That health and social care systems need to work better together. File that under 'Motherhood and Apple Pie'. How to achieve that aim? Now, that might be more tricky.
In some places, of course, they have already glimpsed nirvana - whether or not it takes the form of an Accountable Care Organisation (ACO). Elsewhere, though, Sustainability and Transformation Plans (STPs) - and, yes, I apologise for the acronym soup - are seen by stakeholders, including, in particular, by local authorities, as an NHS-driven, NHS-imposed policy. And a policy to boot which lacks any proper facility for effective, substantive engagement and consultation with system partners.
Mistrust abounds between the two main protagonists in our piece. On the one hand, the NHS feels that it has the monopoly on understanding all things healthcare: and, on the other, councils are suspicious of what they perceive to be the democratic deficit that afflicts their would-be bed fellows.
System re-design is inevitably a highly-charged, highly politicised process. Which presents obvious challenges for those in local government, especially at election time. In practice, though, things may be no less uncomfortable for healthcare commissioners who happen, say, to be practising GPs, with their own local (and often very vocal) constituencies.
It is a given, as I said at the start, that health and social care must be better integrated. What with a relentlessly ageing population, ever more complex co-morbidities, and ever more sophisticated but costly medicine. And that integration must happen soon.
So, how can those councils and healthcare bodies charged with delivering this brave new world secure success? At root, the answer seems to me to lie in working out what politicians really mean - in cold, hard, factual terms, not high-level abstractions - when they say they want devolution plans to go 'even deeper'. In explaining that openly and honestly to Jo(e) Public. And in working hard - together - to win hearts and minds.
The need to deliver more integrated services across the local health and social care system is recognised across the country. However, there has been tension about how this should be best achieved. Sustainability and transformation plans (STP) have been put in place in every area of England and the NHS has indicated that it wishes to see these develop into ACOs for every area. Again, it is accepted that this will take time to achieve. However, the level of local authority input and engagement in the STPs has been questioned. It has recently been reported that the councils in Leicestershire and Rutland have denied supporting the proposal for an ACO in their counties