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This paper reports on experience in making use of Health Act flexibilities and care trusts. Three areas were chosen for study because they were known to have attached priority to health and social care integration and were at the leading edge of development. Drawing on discussions at a series of seminars at which the experience of each area was presented and reviewed, the paper identifies a number of emerging lessons for the future of integration in a context in which the Government has established a Minister‐led review to explore what more needs to be done to encourage integration.

The article outlines the approach taken in Oxfordshire to pool significant County Council Social & Community Services and Primary Care Trust budgets to purchase primarily bed‐based services to achieve the right outcomes for services users and best value for the organisations. It sets this initiative in the context of relevant Oxfordshire data. It describes the processes involved, the benefits and outcomes to date and the initial lessons learnt.

This article follows an earlier article in this journal (Goldman, 2010), examines the emerging government policy on integration and considers some of the implications for joint financing. Most primary care trusts (PCTs) and councils with adult social care responsibilities are engaged in joint financing and wider health and social care partnership arrangements. But, with the demise of PCTs and the growth in GP commissioning, there are issues and questions about the future of such arrangements. However, despite these organisational changes, partners must continue to be able to demonstrate the outcomes that integrated health and social care services are achieving.

Joint financing across health and social care represents an opportunity for NHS bodies and councils to improve outcomes and value for money and to integrate services better. There has been much debate about the appropriateness and application of pooled fund arrangements. This article examines and challenges local partners' perceptions and misconceptions of their ease of use, and considers current challenges to implementation posed by central government policies. It assesses the contribution of joint financing to an improved service user experience as, ultimately, partners must shift their focus from process to improving outcomes.

The number of children in England, and the number who may need additional support from services, is large and growing. At the latest count there are approximately three million children aged under five, 6.4 m aged 5‐14, and 3.1m young people aged 15‐19. Children and young people from ethnic minority backgrounds make up about a fifth of the total population under 20 ‐ much higher than for other age groups. In total there are reckoned to be 12m children, 400,000 children in need, 59,700 looked after children, 320,000 disabled children, 600,000 live births a year and approximately one million with mental health disorders (DoH, 2003a).No single agency or profession can cater for such a large and disparate number of individuals, but increasingly their needs are crossing traditional organisational and professional boundaries. The partnership imperative that has become so influential in services for adults is now set to re‐shape the domain of children's services. Accordingly, the aim of this article is to examine the genesis of this imperative, to explore the emergent policy responses and to gauge their likely effectiveness.

In the second of two articles, the authors consider whether the evidence of joint commissioning's limited success has influenced the new partnership flexibilities. They conclude that, while they offer significant opportunity, their positive elements may be undermined by lack of recognition of the unavoidable complexity of the organisational environment in the health and social care field.

Within the space of three years, the Department of Health oscillated between a commitment to partnership working and the imposition of structural change in the pursuit of integrated care. The idea of care trusts which integrate health and social care functions acquired political currency, despite the absence of any evidence base to inform the model. This article urges caution and suggests that the partnership model deserves a chance to deliver results.

Local government and the NHS in Barking and Dagenham embarked on a bold initiative in 2001 to integrate health and social care management structures. Although it was not sustained, this local experience is an important source of learning as the search for improved partnership working enters yet another new phase. In particular, it demonstrates that the route to better outcomes depends on managing not only the tension between structure and culture, but also that between national targets and local discretion in services based on fundamentally different principles of governance: central management and local accountability.

With practice‐based commissioning becoming a requirement in the NHS, this article reviews its potential impact on the established practical arrangements for health and social care partnerships. It raises a number of serious questions about the future and, with the management of longterm conditions in mind, sets out challenges that lie ahead.

Many of the problems of governance of Health Act partnerships arise from a poor understanding of the legal basis for the partnership arrangements. This article examines the legal framework and focuses on some of the areas of misunderstanding.