Adult Social Care and Health – Q3 2025/26

Summary of progress on Council Priorities, issues arising, and achievements

Adult Social Care (ASC)

Demand for care and support services

In accordance with the Care Act 2014, ASC commission and provide a range of services to support adults and older people across East Sussex. There is an increasing complexity of need amongst people accessing support, with demand for services exceeding pre-pandemic levels and continuing to increase. Some examples include:

·      There has been a 35.8% increase in Mental Capacity Assessments completed between April to December 2025 compared to the same period in 2024.

·      There has been a 6.3% increase in the number of people receiving bedded care (residential and nursing care), and a 4.4% increase in the number receiving Long Term Support in a community setting at 31 December 2025 compared to the same point in 2024.

·      There has been an 8.0% increase in the number of assessments completed between April and December 2025 compared to the same period in 2024 as well as increased levels of contacts handled at Health and Social Care Connect (HSCC) Access (8.1%).

Prevention strategy

The ASC prevention strategy is currently focused on 3 priority areas of its prevention framework – building personal resources (the knowledge, skills, motivation, connections and other resources people need to help themselves in order to live the lives they wish to live and are capable of living), maintaining/improving physical wellbeing, and building community capacity to support individual wellbeing and independence.

The key initiative to building personal resources is the development of a new ‘prevention portal’ which is an online hub to enable people to identify and take preventative action to maintain their wellbeing and independence. In Q3, further steering group discussions involving staff from across the Council as well as representatives from the Voluntary, Community and Social Enterprise (VCSE) and citizen representatives have taken place, and the group has designed and agreed a feasibility study for this portal, which is now being progressed.

Key initiatives on physical wellbeing include confirmation of a c.£350,000 development award from Sport England for a ‘Place Expansion Programme’ in Hastings, which will be delivered in partnership with Active Sussex (lead partner), Hastings Borough Council, and other organisations. This work will focus in part on building system capacity to improve the physical wellbeing of older people (physical wellbeing is the primary driver of presentations into ASC). Other work includes progressing new initiatives on improving physical wellbeing in care homes and extra care settings.

Work on community wellbeing has focused on identifying new volunteering roles that will supports ASC staff and services (directly provided and commissioned) to support peoples’ wellbeing and independence. Resource has been identified to help develop this capacity by recruiting, training, and supporting volunteers alongside other organisations in the VCSE, and these roles will be developed in 2026.

Adult Social Care Strategy

The ASC strategy action plan for 2025/26 contains 23 actions. Highlights of work progressed in Q3 includes the continued delivery of training to over 200 staff and partners on key topics such as safeguarding, Mental Capacity Act, health and safety, communication skills, and resilience. The Mental Health Prevention Strategy (led by Public Health) was progressed, with a focus on addressing the impacts of trauma, and developing peer support. Targeted campaigns were run aimed at increasing take up and receipt of benefits income alongside continuing public campaigns and other work to reduce loneliness. We also supported implementation of the Carers’ Partnership Plan, focusing on peer support and supporting volunteering through the Tribe platform, with growth in awareness of and activity on the platform.

The existing ASC action plan runs to the end of 2025/26. From 2026/27, the ASC Strategy (What Matters To You) priorities will be integrated with the prevention strategy work programme.

Health and Social Care integration

The Government’s national 10-Year Health Plan, published in July 2025, sets out a move to Neighbourhood Health services that deliver joined-up, proactive community-based care through patient-centred teams. In East Sussex, this is being implemented through our shared Integrated Community Teams (ICTs), working in local footprints aligned to the five East Sussex borough and district areas. This is supported by NHS Sussex ICB commissioning plans for 2026/27, and our participation in the National Neighbourhood Health Implementation Programme focussed on Hastings and Rother.

To strengthen Health and Wellbeing Board (HWB) oversight of this whole system work, an informal session on mental health and wellbeing was held in early January 2026. This forms part of a wider programme of development sessions to build a shared understanding of population health and care needs, with briefing notes and key messages.

To help embed new ways of working and aid multi-agency leadership team development, organisational development sessions have been planned and joint leadership groups in each of the 5 ICT footprints have completed a self-assessment to identify development needs. Each group is also co-producing a joint work plan for 2026/27 to set out opportunities for local collaboration in relation to local population health and care challenges and alignment with shared system priorities.

