Councils have realised that they need to look at, and do things, differently. The last several years have been a tremendous improvement journey with authorities having already ‘taken out’ significant money from their budgets. The challenge, however, is how to continue reducing budgets during a period of increasing demand and expectations around service provision.

Local authorities now have to influence other local delivery partners, not necessarily leading on provision, and accept this scenario. They must be more radical and shake out the extra money from the system. Elected members can now be up for this and the requirement for a whole system approach.

Some councils have identified the need for a systemic, radical transformation programme that addresses more than just the challenging issues around the organisation and delivery of health and social care over the coming three-year period and beyond. This would link into and build on various separate transformation projects which are likely to have been commissioned to address particular themes and issues in local areas.