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Care trusts will succeed as long as local needs are catered for and there is an existing culture of integration.

Liam Hughes is social services director in Bradford. He is moving shortly to become chief executive of Leeds East primary care trust.
In Bradford we are consulting on the creation of a care trust which will be formed by merging services from three local agencies, Airedale NHS Trust, Bradford Community Health NHS Trust, and the council. The proposal already has considerable local support, yet it is clearly controversial.

If it gets the go-ahead, the care trust will take responsibility for mental health and learning difficulty services previously provided separately by the three bodies, including social services. It will have to pass some tough tests, but I believe that it is the right thing to do.

The benefits to service users and carers will have to be demonstrated in terms of improvements in quality. Person-centred care will have to be reinforced. Equal respect within the trust for both learning difficulties and mental health will be important. Staff will need to feel that the merger is not a takeover, that arrangements are fair, and that they are valued. Governance, finance and human resources will require effective project management if the care trust is to be in place by April. None of this will be simple to achieve. So why bother?

The simple answer is because this form of organisation will fit the local circumstances. Good joint working relationships have been built up over several years, and the groundwork has been done. It is far better to involve social services from the start of the new organisation and for them to shape its future, rather than stand outside being critical.

The council will nominate board members, it will run the scrutiny process, and it will provide the money, along with the primary care trusts. It will have power and influence in commissioning and procurement. This approach is in line with the "challenge" required under Best Value to find the most appropriate provider, and with the movement towards arm's-length and independent provider organisations. The local authority's role as leader of the learning difficulty partnership will keep open communications with other agencies such as the Benefits Agency, employment services and further education, leisure and housing. Similar links are in place for mental health.

There are risks. It would be unwise to proceed so quickly in situations where integrated working is poorly developed, or professional values are at odds, or there is financial instability. For Bradford, structure follows function, and the proposal builds on our particular history. It is a local solution.

The danger of the care trust model is that it is presented as a one size fits all approach.

Rita Stringfellow is chairperson of the Local Government Association social affairs and health executive.

While in areas like Bradford it is clear that the care trust model may have much to offer, it is equally clear that in other parts of the country it will not be the best fit. What works for local communities must guide us, and there are real issues to be clarified about the impact of front-line integration; encouraging both health and local government partners to establish care trusts is difficult without that clarification.

The Local Government Association believes that what must inform the national debate about the development of care trusts is an analysis of what communities actually need and are asking for. The danger of the present debate about care trusts is its focus on structural solutions, rather than meeting the particular needs of specific communities.

As local government and social services have evolved over the past 20 years, we have seen a movement away from "one size fits all" global solutions to tailored responses to individuals and to the specific needs of communities.

The range of solutions will not only differ across the country on the basis of geography but also according to the services to be included in new arrangements. Solutions that work well for older people's services may not work for children's services.

Local communities and local partners need freedom to develop local solutions. The LGA believes that care trusts are a useful addition to a range of freedoms and flexibilities which may create new ways of delivering high quality services for local people.

Across the country we see local authorities and other partner organisations coming together to develop a wide range of models to meet the needs of local communities, some of which will include care trusts.

The essential criterion that needs to be satisfied is that whatever the choice of organisational structure, it must be focused on the outcomes that will be achieved for the individual and community. These outcomes must be in harmony with the culture and expectations of local people. Local government and the NHS must continue to improve services and develop and maintain close connections to their local communities. Favouring one organisational solution will undermine this work.