The five year Risk Share Agreement between Torbay Council, the Clinical Commissioning Group (CCG) and Integrated Care Organisation (ICO) needs to be reviewed and future model and finance agreed following the memorandum agreement of principles that the 3 parties would continue the financial risk share as the best way of improving outcomes for our communities in October 2018 for health and care delivery for adults with the CCG and ICO.

That Torbay Council in principle commits to a further period of integrated care in order to improve outcomes for our community and officers are asked to continue the financial risk share as part of ensuring resources are used to best effect.  Officers are asked to develop a detailed proposal for consideration and agreement by Torbay Council, Torbay Clinical Commissioning Group (CCG) and Torbay and South Devon NHS Foundation Trust (TSDFT) by March 19.

To demonstrate that in principle to continue to be party to a financial risk share for the provision of health and care in the community for a further period, currently considered as a 5 year period.

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The decision will come into force and may be implemented on 15 October 2018 unless the call-in procedure is triggered (as set out in Standing Orders in relation to Overview and Scrutiny).

The contractual and financial environment in operation in the local system since the formation of Torbay and South Devon NHS Foundation Trust as an Integrated provider of health and adult social care, is a multi-year block contract with a Risk Share Agreement, to which South Devon and Torbay CCG, Torbay and South Devon NHS Foundation Trust and Torbay Council are all parties.  This contract at present sets the income level for the Trust for 2018/19 years and this level of income / expenditure is reflected in the respective plans of the CCG, Trust and Torbay Council.

The advent of Sustainability and Transformation Plans (STP) has required health and social care systems to work together to produce plans to deliver service and financial sustainability over the medium term.

The overall aim from this review is the continued development of the risk share arrangements in the community, including a review of delivery so far with a view to arriving at a place where the intentions and commitment of all parties is clear and negotiations start for the RSA which would need to be in effect from 1 October 2020. 

This would require 3 way agreement and commitment to continuation of ASC contract and extension of RSA with the supporting financial framework effective 1st April. This secures continued investment in the integrated system since October 2015, and the contract for ASC since 2005; It is our intention that this would need to be negotiated and agreed by end of March 2019;

There is therefore a working assumption that minor additions/variations to the RSA may take place, which we remain open to, but all three parties remain with the agreement.

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