Progress on Transforming Community Services indicates more integration is coming our way. “Vertical integration” is the method of the moment, and HSJ understands some primary care trusts feel under considerable pressure to head in that direction.

So the warning from the NHS Confederation that integration of services must not be seen as an end in itself, and that leaders of integrated services must set up structures and develop teams that suit their local priorities is timely.

The jargon of “joined up working” and “integrated services” is in common currency, but the confederation has interviewed the minority of those leaders who are living the professional reality.

They are enthusiastic, despite the pressures of having two jobs in one, but they want more support from the centre(s). And that gives a clue as to the problems they can face.

They not only want to see the DH do more to promote integration on the ground, but to better coordinate the messages it sends out from Richmond House on health and social care. The forthcoming social care white paper is a good place to start.

DH must help make integration seamless