Bath and North East Somerset	Herefordshire	Knowsley
The PCT and council, working in equal partnership, have signed a Joint Working Agreement whereby child and adult health and social care and housing services are integrated using pooled funds combined with a two-way delegation of functions. Partners report to a partnership board that has overall responsibility for implementing and monitoring arrangements.	The PCT and Council explored the option of jointly planning, purchasing, designing and integrating all their local public services, but were unable to do so under current legislation. They are currently pursuing the integration of all public services covering strategic health and well-being as Herefordshire Public Services Partnership. There are joint appointments at all management levels with teams that work towards shared objectives and their joint Steering Group reports formally to the Council Cabinet and PCT Board.	The PCT and Council have widened their health and social care focus by consciously avoiding the care trust model and using the Health Act flexibilities to support a partnership throughout both organisations. This includes the key leadership role of Chief Executive NHS Knowsley—Executive Director of Council’s Well-being Services (including Social Care and Leisure Services)—to create a health and well-being partnership board in line with its LAA. This has enabled it to jointly plan, commission and deliver services across the locality and use resources more flexibly, for example, reducing duplication in commissioning and procurement.

Source: Adapted from Audit Commission [10] and Hudson [11].