By 2037, it is estimated that the number of people aged over 80 in St Helens will have tripled. The borough has distinct challenges that are also increasing pressure on services such as falls, mental health and high numbers of children with disabilities or who are vulnerable and need care. But while demand is increasing, funding is decreasing across all its public services which has resulted ‘in an unprecedented sustainability challenge for the borough,' according to the council's award submission.

The council and its partners realised two years ago that action had to be taken. If it was not, a deficit of £101m was forecast by 2020/21. They realised that health, care and community services were part of a fragmented system which operated almost independently of each other. To address the challenge, a borough-level response was required, and in 2016 the people's board was created.