The sustainability of existing partnership agreements and the simplification of the procedures necessary for the creation of partnerships are promised in the White Paper of the Ministry of Health (2010). Many of the efficiencies and user outcomes discussed in this example are related to new integrated management structures and services. The establishment of a partnership agreement under Article 75 is currently the process that allows for the establishment of such services. However, stakeholder feedback suggests that there is room for simplification and improvement of the process. Section 75 of the National Health Service Act 2006 and the NHS Bodies Regulation 2000 and partnership agreements between local authorities and NHS bodies, including clinical selection groups, may enter into a partnership agreement to establish and maintain pooled funds. The powers of the Act and Regulation allow: The specific objectives for the implementation of The Article 75 Agreements are: The Article 75 Partnership Agreements, provided for by law by the NHS Act 2006, allow for the pooling of budgets between local health and welfare organisations and agencies. Resources and management structures can be integrated and functions can be redistributed among partners. It is believed that the legal mechanisms for pooling budgets (the Article 75 Partnership Agreement) will allow for greater integration between health and social care and services that are better tailored to the region. Legal flexibility allows for a strategic and arguably more effective approach to the implementation of local services in all organizations and a basis for the formation of new organizational structures that integrate health care and social services. This practical example examines the function and impact of Partnership Agreements under Article 75 and examines different local approaches to service restructuring.

Services for learning disabilities are the type of services most often justified by the application of section 75 agreements. Boards tend to host these services after transferring funds from NHS Trusts. However, there are several examples of integrated care locally adapted to the elderly, often in the form of community, multidisciplinary and nurse-led teams and equipment. The BCF team has produced supporting documents for Section 75 agreements, which are a core requirement of the BCF. Bevan Brittan prepared a template for an Article 75 agreement with an explanation. This needs to be adjusted to reflect the local situation, but gives a solid starting point. An example of efficiency gains generated by common structures is the City of Liverpool, where a single commissioning unit has been created through a Partnership Agreement under Article 75. Back-office savings are estimated at around €1.5 million per year. These savings result from the sharing of systems and overhead costs used by the integrated unit team. The team`s location in shared spaces, a single health IT system, a single performance management system, harmonized indicators and common results objectives contribute to a more efficient and focused work practice.

The Article 75 agreement between the Council and the NHS South East London Clinical Commissioning Group clarifies the responsibilities of both parties, avoids ambiguity and provides a point of reference for resolving problems in the event of potential disputes. There will be no change in the services provided specifically as a result of the proposed section 75 agreement. The agreement will allow the two partners to continue to work together to improve commissioning and service delivery. Our current partnership agreement expires on March 31, 2021. The Council and the Clinical Commissioning Group cannot enter into a new agreement under section 75 of the NHS Act 2006 unless we have jointly consulted with those who we believe are affected by such arrangements. On a practical level, managers and directors of the NHS and local councils are directly responsible for initiating and developing partnership agreements. This involves an often lengthy process of local negotiations leading to a new legally binding Partnership Framework Agreement. Agreements can also be complex and require careful consideration to clarify accountability and governance frameworks. In accordance with section 199 of the Health and Social Services Act 2012, the Bexley Health and Wellbeing Board requires the Clinical Commissioning Group and the Council to provide it with relevant information, e.B.

Provide quarterly and annual reports to review performance and consider future work. The Article 75 agreement provides the legal basis and flexibility to pool the necessary resources to support our comprehensive integration plans. This will enable the strategic and more efficient delivery of locally tailored health and social care services, resulting in improvements in the way care and support is delivered, as well as better outcomes for residents and patients. Subject to the approval of the London Borough of Bexley and the NHS South East London Clinical Commissioning Group, the total value of the services covered by the new Article 75 agreement is estimated at £80 million. It is recommended that this include the following: The Bexley Health and Wellbeing Board is the body responsible for the Better Care Fund and the integration work carried out under the Article 75 Agreement between the Council and the NHS South East London Clinical Commissioning Group, which includes responsibility for signing the Local Better Care Fund plans. There is a broad consensus that establishing a partnership agreement and implementing organizational change is a complex and workforce-intensive task that often leads to initial tensions in organizational cultures as roles and responsibilities are redefined. However, evidence of the efficiency gains achieved through the formation of individual structures encourages us to take the path of pooling budgets and forming common structures. Section 75 Partnership Agreements, which are provided for by law by the NHS Act 2006, allow for the pooling of budgets between healthcare and social care planners/providers, resources and management structures can be integrated. Most NHS trusts, care trusts and boards have some form of pooled funding arrangements, with pooled funds accounting for around 3.4% of the total health and society budget. We would like to renew the formal partnership agreement between nhS South East London Clinical Commissioning Group and the London Borough of Bexley covering the provision of adult health and social services and we would appreciate your opinion. One of the weaknesses of the current agreements is the cumbersome nature of concluding a partnership agreement under Article 75.

Managers point out that paperwork can be demanding and that strong and dedicated leadership is needed to guide communities through such restructuring processes. We would be happy to have a wide range of views. We propose to promote consultation with stakeholders, including partnership organizations, the CCG Patient Council, patient engagement groups in general practitioner practices, Healthwatch Bexley and the Bexley Voluntary Service Council. An integrated Bexley Commissioning Team will support the development and implementation of commissioning plans in the health and social services sector and report on progress to the Bexley Borough Board of Directors and its partners. For more information or to request consultation documents in another format, please contact: What are the most common issues when starting integrated commissioning? As part of the Joint Health and Wellness Strategy and the Joint Strategic Needs Assessment, the Bexley Health and Wellness Council sets key priorities to improve the health and well-being of Bexley residents and provides strategic influence on commissioning decisions and planning. By working more closely together and ensuring that all relevant expenditures are considered in a strategic and meaningful manner, Section 75 agreements have the potential to improve the way functions are performed and, in turn, will contribute to better outcomes for Bexley residents. The legal freedom of partners to pool their budgets has the potential to tailor service design more closely to the needs of the local population. Organizations have used budget pooling in different ways, and there is evidence that forming new common structures can take a lot of time and commitment. This consultation is open to anyone who wishes to comment on the proposed agreements, including people who live and work in Bexley, people who use our services, caregivers and family members, professionals, partners, providers and other stakeholders. The UK`s lessons learned on integration remain limited and focus on the process rather than the results. Nevertheless, there are promising indications from individual projects that collaboration leads to positive outcomes for service users.

Responses to the consultations and comments will be considered by the Council and the CCG of the NHS South East London. At the end of the consultation period, we will prepare a brief report outlining the issues raised. A summary of the consultation responses and next steps is available online at Please contact us using our contact information to request feedback in another format. Performance and contract management agreements are used to monitor the impact of interventions in accordance with requirements. These include regular meetings between commissioners and providers, reporting to the borough`s board and submission of monitoring results to NHS England and Improvement, the Department of Health and Social Care and/or the Department for Housing, Communities and Local Government. The Bexley Health and Wellbeing Board has a legal obligation to the NHS South East London Clinical Commissioning Group to prepare the joint strategic needs analysis and a common strategy for health and well-being. Within LTC, community services rather than home care facilities have the greatest potential to be developed through joint budgets and joint action plans. Through joint structures with common funding, multidisciplinary teams led by nurses have been set up to support older people living in the community. .