An ageing population in which more people of all ages have long term health conditions means that many people have a mixture of health and care needs that demand effective joint working with the NHS. Strong and sustained collaboration with the NHS is central to the DASS role.
An important guiding principle is that Integration should be a means to better outcomes—not an end in itself. As DASS, your job is to bring a social care voice, values and perspective to the heart of system leadership. But this is challenging because of profound differences between local government and the NHS in governance, accountability, funding and performance management. Particular flashpoints might be around hospital discharge, continuing healthcare and financial responsibilities at the interface between health and social care. Sometimes you will find yourself managing the inevitable tensions and disagreements so that effective joint working is not derailed.
How the NHS is organized and structured continues to change. Integrated Care Systems (ICSs) are now the formal structure for partnership across health and care. As a DASS you will play a pivotal role in ensuring the effective engagement of your council, particularly in the local integrated care partnership and through your local health and wellbeing board. This will be especially demanding in places where council boundaries are straddled by more than one ICS. Culture, relationships and local context still matter most. You have a key role in shaping priorities, governance, and investment decisions.
Work in partnership, not just alignment. That means:
- Advocating for social care as an equal partner—not a bolt-on.
- Promoting prevention, reablement, and home-first approaches.
- Prioritising carers, workforce, and community services in joint planning.
- Leading the conversation on discharge, flow and intermediate care.
Build trust with NHS colleagues. Be visible, reliable, and values-driven. Make social care leadership clear in place-based partnerships and integrated neighbourhood teams. Develop shared outcomes—and shared ownership of solutions.
Use data and lived experience to make your case. Highlight the contribution of adult social care to hospital flow, health inequalities, and population health. Show how co-production and relational practice deliver better outcomes.
Keep your independence—but don’t work in isolation. Adult social care brings insight into complexity, risk, and rights. Use that to shape integrated working that is ethical, person-centred, and effective.
Finally, relationships are more powerful than structures. – “progress happens at the speed of trust”. Invest in the human infrastructure—mutual respect, shared language, and regular dialogue. Systems are built on people. Lead that connection with care and conviction.