Work is progressing to establish local multi-disciplinary teams (MDTs) to deliver more coordinated care for people with complex health and social care needs, starting with older and frail people and those over 65 with multiple long-term conditions. A new risk-stratification tool, the Johns Hopkins Adjusted Clinical Group (ACG) System, is now in use to identify those who would benefit the most from proactive support, with the aim of improving independence and care experiences and reducing avoidable hospital use. Current work focuses on building a shared understanding of identified groups and designing more integrated health and social care, and the learning will be used to extend the approach to other age groups with growing health risks.

Whole-system efforts have also continued to help to improve hospital discharge processes and to reduce the number of people remaining in hospital unnecessarily due to complex onward care needs. In addition to existing initiatives, the use of funding for additional beds for people to be discharged to recover and be assessed (D2RA), was jointly agreed until the end of January 2026, to support the increased pressure that we would naturally expect to see over the winter period. This was augmented by joint multi-agency discharge events (MADE) prior to Christmas to resolve complex discharge issues.

Third Sector support

During Q3 the Community and VCSE Development Programme providers across the county worked to build engagement with local groups and organisations, identifying the support required to strengthen their roles in supporting communities and working alongside the public sector. In the west of the county Sussex Community Development Association launched the Lewes District Community Action Network, bringing together over 50 groups and organisations to begin the journey of creating an action plan for the local VCSE sector. In the east of the county Hastings Voluntary Action has continued working with local groups and organisations to build the Hastings Aging Network, which is going from strength to strength and celebrated its fifth year in December.


 

Public Health

Weight Loss

During Q2 (reported a quarter in arrears), 239 service users attended at least two sessions and completed a One You East Sussex weight management intervention (ref i). Of these 239 people, 53 (22.2%) achieved at least 5% weight loss. Weight management interventions are 12-14 weeks and so data also includes service users who started a weight management intervention during the previous quarter, Q1, but completed their intervention during Q2. The service continues to monitor weight loss outcomes across its range of programmes and implement relevant actions to maximise ongoing engagement/retention (which should subsequently positively impact on weight loss outcomes). The full data for the year to date is 489 service users attended at least two sessions and completed a One You East Sussex weight management intervention. Of these 489 people, 119 (24.3%) achieved at least 5% weight loss. We anticipate that we will meet the target of 25% at year-end even though we are very slightly under at Q2.

Smoking Cessation

The launch of AI Quit Coach, an artificial intelligence smoking cessation pathway, provides residents with 24/7 smoking cessation support in any language. We have also established a Regional East Sussex Pulmonary Service smoking cessation pathway with the East Sussex Healthcare NHS Trust where patients are provided with two weeks of Nicotine Replacement Therapy and an onward referral to One You East Sussex. Our Stoptober campaign, in October 2025, saw 289 people set a quit date through the One You East Sussex, against a normal monthly average of 218.

Stronger for Life in Hospital

Stronger for Life in Hospital, which is funded by Public Health and managed with the ASC Partnership Team, is part of the wider work to embed physical activity across Adult Social Care and Health. The scheme recently won the President’s Award at the Community Hospitals Association Innovation & Best Practice Awards. This collaborative initiative supports hospital patients, particularly those recovering from strokes, to maintain and regain physical conditioning both during their stay and after discharge. The project, which is co-ordinated by Active Sussex, East Sussex Healthcare NHS Trust and Active Rother, was delivered by health instructors from 20/20 Health at the Bexhill Irvine Unit, and is now expanded through livestreamed sessions to other hospital departments as part of the second phase. It has received outstanding feedback for improving recovery, independence, and wellbeing, while setting a strong example of innovation and partnership in tackling hospital deconditioning.

Stay Strong, Stay Steady, Stay Independent

A Stay Strong, Stay Steady, Stay Independent falls prevention campaign was launched for Falls Prevention Awareness week and the Full of Life festival that ran in September and October 2025. This campaign was targeted in Hastings and Bexhill due to the high rates of emergency admissions in these areas for the over-65s following a fall. Inappropriate footwear is a contributory factor to falls and 300 pairs of non-slip slippers were distributed to reduce this risk, along with falls prevention advice and signposting to local strength and balance classes. Additionally, there were over 10,000 unique visits during Q3 to the dedicated webpage for the campaign which included links to local classes in Hastings and Bexhill and exercises that could be carried out at home.

