What it means for all of us?

As we’ve gathered evidence to underpin our case for change, it’s also begun to shape our thinking about priorities and proposals for integrated health and care services. We all want to see more joined up services, many of them provided locally in the community, with the individual or patient at the heart of where and how they’re delivered.

Emerging Proposals

Our thinking about emerging proposals is not set in stone, but an indication of the kind of options we think could deliver a better, more integrated health and care service, on budget. Learn more about our thinking.


Urgent and emergency care
  • Single system for accessing urgent and emergency services - which minimises referrals and cuts duplication, partly delivered through 111, clinical assessments, face to face consultations and a single point of access.
  • Network of Urgent Treatment Centres (UTCs) - to reduce A&E visits and hospital admissions and replace minor injury units as part of more integrated, community centred health and care services; UTCs are a government requirement
  • Review of stroke services including stroke and brain injury rehabilitation - to understand the best future shape and model for these services
  • Enhance the sustainability of vulnerable specialities and improve the efficiency of non-urgent acute hospital based treatments - better access for urgent and planned treatments
Long term health conditions and frailty
  • Improve health and wellbeing with local communities and neighbourhoods - encourage people to understand health risks linked to lifestyle, develop networks of support and support vulnerable groups
  • Proactive care close to the community - work with GP practices to achieve a consistent approach to health and wellbeing through better care planning and coordination, health coaching and drawing on local networks of support
  • Neighbourhood team approach - closer working between health and care services in the community in 14 new localities
  • Draw people out of hospital and support them in their homes - community based packages of care to support people at home for longer
  • Joined up support in the community for people who are frail - build on the integrated care model for diabetes that has proved so successful
  • Network of cancer (oncology) services - to make best use of staff and resources, support faster diagnosis, deliver high standards of cancer care, and ensure sustainability of some services which are vulnerable
Planned care
  • Transformed services for outpatients - streamline and speed up the process, and develop a new range of approaches for outpatients such as telephone appointments, virtual clinics and triage by clinicians
  • Transformed diagnostic services - right capacity in the right place, 24/7, to support early diagnosis and better clinical access to tests
  • Enhance the sustainability of vulnerable specialities and improve the efficiency of non-urgent acute hospital based treatments - to reduce waiting times for non-urgent treatments which are sometimes dropped down the list to make room for more urgent treatments
Mental health and learning disability
  • Improved services for people with mental health - better access to psychological therapies, wider range of services and support for less complex conditions and stronger community focused support for people with complex needs
  • Improved services for people in crisis - better 24/7 support in the community for people in crisis so they don’t have to go to hospital
  • Make it as easy for people with learning disabilities to access health and care services as it is for everyone else
  • Better services for people with memory loss - achieve earlier diagnosis and design care support to help people stay in their own homes for as long as possible
Children's and Maternity Services
  • a single integrated paediatric workforce - doctors, nurses, other health professionals & support workers - with alliances across all services for children
  • multi-agency teams based in community / locality hubs in local neighbourhoods
  • review support services for emotional and mental health to understand the gap and potential opportunities
  • review transition arrangements for young people from children's to adult services
  • greater access to midwife-led births as standard for most women, and...
  • centralisation of high-risk and complex cases through staff specialisation and locality based expertise


Engagement and consultation on our proposals

We want to work closely with local people including patients on the development of all of these proposals. In some cases we think the proposals may lead to significant changes in how and where services are provided. Before we make any decisions on those things we will carry out a full 3 month public consultation process.  This may include:

  • Changes to the configuration of some acute services where we think this would result in better quality.   This is likely to affects obstetrics, paediatrics and stroke, and may also include other specialities
  • Developing new options for how we use our community hospitals – particularly given that we will be developing community services so that fewer people need to stay in community hospital beds, and that we are looking at how many urgent treatment centres we need
  • The nature and configuration of our mental health inpatient services