Our recent survey of around 100 council chief executives and senior directors showed that the financial sustainability of adult social care remains a key worry. On the ‘worry list', behind overall balancing of the budget, the next highest concerns were ‘finding fresh efficiencies in adult social care' and ‘moving health and care integration forward'.

We have found although the worries may be consistent, the outlook certainly isn't. In fact, there is a very worrying polarisation developing. There are two aspects to this: