Clinically integrated systems: The next step in English health reform?

The programme for NHS reform focuses on competition between providers as a driver for improvement. It also requires hospitals to collaborate with each other and with local GPs and PCTs. Can collaboration and competition develop together in the NHS?

To explore the issues involved in the health reform programme in England, the Nuffield Trust held a series of seminars led by experts in this field between June and September 2007.

The lead speakers were:

• Carol Black, Chair of the Nuffield Trust
• Julian Le Grand, Richard Titmuss Professor of Social Policy at the London School of Economics
• Carolyn Tuohy, University of Toronto
• Adair Turner, author of the Health Strategy Review commissioned by the Prime Minister in 2001

The seminars focused particularly on the use of competition and collaboration to bring about service improvements. This report is a synthesis of the seminars prepared by Professor Chris Ham, chair of the series and adviser to the Nuffield Trust.