Four times more bids for health action zone status are expected than the government plans to approve this year, the Journal has learned.

Stiff competition is emerging for HAZ status, with interest in piloting new collaborative models of care far exceeding expectations.

Tim Sands of the NHS Executive's HAZ policy team confirmed that 30-40 areas have signalled they will seek HAZ status. But only 10 zones are expected to go live in the first wave this year.

The Journal has obtained details of bids as the 23 January deadline for applications approaches. The NHS Executive expects at least four bids from each English region, with up to seven from some.

Mr Sands predicted there would be many applications from deprived urban areas, given the initiative's emphasis on eradicating health inequalities.

But he said a number of bids addressing rural health needs, including those from Northumberland and West Cumbria, were also expected.

The Isle of Wight, which has a higher proportion of elderly people than the rest of the country with nearly a quarter of its 126,000 population aged over 65, is also planning to seek HAZ status.

A feature of its bid, like several others, is a focus on elderly people, as well as children and young people. Other areas being targeted for action include mental health and respiratory diseases.

Even though there will be many disappointed applicants, Mr Sands said the intention was not to create a 'club of 10 HAZs' but for there to be a much broader approach to redesigning healthcare.

He said: 'We do not want this to be seen as a winners and losers situation. We do not see HAZs as a separate initiative to implementing the white paper and the public health green paper.

'It is about implementing care under the new structures, so we are keen to involve everyone in that process.'

Ministers have already signalled there will be a second wave of HAZs. But at least one HA - Dorset - has put together a bid it will not now be submitting.

HA chief executive Ian Carruthers said the area did not meet the criteria for HAZ status.

But the HA still plans to implement the strategy on which the bid was based, which could result in substantial cash savings for reinvestment in patient care.

The Journal has learned of 15 other bids which HAs plan to submit as lead partners in the schemes with local government bodies and other organisations.

They include three London HAs - Lambeth, Southwark and Lewisham; Barking and Havering; and East London and the City - as well as Croydon, Manchester (which plans a joint bid

with Salford and Trafford) and Leeds.

Other bids are expected from Barnsley HA (bidding with Doncaster and Rotherham HAs), Leicester, Sheffield, Cornwall and the Isles of Scilly.

Liverpool, Sefton, St Helens and Knowsley, and Wirral HAs could each apply separately or under a Mersey-wide umbrella.

A bid from the North East involving Newcastle and North Tyneside, Sunderland, and Gateshead and South Tyneside HAs, will also be submitted.

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