Sandwell Metropolitan Borough Council: local authority assessment

The local authority integrated aspects of its care and support functions with partner agencies evidencing improved outcomes for people. As part of the 12-Week Pathway programme offered to people with learning disabilities and/or autism, staff worked closely with a range of community organisations such as those offering talking therapies, employment support and social groups, leading to a broad range of meaningful activities for people once the pathway ended and positive outcomes.

The local authority worked collaboratively with partners to agree and align strategic priorities, plans and responsibilities for people in the area. The local authority was clear about the challenges it faced within its adult social care system, and its need to work with partners including the NHS and voluntary sector to deliver outcomes across strategies including commissioning, transformation, digital and technology, and the Adult Social Care strategy 2023 to 2027 with visions of prevention, rehabilitation and care.

The local authority recognised that improved recruitment and retention was essential to delivering consistent care. Planned recruitment campaigns were developed to increase reach and reduce vacancy pressures. Joint recruitment campaigns with NHS partners were in place to support integrated care roles. This ensured that health and care services could access the skills needed to deliver coordinated support.

The local authority recognised the importance of leadership in partnership and were actively engaged in working with partners such as the Health and Wellbeing Board and the Health and Care Partnership. Health partners felt Sandwell had a strong voice within partnership working and stressed the importance of this regarding Birmingham and the wider Black Country area. There was confidence Sandwell's voice would continue to grow in strength with local authority senior leaders raising its visibility and promoting the ‘Sandwell Story’. The Director of Adult Social Services (DASS) attended the Sandwell Health and Care Partnership, and it was felt there was a will to be more collaborative with health partners, with respect and understanding of different roles. The partnership was keen to identify and explore greater opportunities for integrated working including an integrated health and social care model in each of the 6 towns of Sandwell. Health partners were represented on many local authority governance boards and feedback was there was evidence of thoughtful interlinking to ensure best practice. Strong relationships meant there were regular meetings and communication between senior leaders, which ensured close operational working relationships alongside formal arrangements.

The local authority supported the Black Country Integrated Care Board in the development of a Dementia Strategy. The focus in Sandwell during 2024 was co-production with people living with young onset dementia which was in response to higher than the national average of young onset dementia. Plans were to prioritise this work during 2025 in the refresh of the Sandwell Dementia Strategy.

Staff worked closely with partners in a range of ways, such as sharing data and working with other local authority teams, health and community groups to achieve shared goals. For example, there had been some recent work with health partners on breaking down barriers in the use of terminology by not using acronyms, but plain language to help teams with understanding each other.

Some partners felt there should be better pathways and communication between adult social care, health, and unpaid carer support providers, to help align priorities across the system. However, positive examples included consistent engagement from local authority leaders and constructive challenge from other partners.

Transition from social care to health funding was described as a problematic area by some with lack of coordination and clarity of responsibility for funding and support. Policies and processes were in place documenting where funding responsibility lay.

The local authority used opportunities to pool budgets and jointly fund services with partners to achieve better outcomes for people. The 2025 to 2026 integrated BCF utilised by the local authority was clear in its key priority of a preventative ‘home first’ approach which was evident in reducing hospital admissions and maintaining people, where possible, at home with preventative measures.

Integration with the local authority and health was mature across the West Midlands and partners told us Sandwell were at the forefront, although not always as proficient and insistent about celebrating and promoting their strengths. There was pride in partnership arrangements for the BCF and true integrated services where it was described as impossible to tell who was employed by health and who by the local authority, for example, in the integrated discharge hub where staff sat together to work for the best outcomes for people. There had been input into the BCF from wider engagement work involving a range of other partners, including voluntary and community organisations, care providers and user groups.

The local authority worked in partnerships with other agencies with clear arrangements for governance, accountability, monitoring, quality assurance and information sharing. The place-based Sandwell Health and Care Partnership Board was established with all partners represented including the ICB, Acute Trust, Mental Health Trust, primary care, Public Health, Children’s Trust and the community and voluntary sector. This Board met monthly and had an independent chair. Senior staff told us about strong relationships with the ICB, having been built for over 20 years. There were monthly meetings with senior leadership from both partners and felt to be equality in decision making over pooled budgets.

Joint work with health and social care was in progress to review funding for people with mental health needs. Feedback from staff was some partnership working arrangements could be improved, for example staff working in mental health teams could not always access partner IT systems which meant having to telephone for relevant information prior to visits. Feedback from the local authority was this had been addressed and was awaiting final resolution from partner agencies.

Partners praised front line teams, stating how responsive and supportive they were, especially when working with people whose needs were complex. It was felt that such partnership working was key to getting the best outcomes for the people they worked with. Communication had improved through direct telephone contact to commissioners. Previously contact was mainly through email and the change had been welcomed to strengthen partnership working.

