Integrated care is a key topic of discussion when I meet with NHS clients and in my wider NHS network. Many NHS organisations are talking about Accountable Care Systems and yet when I meet with Local Government the challenge of adult social care is discussed but it is unusual for the phrase Accountable Care System to be used.

For Accountable Care Systems (ACS) to make an impact it is vital that all parties understand each other's role. This survey suggests that the role of providers in an ACS is not well understood by local government. In some areas we see local government, commissioners and providers working together to overcome organisational barriers. In other areas the relationship remains very transactional and it feels as though there is a long way to go.