| Efficiency/Value for Money | Both the NHS and local government are facing huge budgetary reductions. Encouraging them to work together to achieve efficiency through joint commissioning may be one way of coping with this situation. |
| The ‘Place’ Agenda | An emerging policy focus in England is to look at the needs of geographical localities as a whole, rather than working in separate organisations. Joint commissioning could encourage PCTs and LAs to focus on working together rather than delivering silo-driven, centrally imposed targets. |
| Personalisation | Personalised support is a key policy objective in England. Individuals’ needs rarely fit around traditional service boundaries, especially in the more complex cases. If services are to become more tailored to individual needs, a more coherent approach to support will be required. |
| Prevention | Prevention is seen as important as a means of driving efficiency and as a policy end in its own right which will improve people’s quality of life. To be successful it will require numerous inputs of services and support that include (but also go beyond) both the NHS and social care. |
| Care Closer to Home | The opportunity for improvement created by joint commissioning is to enable more care to be provided closer to home and to reduce the use of expensive and often inappropriate residential and hospital services—key objectives for both PCTs and councils. |
| Overlap of Clientele | The people who make use of health and social care are often one and the same. In order to ensure a holistic view of their needs it is essential that their support is jointly planned and commissioned. |
| Bath and North East Somerset | Herefordshire | Knowsley |
| The PCT and council, working in equal partnership, have signed a Joint Working Agreement whereby child and adult health and social care and housing services are integrated using pooled funds combined with a two-way delegation of functions. Partners report to a partnership board that has overall responsibility for implementing and monitoring arrangements. | The PCT and Council explored the option of jointly planning, purchasing, designing and integrating all their local public services, but were unable to do so under current legislation. They are currently pursuing the integration of all public services covering strategic health and well-being as Herefordshire Public Services Partnership. There are joint appointments at all management levels with teams that work towards shared objectives and their joint Steering Group reports formally to the Council Cabinet and PCT Board. | The PCT and Council have widened their health and social care focus by consciously avoiding the care trust model and using the Health Act flexibilities to support a partnership throughout both organisations. This includes the key leadership role of Chief Executive NHS Knowsley—Executive Director of Council’s Well-being Services (including Social Care and Leisure Services)—to create a health and well-being partnership board in line with its LAA. This has enabled it to jointly plan, commission and deliver services across the locality and use resources more flexibly, for example, reducing duplication in commissioning and procurement. |