An example of efficiency gains created by common structures is in the City of Liverpool, where a single commissioning unit has been created through a Section 75 partnership agreement. The savings in the back office are estimated at around 1.5 million euros per year. These savings are the result of common systems and overheads used by the integrated unit team. The location of the team in common premises, a unique health computer system, a harmonized performance management system and indicators, and common results goals contribute to a more efficient and focused work practice. Section 75 Partnership agreements, provided for by NHS Act 2006, allow for the pooling of budgets between health planners/providers and social providers, resources and management structures. Most NHS Trusts, care trusts and councils have a kind of bundled funding system, with pooled resources that account for about 3.4% of the total health and social services budget. Section 75 Partnership agreements under the NHS Act 2006 allow for the pooling of budgets between institutions and local health and social services authorities. Management resources and structures can be integrated and functions redistributed between partners. The legal mechanisms for pooling budgets (the Partnership Agreement under Section 75) should allow for greater integration between health care and social services and more locally-friendly services.
Legal flexibility allows for a strategic and more effective approach to the commissioning of local services in all organizations and a basis for the establishment of new organizational structures integrating health and social services. This practical example examines the function and impact of partnership agreements in accordance with Section 75 and discusses different local approaches to restructuring services. Apprenticeship services are the type of offer most often justified by the application of Section 75 agreements. Councils tend to host these services after the transfer of funds from NHS Trusts. However, there are several examples of integrated local care for the elderly, often in the form of community-based multidisciplinary teams and equipment, under the direction of nurses. It is widely accepted that the creation of a partnership agreement and the implementation of organizational changes are a complex and labour-intensive task, often leading to initial tensions in organizational cultures, while roles and responsibilities are redefined. However, demonstrating the efficiencies achieved through the establishment of uniform structures encourages a commitment to pooling budgets and establishing common structures. On a practical level, the directors and directors of the city council are directly responsible for the initiation and development of partnership agreements.
This requires an often lengthy process of local negotiations, which results in a new legally binding partnership framework agreement. Agreements can also be complex and require careful consideration to clarify the framework of accountability and the governance framework. The Ministry of Health`s White Paper (2010) promises both the sustainability of existing partnership agreements and the simplification of the procedures needed to establish partnerships. Many of the efficiency gains and user outcomes mentioned in this example relate to new integrated management structures and services. The establishment of a Section 75 Partnership Agreement is currently the process for the creation of such services. However, feedback from stakeholders suggests that the process can be simplified and improved.