Nick Bye: Financial gamble or necessary reform for Torbay’s care system?

The extraordinary meeting of the Adult Social Care and Health Overview and Scrutiny Sub-Board (what a mouthful) held on February 4th probably deserved more attention than it received. 

Town Hall colleagues stepped up to the mark to hold the Torbay and South Devon NHS Foundation Trust to account for their likely & impending decision to end the Section 75 Agreement. 

This provides for integrated health & social care delivery in Torbay, widely regarded as a model of best practice.

Yours Truly was sat there bursting to ask a question but unfortunately, the meeting ran out of time. Had I caught the Chair's eye earlier or had time allowed, I would have attempted to dig a little deeper on the financial consequences for the Trust on potential savings to be made, the reason given for this likely decision, as well as whether enough preparation had been undertaken before such a big change in service delivery was put in place. In a nutshell, had the Trust done their homework?

Above our Torbay and South Devon NHS Trust (basically the folk who run the hospital & much else in this neck of the woods) sits the Devon ICB ... Integrated Care Board. When twice asked for comment, the representative of the ICB simply stated they were waiting for an impact assessment report.

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This for me was quite an extraordinary revelation: those overseeing health services in Devon had not yet received a report which would outline the impact of any decision to end the agreement!

My guess is that the Trust hasn't just forgotten to put the report in the post but most likely hasn't come up with an impact assessment report to begin with.

At times it was a little difficult to hear what was being said (I do wish people would SPEAK UP) but I believe Councillor Mark Spacagna deserved a more substantial reply after he asked for more details about the savings which would be achieved by the Trust if they ended the agreement. The Trust has stated they are overspent by £35million through providing adult social care & believe they would save between £20 & 25million if they ended this arrangement.

Crucially they could provide no detail to back this up & skated over the subject. 

As health & social care is delivered in Torbay in a totally integrated system, I accept it is going to be very difficult to come up with accurate figures. After all how do you allocate costs to health or social care when you have a totally joined up team?

However, there was no attempt to outline how savings might be achieved & very little detail provided to support the case there would only be limited additional pressures on the hospital which would require further hospital beds for example, as a result of delayed discharges.

It would be an absolute tragedy if we ended this integrated system of health & social care delivery, which provides so many benefits for residents in the Bay, then failed to achieve the savings which the Trust needs to balance their books. You could easily end up with the worst of all worlds.

As I was expecting to leave the meeting before the end, I sat close to the exit, to the side & slightly behind the Torbay and South Devon NHS Trust Chief Executive, Joe Teape. In fairness it was good of him & another colleague to come along. Originally it was thought there would be no one from the Trust. 

However, from my vantage point, his body language was interesting to observe. Although I usually avoid making personal comments, preferring to play the ball rather than the man, I couldn't help but notice his awkward posture & legs moving frantically below the table when he was speaking. He did not appear confident or comfortable to say the very least.

We went over all this at some length at our most recent Wellswood Community Partnership meeting. Many residents expressed frustration & asked if there was anything anyone could do?

My suggestion was to write, courteously please, to Chris Balch, Chairman of the Torbay and South Devon NHS Foundation Trust who, with his fellow board members, will make this decision in March.

Will they want to be remembered for ending an arrangement which has served us well for twenty years? Especially as central government now appears to be considering this model as they look for solutions which will ease pressures on our hospitals in the face of challenges created by an ageing population & much else.

The email contact for the Trust is foundationtrust.tsdft@nhs.net

It's a shame none of the Trust Board members appear to live in the Torbay area. Yours Truly put his name forward for a position on the Board many moons ago but unfortunately never got to the interview stage. 

"It's the fish John West rejects which makes John West salmon the best" was a jingle from years ago, so let's hope it's still true now.

To happier subjects, I was delighted to attend our first TOADS Cabaret Supper at the Grand Hotel, Torquay, on Saturday February 7. 

As might not be widely known, the marvellous musicals put on in our Bay theatres by talented local groups, rarely cover their costs so another group of members are constantly fundraising so the show can go on. 

This cabaret supper included some wonderful numbers from a range of shows, especially newer shows which were unfamiliar to me. The musical world has moved on it seems from Roger & Hammerstein, never mind "Darling Ivor" (Novello).

Perhaps I should be a little more adventurous the next time I find myself queuing at the Half Price Ticket Booth in the West End.

Many thanks indeed to all those who took part, including our charismatic compere Robert Palfrey & the charming staff at the Grand who swiftly served a top notch dinner.

Tickets are available for the next TOADS production, "We Will Rock You" at the Palace Theatre, Paignton, June 2nd to June 6th.