More than 100 jobs may go as part of plans in Herefordshire to save £33m over 10 years, it has been revealed.
The public sector venture would see some care services shared across Herefordshire Council, the primary care trust and county hospital.
The plan still needs to be given the green light by the three bodies.
The council said it was part of the county's response to the "challenge" of the government's spending review, which is being unveiled in the Commons.
Council leader Roger Phillips said: "Our aim is to combine services where we can - not cut them.
"The benefit for local people is more than just cost savings, our public services would be more joined up, be of higher quality and able to focus better on customer needs, while maintaining a strong Herefordshire identity".
He said the move was prompted by the need to protect services for the most vulnerable members of society, including elderly people and children in the council's care.
Mr Phillips said: "Making redundancies is never easy but you have to recognise what are your alternatives and that is to cut front-line services to some of the most vulnerable people in your community.
"You cannot do that unless you can look these people in the eye and say 'look we have done all we can before getting to that level to cut administration and bureaucracy'."
The joint venture plans need to be approved by the council's cabinet on Thursday and the boards of NHS Herefordshire and Hereford Hospitals later this month.