Kathryn Marsden, Chief Executive at the Social Care Institute for Excellence (SCIE), explains how local authorities can drive real collaboration across health, housing and social care through co-production — turning shared responsibility into meaningful, person-centred reform.
Too often, health, housing and social care operate in parallel rather than in partnership – with social care, particularly, positioned as an adjunct. The result is fragmented services that leave people without the care they need. This runs counter to the government’s ambition for prevention-focused, community-delivered public services – particularly the prevention-focused, community-delivered NHS outlined in its 10-Year Health Plan – which is dependent on strong social care infrastructure.
Local authorities are uniquely positioned to change this. Their accountability to local people and deep connections within communities make them ideally placed to foster bottom-up, citizen-led, co-produced approaches. SCIE’s work continues to demonstrate that local authorities can drive integration by bringing together partners across health, housing, and social care to design solutions that work for people, not systems.
Through our Embracing Change: Scaling Innovation in Social Care in Practice report – which draws on our work with over 120 local projects funded through the Department of Health and Social Care’s Accelerating Reform Fund – we’ve seen how co-production can expose where misaligned priorities and uneven resources create bottlenecks that limit independence and force services into reactive, crisis-driven responses. Understanding these dynamics allows local authorities to act earlier, with coordinated, evidence-informed interventions.
One example of this in practice is our partnership with Worcestershire County Council and a coalition of local partners. Together, we responded to feedback from unpaid carers who said they often experience anxiety when the person they care for is discharged from hospital. In response, the project established a dedicated Hospital Discharge Carers Adviser role on a hospital stroke ward to support carers and connect them with further services. It also explored how assistive technology, such as emergency buttons, could help create safer care at home. The project showed how targeted, co-produced initiatives can strengthen relationships between services and lead to better outcomes for people.
Co-production has also proven vital in shaping resources that flex around existing local strategies and structures. This encourages greater buy-in from all partners and enables genuine collaboration. Our Toolkit for Place-Based Strategies for Housing for Autistic Adults and Adults with a Learning Disability was developed by SCIE’s research analysts in partnership with national and local stakeholders, alongside people with lived experience. The toolkit outlines ten flexible steps that can be adapted or followed in full, helping local areas bridge the gap between where they are now and where they want to be. It supports local partners to clarify current and future demand, understand people’s housing preferences, and align commissioning accordingly.
Developing the toolkit together also revealed just how many voices need to be involved in designing housing strategies for autistic adults and adults with a learning disability. Autistic adults themselves, adults with a learning disability, family carers, representative groups, social care providers, NHS leaders, discharge teams, housing officers, and local planning departments all have vital perspectives. This process highlights how co-production fosters shared responsibility – reshaping services around people’s complex needs and aspirations rather than institutional boundaries.
To build on this progress, SCIE is now working with local authorities to identify barriers to embedding co-production more widely. Our goal is to help councils draw on the knowledge, ideas and lived experience of people who use social care, their families, carers, professionals, providers and commissioners – enabling them to turn collaboration into everyday practice.
True integration cannot be achieved by structure alone. It requires partnership built on trust, shared purpose and mutual accountability. Co-production gives local authorities the means to make that a reality – creating joined-up systems that not only meet people’s needs but reflect their lives.
