1. 1. Inform European colleagues about current transformational changes in the organisation and delivery of care services in England to a vulnerable group of individuals with both intellectual impairment and multiple complex needs.

2. 2. Compare and contrast English strategic direction /policy with European Union commitments

3. 3. Stimulate debate on how such trends compare with the experiences of colleagues across Europe.

Examination of key English policy drivers including:

1. 1. Valuing People Now (Intellectual Impairment).

2. 2. New Horizons (Mental Health).

3. 3. Putting People first (Social Care)

Review of the implications of:

1. 1. Demographic factors

2. 2. Economic considerations

3. 3. Diagnostic uncertainty

4. 4. Scandals as catalysts

5. 5. Personalisation

6. 6. People being cared for away from their home areas

1. 1. Cost, access and quality considerations are the priority areas under review.

2. 2. Though care systems vary enormously across Europe, public expenditure as a share of Gross Domestic Product is unlikely to increase in the short to medium term and this irrefutable fact will challenge strategic intentions and citizens’ expectations, especially in England.

3. 3. Both English and European Union strategic directions/policy contexts could be cynically viewed as being strong on principle and weak on implementation.

4. 4. There is a profusion and confusion of existing terminology.

5. 5. For individuals with intellectual impairment and complex needs and for their carers and families, what they all want is more choice, control and flexibility.

6. 6. Affected individuals in England appear more satisfied with the strategic direction than are their carers and families.