I have always had difficulty with people saying "we need some money to change".

In a small number of cases this may be so, but I have yet to see examples that actually deliver something completely different as a service/ pathway, rather than a stepped evolution from existing to something new - anything else would almost certainly be unsafe.

The issue is the will to do something about the situation, not the need for more money.

Speaking as a leader of an organisation which was unsuccessful in its vanguard application but has now progressed further and faster than the local vanguard, I wonder whether one of the planned consequences of the vanguard approach was to shock our system into action? It has been painful, but seems to have had the desired effect.

Dear David and Anon at 334pm

Both the BCF and TF are bureaucratic responses is my point.

A transformation fund will not be provided without more form filling, more justification, a generic project plan and various amounts of new onerous administration. The amount of planning time, consulting validation that went into the BCF would be needed to administrate the TF. The Vanguards are still challenged to provide upwards pointing administration.

The TF is yet another chronic case of initiative-itis.

Insanity. Doing the same thing over and over again and expecting the same outcome.

Transformation fund is different. It will support the development better integrated organisations by focusing various agencies on big change projects only some of which will be about health and social care integration.