Integrated working across health and social care

'Ambitious for Health': a new approach to transforming health and care in North Yorkshire through an NHS/ North Yorkshire Council Joint Committee and Section 75 agreement

North Yorkshire Council and Humber and North Yorkshire Integrated Care Board (ICB) propose to initiate an overarching joint working arrangement under a Section 75 agreement with a joint committee for North Yorkshire Place, which will be called the North Yorkshire Health Collaborative. 

The legislation which placed NHS Integrated Care Boards (ICBs) on a statutory footing set out arrangements for Integrated Care Boards to establish Joint Committees between themselves and local authorities. Humber and North Yorkshire Integrated Care Board (which plans, funds and provides NHS services to 90 percent of the population of North Yorkshire) and North Yorkshire Council wish to establish a Joint Committee for North Yorkshire and to devolve funding to these new arrangements for North Yorkshire Place. 

This collaboration aims to strengthen how health and social care services can be delivered to people within our neighbourhoods and communities within North Yorkshire. 

Background

Over the summer in 2024, the North Yorkshire Place Board (NHS and North Yorkshire Council partners) considered future arrangements to lead and develop prevention and community services; to improve outcomes; and to join up services between the NHS and the council. The focus was the potential opportunities of a joint committee and a single Section 75 agreement. 

The proposal is to establish a North Yorkshire Health Collaborative joint committee (NYHC) including a new Section 75 agreement and a formal joint committee. 

North Yorkshire Health Collaborative joint committee will facilitate further opportunities to enhance and develop integrated approaches, collectively understand how resources across the system are most effectively deployed and explore further joint commissioning and delivery models.

Section 75 agreement

The intention is for the partners to enter into an agreement under Section 75 of the NHS Act 2006 to facilitate a Joint Committee for North Yorkshire Place.

Section 75 agreements are made between local authorities and NHS bodies and can include arrangements for pooling resources and delegating certain NHS and local authority health-related functions to the other partner/s. The aim of which is to integrate health and social care services to help provide better support for individuals in our communities, promoting independence and improving quality of life.

Our organisations and our teams already work closely together to provide the best services we can, but by establishing this Section 75 agreement new opportunities can be maximised to commission and deliver some health and care services once across our organisations. This can help reduce duplication and bureaucracy, but also bring related services closer together so that people and patients can get the help they need in a more joined-up, consistent way.

Services which are being considered as part of this agreement are likely to include:

• prevention and well-being
• addressing health inequalities and increasing healthy years lived
• community health services and neighbourhood working
• intermediate care, reablement and rehabilitation
• support for unpaid carers
• planning for NHS and social care services as part of housing and population growth

Governance and accountability

The Section 75 agreement and aligned services which are provided through it will be managed through the North Yorkshire Health Collaborative, acting as a Joint Committee. Although, legally the Joint Committee relates to the Humber North Yorkshire Integrated Care Board and the council, the intention is that other partners (for example healthcare providers, voluntary, community and social enterprise sector) are full and active participants of the North Yorkshire Health Collaborative.

The North Yorkshire Place (NYP) Board, chaired by the council’s Chief Executive, involving the NHS North Yorkshire Place Director, NHS Chief Executives and senior leaders from Primary Care, the voluntary sector and the wider council, has supported the principle of strengthening the partnerships between health and local authorities through the proposal to create the North Yorkshire Health Collaborative.
 
Discussions are also taking place with representatives from West Yorkshire Integrated Care Board and Lancashire and South Cumbria Integrated Care Board which serve people in the west of the county and they have been invited to be part of the North Yorkshire Health Collaborative.

Proposed draft governance structure

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