The creation of a new service within the NHS providing intermediate care not just to older people, but children, people with disabilities, learning disabilities and mental illness will be a 'huge element' of the national plan, delegates heard.

David Panter, chief executive of Hillingdon primary care trust and a prominent member of the partnership modernisation action team, told delegates that new intermediate care services would not just be about 'beds in different places'.

It meant entirely different services and models of care to what has historically been provided, he told the conference.

But Mr Panter also insisted that the aim of providing integrated local services should not be achieved by further organisational change, such as creating new levels of PCT.

'We don't need to create another organisation. Within the Health Act flexibilities there's plenty that can be done to achieve integrated services, ' he said. We need to explore these before creating a level-5 PCT.

Organisational fixes are not the right way.'

He told delegates that NHS staff needed to overcome their 'overwhelming arrogance' when it came to developing partnerships with other organisations.

'We need to learn a bit of humility - we are the providers of health services. We don't cover the whole market in health and well-being.

'We have to recognise the contribution - often more significant - that local government can make, ' he warned. He said that integration of teams had moved on enormously in Hillingdon in the three months since the PCT went live, through simple measures such as chief executives of the PCT and social services sitting on each other's management teams.

Mr Panter also suggested that a key element of partnership-working which would emerge from the national plan would be links between the NHS and the independent sector 'in all its forms' including nursing and home care providers, building developers, information technology suppliers and pharmaceutical companies.

But he also cautioned against focusing on partnerships entirely outside the NHS because, he maintained, much more work needed to go into ensuring that the primary and secondary care sectors within 'the NHS family' worked together.