The Department of Health’s integrated care “pioneers” will be monitored centrally to check progress against their plans and could be stripped of their status if they lose their way, health minister Norman Lamb has said.

The care and support minister made the announcement in an interview with HSJ as he revealed the 14 sites across England that will become the DH’s integration pioneers.

Mr Lamb said the scheme was “integral” to the implementation of the £3.8bn Integration and Transformation Fund from 2015-16, and that it could lead to the establishment of the first NHS accountable care organisations.

The DH’s 14 integrated care pioneer sites are:

  • South Devon and Torbay
  • North West London
  • Worcestershire
  • Cornwall
  • Islington
  • Waltham Forest, East London and the City
  • Greenwich
  • Leeds
  • South Tyneside
  • Staffordshire
  • Southend
  • Cheshire
  • Barnsley
  • Kent

A full list of organisations involved in each pioneer bid, and a short description of their plans, is attached on the right hand side of this article.          

Mr Lamb said the 14 were leading a “quiet revolution” in the delivery of health and social care in England.

As part of their bids for pioneer status, each site set out their ambitions for how they wanted care to improve in their local areas. Mr Lamb said the DH would be monitoring their progress, adding that he would remove them from the programme if their projects failed on their own terms.

“If some pioneers fail or lose their way, they can no longer be exemplars,” the minister said. “There will be pressure on them to keep developing… they want to be able to demonstrate that they’re forging ahead and achieving their ambitions.

“You can’t be held up as a pioneer, or as a leader and one that’s influencing others if actually the leadership has dissipated or if the objectives they set themselves aren’t being met.

“We will be closely monitoring, but in a very supportive way.”

Mr Lamb told HSJ that the Torbay and Greenwich schemes in particular were moving towards the setting up of the NHS’s first “accountable care organisations”, co-ordinating teams spanning health and care agencies, including primary and secondary care.

The DH received 99 bids from groups of health and social care organisations who wanted pioneer status.

Mr Lamb told HSJ the 14 chosen had been identified as “real leaders” in driving integration across health and social care, and that together they represented an opportunity to inform the rest of the system about how barriers to integration could be overcome.

Disseminating their learning across the NHS will “literally be critical to the rest of the system” as they design their plans for spending the £3.8bn integration fund, he said.

NHS Improving Quality, NHS England’s agency for supporting innovation in the NHS, will support the pioneers in designing integrated payment systems, for instance, or enabling them to share data across health and care agencies. This practical advice could then be made available to the rest of the NHS, Mr Lamb added.

Although the pioneers will not be given any special legal status or any protection from competition law, Mr Lamb said he would keep a “watching brief” on the issue.

He did not rule out further legislation to ensure local attempts to integrate care were not scuppered by the Competition Commission. Asked whether he would change the law on competition, Mr Lamb said: “We have to avoid frustrating the development of joined up care for the benefit of the patient… let’s see what happens.”

He added: “We need to monitor this very closely. We must not allow a purist view of competition to frustrate what we collectively know needs to happen.”