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This paper aims to examine the role of health and wellbeing boards in the context of the Government's reforms introduced by the Health and Social Act 2012 and the fundamental challenges facing the NHS and local government; it also aims to assess evidence from the early experience of shadow boards and considers what factors will most influence their success.

The paper draws on an analysis of the policy literature and on structured telephone interviews with lead representatives of 50 health and wellbeing boards randomly selected from a representative cross section of English local authorities; it also draws on case study material, some of which has been written up for other articles in this Special Issue.

Early experience of the boards in shadow form indicates there is considerable optimism about their prospects to achieve greater success in achieving integrated services but they face formidable challenges arising from a hostile financial climate and unchanged national policy fault lines that have hindered effective integration to date. Poor engagement with providers will limit progress. Five factors that are likely to determine the effectiveness of boards are identified. Their biggest single challenge arises from the role of local government in delivering strong, credible and shared leadership which engages people in transforming local services.

Current knowledge is based on the operation of shadow boards at a very early stage in their development and in the context of complex organisational change in which there is major uncertainty about emerging roles of new bodies.

There is very little systematic research evidence about the development of health and wellbeing boards other than the work reported in this paper, illustrated by the linked articles which follow it.

Richard Humphries has enjoyed an impressive career, working his way from a trainee social worker in the late 1970s to the Care Services Improvement Partnership where he was Chief Executive until 2007. In this final article, Richard describes his career to date and compares how social care for older people was delivered when he first started out, with now, concluding that while much has been achieved, the job will only be done when we ourselves will be happy to use the services.

This article examines options for the reform of adult social care funding, noting that universal agreement on the need for a new system has not been matched by political consensus on how this could be achieved. The costs and outcomes of some of the principal options for reform are summarised ‐ including a revised version of The King's Fund partnership model and the policy of free personal care ‐ and how these compare with the existing means‐tested system if left unreformed. These and other models are not mutually exclusive, and the selection of which options to pursue will involve delicate balancing of political, economic and administrative criteria. On balance, our view is that a revised version of the original partnership model offers the best outcomes in relation to costs, and one that can be blended with other funding options to reflect the changing nature of trade‐offs between costs, affordability and simplicity.

Social care is likely to be a key campaign issue in the 2010 general election. An overview of the current policy positions of the major political parties suggests a consensus in many areas, notably personalisation, the third sector, reducing bureaucracy, and closer working between health and social care. Differences may be sharper in policy detail and how future funding should be reformed. Irrespective of who wins the election, the forthcoming spending squeeze will focus attention on how to achieve more with fewer resources, and health and social care integration is likely to become a higher policy priority.

The purpose of this paper is to describe the principal challenges facing the health and care system in England arising from an ageing population, assess the track record of the coalition government in addressing these and offer a perspective on the priorities likely to be faced by the next incoming government in relation to health and social care for older people.

Assessment of key policy documents and legislation and interpretation of published data on trends in health and social care activity and expenditure.

An ageing population requires a fundamental shift towards a new model of care that offers better coordinated care and promotes independence and healthy ageing. The Care Act 2014 is a significant achievement and NHS spending has been protected, but resulting cuts to local government budgets have since sharp reductions in social care for older people. The next incoming government will need to address a deepening financial crisis in health and care system; the increasingly unsustainability of means tested and rationed social care alongside universal free health care; and the need to make faster progress in developing a new models of integrated care closer to home.

The issues raised in this paper affect older people as voters, tax payers and as existing or potential users of health and social care services. As a group they will attract significant attention from political parties in the next election campaign.

This paper aims to contribute to the discourse on the role and efficacy of the newly emerging health and well being boards which are established within the Health and Social Care Act 2012. It also aims to propose the importance of high functioning relationships underpinning clear but flexible local design.

The paper is based on the reflections of the chair of the shadow Health and Well Being Board in Bath and North East Somerset and the chief executive of one of the local provider organisations. They share a commitment to effective joint working and see the workings of health and well being boards epitomising the functionality of local interagency working. This is explored through a case study of the development of the Health and Well Being Board in Bath and North East Somerset.

The paper proposes the importance of high functioning relationships that can transcend structures and suggests that health and well being boards be considered as system orchestrators creating space for the challenge and creativity that creates “good enough” solutions to complex issues.

The paper contributes to the active discourse on how best to establish and develop effective health and well being boards and aims to create value through shared learning and experience.

The purpose of the paper is to provide an overview of issues being faced, and likely to have to be faced, in establishing effective health and wellbeing boards.

The paper is based the perspective of the Department of Health's lead for implementation of these boards. Set in the context of national policy expectation, it draws on the early experiences of board development all over the country; and on discussions and seminars held to test their practical implications.

Transformation of the current pattern of services is needed to meet the preferred needs of the public. This is a major challenge at local level, and the leadership capacity and style of the new boards, and their communication skill, will be vital to the creation of responsive integrated services.

The paper draws together current thinking on a key policy initiative of the current government, and links it directly to integrated health and social care.

This paper seeks to explore the potential of micro‐enterprises to assist local health and well‐being boards in delivering their strategies, especially in relation to tackling health inequalities, prevention and community support.

This paper draws on experience gained by Community Catalysts from its work supporting social care and health micro‐enterprise across the UK. There has been little formal research into social care and health micro‐enterprise and so the paper relies heavily on data gathered by Community Catalysts in the course of its work and uses local case studies to illustrate points.

The paper explains the importance of social care and health micro‐enterprise to the work of health and well being boards, emphasising its potential to help tackle health inequalities and contribute to effective health and well‐being strategies.

There are no examples as yet of imaginative health and well‐being boards engaging effectively with micro‐providers, but boards can draw on learning from local authorities actively stimulating and supporting local micro‐enterprise.

This report aims to summarise the principal conclusions from the pilot reviews and key learning points to assist the improvement of safeguarding policy and practice.

A pilot programme of peer reviews of adult safeguarding arrangements was carried out in four English local authorities by Local Government Improvement and Development in 2009‐2010. The pilot programme sought to customise, test and adapt this established peer review methodology to adult safeguarding.

Key messages from the peer reviews of the adult safeguarding arrangements include: outcomes and experience of people who use services; leadership, strategy and commissioning; service delivery, effective practice and performance and resource management; and working together.

Councils may need to revisit how they develop their safeguarding arrangements in the light of major policy, financial and demographic shifts over the next few years.

The aim of this paper is to bring attention to the current level of engagement of care service provider organisations with shadow health and wellbeing boards. The paper argues that full engagement of provider organisations will improve the effective working of the future health and wellbeing boards; both in the creation of good commissioning strategies and in their subsequent implementation.

A survey of Voluntary Organisations Disability Group (VODG) members was undertaken, and analysed alongside other reports of progress in implementation.

Currently there is a very low level of engagement of provider organisations. A notable exception is in Coventry which is an exemplar for good engagement: a case study is provided.

This is new knowledge. Also, a connection is made between emerging government policy on market facilitation in social care and its implications for health and wellbeing boards.