Reform is coming for the health and social care sectors whether we like it or not. Doing nothing is not an option. These were some of the main themes to emerge from the recent National Children and Adult Services (NCAS) Conference – for the heads of children’s and adults’ social services, and the Local Government Group. Another key theme to emerge was the need for greater integration of health and social care services – in budgets as well as in frontline care. All this will inevitably impact on people with learning disabilities and, if got right, could see treatment and care services improve – or, at least be shielded from the worst effects of the cuts. But the operative word is “if”. There are still worries about where people with learning disabilities, and especially those with complex needs, will fit into all this. For instance, Labour MP Andy Burnham, who recently returned to his role as Shadow Health Secretary, mentioned his fears in his speech at the NCAS conference. In talking about the health and social care bill – which he is against – he questioned whether specialist services, such as speech and language therapy, would be seen as a commissioning priority. Concerns such as this have been voiced by many others since the plan to introduce GP commissioning was announced last year. That they are still being discussed is indicative of the government’s failure to adequately address these issues. There is no question that they will have to be reconsidered as the health and social care bill passes through Parliament. Meanwhile, adult social care funding reform is also still on the agenda, as care services minister Paul Burstow confirmed in his speech to the conference. While Burstow did not commit the government to implementing the recommendations from the Dilnot Commission  – saying only that it pointed out ways that care could be paid for – he confirmed the government’s response will come in the adult social care White Paper next year. The government is currently conducting an ‘engagement exercise’, which will, they say, inform the content of the White Paper. So now is the time for everyone to get their opinions in to try and influence policy. Elsewhere at the NCAS conference, the Care Quality Commission (CQC) confirmed it is planning to change the way it inspects care homes, including all homes having one unannounced inspection per year. The changes seem to be positive ones which take a step towards ensuring that another scandal like Winterbourne View does not happen. But while some details of how health and social care will be reformed are beginning to emerge – frustratingly – the bigger picture still remains unclear. That does, however, mean that there are still opportunities for the learning disability sector to influence policy and we must ensure that is  what happens. Pressure must be kept up to influence policy and ensure that services for people with learning disabilities do improve.