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As the social care system ‐ and potentially the health care system and other public services ‐ move increasingly towards a model of personalised support, questions arise about whether and how it can work for people with multiple and complex needs. The evidence is that it is possible to achieve this, and that the outcomes and quality of life can be dramatically improved, but many councils and their partners have yet to move into this demanding activity, and face considerable obstacles in the form of conventional approaches to policy and practice if and when they do. This article draws on the findings of a special study undertaken for the Commission for Social Care Inspection. Alongside some of the difficulties of personalising support for people with multiple and complex needs are inspirational stories of innovative developments which have transformed the lives of people and their carers.

Following publication of a new vision for the English National Health Service (NHS) in 2014, known as the NHS Five-Year Forward View, a Vanguard programme was introduced by NHS England charged with the task of designing and delivering a range of new care models (NCMs) aimed at tackling deep-seated problems of a type facing all health systems to a greater or lesser degree. Drawing upon recent theoretical developments on the multilevel nature of context, we explore factors shaping the implementation of five NCM initiatives in the North East of England.

Data collection was based on semi-structured interviews (66 in total) between December 2016 and May 2017 with key informants at each site and a detailed review of Trusts' internal documents and policies related to the implementation of each NCM. Our analysis explores factors shaping the implementation of five NCM pilot sites as they touched on the multiple levels of context ranging from the macro policy level to the micro-level setting of workforce redesign.

It is far too early to conclude with any confidence that a successful outcome for the NCM programme will be forthcoming although the NHS Long-Term Plan seeks to build on the earlier vision set out in the Five-Year Forward View. Early indications show some signs of promise, especially where there is evidence of the ground having been prepared and changes already being put in place prior to the official launch of NCM initiatives. At the same time our findings demonstrate that all five pilot sites experienced, and were subject to, unrealistic pressure placed upon them to deliver outcomes.

Our findings demonstrate the need for a deeper understanding of the multilevel nature of context by exploring factors shaping the implementation of five NCMs in the North East of England. Exploring the wider national policy context is desirable as well as understanding the perceptions of front-line staff and service users in order to establish the degree of alignment or, conversely, to identify where policy and practice are at risk of pushing and pulling against each other.

The literature on inter‐professional working has not generally yielded evidence of great success, and this has led some to lose patience with the interprofessional enterprise. This article reports the findings of an evaluation of an ambitious programme to integrate social workers, district nurses and housing officers on a locality basis in Sedgefield, County Durham. It articulates an ‘optimistic model’ of inter‐professional collaboration and suggests that the findings of the Sedgefield evaluation offer some support for the validity of the model.

The modes of governance underpinning public sector services have been reshaped several times in the post‐war period, leaving a mixture of command and control, marketisation and partnership working. There is now a call for a new and ambitious phase that might be termed ‘whole systems working’, and the most ambitious focus for this phase is the Every Child Matters reforms being ushered in under the Children Act 2004. This article describes the whole‐systems nature of the changes and identifies a range of difficulties that need to be addressed.

The purpose of this paper is to reflect on 20 years of joint working between health and social care in England, to take stock of the lessons learned and to consider future scenarios.

The paper consists of secondary research, drawing upon two decades of published work by the author and other analysts.

Despite some pockets of innovative practice, the findings are disappointing for the progress of integrated care. It is suggested that the main reason for this is that the concept has never been used consistently and that underpinning policies have been insufficiently strong to ensure policy success.

This anniversary issue offers an unusual opportunity to reflect back on 20 years of policy and practice in a significant field of study, and to draw out some implications for future directions.

In the first of these two articles on integrated team working (Hudson, 2006) the focus was on the nature of the front‐line integration ‐ the Sedgefield Integrated Team (SIT). Positive findings were reported on the ways in which professionals from disparate backgrounds under single management were working together for service users. However, it is important to nail the myth that front‐line staff will happily and creatively collaborate if only managers would leave them to it. The reality is that initiatives like SIT have no qualities of spontaneous growth or self‐perpetuation ‐ they need to be planned, created and nurtured by policy‐makers and managers. This article looks at how these activities, known locally as the ACCESS programme (Adult Community Care Enhancement Strategy for Sedgefield), were undertaken in Sedgefield.

Public sector reform will be at the heart of Labour's third term of office. The changes under way or planned in children's services and adult social care services in England are prototypes of the pursuit of services that are person‐centred, seamless and proactive, with a focus on positive outcomes and well‐being. This article examines the similarities in approach between the two sets of changes, and warns that implementation will be a difficult task.

Partnership working appears to be a key principle of public services reform in both England and Scotland, but there are important contextual differences between the two countries. Whereas the Scottish agenda is relatively consistent, in England there are competing policy imperatives at work that could undermine improved partnering. This article examines the public services reform context in England and Scotland, and suggests that English policy is a complex mixture of network, market and hierarchy which gives rise to tensions that remain unaddressed.

Within the space of three years, the Department of Health oscillated between a commitment to partnership working and the imposition of structural change in the pursuit of integrated care. The idea of care trusts which integrate health and social care functions acquired political currency, despite the absence of any evidence base to inform the model. This article urges caution and suggests that the partnership model deserves a chance to deliver results.

The number of children in England, and the number who may need additional support from services, is large and growing. At the latest count there are approximately three million children aged under five, 6.4 m aged 5‐14, and 3.1m young people aged 15‐19. Children and young people from ethnic minority backgrounds make up about a fifth of the total population under 20 ‐ much higher than for other age groups. In total there are reckoned to be 12m children, 400,000 children in need, 59,700 looked after children, 320,000 disabled children, 600,000 live births a year and approximately one million with mental health disorders (DoH, 2003a).No single agency or profession can cater for such a large and disparate number of individuals, but increasingly their needs are crossing traditional organisational and professional boundaries. The partnership imperative that has become so influential in services for adults is now set to re‐shape the domain of children's services. Accordingly, the aim of this article is to examine the genesis of this imperative, to explore the emergent policy responses and to gauge their likely effectiveness.