Stockton-on-Tees Borough Council

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Cabinet Decision: 25th October 2007
Title of Item/Report
The Integration of Adult Services across SBC and NTPCT
Record of the Decision
Members considered a report that proposed a restructuring and reconfiguration of adult services across Stockton on Tees. This was linked to the national drive to improve outcomes for all members of the community as determined by the government white papers Choosing Health, Safeguarding Children and Our Health, Our Care, Our Say

It was explained that the government white paper "Our Health, Our Care, Our Say" described a vision to "provide people with good quality social care and NHS services in the communities where they live" requiring improved access and care closer to home, practice based commissioning and joint PCT / LA teams.

Members were advised that in order to achieve these goals the government had set milestones for Trust and Local Authorities, one of which was:

Joint networks and/or teams for the management of health & social care needs between PCTs and local authorities.

Members were advised that the aim was the integration of community nursing and adult social care services in Stockton. It was explained that the intention was to create easily accessed, multi skilled teams to respond quickly and appropriately to a persons needs which included:-

Multi-disciplinary teams developed where appropriate
Multi-agency integration with services being closely aligned and managed under common management
The continued practice attachment of adult community nursing services
Co-location of services
Geographically/locality based services, which are accessible by communities.

It was explained that in order to achieve this goal, Stockton Borough Council and North Tees PCT were developing a vision to provide a central hub of service delivery for adults within discreet communities.
This central hub would act as a one-stop shop for services, through which patients/clients, carer's and professionals could access advice, assessment and service provision.

It was proposed that community nursing staff and CESC staff from older people & physical disabilities social work teams would integrate into 4 teams across Stockton, each team providing health & social care to the community within which it resides. It was noted that specialist services would continue to work across the borough/trust.

Four Integrated Service Area Managers and one Specialist Service ISA Manager posts were in development.

Members were advised that formal consultation would be entered into in October 2007 on the following proposals:

Integrated Service Areas for Adults - the geography of which mirrored the Children's Service ISAs
The Job descriptions of 5 ISA managers (4x ISA Managers / 1x Specialist Service Manager)
Those services that were ‘specialist' and would continue to work across the borough/trust
Domiciliary care, day care and 24-hour residential care would be considered as an integral part of the development of integrated services on a Stockton wide basis with strong links to ISA's if not actually line managed within them.
The ‘role' composition of the ISA teams - that is to say that each ISA would have a team composed of Community Matrons, CESC Administrative Staff, Review Staff, Assistant Care Coordinators, District Nursing Staff (Sisters / Staff)Health Care Assistants and Social Work Staff (Social Workers / Seniors / Team managers).

It was noted that the project aimed to advertise and appoint ISA managers by January 2008.

In January 2008 the next phase of the project would be planned to include the development and definition of structures of ISA teams and the timescale in which these became operational.


1. NTPCT community nursing staff and CESC staff from older people & physical disabilities social work teams integrates into 4 teams across Stockton, each team providing health & social care to the community within which it resides.

2. The Integrated Service Areas for Adults mirror the geographies established within the Integrated Service Project developed through the Children's Trust.

3. Specialist services continue to work across the borough / trust.

4. Five new posts are created (replacing existing 3rd tier Adult Operations management roles in both organisations) to provide joint management of adult service areas across NTPCT & SBC: -

Integrated Service Area Manager x 4
Specialist Service ISA Manager x 1

Reasons for the Decision
1. Integrated teams of community nursing staff and social care staff provides the opportunity to remove barriers to seamless care, allows for improved communication and allows community services to be more locally tailored to the community needs.

2. The proposed model demonstrates a reasonably equitable split in service demand for adult social care.

3. This provides a good starting point from which to build services and tailor them to the communities needs whilst maintaining current quality of service.

4. Demand for community nursing services varies across the four proposed areas however maintaining practice-attached community nursing staff mirrors the pattern of demand.

Alternative Options Considered and Rejected
Declared (Cabinet Member) Conflicts of Interest
Details of any Dispensations
Not applicable
Date and Time by which Call In must be executed
By no later than midnight on Friday 2nd November 2007

Date of Publication: 30 October 2007

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