This is a complex work in progress with different parts of the health and social care system moving at different rates. Shadow arrangements are being put in place in anticipation of Parliamentary approval of the Health and Social Care Bill that will be introduced next session. Pathfinders have been announced, consortia are forming, clustering arrangements are emerging and commissioning support units are being encouraged to set up as social enterprises or as joint ventures with private sector or civil society organisations.
This is perhaps the most significant and complex change agenda the NHS has ever faced, and of course the financial challenge remains, so there is much disquiet in the media, newspapers, clinical and managerial communities. There is also a considerable amount of confusion and maybe even dis-information so Sir David Nicholson’s letter Equity and Excellence: Liberating the NHS – Managing the Transition and the 2012 Operating Framework provides a helpful synopsis of where we are now, where we are going, how we will get there and includes a grounded call to remember that improving the quality of care is the core business of the NHS. You might want to read it alongside Michael Porter's recent New England Journal of Medicine article on What is Value in Healthcare?.
Both are well worth a read.