Shifting the centre of gravity: making place-based, person-centred health and care a reality

The examples in this report show what can be achieved by system leaders and staff from local government, the NHS, the voluntary, community and social enterprise sector, and service user and carer groups working together to improve health and deliver person-centred care.


In 2016, the Association of Directors of Adult Social Services (ADASS), the Local Government Association (LGA), NHS Clinical Commissioners and the NHS Confederation published Stepping up to the place which set out our shared vision for transforming health, care and wellbeing and the key actions that national and local organisations should take to successfully integrate health and care.

Now, in 2018, joined by NHS Providers and the Association of Directors of Public Health (ADPH), we have refreshed our vision and action priorities to make sure they remain relevant for the next phase of transformation. The refreshed vision is based on a wide-ranging review, including a study of progress since ‘Stepping up to the place’ and the implications for our original vision, commissioned from the Institute of Public Care (IPC) at Oxford Brookes University. This included case studies on six localities – Croydon, Dorset, North East Lincolnshire, Nottinghamshire, Plymouth and Rotherham – and an evidence review of good practice which includes many case examples.

Based on learning from the past two years, this report sets out our refreshed, shared vision and the actions that will help local systems to progress their work on system-wide transformation. We ask you to use this vision to shape your own work on integrated health and care. We will continue to support you to implement the shared vision by collaborating to provide good practice information, case studies, tools, guidance and support programmes.