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The report of the Royal Commission on Long Term Care, published in March 1999, is to be subject to further consultation, thus delaying any progress on its recommendations which include important links to other Government initiatives in health and social care. The paper argues that its proposal for a National Care Commission could be the missing link to equity of care provision and care standards for older people, and early implementation should not be lost.

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.

A recent Law Commission paper claims that the law on adult social care is complex and based on outdated concepts, and therefore needs to be reformed. The boundary between health care and social care services is less clear than it once was, but its existence can be damaging to service users. Although there is good evidence of integrated working, more needs to be done. Existing duties could be consolidated, or health care and social care bodies ‐ and perhaps others ‐ could be placed under a general duty to co‐operate.

This paper is the sequel to the authors' earlier paper in this journal and aims to present the “future research” outlined in that paper.

The approaches being employed by Welsh local authorities in commissioning home care from the independent sector are surveyed to see how a mixed economy of care is being implemented. The observed differences are analysed to see what can be learnt for the benefit of public sector managers concerned with the development of commissioning practices. Semi‐structured interviews have been performed with home care managers and commissioning officers in 13 (60 per cent) of the local, unitary authorities in Wales. Managers at independent home care providers have been interviewed also. The study has been ongoing since September 2004. For comparison, Barnet in England has been included because, unlike any Welsh authority, it has implemented 100 per cent outsourcing of home care. Croydon has been included as it has a good practice brokerage that has helped it to expand its provision from the independent sector.

Great diversity is seen in the approaches adopted by the Welsh local authorities when commissioning home care from the independent sector. They differ in the proportion of home care that is commissioned from the independent sector, what is commissioned, the number of independent providers and the contractual arrangements. These features are used to develop a taxonomy of home care strategies that reveals high levels of diversity. It is seen that in Wales there has been less political drive and compulsion to outsource home care than in England, but the natural desire to reduce costs in the face of a growing need for home care is now driving outsourcing in Wales.

This paper provides guidance to public sector managers in local authorities seeking best practice in the commissioning of home care from the independent sector.

The existing literature contains little research into good practice in the commissioning of home care by local authorities from the independent sector. This paper is a timely contribution to addressing this shortfall.

Ideas about joint commissioning between the NHS and social care have been around for a long time ‐ since at least the publication of Practical Guidance on Joint Commissioning for Project Leaders by the Department of Health in 1995, and stemming from the roots of joint planning and joint finance way back in the mid‐1970s. Achievements have generally not been spectacular, but the issue is now squarely back on the policy stage with a rebranding: ‘integrated commissioning’. This implies a shift from ad hoc and opportunistic partnering to something more systemic and long‐term. However, the policy context is now very different, and the scale of ambition hugely heightened. This article examines whether integrated commissioning is an idea whose time has come.

Joint commissioning is an important part of the current health and social care context and will continue to be crucial in the future. An essential component of any commissioning process is priority setting, and this paper begins to explore the idea of integrated priority setting as a key element of health and social care commissioning. After setting out the key terminology in this area and the main priority‐setting processes for health and social care, the paper describes a number of barriers that might be encountered in integrated priority setting. We argue that there are significant barriers in financing, accessibility, evidence and politics, and it is important that such barriers are acknowledged if priority setting is to become a component of joint commissioning. While these barriers are not insurmountable, the solution lies in engagement with a range of stakeholders, rather than simply a technical process.

UK policy seeks to shift commissioning of services ‘closer to the people’ with a view to establishing shared visions of local care services grounded in the opinions and priorities of the public. The participation of older people with mental health problems and their carers in the strategic planning process has been patchy, however. This article compares practitioner and public perspectives of the services that should be provided for older people with mental health problems in an area of North West England. Significant differences were found in the services the various stakeholder groups prioritised for development, and in their views on how they should be organised. The implications for commissioning are discussed.

The law and guidance concerning the social care of adults are a mess. More than 30 statutes and guidance documents deal with this area, many of which overlap or contradict each other, some dating back five decades. Because of this, the Law Commission has been asked to review the law and propose changes, which is, as the Law Society Gazette has put it, ‘the most radical shake‐up of adult social care in 60 years’ (Rayner, 2010). It is estimated that such legislation would affect 1.8 million people and six million carers (Brindle, 2010). The consultation document was published in February 2010 following a scoping exercise, and the closure date for responses was the 1st July 2010. The hope is that the consultation exercise will result in a response next year and a Bill drafted by the summer of 2012. In this article, we review the background to the consultation, and explore the Law Commission's proposals for reform. We examine the issues with particular reference to the readership of this journal, and make suggestions for change. We have also submited this article to the Law Commission as a response to the consultation document.

The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing.

The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings.

The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings.

Addressing the implementation of OBC in adult social care in England in the context of extra care housing.

In 1988 the Government of Israel appointed a Commission of Inquiry (of which the authors were members) to examine the state of its health‐care services. Although relating to Israel, some of the problems contributing to the crisis in the health services are shared by other industrialized nations. In 1991 the findings and recommendations of the Commission were adopted by the Government. They related to the major problem areas analysed by the Commission: poor standard of service to the public; health ministry structure and performance; funding and budgeting; poor labour relations in the public health sector; surplus of physicians; mix of public and private health care; shortage of qualified health‐care managers. The main recommendations adopted were: legislation for compulsory health insurance (due to be effective on 1 January 1995), establishing a National Health Authority, running of hospitals by autonomous corporations and reform in salary structure.