Dr Richard Dune

27-06-2025

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Exploring statutory duties, public health responsibilities, and partnerships

In England, Local Authorities (LAs) play a central, yet often underappreciated, role in the delivery, commissioning, and oversight of health and social care services. While the NHS and regulatory bodies like the Care Quality Commission (CQC) may attract more headlines, it is local authorities that often hold the keys to community-based care, safeguarding, public health, and service integration.

In this blog, Dr Richard Dune explores the legal duties, operational roles, and strategic partnerships of local authorities in the health and social care system. If you are a provider, commissioner, or professional in this sector, understanding the function of your local authority is not optional, but essential.

What are local authorities responsible for?

LAs are statutory bodies governed by elected councillors and professional officers. In England, there are several types, including:

• County councils
• Unitary authorities
• Metropolitan boroughs
• London boroughs.

All LAs share legal duties under national legislation to provide or commission key health and care-related services, including:

• Adult social care (under the Care Act 2014)
• Children’s services (under the Children Act 1989/2004)
• Public health (under the Health and Social Care Act 2012)
• Safeguarding of vulnerable children and adults
• Joint commissioning with the NHS and the voluntary sector.

Statutory duties in adult social care

Under the Care Act 2014, LAs have a legal duty to:

• Assess the care and support needs of adults (and carers)
• Commission services to meet eligible needs
• Promote individual well-being and independence
• Safeguard adults at risk of abuse or neglect
• Facilitate a sustainable local care market.

They must also:

• Produce a Market Position Statement (MPS)
• Ensure continuity of care if a provider fails
• Enable personal budgets and direct payments.

LAs are expected to commission care that aligns with the wellbeing principle, including personal dignity, control, and community participation.

Responsibilities in children’s social care

Children’s services departments are responsible for:

• Safeguarding and child protection
• Looked-after children (foster care, residential homes)
• Special Educational Needs And Disabilities (SEND)
• Early help and family support services
• Youth offending teams and care leaver support.

They must comply with:

• The Children Act 1989 & 2004
• Working Together to Safeguard Children 2018
• Local Ofsted inspection frameworks.

LAs are the corporate parents for children in care and must ensure they are safe, educated, healthy, and given opportunities to thrive.

Public health - From prevention to population health

Since the Health and Social Care Act 2012, LAs are also responsible for a broad range of public health duties, including:

• Health protection and emergency preparedness
• Sexual health services
• Stop smoking services
• Obesity prevention and physical activity initiatives
• Drug and alcohol misuse services
• Health checks for 40 - 74-year-olds
• Mental health promotion
• Air quality and environmental health.

Each LA has a Director of Public Health (DPH) who leads local strategy and contributes to wider system planning. Public health services are funded by a ring-fenced grant from the Department of Health and Social Care (DHSC).

Partnerships and integrated care

One of the most important shifts in recent years has been the move towards integrated care systems (ICSs). LAs are:

• Statutory partners in Integrated Care Partnerships (ICPs)
• Members of Health and Wellbeing Boards (HWBs)
• Co-commissioners of services with Integrated Care Boards (ICBs).

This collaboration is central to:

• Reducing health inequalities
• Coordinating discharge from the hospital
• Delivering care closer to home
• Improving population health
• Aligning budgets for greater efficiency.

LAs often lead on place-based care, working with voluntary sector organisations, care homes, and community groups.

Safeguarding - Adults and children

LAs chair and support Safeguarding Adults Boards (SABs) and Local Safeguarding Children Partnerships (LSCPs).

Key duties include:

• Investigating safeguarding concerns (Section 42 Care Act)
• Coordinating multi-agency responses to abuse or neglect
• Auditing safeguarding practices across partner organisations
• Ensuring robust training and procedures are in place.

Providers must work closely with their local authority to meet mandatory reporting duties, participate in serious case reviews, and implement safeguarding improvements.

Commissioning and market shaping

LAs commission a large proportion of social care services, from residential and nursing care to supported living and domiciliary care.

Commissioning responsibilities include:

• Conducting needs assessments
• Publishing strategic commissioning plans
• Awarding contracts based on quality, cost, and outcomes
• Monitoring provider performance
• Managing provider failure or market exits.

In return, providers are expected to:

• Deliver safe, effective, and person-centred care
• Maintain regulatory compliance
• Submit accurate data and reports
• Cooperate with inspections and audits
• Be financially and operationally resilient.

Local government oversight and inspections

Unlike the NHS, local authorities are subject to a range of external inspections and reviews, including:

• Ofsted (children’s services and SEND)
• CQC local system reviews (joint reviews of health and social care)
• Public health outcomes framework reporting
• External audits by the Local Government and Social Care Ombudsman (LGSCO)
• Care Quality Commission (via provider-level inspections).

Councillors also hold scrutiny powers, and many LAs run health overview and scrutiny committees to hold services accountable.

The role of providers in supporting LA duties

Whether you run a care home, children’s home, homecare agency or therapy service, your organisation contributes directly to your local authority’s ability to meet its duties.

Providers must:

• Understand local commissioning strategies
• Ensure contractual compliance
• Collaborate with LA teams during safeguarding cases, care planning, or discharge.
• Participate in joint audits or quality monitoring visits
• Support integrated working through data sharing, co-location, or partnership delivery.

Being responsive to your LA’s priorities can strengthen relationships and increase your visibility as a high-quality provider.

Why this matters for compliance and governance

The influence of local authorities goes beyond commissioning. Many LAs:

• Fund and monitor training compliance
• Set local policy priorities around dementia, autism, reablement, or workforce
• Lead multi-agency safeguarding audits
• Partner with the NHS and CQC in quality improvement programmes.

As such, understanding your LA’s structures, strategies, and people is not just a contractual obligation; it’s a compliance imperative.

Local authority challenges in 2025

LAs are currently facing:

• Severe financial pressures and rising demand
• Challenges with provider sustainability
• Increased complexity of care needs
• Workforce recruitment and retention issues
• The continued integration push through ICSs.

Providers that can demonstrate value for money, resilience, and innovation are better positioned to support and succeed in this evolving landscape.

Final thoughts

LAs are not just funders. They are strategic partners, safeguarding leads, and community health drivers. Their statutory responsibilities shape how care is commissioned, delivered, and improved.

By understanding the role of your local authority and aligning your service delivery to their evolving goals, you can better support compliance, partnership, and long-term sustainability.

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