East Sussex Housing Partnership Strategy

In December 2025, all five District and Borough housing authorities and our Lead Member for Adult Social Care and Health approved the first East Sussex Housing Partnership Strategy. The strategy has been co-produced with partners to sit alongside and complement the individual strategies in each of the district and borough areas to provide a framework for services working together. The strategy includes priorities for preventing homelessness and ending rough sleeping, working together to reduce health inequalities, improving housing management and standards, delivering the homes we need, tackling climate change, and private rented homes.

Housing Retrofit Programme

Public Health played a key role in an East Sussex local authority consortium, led by Lewes District Council, which during Q3 secured an additional £880,000 for delivery of the Warm Home Local Grant in 2025/26, due in part to the strong partnership working developed through the housing retrofit strategy. This is on top of the £3.9m originally awarded for 2025-2028. The additional allocation almost doubles the amount for delivery in the first year of the scheme, with this success being facilitated by the pipeline of potential beneficiaries built up by the Council’s Warm Home Check service.

Prevent Community Engagement and Support

Community Outreach during Q3 included engaging with members of the Eastbourne Cultural Involvement Group and providing specialist advice at the School Safeguarding Conference. Collaboration with Sussex Police involved five joint activities focused on faith, worship, and youth engagement.

In Q3, Prevent awareness and training sessions were delivered to over 120 professionals working across schools, Council libraries and district and borough councils to strengthen referral processes for vulnerable groups. 14 school assemblies on Challenging Hate, Cyber Responsibility and Personal Safety were delivered to over 600 children and young people. A small number of educational support sessions were held with young people at risk of developing extremist views.

Revenue Budget Summary

ASC and Safer Communities

The net ASC and Safer Communities budget of £286.153m for 2025/26 includes a 4% inflationary uplift of £10.724m to support the care market across the Independent Sector. This uplift is in addition to £9.626m to fund growth and demographic pressures and service demands, with the costs of the increases being partially funded by £7.515m raised through the 2% ASC Care Precept. The department has savings targets of £7.420m for 2025/26.

The net forecast ASC outturn for 2025/26 is £295.159m, which is an overspend of £9.006m. This largely relates to the Independent Sector, where the overspend is £9.435m.

This is due to a 7.4% increase in demand compared to Q4 2024/25 and periods before, which informed the modelling for 2025/26 budget setting in November 2024 and therefore would not have captured the growth in demand. More people are being supported but at a lower average cost compared to Q4 2024/25 (a decrease of 3.4%) because we are working closely with the market, being prudent with packages of support and reviewing more people.

There is a net underspend across the rest of the directorate of £0.429m due to delays in recruitment and staff vacancies in Directly Provided Services, offset by increasing costs and demand for equipment services to support people in their homes. Legal costs have also increased due to an increased volume and complexity of cases and an increased need to instruct barristers to provide specialist legal advice and representation.

ASC has a savings target of £7.420m this year of which £7.365m will be achieved. The savings for Linden Court will partially be achieved following the decision to continue providing the service at a reduced level. The remaining saving will be achieved through projects currently underway that will increase operational income.

Public Health

The Public Health budget of £38.295m comprises of the PH grant allocation of £32.679m, additional grants of £3.903m and a planned draw from reserves of £1.713m.

The projected outturn position is for a £0.059m overspend.

The General Public Health Reserve of £2.171m is projected to reduce to £0.399m by the end of 2025/26. The Health Visiting reserve of £1.827m is projected to reduce to £1.727m.

Homes for Ukraine

HFU Grant Funding

Funding b/fwd

£’000

Expected Funding

£’000

Total Funding

£’000

Planned Usage

£’000

Funding c/fwd

£’000

Tariff Funding

4,767

218

4,985

2,581

2,404

Thank you Payments

-

820

820

820

-

Total

4,767

1,038

5,805

3,401

2,404

Capital Programme Summary

The ASC Capital programme budget for 2025/26 is £1.868m, with the Supported Living Project forecasting £1.808m and slipping £0.060m to 2026/27. At Greenacres, the NHS are in the process of securing alternative care settings, so this budget has been slipped to 2026/27. Construction works on the Supported Living Project are complete and the buildings have been handed back to the Council, with work now focussed on some minor improvements and getting the buildings into operational usage in Q4.

