Writing for our sister title, The MJ this week, policy lead for health and social care at chief executives' organisation Solace, Mark Palethorpe, said the fund had ‘too often become a compliance exercise, characterised by restricted spending, short-term planning horizons and an emphasis on managing demand rather than reshaping it'.

Palethorpe, who is chief executive of St Helens BC, wrote: ‘Too many national conditions and spending rules inadvertently reinforce siloed behaviours and discourage prevention. Relaxing these constraints would allow councils and NHS partners to tailor investment around the specific needs and assets of their populations. 

‘The current system remains overly focused on inputs, activity and compliance with established pathways. 

‘If integration is to deliver real value, we must adopt outcome-based metrics that assess health and social care performance together. Measuring success in terms of improved quality of life, reduced inequalities and sustained independence would allow funding to be aligned to demonstrable impact. It would also incentivise innovation, rewarding approaches that achieve better outcomes rather than simply doing more of the same.'