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Totally agree. One good thing about the reforms is that they have provided an opportunity to have lots of discussions across the whole sector on what "integration" means, on what "choice" means, on what "information" means, and what genuine patient empowerment looks like. We know what works. We know what good looks like. Now is the time to make it happen.

But to do this, we must divest the reforms of ideological flavour and genuinely bring it all back to the patient.

It is also important to take a long-term, big picture view of health needs, and tackle problems at source. Local populations are not distinct, homogenous entities, and we must not let localism blind us to the shared needs which cut across local and regional boundaries. An ageing population with an increasing number of co-morbidities requires a genuinely patient-centred approach focused on self-care, shared decision-making, care planning, prevention and challenging health inequalities - and getting the right care to the right people, at the right time. That is not going to be achieved by simply pushing all the difficult decisions down to bodies and individuals who may or may not be adequately equipped, or desiring, to take them.

Organisations like National Voices and ARMA can provide a wealth of expertise, as well a direct line to the patient voice. We can and want to help. But as Jeremy said, communication is a two-way street.