The impact of Partnership working was shared by the local authority, for example, close working with adult social care had encouraged increased use of the Better Care funding by Housing teams. An example was given of a young person with learning disabilities who was supported to purchase a property more suited to their needs through partnership working with adult social care and others.

A nationally recognised service to support people living with dementia had been developed following extensive engagement with stakeholders and people to design and reshape their dementia support services. The local authority said the implementation of the new model has led to improved outcomes for people, with waiting lists reducing and dementia diagnosis rates increasing due to people increasingly coming to be assessed.

The intermediate care bedded service in Sandwell jointly commissioned by the local authority and ICB was described by a VCSE partner as an example of good partnership working where the partner had received positive feedback from people and unpaid carers about the impact on them.

Local authority staff continued to review ways of working with partners to ensure efficiency. Staff had tried to reduce the work load for care providers by allowing more time for data to be collated when monitoring services, such as nursing homes. Striving to complete inspections jointly with health partners to reduce impact and duplication for providers.

Sharing of integrated performance data between health and the local authority took place and was described as 'dipping a toe in strategic data sharing' with mature data sharing as the goal. Partnership working across the Black Country and several neighbouring local authorities was part of working together to develop a risk strategy tool which, when finalised, hoped to provide an effective model across the region.

The local authority monitored and evaluated the impact of its partnership working on the costs of social care and the outcomes for people. This informed ongoing development and continuous improvement. Partners told us they were aware of local authority grants being reviewed to ensure spending was not duplicated. Other partners reported commissioners diligence in incorporating feedback, particularly in the health contract and unpaid carers initiatives, with visible efforts made at stakeholder engagement.

Support provided by the local authority helped people to understand and access available community resources. Some people fed back that the local authority helped them understand and navigate VCSE groups so they could choose support which was suitable for them.

The local authority worked with the VCSE to understand and meet local social care needs, providing funding and other support opportunities. The local authority provided funding to an umbrella organisation in Sandwell to facilitate a VCSE owned and led forum. The forum met to discuss issues the sector faced, provide information and advice to VCSE organisations regarding health and social care and to be a point of contact between the local authority and adult social care, public health, health and the ICB.

Partners told us the local authority were good at engaging with the forum and VCSE for pieces of work. Relationships were positive and valued. Examples given included involvement in development of the co-production strategy and it was felt the local authority were good at informing the forum of changes or new specific pieces of work. Senior local authority leaders attended the forum to engage with members, offering support with issues.

Key challenges identified by the VCSE were funding and barriers such as use of jargon with some feeling schemes were not always tailored to all. Feedback was the local authority could feel ‘corporate’ and they did not necessarily have the experience navigating a complex health and social care system. Although they were often specialists, partners felt they could work alongside the local authority more collaboratively in some cases. Local authority staff told us about the process for awarding grants to the VCSE now which included having more transparent meetings.

Other partners felt there was keenness to involve the VCSE in different projects and programmes of work. For example, some partners had successfully been involved in a task and finish group to review safeguarding systems and processes. Funding was provided by the local authority which included support to an organisation which supported the LGBTQ+ community and funding to support people with drug and alcohol addiction.

In the Sandwell Narrative Plan, 2025 to 2026, the local authority outlined plans for refinement of their governance framework to ensure systematic engagement with wider stakeholders, including voluntary and community sector organisations. They stated that, like many other local authorities, they were facing substantial financial and demographic pressures. Their challenge was enabling people to do as much for themselves as possible with the personal and community resources that were available to them. This involved changing current methods of commissioning and service delivery and meant activity was reduced or ceased in some areas, yet developed in others, and acknowledging this had created some uncertainty.

A review of Sandwell Council’s funding of the VCSE in November 2024 identified areas for improvement which included the application processes, administration cost reductions and duplication in funding activities. This review had been welcomed by VCSE organisations and the findings emphasised the need for greater clarity and transparency in processes.

Health partners said there was a move from treatment to prevention where people were empowered to take responsibility for their health and wellbeing. They told us the local authority supported the VCSE to allow self-sufficiency and the strength of the community offer showed that support was not always needed from statutory partners. The challenge was to prevent offers from overwhelming people and supporting navigation. Opportunities for partnership working could result in a bigger offer to the VCSE following on from the work undertaken to better support unpaid carers.

Staff spoke positively about the range of focused work which had taken place in Sandwell communities, for example, in the Sikh communities, work with a local charity supporting Sikh men around alcohol use. VCSE groups were invited to local authority overview and scrutiny meetings to talk about their work and feedback on support received from the local authority. The local authority provided financial support for projects and pieces of work and it was felt by staff that partnership working was something they did well with good outcomes. Senior leaders told us about working with and alongside communities, working with leaders of all faiths, with close and valued working relationships. The impact of this work was measured via regular reviews and with feedback sought.