The NHS Integrated Service Improvement Programme has brought about big changes, but the need for an integrated approach to service transformation has never been stronger.

We want to achieve integration by setting out a whole system model of care; thinking about keeping people well; then through interventions, rehabilitation and end of life care. We need to integrate planning and transform delivery across local health and care organisational boundaries, and integrate and align opportunities by combining service redesign, technology and workforce reforms as enablers to change.

Our Roadmap for Transformational Change is not a rigid recipe, it is more like ingredients for a great cake - some you already have, and some you need to acquire. The firm emphasis on securing benefits differentiates it from a plain planning and programme management approach.

We invited 16 demonstrator communities to work with us during 2007 to test ISIP guidance and toolsets, helping us create live examples from real NHS experience. Now our body of knowledge is being migrated to eSpace where the learning exchange will continue and new offers of support can be found.

It has been a thrilling and rewarding journey. Now what surprises me is that successfully managing complex change leading to patient benefits is just becoming recognised as a set of core competencies and key to responding to the communities' health needs.

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