its 5 November 2025 meeting were correctly recorded and approved for signature. No declarations of interest were made. Five public questions were table. The first, from Mr Evans (St Austell), asked who authorised the £50 000‑plus payment to Kingsgate consultancy for the Royal Cornwall Hospitals Trust (RCHT) restructuring. The Chairman replied that the appointment was approved by the RCHT Board in February, with funding approved by the Cornwall and Isles of Scilly Integrated Care Board and NHS England, and that the cost would be met by RCHT. The second question, from Mr Seaborn (Truro), raised concerns about cumulative hospital budget cuts of £49 m this year and further reductions projected for next year. The response outlined the Trust’s £49.3 m savings target (approximately 7 % of the 2025/26 operating plan), its alignment with regional and national acute providers, and the use of equality‑quality impact assessments to monitor service effects. The third question, from Miss Best (Bodmin), queried whether the Trust was considering privatisation as a response to financial pressure. The Chairman stated that the Trust’s primary strategy is to improve productivity using existing resources, with external support considered only where required and any changes subject to the normal business‑case process. The fourth question, from Mr Bramwell (Truro), concerned the potential loss of experienced staff through the Kernow Health restructure. The Chairman referred to the not‑for‑profit Kernow Health CIC and indicated that the committee would monitor any unintended consequences of the restructure, holding the Trust accountable for impacts on frontline care.

During a formal mid‑year review of the committee’s work programme, members were invited to suggest new scrutiny items and to engage the public. No new items were proposed for this committee, and the programme was deemed to contain a substantial range of relevant work for the remainder of the year. Consequently, it was resolved that no amendments be made to the work programme at this time and that any future changes would follow the Overview and Scrutiny Protocol, with the Chairman, Vice‑Chairman, Senior Responsible Officer and Democratic Services Lead overseeing any adjustments. The delegation to the Chairman was confirmed to remain in place, having been exercised on three occasions this year to incorporate urgent reports.

The Director of Delivery for the Cornwall and Isles of Scilly NHS Integrated Care Board presented a progress report on the national 10‑year NHS plan, which aligns with the Cornish model’s three principles: shifting care to the community, prioritising prevention, and advancing digital services. Cornwall has established 16 integrated neighbourhood health teams, launched new primary‑care hubs, expanded frailty and end‑of‑life services, and opened an elective surgical hub at St Austell. Digital initiatives include the NHS App, shared care records and AI‑driven risk stratification. Preventative programmes such as “Starting Well, Living Well, Ageing Well” and enhanced dental care for children were highlighted, together with modelling work to forecast population growth and associated service demand.

Healthwatch Cornwall’s report “Cornish Communities in Focus, Evolving Voices in Mental Health” was introduced by its Chief Executive. The report, based on over 500 respondents, identified a gap between demand and capacity in mental‑health services and noted that 24 % of healthcare needs relate to mental health while only 10 % of funding is allocated to the area. Officers acknowledged the findings, emphasized the need for whole‑system partnership working, and discussed the importance of neurodiversity diagnosis and a life‑course approach. The Director of Public Health reiterated the link between mental health and broader social factors, and the committee noted the disparity in funding uplift compared with other regions.

Finally, the Chief Finance Officer of RCHT, accompanied by a Clinical Ophthalmology Consultant, reported on the decision to repatriate certain subcontracted ophthalmology services, a