What this consultation is about
We are working with Derbyshire Community Health Services (DCHS), to consult on further integration between the 2 organisations, including the possibility of entering into a formal partnership agreement, to jointly deliver a range of assessment, reablement and intermediate care services aimed at helping people remain independent at home for as long as possible. This may include the provision of community-based support beds, short-term care and any other services, where further integration would benefit the people of Derbyshire. Section 75 of the National Health Service Act 2006 enables councils and NHS bodies to work in partnership and pool budgets and an agreement of this nature if often referred to as a ‘Section 75 Partnership Agreement’.
We are already working closely with DCHS to deliver assessment and reablement services using multi-professional assessments, by sharing staffing skills, training and development. The proposal to enter a formal partnership arrangement would be about building on the success so far, to enable both organisations to manage increasing demand for services into the future. The partnership would be aimed at providing more people with reablement and assessment so that they have a better chance of remaining independent at home and returning home after a hospital stay. The proposal would also seek to reduce dependency on health and care services as a way to keep people safe, healthy and living well.
What would this new partnership look like and what would it do?
We are proposing that the partnership creates a single service to provide assessment and a short period of intensive reablement for people when their health or care needs change at home or following a stay in hospital. These services are commonly known as 'intermediate care' or 'reablement services' and are generally provided for up to 2 weeks on average.
This team would be made up of colleagues from ourselves and the DCHS, however, in the future they may be in one team with a single employer. This would mean the team would be able to use a wide range of skills to try and assist people.
Why is this being proposed?
With a growing population and as people live longer, bringing health and care services closer together is at the heart of the NHS and government plans, making sure that more people can receive support to remain healthy and independent at home for as long as possible. This support is even more critical after someone has had an episode of ill health or has been admitted to hospital. We are already working closely with DCHS by sharing the skills of their staff, but this proposal will take this a step further so that the teams will be better placed to support more people into the future.
What could the benefits be?
We believe that a formal collaboration would help DCHS and ourselves provide a more seamless service for local people by removing duplication of efforts, differences in approach and organisational barriers that exist by operating separately. It would be designed to improve the quality, co-ordination and accessibility of health and care for local people.
The aims of entering a more formal partnership arrangement would be to:
- help more people to be supported with a period of intensive assessment and reablement, care and physical therapy to help regain their physical ability and remain living independently following a deterioration in health or hospital admission
- create a more consistent care offer by increasing the overall capacity to respond to demand for assessment and reablement across the county. This demand for health and care is anticipated to rise due to the demographic changes in the population in the coming years
- reduce the different contact points for individuals, their families and professionals by undertaking a streamlined assessment process and then responding using a wider mix of skills and abilities in a new single staff team. By working as one team, with access to shared care records, this would help individuals to be able to 'tell it once' and people would know that their health and care information is available to all the professionals who support them
- improve and develop a shared workforce to see an improvement in the recruitment and retention of carer and support worker roles by having a wider and more varied career pathway for staff. Both organisations are experiencing vacancy rates, and a new partnership arrangement will offer an opportunity to design job roles differently as part of a single service offer
What would change for local residents and partner organisations in Derbyshire?
The main change would be that for those people who need assessment and a period of reablement in the future there would be a new combined team. Where people have accessed support, especially after hospital, in a temporary bedded care environment, the location of this may also change and the people supporting them may be from a single multi-disciplinary team. Also, the process of arranging and advising people about their ongoing health or care support would be carried by a single team, rather than using different organisations which sometimes happens now.
What would change for anyone currently working in the relevant teams at the council or Derbyshire Community Health Services?
The main change would be the makeup of the team as existing employees of the relevant teams with us or DCHS would be part of a larger single team. It may also be beneficial for all colleagues to be employed by the same employer. There may be some future changes to the ways in which the teams currently work, and whom they work with. The changes could also mean a reduction in vacant posts as both organisations would combine their recruitment. Training and development could also be carried out differently to enable potentially wider career opportunities for staff. Any major changes to work practices would need a more detailed consultation with staff affected before being implemented.
How can the council and Derbyshire Community Health Services do this, and how will they know they are doing the right thing?
There is legislation at Section 75 of the National Health Service Act 2006 which enables councils and NHS bodies to work together in partnership by joining their resources to fulfil their respective legal duties. This is referred to as a ‘Section 75 Partnership Agreement’. The council and DCHS would use this legislation to set out the aims of the partnership in a formal agreement and would regularly review that its desired aims were being met. Feedback from people using the service, and staff working in the service, will be used in future to determine whether the desired improvements have been made.
When would this proposal take effect?
A decision on the proposal will not be made by DCHS and ourselves until after this consultation process. If the proposal goes forward, it is not likely there will be any final changes before spring 2026.