The government has proposed that councils and primary care trusts sign up to joint 'strategic assessments' of local health needs and, potentially, 'a single regime' to meet them (news, page 5). The details will emerge next month, but already a number of things are clear.
One, it would need a joint commitment to and understanding of the need for a more sophisticated approach to information. As Tim Kelsey argues this week (see pages, 18-19), the NHS does not want for information but for more useful information - real joint working towards community well-being is going to set a new bar in terms of getting to grips with that.
Two, the drive for greater independence for the NHS from national politicians (see comment above and roundtable discussion on pages 22-25) will go hand in hand with greater power for councils. That will destabilise relationships and mean that even traditionally good ones cannot afford to remain static. Accountability will be a key word in 2007. Many managers will feel instinctive relief that the plans for 'strategy by petition' seemed to have been shelved, with much less importance placed on gathering local opinion. That relief is only viable if they make local involvement networks work.
Three, the NHS Confederation is absolutely right to call for the duty to consult to fall only on commissioners and strategic health authorities rather than on providers (news, page 6). It makes no sense to extend it to all parties and shows a lack of understanding of the whole direction of NHS reform.