The NHS in England is launching the first wave of a series of new "vanguard" projects aimed at driving forward more integration between health and social care.
Proposals put forward by doctors, nurses and other healthcare staff in 29 areas have been selected to go forward backed by a £200 million transformation fund.
The move follows on from the launch last October by NHS England chief executive Simon Stevens of the NHS Five Year Forward View.
From next month, the "vanguards" will begin developing local health and care services, bringing together home care, mental health and community nursing, GP services and hospitals.
Mr Stevens (pictured) said there was widespread support across the NHS for the changes.
"The NHS now has its own long term plan, backed by just about everybody, and today we're firing the starting gun," he said.
"Instead of the usual top-down administrative tinkering, we're backing radical care redesign by frontline nurses, doctors and other staff - in partnership with their patients and local communities."
Speaking on BBC Radio 4's The World at One, he added: "One of the things we are going to see is some big shifts in the way care is provided so, for example, we would hope that on the back of these new care models more dialysis will be done in community hospitals or community settings, more chemotherapy, more outpatients."
Chris Ham of the King's Fund health think tank said that change was "long overdue" but warned that it would impose new strain on the system.
"The challenge is the NHS is under huge operational pressures. Staff are working incredibly hard to deal with the day-to-day and now they are being offered the opportunity of re-inventing the NHS," he told The World At One.
"It's a bit like the airline pilot taking off from Heathrow in the jumbo jet and being expected to land in Bangkok in the Dreamliner. You have got to get the passengers there safely but you've got to re-invent the machine you are travelling in. That's a very big ask of the NHS."
Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: "The Five Year Forward View laid out in the clearest terms the need to meet our country's changing needs and demands, so it is good news that this innovative programme is making steady progress.
"RCN members across the country look forward to seeing more detail about the individual sites, and how they might learn from their progress. The RCN is also keen to develop its role in this project, and to work with nursing leaders to ensure it meets the demands of a changing population, and a changing workforce.
"Frontline staff are often the driving force behind successful innovation and change in the health and social care system, and it is vital that they are involved in the programme as it develops, along with patients and carers.
"We also urge all of the political parties to commit to ensuring that this invaluable work continues in the next Parliament."
Shadow health secretary Andy Burnham said: "We welcome the vision set out by NHS England but it will never be turned into reality if current Government policy remains in place.
"The Tories' extreme plan for £70 billion of spending cuts will put the NHS and social care at risk, severely damaging efforts to integrate services at a local level. In addition, the Government's drive to increase competition in the NHS is leading to greater fragmentation of services and making integration harder to achieve.
"The NHS as we know it can't survive five more years of the Tories. Labour will bring the NHS and social care together in a fully integrated service, increase investment and repeal the rules that require NHS bodies to put services out on to the open market. This is the only way to make integration a reality and, until these changes are made, the Five Year Forward Way will remain an aspiration rather than a reality."
Health Secretary Jeremy Hunt said: "This is a pivotal moment for the NHS and supports the Government's long-term plan to deliver more joined-up, proactive, personalised care for our most vulnerable.
"By integrating services and moving more care closer to people's homes, we can ensure efficient spending and prevent unnecessary trips to hospital for the frail elderly and people with long-term conditions."
This is the list of new "vanguard" projects announced by NHS England:
- Primary and Acute Care Systems (PACs)
- Wirral Health and Social Care Economy
- Northumbria Healthcare NHS Trust
- Salford Royal Foundation Trust (FT)
- Harrogate and Rural District Clinical Commissioning Group
- Multispeciality Community Providers (MCPs)
- Fylde Coast Local Health Economy
- Calderdale Health and Social Care Economy
- West Wakefield and Wellbeing Ltd
- Sunderland CCG and Sunderland City Council
- Stockport Together
- NHS West Cheshire CCG/Primary Care Cheshire
- Care Homes
- Airedale NHS FT
- NHS Wakefield CCG
- NHS Gateshead CCG
Midlands and East
- Mid Nottinghamshire CCGs (Mansfield and Ashfield and Newark and Sherwood CCGs)
- Erewash clinical commissioning group and primary and community care providers
- Vitality (Birmingham)
- Dudley CCG
- Lakeside Healthcare (Northamptonshire)
- Principia (Rushcliffe)
- Care Homes
- Nottingham City CCG
- Tower Hamlets Integrated Provider Partnership
- Care Homes
- Sutton CCG
- Yeovil District Hospital NHS FT
- North East Hampshire and Farnham CCG
- Isle of Wight
- Whitstable Medical Practice, Northgate Medical Practice & Saddleton Road & Seasalter
- Southern Health NHS Foundation Trust
- Care Homes
- East and North Hertfordshire Clinical Commissioning Group
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