The attached item paints a relatively optimistic picture about the impact of the election on social care. It reflects the view that the election manifestos will commits parties to social care commitments ( the current Government have already claimed that a review is in train) and the BREXIT will ensure that Government gets out of the way as councils go about implementing any changes.   

All this is of course possible but at the heart of this, the challenge will always be that NHS bodies from Cornwall to Carlisle are answerable to the DH in London and that Council officers are answerable to local members. Its very difficult to serve two masters as we all know. 

Accountable Care Organisations may be the way forward and will certainly help reduce transaction costs. They will only really have a game changing impact if they report to local government rather than the DH. Central control of public services is a 20th century construct  built on the collectivism driven by the fall out from World War 11. The challenges facing us 70 years on are very different and very local - our NHS needs to reflect this locally , not via Richmond House.