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In this paper, we draw on ethnographic research which tracked older people's journeys through the health and social care system, highlighting some of the key issues which will need to be addressed if the new single assessment process is to become user‐ and carer‐friendly. We argue that the concept of the ‘whole system’ is a misnomer, and a more accurate picture is that of a world at war, with territorial disputes rife and border controls tighter than ever. We suggest that too much emphasis has been placed on IT systems and paperwork and that the real challenge is to cut through the jargon of modernisation and to see things from a wholly different perspective.

The important role of comprehensive assessment in recognising the need for and organising often complex care regimes for individual older people is widely accepted. However, the process of carrying out such assessments continues to present challenges to those involved, as it frequently requires people to work in different settings and across professional and agency boundaries. This paper explores the situation in the light of current working practice and policy directives. More work will be needed if small‐scale examples of good practice are to be applied across whole systems.

This article considers the potential for single assessment to overcome longstanding difficulties with care management, looks at initial progress in one SHA area and identifies some key priorities for the next stages of local implementation. We conclude that, not only is much more work required in localities, but additional national guidance and resources may also be required.

This paper seeks to set out the Law Commission's final recommendations for the reform of adult social care, including the community care assessment process, service provision, and the recommendations for a new legal framework for adult safeguarding in England and Wales.

The paper discusses each of the Law Commission's recommendations for adult social care and contrasts them with the proposals put forward at the consultation phase of the review.

The paper argues that a single legal framework for adult social care, including adult safeguarding, will have substantial benefits in terms of legal clarity, consistency, and efficiency. A clear and single legal framework is important for older and disabled people, and their carers, in order to understand fully their entitlements, and for local authorities and partnership agencies (such as the NHS and the police) in order to fully understand their responsibilities.

The paper provides a clear summary of the Law Commission's final report – in particular the recommendations for community care assessments and service provision and adult safeguarding.

This project compared the use of an evidence‐based, systematically developed, standarised assessment instrument for community care with existing assessment instruments, in two social services departments. We conclude that assessment methods without proven reliability may jeopardise the interests of older people and the need to raise standards.

Based on a postal survey in 1995 of all front‐line staff in Wales with an assessment and/or care management role, findings are reported about how tasks and roles were operationalised following the full introduction of the new community care in April 1993. Further information was obtained by interviews with managers in health and social services. Only a fifth of social services posts were designated or titled as care management posts. The majority of these workers were located in services for elderly and physically disabled people. Although few had a specific budget, the majority considered that they had greater control over financial resources than before April 1993. The analysis of tasks undertaken by front‐line staff shows that there remains a broad overlap between the roles of care managers and social workers. The results highlight the nature of increasing demands on staff and raise issues about the impact of increased workloads and administration on service quality. They also highlight tensions between care management and traditional professional roles. Some pointers for continuing debate are provided.

The purpose of this paper is to evaluate the implementation and potential value of an electronic referral system to improve integrated discharge planning for hospitalised older adults with complex care needs. This new technology formed part of the “Common Assessment Framework for Adults” policy in England.

Mixed methods were undertaken as part of a case study approach within an acute hospital in the North West of England. First, qualitative interviews were undertaken with practitioners to explore early experiences using the new technology. Second, routinely collected administrative data were analysed, comparing referrals made using the new technology and those made through the usual paper-based process.

Qualitative interviews found that an electronic discharge system has, in principle, the potential to improve the efficiency and suitability of integrated care planning. However, the implementation proved fragile to decisions taken elsewhere in the local care system, meaning its scope was severely curtailed in practice. Several “socio-technical” issues were identified, including the loss of valuable face-to-face communication by replacing manual with electronic referrals.

The small number of patients referred during the implementation phase meant that patient outcomes could not be definitively judged. Research into the longer-term implications and value of electronic referral systems is needed.

There is concern that attempts to integrate health and social care are stymied by incompatible systems for recording service user information. This research explores a novel attempt to share assessment information and improve support planning across health and social care boundaries.

This paper considers cash for care as reflected in direct payments and the more recent development of individual budgets in England. While the momentum to roll out individual budgets gathers pace in England, Wales has embarked on a more cautious approach in wishing to evaluate the impact of individual budgets on social services. The paper identifies some of the far reaching implications of cash for care in general and individual budgets in particular, for service users, carers ‐ both paid and informal ‐ and for the social work profession. The policy incoherence in relation to risk and safeguarding is highlighted. This paper supports the approach currently adopted by the Welsh Assembly Government in relation to the ‘rolling out’ of individual budgets. The Assembly's 10‐year strategy for social services focuses on the rights of citizens and the needs of communities. This paper argues that fulfilling that vision should not be wholly contingent upon an unproven extension into the field of individual budgets.

In May 2011, the Law Commission proposed wide‐ranging reform to adult social care law for England and Wales. This paper aims to identify and analyse the implications for integrated care and other forms of collaboration in health and social care.

The paper takes the form of an analysis of the Law Commission's final report.

The Law Commission proposes a number of changes designed to facilitate joint working between local authorities and NHS bodies in England and Wales and the Law Commission's approach marks a departure from the current reliance on consensus and soft‐edged rules such as government guidance to bring about more integrated care.

The paper analyses the changes to practice that would result from implementation of the Commission's recommendations.