The Department of Health has received more than twice as many bids than expected to set up integrated care schemes.

By Friday's deadline, it had more than 100 applications from organisations keen to be among the pilots, which were proposed in health minister Lord Darzi's next stage review.

The most ambitious schemes could lay the groundwork for a new approach to commissioning, with primary care trusts paying for outcomes rather than services from integrated organisations.

One bidding group has proposed an ambitious scheme for the "vertical" integration of primary care and community services with an acute foundation trust, supported by the private sector, to improve diabetes care and end of life services for a population of more than 170,000.

Going horizontal

Another is hoping to get the green light for a "horizontal" scheme where a PCT, a practice based commissioning consortium, mental health trust and local authority will work together to integrate primary care, mental health and well-being services for people of working age.

NHS Alliance chair and primary and community care strategy panel member Michael Dixon had predicted there would be around 50 applications.

The Department of Health will draw up a shortlist by the end of December.

Shortlisted sites will then undergo more detailed assessment with the final set of around 20 pilots to be unveiled by the end of the financial year.

A DH spokeswoman said the department was delighted with the number and quality of bids.

"Not only will the pilots add to the evidence base for integrated care but they have the potential to deliver significant improvements in the way health and care services are delivered in this country."

Raising awareness

Oliver Bernath, managing director of GP partnering organisation Integrated Health Partners, said unsuccessful bidders should still consider developing integrated care schemes.

"What the pilot does mainly is raise awareness but... if other areas fall asleep [during the pilot phase], the whole thing will be dead in the water," he said.

Surrey PCT deputy chief executive Paul Bennett said his organisation had submitted a scheme based around practice based commissioners "re-engineering" outpatient, elective and non-elective care in partnership with acute providers.

"What we're trying to do is align the primary-secondary-tertiary supply chain so that if there's a requirement for an organisation to shift in shape or form, it's not just a negative shift," he said.


  • Practice based commissioning cluster, PCT, mental health trust, local authority and new deal for communities partnering on mental health and well-being services for people of working age

  • Practice based commissioning consortium, PCT and acute trust forming a "virtual urgent care organisation" covering 150,000 people

  • Creation of not for profit community interest company run as a social enterprise providing "health maintenance organisation" services

  • Integration of primary, community and acute foundation trust services, supported by the private sector, to improve diabetes and end of life services for more than 170,000 people