Local government leaders have raised major concerns about the implications of the Wanless review of health and social care in Wales.

They fear the recommendations may be the precursors to structural change despite ministerial assurances to the contrary.

The comments come in the Welsh Local Government Association's initial response to the review's recommendations on redesigning services and the links between health and social care.

Derek Wanless's review, published earlier this month, found that increasing demand for care could overwhelm providers unless health and social care services were modernised and brought closer together (news, page 7, 17 July).

The association's disquiet comes despite Welsh ministers insisting that the report's emphasis is on integrated thinking, not structural change.

The association says it is important that action to break down the barriers between health and social care "does not weaken the links and capacity for a seamless service between social care and other local government services such as education, housing, environmental services and leisure, which can deliver prevention and earlier intervention and a holistic approach to individual needs".

It raises concerns about an over-emphasis on a seamless approach that may encourage local health boards and authorities to focus on a narrow agenda for change.

"If the objectives from the recent health reforms are to be achieved and the pressures on acute hospital services reduced, we must ensure that health and well-being strategies are more than health and social care plans," it warns.

However, the report broadly welcomes many of the review's recommendations, and calls for the association to be fully involved in the operational detail of the Welsh assembly's long-term intentions on how best to implement the review's findings. A formal response from the Welsh assembly is expected in the autumn.