David Thomas on why Torbay’s health and care split raises serious questions

In previous columns, I have spoken about something we in Torbay can be genuinely proud of, our well-established integrated adult social care service.

For more than 20 years, this approach has supported residents across our Bay, bringing together health and social care in a way that is seamless, joined up and focused on people.

This service is commissioned by Torbay Council and delivered in partnership with Torbay and South Devon NHS Foundation Trust. It is a model that has stood the test of time and, importantly, it is one that works. In December last year, following a recent inspection, the services offered to residents were rated ‘GOOD’ by the Care Quality Commission (CQC), a recognition of the quality of care being delivered to our residents every single day.

While this approach may be unique to Torbay, it is far from unnoticed. National government increasingly recognises integrated care as the direction of travel for health and social care across the country. Here in Torbay, we are not talking about theory, we are living it. Our voluntary and community sector is also deeply embedded in this system, providing vital support and ensuring that care extends beyond statutory services and into the heart of our communities.

Over the summer, Baroness Casey and her government team visited Torbay to see our integrated model in action. That visit led to our Director of Adult Social Care, Anna Cole, being invited to London to speak at various select committees. I genuinely believe that what we have built here is being looked at as a blueprint for the future of care across the UK. This was reinforced again in 2024, when the Local Government Association, during its peer challenge of Torbay Council, singled out our integrated system for praise.

However, over the past year there has been increasing discussion about the future of this partnership.

We have continued to work constructively with both NHS Devon and the hospital to find a way forward. A key issue raised by the hospital has been financial risk, and I believe we have reached agreement with NHS Devon on a fair and balanced risk share arrangement. Despite this, it became clear last week that the hospital is no longer willing to move forward with a renewed partnership, even with those concerns addressed.

On Friday, I received formal papers from the Trust’s Chairman, Chris Balch, setting out their intention to issue notice to end the Section 75 partnership. If approved, this would bring to an end more than two decades of integrated working by 31 March 2026.

I cannot overstate how disappointing this is.

This is not just disappointing for me, or for the Council. It is disappointing for every resident in Torbay who relies on joined up health and care services, particularly the most vulnerable in our community.

The Trust recently attended the Council’s Health Overview and Scrutiny Board. While it is clear that changes are being proposed, there has been no clear explanation of what those changes will look like in practice.

There has also been no meaningful consultation with residents, patients or service users.

The Council’s Health Overview and Scrutiny Board is of the view that consultation is required under the relevant legislation. The Trust, however, does not share that view and has moved directly towards a decision without engaging the public in the way many would reasonably expect. As a result, the Board has formally asked the Secretary of State for Health, Wes Streeting, to call in this decision for further consideration.

Alongside this, I have also issued an open letter to the Chairman of the Trust, Chris Balch, which you will find elsewhere in this paper, setting out my concerns in full.

Later this week, on Thursday 26th March at 5pm, the Trust Board will meet to consider this decision. This meeting is being held in public.

Given the significance of what is being proposed, I asked the Chairman if I could address the Board directly. That request was declined. In his correspondence to me, he stated, “this is a meeting held in public and not a public meeting.”

I find that position extremely disappointing.

Nevertheless, I can confirm that I will be in attendance at the Board meeting on Thursday. My request to speak remains open, and I know that a number of residents will also be there to express their concerns about the lack of consultation, the lack of engagement and the lack of clarity about what comes next.

And this brings me to some fundamental questions.

Let me be clear, over the 20 years the hospital has removed 68 acute beds on the strength of our integrated system delivering care more effectively in the community.

If this partnership ends, what replaces it?

Where is the plan for those beds?

What will the new system look like?

At this stage, all those questions remain unanswered.

This is too important to get wrong. It affects real people, real lives and the future of care in Torbay.

If you share these concerns, I encourage you to take an interest in what is happening and, if you are able, to join me at the meeting on Thursday evening. (Torbay Hospital Boardroom 5pm)

Because this matters to all of us.