Jim Parker: Is threat to pioneering Torbay health partnership thin end of the wedge? Is the entire future of Torbay Hospital at risk?

I lost my father-in-law a few weeks ago. He was 91 and we will all say he had a good innings but that has not made his passing any easier to accept. He was like a dad to me and I and my family will miss him dearly.
He was in Torbay Hospital for the past few weeks of his life and it brought me close to the health service and the way we look after people, especially the elderly.
You will never hear me criticise the doctors, nurses and all the support staff for the work they do at the coal face. They are our unsung heroes and they are saving lives every minute of the day.
But it doesn’t take a lot or much time to come to the conclusion that the NHS is broken. That is backed by news reports and pictures on national TV of patients waiting to be seen, being treated and in some cases dying on trollies in hospital corridors.
In the 21st century. In Britain. Really?
It was blatantly obvious that Torbay, like many other hospitals up and down the country, is in desperate need of repairs, refurbishments, an upgrade or whatever you wish to call it running into many millions of pounds.
People, like my dad-in-law, don’t deserve to be cared for in ancient wards that are simply not fit for purpose and we as a family can only thank God that he was allowed to spend his albeit short last moments in the peace and tranquility of Rowcroft Hospice.
It could have been even worse…..
Adult social care in Torbay is delivered under the umbrella of a pioneering partnership between the Torbay and South Devon NHS Foundation Trust and Torbay Council.
The Integrated Care Organisation has attracted the interest of the government and other areas for the unique way it operates. Some want to follow in our footsteps.
The health and care partnership is designed to provide joined-up, person-centred care. Torbay Council still plans and oversees adult social care but most day-to-day delivery and co-ordination are done through the integrated organisation under a legal agreement between the NHS and council.
Hospitals, community health services and adult social care are brought together under the agreement, with the local authority paying the health trust to deliver those services.
It has been hailed as a trail-blazer because it is meant to be based on putting people first, making sure they only have to tell their story once and not to lots of different professionals, they get the care that works seamlessly whether they’re at home, in the community, or in hospital and they can have faster support to stay well and avoid unnecessary hospital stays.
Only recently Care Quality Commissioners gave Torbay adult social care services a ‘good’ rating after an inspection.
But the landmark partnership may be at risk.

Dave Thomas

Council leader Dave Thomas delivered some shocking and worrying news at this week’s Torbay cabinet meeting when he said: “I want to advise Cabinet, all councillors and our community that Torbay and South Devon NHS Foundation Trust is giving serious consideration to ending the Section 75 Partnership Agreement with Torbay Council for the delivery of adult social care in Torbay.
“The Torbay Integrated Care Organisation is a truly integrated approach to the delivery of health and social care that benefits our residents. The model is pioneering — it is currently being considered by the Casey Commission as part of Baroness Casey's review into the reform of adult social care across the country — and it is completely aligned to the NHS 10 Year Plan, which is aiming to shift activity from hospital settings into communities.
“The Trust do not currently believe that any such decision requires consultation with residents. However, I believe that such a decision is hugely significant for our communities and that consultation is required as this is a ‘substantial change’.
“I cannot force the Trust to undertake consultation but I can make everyone aware of the potential for such a decision to be made — hence why I am making this announcement today, so as to allow fellow councillors and residents the opportunity to express a view directly to the Trust.
“I was advised yesterday that it is likely that decisions will be made in January and February, which could ultimately lead to notice being given to the council by March 31.”
He added: “Whilst I understand the financial pressures in health, it is important to remember that the Torbay model has always been predicated upon using health monies in the delivery of adult social care so as to reduce more costly admissions into the hospital.
“As a result of the integration, a number of wards in Torbay Hospital have been closed over the years. It is not a case that the council is underfunding the delivery of adult social care - it has been independently verified that the money that we pay as a council into the Integrated Care Organisation is fair.
“It is system behaviours that result in the need for significant health contributions, but I do genuinely believe that there is work that can be done within the Integrated Care Organisation to bring down the costs whilst maintaining the benefits of integration for our residents. Indeed, transformation plans have been developed but not delivered.”
Councillor Thomas said he has been in regular dialogue with the Trust and they say they require financial support from within the NHS to allow the arrangements to continue.
He added: “It is disappointing I have not yet been invited to any board meeting to present the case for the continuation of the arrangements on behalf of the residents of Torbay. I understand that discussions are to take place with NHS England at regional and national levels, and I call on the government to support the continuation of the Integrated Care Organisation in Torbay.”
For me, it is absolutely crucial that consultation is carried out before even the mere threat of this potential move goes any further.
It could be damaging in so many ways. I gather the ultimate decision will be taken by the Trust and then agreed by Integrated Care Board, which has already set the cat among the pigeons with fears that it will still go ahead with switching life-saving heart treatment from Torbay Hospital to Exeter despite a growing protest campaign in the Bay.
I don’t want to set the alarm bells ringing but that has set the hares running over the future of other services locally, like maternity. Wait for the outcry on that one if it ever goes ahead.
Now we have the possible disbanding of a pioneering partnership which will only fuel further speculation about the entire future of Torbay as an acute rather than cottage hospital.
That just cannot be allowed to happen, financial pressures or no financial pressures for the sake of the Bay, its residents and for the sake of any other people like my father-in-law and our family.

PS The Torbay and South Devon NHS Foundation Trust have been asked for a comment