'Anxious to move on from rows over cost-shunting, the Association of Directors of Adult Social Services has pledged to champion partnership working, pooled budgets and joint commissioning'

There have been two more steps down the road to joint working between health and social care.

First, the Department of Health has announced pilot sites for using telemedicine to increase independence for people with long-term conditions. Besides the benefits for the client, accident and emergency admissions could be slashed.

Second, the newly-formed Association of Directors of Adult Social Services, the professional embodiment of the split between adult and children's services, has called for joint working to be the first, not the last, option considered by social services and primary care.

Anxious to move on from rows over cost-shunting, it has pledged to champion partnership working, pooled budgets and joint commissioning.

But none of this can provide a coherent response to the challenges laid down to ministers last year by Sir Derek Wanless in his report into long-term care costs.

This landmark report laid bare profound issues about old age in society. Incoming prime minister Gordon Brown has said healthcare is his priority. For this to have meaning, this October's comprehensive spending review must stake out a robust, long-term response to the challenge of an ageing population. This will form the political and financial bedrock upon which joint working across health and local government will be built.