Jim Parker: Having a say is healthy way forward before plug is pulled on pioneering Torbay partnership

Only in Torbay — a phrase I use from time to time and, perhaps, very apt in this particular instance.
It concerns the health and care partnership between Torbay Council and the Torbay and South Devon NHS Foundation Trust.
The Integrated Care Organisation dates back 20 years and oversees and delivers the care, especially adult social care, of some of our most vulnerable and needy residents.
The concept is based on services being delivered in a joined-up way rather than a duplicated way.
It has been seen as trail-blazing by the government who would like to see the ICO model adopted by other areas.
Trouble is, back in the Bay the Trust has decided the partnership is no longer working or sustainable. It is costing them money and they are considering pulling the plug on the Section 75 agreement which is the legally binding deal between the Town Hall and the Trust.
Now here is the ironic bit. The council reckons the public should be asked to give their feedback before any decision is made because this partnership severing will represent a ‘significant change’ in services.
The Trust has intimated that there is no need for such mass consultation because the actual services will still be there but delivered in a different way.
Now ministers are being asked to intervene and help break the stalemate so you have the government trying to rule on and, perhaps, save a health and care system they want to see rolled out elsewhere because it is the bee’s knees and seen as the way ahead apart from back in the Bay where it all began. Are you still with me?

Only in Torbay.
Councillor Cat Johns chaired an extraordinary meeting of the council’s adult social care and overview and scrutiny with a large number of public spectators, council officers and fellow councillors as well as professionals.
It was about the future of Section 75 and the impact it would have on vulnerable residents if it became absolute.
A representative of the Integrated Care Board and two members of the Trust, which included chief executive Joe Teape attended.
Cllr John said: “The committee board asked questions about how this would affect Torbay Care Services, that we currently provide for patients in our area, the lack of transparency about funding and the fact we require clear guidelines to what support would be for the good people of Torbay.
“The committee came away disappointed that the responses to our questions lacked transparency and a real commitment to providing support especially about patients’ health. The answer from the Trust says the services would not change for Torbay but has no evidence to back that conclusion.
“Recommendations have been made and our concerns will be referred to the secretary of state.”
“The committee all agreed that public consultation is required and any decisions made about residents’ health should be taken with careful consideration and not kept behind closed doors.”

Joe Teape - Chief Executive of Torbay and South Devon NHS Foundation Trust

Meanwhile, Joe Teape had put out a nicely-timed open letter to the people of the Bay.
He wrote: “For many years, Torbay has been recognised nationally for its integrated approach to health and social care. It’s something we are genuinely proud of because it reflects our community’s commitment to working together, putting people first and supporting one another.
“Adult social care matters deeply to our communities. It supports some of the most vulnerable people in Torbay and plays a big role in helping people live well, stay independent and remain close to home.
“And importantly, adult social care is not just about older people — it also supports adults of all ages living with learning disabilities, physical disabilities and neurodiversity. And much of the support that helps people to thrive — things like suitable housing, employment opportunities and community participation — often sits outside the NHS’s control. That’s why strong partnership working with local authorities and the wider system is, and always has been, essential.
“However, demand for adult social care continues to grow, especially in a place like Torbay where we have a larger older population than many other areas.
“Over the past three years, the cost of providing adult social care has increased by around 48 per cent.
“This is far more than we are funded for as an NHS Trust and far more than Torbay Council pays us for delivering adult social care. The work we have undertaken so far shows that the gap between the cost of delivering adult social care and the funding available is around £35 million each year and we will continue to test and validate this figure as we progress.
“This is no longer financially sustainable. As an NHS Foundation Trust we have a statutory duty to break even and we cannot do that with such a significant shortfall in adult social care funding.
“Covering that gap puts real pressure on our ability to invest in other NHS services — in our hospitals, our community teams and in the services that support people to stay well at home. Ultimately, this overspend will impact on the NHS services we provide and we have to prioritise these for our local communities.”
He added: “When Section 75 was first created, the financial risk was shared. Over time, those arrangements changed, and the risk‑share has been removed. Several reviews — both internal and external — confirm that the current model has run its course.
“This review is not about ending partnership working. It is about resetting and re‑establishing the partnership so we can build a new, more effective agreement with Torbay Council — one that is sustainable, fair and focused firmly on improving outcomes for local people. We remain committed to working openly and constructively with the council and our wider partners. “We are reviewing the current arrangements carefully and transparently and any decision will be taken with local people firmly in mind. We expect to make a final decision at our board meeting held in public on March 5.
“This review is not about stepping back from partnership working. It is about finding a fair, long‑term solution that protects adult social care and the wider health and care system that local people rely on.
“I want to reassure you that if we decide to serve notice on the Section 75 agreement, there will be a 12‑month notice period. During that time, we would work closely with Torbay Council to plan any transition carefully so that:
 * people continue to receive the care they depend on
*  there is minimal disruption for residents, carers and staff
*  services remain joined up and easy to access.
He promised: “We are committed to engaging openly as this work continues — and, importantly, to listening. People who use services, families, carers, staff and partners all bring invaluable insight, and we want to ensure those voices shape our thinking as it develops.”
Torbay MP Steve Darling has accused the Trust of letting spending spiral out of control.
He claimed: “They have added additional unnecessary costs. They have done a belt-and-braces approach when just a belt would have done.”
Mr Darling said the trust had ‘just let the spending rip’ and had ‘over-medicalised’ its care packages.
“They have failed to grasp the nettle due to their failures as a management organisation. The local authority has given the trust clear guidance,” he claimed.
“As is the case with children’s services, you can get a firm grip on it by looking at the most expensive cases and doing the hard yards to get those sorted out.
“The trust is letting down the people of Torbay by its clear failure to properly engage with these issues.”
It is such a shame that a pioneering partnership should come to this. Somebody, somewhere has their sums wrong.
The talking just has to continue, with the public having their say, and a solution found.
Otherwise, ministers may be faced with making a decision which could ultimately lead to the collapse of a pioneering partnership they want to see adopted in other parts of the country.
Only in Torbay indeed.