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Flexibility in all health and social budgets can make it possible to use resources where they are most needed. For example, health money could be used for preventive community services. Within the LTC, it is municipal services, not home care, that have the greatest potential to be developed through joint budgets and action plans. Multi-disciplinary teams, led by nurses, have been set up to help seniors in the community through common structures, with shared financial resources. Such services have improved access to health professionals in the community, such as physiotherapists, and accelerated the process of evaluating and distributing ancillary technologies in people`s homes. The CPI program aims to develop a future health and care system that can help and help individuals manage their own health and lead better lives with the support they need. However, the commissioning of humane services and social assistance are shared between the GCC, local authorities and others. This fragmentation often makes it more difficult for commissioners to design and provide personalized and coordinated care. The pooling of budgets between Commissioners is a practical way to overcome this fragmentation and to enable the creation of a common Commission throughout the system.

In another northern town, Barnsley, the City Council and the Health Authority are pooling their budgets and have restructured their services to seniors into an integrated level of commissioning and an integrated provider level. The Council plays a leading role in the commissioning of services and the Public Health Authority is leading the way. The region has received excellent inspection reports for their services, including a decrease in the ratio of seniors permanently admitted to foster care or care facilities. Apprenticeship services are the type of offer most often justified by the application of Section 75 agreements. Councils tend to host these services after the transfer of funds from NHS Trusts. However, there are several examples of integrated local care for the elderly, often in the form of community-based multidisciplinary teams and equipment, under the direction of nurses. The legal flexibility required to pool budgets provides local health and social service organizations with a clear way to create integrated services. The legislation is multi-faceted and allows local authorities to put in place new governance and procurement systems tailored to the capacity of local partners and the needs of their populations. Local knowledge indicates that integrated management structures and services have several positive outcomes for users and can achieve efficiencies by avoiding duplication.

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