13 Aug 2026
Changes across the NHS and local government are raising questions about how health and social care services will work together in future, and the role councils will play within changing health structures.
Lincolnshire County Council has decided to bring adult mental health social care services for people aged 18 to 64 back under direct council management, ending a long-standing Section 75 agreement with Lincolnshire Partnership NHS Foundation Trust (LPFT).
Section 75 agreements allow NHS bodies and councils to work together through arrangements that can include pooled budgets and delegated responsibilities.
Lincolnshire’s decision followed independent reviews which identified a number of challenges, including financial pressures, limitations in data, reporting and forecasting, and the need for stronger governance and assurance. The council and LPFT agreed that the existing arrangement was no longer the most appropriate model, with the agreement due to end no later than March 2027.
The decision comes amid wider changes to the health landscape. NHS England is implementing mergers and boundary changes to Integrated Care Boards (ICBs), while proposals in the Health Bill have prompted debate about local government representation within ICBs.
The Local Government Association has raised concerns about plans to remove the existing requirement for local authority representation on ICBs, warning this could weaken links between health decision-making and local communities.
For rural areas, where access to services can be shaped by distance, transport, workforce pressures and dispersed populations, maintaining a strong understanding of place will be particularly important as health structures evolve.
Whatever the structures, effective integration will depend on health services and councils being able to work together around the needs of the communities they serve.