Performance exceptions (see How to read this report for definition)

Priority – Helping People Help Themselves

Performance measure

Outturn 24/25

Target 25/26

RAG

Q1 25/26

RAG

Q2 25/26

RAG

Q3 25/26

RAG

Q4 25/26

Q3 outturn

Note ref

The percentage of people who achieve 5% weight loss as part of a One You East Sussex intervention

 

>25%

G

G

A

 

24.3%

i

 

Savings exceptions 2025/26 (£’000)

Service description

Original Target For 2025/26

Target including items c/f from previous year(s)

Achieved in-year

Will be achieved, but in future years

Cannot be achieved

Note ref

Older People’s Directly Provided Services

712

-

712

-

-

 

Learning Disability Directly Provided Services

804

-

662

87

55

 

Vulnerable Adults Supported Accommodation

129

-

129

-

-

 

Adults with Mental Health needs Supported Accommodation

178

-

178

-

-

 

Housing Related Floating Support

1,937

-

1,937

-

-

 

Substance Misuse Contracts

641

-

641

-

-

 

Learning Disability Commissioning

50

-

50

-

-

 

Strategy

180

-

180

-

-

 

Operations

770

-

700

70

-

 

Community Development

500

-

500

-

-

 

Planning, Performance and Engagement

425

-

425

-

-

 

Public Health

1,094

-

1,094

-

-

 

Total Savings

7,420

0

7,208

157

55

 

 

 

 

-

-

-

 

Operations

 

 

55

-

(55)

 

Subtotal Permanent Changes 1

 

 

55

0

(55)

 

Total Savings and Permanent Changes

 

 

 

 

 

 

 

Memo: treatment of savings not achieved in the year (£'000)

Temporary Funding 2

Part of reported variance 3

Total

Note Ref

Learning Disability Directly Provided Services

87

-

87

 

Operations

70

-

70

 

 

-

-

-

 

Total

157

0

157

 

1 Where agreed savings are reasonably unable to be achieved other permanent savings are required to be identified and approved via quarterly monitoring.

2.Temporary funding will only replace a slipped or unachieved saving for one year; the saving will still need to be made in future years (or be replaced with something else).

3 The slipped or unachieved saving will form part of the department's overall variance - it will either increase an overspend or decrease an underspend. The saving will still need to be made in future years (or be replaced with something else).

 

Revenue Budget 2025/26 (£’000)

Adult Social Care – Independent Sector:

Divisions

Planned

Gross

Planned

Income

Planned

Net

Projected

Gross

Projected

Income

Projected

Net

(Over)/ under spend Gross

(Over)/ under spend Income

(Over)/ under spend Net

Note

ref

Physical, Sensory and Memory and Cognition Support

203,984

(112,849)

91,135

211,063

(109,429)

101,634

(7,079)

(3,420)

(10,499)

 

Learning Disability Support

102,085

(10,584)

91,501

103,070

(11,776)

91,294

(985)

1,192

207

 

Mental Health Support

44,285

(19,570)

24,715

43,106

(19,248)

23,858

1,179

(322)

857

 

Subtotal

350,354

(143,003)

207,351

357,239

(140,453)

216,786

(6,885)

(2,550)

(9,435)

 

Adult Social Care – Adult Operations

Divisions

Planned

Gross

Planned

Income

Planned

Net

Projected

Gross

Projected

Income

Projected

Net

(Over)/ under spend Gross

(Over)/ under spend Income

(Over)/ under spend Net

Note

Ref

Assessment and Care Management

37,415

(2,913)

34,502

38,601

(3,308)

35,293

(1,186)

395

(791)

 

Directly Provided Services - Older People

18,524

(6,323)

12,201

17,785

(6,417)

11,368

739

94

833

 

Directly Provided Services - Learning Disability

9,959

(618)

