Service integration is the most exciting game in town for local government, and there’s a surprisingly large amount of it going on. But the question I keep picking up in discussions with councils is about business models.
Once you’ve decided to integrate, how can you make that happen? Pooled budgets seem an obvious answer, but in practice many councils are finding them difficult to manage.
Take the Better Care Fund, which is supposed to integrate health and social care. Some of the most advanced councils have found that this new pooled budget is actually setting them back a few steps, forcing them to negotiate governance structures at a time when they would much rather be aligning budgets and integrating frontline teams.
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