7. Summary of key points

Delivering and improving wellbeing

  • We are best able to live the life we want to live if we are independent, well and live in communities that support and encourage the many aspects that make us unique.
  • This is true for everyone but the support we may need is unique to us as individuals and must therefore be personalised.
  • Local government exists for this very purpose, affecting multiple dimensions of our communities and lives, throughout our lives.
  • Supporting and improving people’s mental and physical wellbeing is at the heart of local government’s work and that of many other local public, private and voluntary sector organisations ,it can only be delivered with communities.

Setting the scene – the case for change

  • Social care and support matters to individuals, our communities, our NHS and our economy.
  • The local dimension of social care matters because it ensures the service is accountable to local people.
  • Despite a challenging financial environment, social care has delivered – it has improved and innovated.
  • While diversity of local care and support is the positive result of a health and care system that is responsive to the diversity of the community it serves, unwarranted variation in quality, access and outcome is not acceptable. Local government is committed to addressing this and is best equipped to lead improvement.
  • Significant reductions to councils’ funding from national government is now jeopardising the impact local government can have in communities across the country.
  • In particular, the scale of funding pressures within adult social care threatens progress made to date and now risks people’s wellbeing and outcomes and the stability of the wider system.
  • There are continuing recruitment and retention challenges in the adult social care workforce.
  • The Care Act remains the right legal basis for social care but funding pressures are threatening the spirit and letter of the law.

The options for change

  • Social care is becoming a greater public priority.
  • The public and politicians (local and national) support greater funding for social care.
  • People find the social care system complex and confusing, it is hard to understand, particularly for those facing the immediate pressures of requiring care and having to engage with a system they have never encountered before.
  • People worry about the costs of social care but are not making preparation for them and the rules are not clear.
  • Although it is hard to define, people want a greater sense of fairness within social care.
  • There are a number of options for making social care better.
  • Making these changes will require more funding. There are different ways of raising this.
  • Cross-party consensus or co-operation must be sought to secure a workable long-term solution.

Adult social care and wider wellbeing

  • Tackling the full extent of future demand requires a shift in focus and a far greater emphasis on prevention and early intervention.
  • Public health has a fundamental role to play in this – investing in public health helps to deliver the wider prevention agenda that is critical to our health and care system overall.
  • Council services – including those provided by district councils – support people’s wellbeing, as do those of councils’ many local partners.

Adult social care and the NHS

  • Our care model must change so that people experience it as a seamless package of care and support to address their specific needs and aspirations, helping them to live independent and fulfilling lives.
  • Integration is not an end in itself but a means of improving health and wellbeing outcomes for individuals and communities, improving the planning and delivery of services and making the best possible use of resources.
  • The Better Care Fund has been a driver for joined-up planning but it should be locally-led by health and wellbeing boards.
  • Local government provides vital local leadership and democratic accountability. This must be harnessed, particularly through strengthened health and wellbeing boards, to address the democratic deficit in the NHS.
  • Council and health leaders are also best placed to drive improvement at the local level. The LGA, working with national partners, is committed to supporting local areas to improve and spread good practice.
  • Extracting maximum value from the new NHS funding requires priorities to be set at the local level, with minimum top-down influence from government and the NHS nationally.

What our partners have said

We’d like to thank our partners from across the sector for their thoughts, comments and input into the green paper. Here’s what they have to say…


High quality social care and support helps people live the life they want to live. It helps bind our communities, it sustains our NHS and it provides essential economic value to our country.

Executive summary

While it is true that social care and the NHS are inextricably linked, it should be seen an essential service in its own right and the people who work hard to deliver the service should be seen as just as valuable as staff in the NHS.

Who is this green paper aimed at?

Questions about the future of adult social care and support, and the wider changes we need to make to our care and health system to improve wellbeing, should be everyone’s business.

4. The options for change

Why has it proved so hard for successive governments to deliver sustainable long term funding for this crucial service?

5. Adult social care and wider wellbeing

If we are to really tackle the full extent of future demand with quality services we need to refocus our efforts on intervening earlier and preventing needs developing in the first place.

6. Adult social care and the NHS

Joining up care and support and intervening and offering early support to keep people well is a more efficient use of resources but efficiency alone is not enough.

8. Have your say

Answer the questions relevant to you and your organisation and submit your views to be added to our research.