England Scotland Wales

Last updated:

What are reconfiguration and integration?

The NHS is under constant pressure to change as it responds to advances in medical technology, an ageing population and the burden of disease. Inevitably this involves reconfiguring the way in which NHS services are structured and delivered.

At the same time, patients may not always get the best possible care because of bureaucratic barriers that exist between primary care, hospitals and providers of social care. The integration of healthcare and social care services aims to break down these barriers to ensure that patients are seen by the most appropriate professional at the best time in the best place.

Why is it important to know about reconfiguration and integration?


What do they mean for you?

Examples of reconfiguration and integration are happening all over the UK in many different ways. These include:

The five year forward view
One of the biggest initiatives to change the way services are delivered is the NHS vision, ‘the five year forward view’, which describes a number of new care models for service provision in England. These models aim to break down the traditional divides between primary, secondary and community care, mental health and possibly social care.

Find out more about the five year forward view and the new care models
Read our briefings on the new care models


Devolution in England
Another big change taking place right now is that, as part of the UK government’s agenda, English regions are being given the opportunity to bid for full control of their health and social care budgets. This has gone furthest in Greater Manchester so far, where local authorities and health providers are working to create an integrated health and social care system for the region from April 2016.

Find out more about health and social care devolution


Integration authorities in Scotland

A big change in Scotland for health and social care integration was the legislation introduced in 2014. The legislation required NHS boards and local authorities to integrate health and social care functions. They are required to integrate the governance, planning and resourcing of adult social care services, adult primary care and community health services and some hospital services. Integrated authorities are required to be operational by April 2016.

Find out what reconfiguration and integration initiatives are happening in your area


Principles of reconfiguration

BMA policy on redesign states that it must:

  • First have a thorough impact assessment, including an examination of safety issues
  • Include all sectors and patient groups
  • Be led by clinicians
  • Be based on good clinical evidence that care will be improved or at least not compromised
  • Be monitored post-implementation

BMA policy on redesign also states that it must not:

  • Be driven only by financial pressures
  • Be imposed without prior consultation with staff and patients
  • Be a duplication of existing services

Read the five ways that the five year forward view in England must meet doctors' concerns


Integration across the UK

Although not new, the pursuit of greater integration between health and social care, and different parts of the health service, continues to gain prominence in Government health policy across the UK.

Read more about types of integration across the UK


Models for preventing and addressing failure

Sometimes service change is triggered by efforts to prevent and/or address failure. This series of briefings has been designed to help members understand the changes that can occur from different models used by NHS England and national health regulators to prevent and/or address failure.

Find out more about models for preventing and addressing failure


Related news and discussion

Catch up on the latest developments from around the country