Nick Bye: It would be a tragedy to lose Torbay’s care system just as the nation could follow its lead

I’ve been to some marvellous parties (with Nuno and Nada and Nell, as the Master might have put it) at our dear old Imperial Hotel, but the recent gathering to consider the future of Torbay Hospital and our Integrated Care Organisation was far from uplifting, to say the very least.

You will have noticed all the banners for The Heart Campaign around the Bay to raise awareness of possible changes to cardiac services at Torbay Hospital which would then most likely lead to a wider reduction in services and status.

We now have the hospital trust saying they are considering giving notice to Torbay Council on the Section 75 agreement which provides “joined up” health and adult social care services in a way which is unique and regarded nationally as a model of good practice.

I have been banging on about how fortunate we are to have such an integrated system for some time. Torbay being Torbay, it’s all been taken for granted and only now as the future of these arrangements becomes uncertain are folk waking up to what is at risk.

These arrangements in one form or another have been in place for just over 20 years. I recall signing the relevant document on behalf of Torbay Council at St Edmunds, Plainmoor, just a short time after I became Torbay’s first elected mayor.

It certainly wasn’t my idea so, I am not going to attempt to take the credit. In a nutshell it was intended as a new way of everyone working together, the health service and Torbay Council, to ensure residents got the best possible support to live independently when possible, with access to good quality health care when necessary without boundaries & bureaucracy getting in the way.

The belief at the time, which is still relevant now, was that we needed to do things differently in the Bay as we had an exceptional older population, quite possibly the largest number of over-eighties in the UK, who are exactly the demographic who are most likely to need both health and social care services.

You need good quality social care to support people effectively so they stay out of hospital (ideally) and you certainly need good quality care in place to enable timely discharge from hospital, therefore, freeing up beds for the next patients.

Our joined up arrangements enabled the hospital to decommission beds at Torbay Hospital which generated significant savings mostly as a result of speedy discharge. Bed blocking became a thing of the past here at least and I would regularly question colleagues in the Town Hall about how many residents were waiting for care packages.

Invariably the answer was none, which put us ahead of the pack as well as meaning residents got back home swiftly, which is where the great majority would prefer to be.

Our recent Care Quality Commission inspection of adult social care services carried out in September 2025 rated us as ‘good’, which is another feather in our cap. Baroness Casey no less, who is chairing an independent commission to advise the government on reforming adult social care in England, has understandably taken an interest in what we are doing in Torbay.

In my view, it would be an absolute tragedy to pull the plug on all this when the government might well decide doing things the Torbay way is the best way forward everywhere.

The reason given for this likely change is to save money. What I wanted to shout out at the Imperial meeting but didn’t because it wasn’t really my night was: “A joined up system is inherently a more economical way of providing these services!”

Something has gone very wrong when the hospital, on behalf of the Integrated Care Organisation, are saying they are between £30 million and £35 million overspent delivering adult social care services.

Clearly there are synergies in delivering a joined up system, as I have tried to explain above; many services are commissioned so why the extra cost in Torbay? Services should be provided to residents by single/joined up teams, avoiding duplication. Overheads on back office functions such as payroll can be shared.

My guess is the overspend is nothing like the figure stated and if the arrangement came to an end then the hospital would not achieve anything like this improvement in its finances. Because we have a truly integrated care organisation then unravelling the finances to allocate money separately to health and social care would be an incredibly complex task.

Our highly regarded director of adult social care has come up with a “transformation programme” to support the Integrated Care Organisation to make the necessary changes in its practice to help balance the books.

At the very least I believe there should be time to go through finances on an “open book” basis and properly consider her proposals.

Torbay Council’s funding of adult social care is benchmarked and shown to be amongst the highest of similar councils. Every extra pound which comes to us from the government for adult social care (or every special increase in council tax intended for adult social care) goes to the Integrated Care Organisation to spend on adult social care.

Frankly, if it turns out they really are overspending by £30/35 million each year then it raises all kinds of questions about what’s going on in our local health service.

Finally, as Torbay Hospital fights for its future at a time when there’s great pressure to concentrate services at much larger hospitals such as at Plymouth and Exeter, then surely it makes sense for our local health service leaders to celebrate what we do well? I have heard our MP, Steve Darling, say “integrated care runs through Torbay like Blackpool through a stick of rock”.

If I was Joe Teape, Chief Executive of the Torbay and South Devon NHS Foundation Trust, the sponsor of the show, as it were, I would be working towards a solution which shows Torbay can provide the very best joined-up services for its residents in a way which is the envy of other places.

Please think again!