The NHS Confederation believes the integration of secondary, primary and social care services is key in redesigning services around the needs of patients rather than NHS structures. This is especially so for patients with long-term conditions.

The launch of the Department of Health document 'Commissioning a patient-led NHS' has increased interest in integration. However we are concerned that there are a number of pitfalls we need to avoid if we are to create successful integrated organisations. For instance a common mistake is over-optimism about timescales and under-estimating difficulties in managing cultural issues and change.

There is strong evidence integrated care is an effective way of delivering healthcare especially if it is focused on the patient pathway. Our work programme is looking at issues such as how to:

• create integrated care based on population and patient need
• provide a focus for clinical leadership
• create viable hospital services for relatively small populations
• develop ideas about vertical integration, specialist disease management and alternative providers.

Models being considered include hospital-led integration, primary care-led integration and medical group practice models.

For more information about our related work go to our pages on primary care and acute care .

How we involve members

We hold specific seminars and meetings to inform our policy positions - invitations either appear in our email bulletin Interchange Alert or are sent out individually. We have regular meetings bringing together key stakeholders with NHS Confederation members.

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