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The article shows how Southwark and Salford have attempted to bring alive government guidance by developing a mental health resource for those working at the intersection with integrated mainstream care. Although a local context receptive to partnership working was important, connecting collaborative theory with practice was crucial to the successful development of this resource.

In the UK there has been a shift over the last decade towards the setting of targets by commissioning or regulatory bodies so that health services provide improved levels of care. For mental health services this has occurred in three phases: phase one related to simple key performance indicators (for example collection of patients' diagnostic codes); phase two placed greater emphasis on more meaningful clinical outcome data; the third and most recent phase placed prominence on patient‐focused data collection. We report the development and preliminary findings of a piloting of a patient‐related outcome measure (PROM) and patient‐related experience measure (PREM) created specifically for older adult mental health services in Central and North West London NHS Foundation Trust. PROMs/PREMs are in keeping with an increased focus on patients' experience of health care, the provision of quality services and various key policies such as the recent government white paper Equity and Excellence: Liberating the NHS.

Despite older adult community mental health team (CMHT) workers inevitably encountering service users with alcohol use disorders (AUDs), they have a limited evidence base for working with this group. This paper aims to argue against a wholesale transfer of knowledge and practices from working age adults with dual diagnosis to the older age group.

The paper aims to address the scant attention given to the needs of older service users with a dual diagnosis by detailing the progress of four older adult service users with AUDs in a CMHT.

This case study series illuminates some of the clinical and professional dilemmas and challenges encountered when working with this group. Suggestions of how to respond to some of these challenges are provided by focussing on aspects of identification, assessment and treatment.

This paper provides a catalyst to further discussion, debate and publications on the issue of older people misusing alcohol by presenting and reflecting on the issues raised by four practice vignettes.