9,341

8,937

(472)

8,465

1,022

(146)

876

 

Subtotal

65,898

(9,854)

56,044

65,323

(10,197)

55,126

575

343

918

 

Adult Social Care- Strategy, Commissioning and Supply Management

Divisions

Planned

Gross

Planned

Income

Planned

Net

Projected

Gross

Projected

Income

Projected

Net

(Over)/ under spend Gross

(Over)/ under spend Income

(Over)/ under spend Net

Note

Ref

Commissioners, Commissioned Services and Supply Management

10,675

(4,129)

6,546

10,183

(4,014)

6,169

492

(115)

377

 

Supporting People

4,252

-

4,252

4,252

-

4,252

-

-

-

 

Equipment and Assistive Technology

8,917

(4,487)

4,430

9,428

(4,742)

4,686

(511)

255

(256)

 

Carers

2,387

(1,693)

694

2,385

(1,659)

726

2

(34)

(32)

 

Subtotal

26,231

(10,309)

15,922

26,248

(10,415)

15,833

(17)

106

89

 

Adult Social Care- Planning, Performance and Engagement and Other:

Divisions

Planned

Gross

Planned

Income

Planned

Net

Projected

Gross

Projected

Income

Projected

Net

(Over)/ under spend Gross

(Over)/ under spend Income

(Over)/ under spend Net

Note

Ref

Planning, Performance and Engagement

6,223

(1,131)

5,092

6,528

(1,389)

5,139

(305)

258

(47)

 

Service Strategy

752

(160)

592

1,283

(160)

1,123

(531)

-

(531)

 

Safer Communities

1,994

(842)

1,152

3,787

(2,635)

1,152

(1,793)

1,793

-

 

Subtotal

8,969

(2,133)

6,836

11,598

(4,184)

7,414

(2,629)

2,051

(578)

 

 

Divisions

Planned

Gross

Planned

Income

Planned

Net

Projected

Gross

Projected

Income

Projected

Net

(Over)/ under spend Gross

(Over)/ under spend Income

(Over)/ under spend Net

Note

Ref

Total Adult Social Care

451,452

(165,299)

286,153

460,408

(165,249)

295,159

(8,956)

(50)

(9,006)

 

Public Health – Core Services:

Divisions

Planned

Gross

Planned

Income

Planned

Net

Projected

Gross

Projected

Income

Projected

Net

(Over)/ under spend Gross

(Over)/ under spend Income

(Over)/ under spend Net

Note

Ref

Mental Health & Best Start

3,795

-

3,795

3,731

-

3,731

64

-

64

 

Health Visiting

8,556

-

8,556

8,556

-

8,556

-

-

-

 

Risky Behaviours and Threats to Health

16,812

(3,903)

12,909

16,681

(3,903)

12,778

131

-

131

 

Communities

774

-

774

772

-

772

2

-

2

 

Central Support and One-off funding

3,977

-

3,977

4,143

-

4,143

(166)

-

(166)

 

Recovery & Renewal

12

-

12

12

-

12

-

-

-

 

Funding/Savings to be released

3,055

-

3,055

3,235

-

3,235

(180)

-

(180)

 

Projects - Reserve

1,314

-

1,314

1,224

-

1,224

90

-

90

 

Public Health Grant Income

-

(32,679)

(32,679)

-

(32,679)

(32,679)

-

-

-

 

Draw from General Reserves

-

(1,713)

(1,713)

-

(1,772)

(1,772)

-

59

59

 

Total Public Health

38,295

(38,295)

0

38,354

(38,354)

0

(59)

59

0

 

Capital programme 2025/26 (£’000)

Approved project

Budget: total project all years

Projected: total project all years

Budget 2025/26

Actual to date Q3

Projected 2025/26

Variation (Over) / under 2025/26 budget

Variation analysis:

(Over) / under spend

Variation analysis:

Slippage to future year

Variation analysis:

Spend in advance

Note ref

Supported Living Projects

6,460

6,460

1,868

1,660

1,808

60

-

60

-

 

Greenacres

2,598

2,598

-

-

-

-

-

-

-

 

Total ASCH

9,058

9,058

1,868

1,660

1,808

60

0

60

0