Over the last decade, Britain’s public services have faced a number of challenges related to a changing population profile, growing demands from more assertive users, and the need for a more sustainable model of delivery. The UK’s huge fiscal deficit will now add the most pressing and complicated challenge of all: cutting expenditure on public services while maintaining quality and user satisfaction.
This paper opens a debate around the prospects for a more innovative, more responsive model of public services for groups of users with complex needs. This model revolves around integrating healthcare and social care budgets. The paper analyses the policy landscape, the key determinants of modern public services and the main financial aspects of integrated budgets. It recognises that there are two different approaches to integrating budgets – an ‘individually-centred’ approach and a ‘system-centred’ approach – and argues that the best way to create a more responsive and financially effective service model is to combine the two.