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Social care leaders have called for a duty of co-operation to be placed on councils and primary care trusts to stop NHS instability undermining the white paper's ambitions for integration.

The white paper stops short of calling for such a duty, saying it will be considered as part of a review of local strategic partnerships being carried out by the Office of the Deputy Prime Minister

However, Association of Directors of Social Services president Julie Jones said the current reorganisation of the NHS put at risk the "trust, confidence and stability" necessary for strong partnerships.

She said a duty of co-operation in pursuit of shared objectives could reduce this risk.

The white paper promises to drive integration between health and social care through a number of different routes.

By 2010, everyone with a long-term condition will have a joint health and social care plan, while those with the most complex needs will, by 2008, be supported by joint health and social care teams.

Inspection systems for councils and PCTs will become more closely aligned against the seven outcomes outlined in last year's adult green paper: health, quality of life, choice, freedom from discrimination, making a contribution, economic well-being, and dignity.


Local area agreements, which apply to both councils and PCTs, will be based around the same set of outcomes.

Directors of public health, which the government expects to be joint appointments by PCT and councils, and directors of adult social services will be collectively responsible for the long-term planning of care services for their communities.

To support this, councils and PCTs will have their budgetary cycles aligned around the current local government financial timetable.