NHS Confederation deputy policy director Jo Webber said:

"The key to integrating services is to make sure everyone is working towards the same goal which is improved outcomes for patients.  Integrating care will improve services, particularly for people who are frail and those with long term conditions. But it will also involve making some really difficult decisions as hospital activity is reduced and moved into the community.

"While we agree with many of the report’s findings, its recommendations will only work if they are accompanied by fundamental reform of social care so it is put on a sustainable footing.  Coupled with this, the way health services for people with complex health needs are currently paid for will need to be fundamentally altered. These are big changes that will require significant political courage and leadership.

"Integration will take a long time to bed down and start improving the quality of care patients receive. Constantly tinkering with implementation must be avoided if at all possible. Integration will produce more sustainable models of care in the long term but many local initiatives could mean new services being run in tandem while old ones are shut which could be more expensive in the short term."