Many readers will have seen the initiatives involving health and social care and, in particular, the various partnership models involving joint management of social and health care. 

Here at the mouth of the Humber, in North East Lincolnshire, we believe we have gone that little bit further in the establishment of a Care Trust Plus which, we think, could well provide a national model for the future of further co-operation between primary care trusts (PCTs) and local authorities.

Thoughts on our plans had started before the Crisp proposals were announced in July 2005, but were given further impetus when we were faced with the very real prospect of a Northern Lincolnshire PCT – North Lincolnshire and North East Lincolnshire – being imposed on us. 

Not only would this have merged the different demographic and health inequalities issues between the two areas – to our detriment as we are a spearhead PCT – but it also  imposed the significant financial challenges of North Lincolnshire PCT on the North East Lincolnshire area. The North East Lincolnshire PCT was in financial balance and was also a three-star PCT.

Initial discussions between the authority and the PCT were based on the strong partnership working for health and adult social care, which was already in existence, and a desire to attack worrying health inequalities, particularly in our inner-city wards. 

There was a lot of initial scepticism about what we were doing, especially because of the former reputation of the council. However, our partners knew our standing was based on historic performance, and the council was improving at a rate of knots. 

Eventually, we were able to prove to both the strategic health authority and the Department for Communities and Local Government (CLG) that what we were proposing was not only feasible but achieveable. So, what is so different about the Care Trust Plus (CTP)? The initial merger of adult social care and health, while not that common, is not unusual and the merger – with the establishment of a new CTP – went live on 1 September 2007.

Within the governance arrangements, there are some innovative propositions, including a community governance framework for the CTP which will see members of the public and service-users playing an active part in key decisions of the new organisation.  

In addition to the council's director of adult social services sitting on the CTP board, the council has, of right, three non-executive places – matching three other non-executive directors. Thus, councillors now have a permanent position on the CTP board – they are appointed for the usual three-year term, but the council has the right to replace them, eg, if there is a change of political control.

This ability of elected members to be involved in health governance is satisfying enough, but our proposition is going much further.

Those of us who are long in the tooth remember before 1974, when councils had their own public health departments. Well, North East Lincolnshire Council is now, we think, the only council in the country with a department of this nature. We are not talking about just having a jointly appointed – and paid for – director of public health, but the wholesale transfer of the department into the council, and the CTP delegating delivery of its health improvement responsibilities to the local authority. 

We think this will better able us to tackle the significant health inequalities in North East Lincolnshire, and already we are showing the start of some real benefits. The director of public health sits on the council's corporate management team as well as the CTP board and again, this provides valuable cross-fertilisation.

But we have not stopped there. Consultation is due to start shortly on the council hosting the integrated children's teams operating from 12 children's centres across the borough. This will transfer the employment of the health professionals to the local authority.

The children's trust will also gradually take on direct responsibility for the joint commissioning of children's services on behalf of both the local authority and the CTP. 

None of this has been achieved without detailed negotiation which has sometimes been fraught. The council has not delegated its statutory responsibilities for social care, nor has the CTP abrogated its statutory responsibilities for public health and children's services.  Thus key decisions on either side cannot be taken without consultation and, if there is conflict or disagreement, then we have appropriate mechanisms.

We believe some elements of our partnership approach are ground breaking but essential if we are to deliver stronger and better outcomes for our local population.

George Krawiec is chief executive of North East Lincolnshire Council and Jane Lewington is chief executive of North East Lincolnshire Care Trust Plus