What Do Elected Councillors Do in Long-Term Care Systems? Understanding the Contribution of Political Leaders

Context: This article fills a gap in the literature on long-term care by focusing on the role of local elected officials. The balance between local and national influence over long-term care varies by country. We here focus on England, where local elected councillors make key decisions on the design and delivery of support for frail older people and disabled people. Objectives: The article draws on new empirical data to highlight the different ways in which executive councillors, i.e. those in Cabinet positions, can exercise collaborative leadership in adult social care. Method: Structured literature review and 55 semi-structured interviews with national stakeholders and local case site interviewees. Findings: Drawing on the work of Ansell and Gash (2012) we use empirical data to identify how executive councillors operate as both organic and political leaders in the collaborative governance setting of adult social care in England. In particular we distinguish between councillors as stewards, mediators and catalysts. Limitations: Case study drop-outs limited the scope of our research. The sample size is small. The findings would need testing to explore their applicability outside England given the different balance of national and local roles in long-term care elsewhere. Implications: Councillors in care leadership roles need to better understand the difference they can make and be supported in skills acquisition to be more effective.