The report concludes that structural integration of health and social care will not bring benefits in itself but must be accompanied by other changes.

Key findings
Northern Ireland has had integrated health and social care since 1973 but there has always been a commissioner–provider separation throughout this period.
Scotland has had an integrated NHS structure since 2004 when the commissioner–provider separation was ended and unified health boards created but local authorities continue to have responsibility for social care.
Wales has followed the example of Scotland since 2009 with the creation of unified local health boards and again local authorities continue to have responsibility for social care.

The structural integration of the health and social care system in England will bring few benefits unless it is accompanied by other changes, including:
a willingness to challenge and overcome professional, cultural and behavioural barriers
action to share information both within the NHS and between health and social care
organisational stability to avoid the distractions and delays that occur when structures are altered frequently
a willingness to provide financial support and flexibilities to enable the introduction of new models of care.
Organisational stability and leadership continuity are important facilitators of integrated care.

Policy implications
Coherent policies should be developed to promote and support integrated care – including a national performance framework and a single outcomes framework.
Governance arrangements should be established to enable different organisations (especially local authorities and NHS bodies) to work together to develop joint strategies.

I suppose the only other way to look at this is that there is enormous waste in the NHS. Maybe a local authority can more closely scrutinise local spending including the ridiculous agency staff cost.

In the main though I'm wary of the longer term plans. Break it up then push it out to private enterprise.

The current NHS funding/operating model is unsustainable so change must come in whatever shape it takes.

NHS Institute for Innovation and Improvement and its influence

Helen Bevan is Chief of Service Transformation at the NHS Institute for Innovation and Improvement. She co-authored a research document entitled Towards a million change agents, a review of the social movements literature: implications for large scale change in the NHS. Within this document comparisons were made between a project management approach to change and a social movements approach where “people change themselves and each other – peer to peer”.
Bevan refers to the following definitions of a social movement:
 “A group of people who consciously attempt to build a radically new social order; involves people of a broad range of social backgrounds; and deploys politically confrontational and socially disruptive tactics.” Zirakzadeh 1997
“Collective challenges, based on common purposes and social solidarities, in sustained interaction with elites, opponents, and authorities” Tarrow 1994
Isn’t this precisely what we are witnessing in relation to the major transformation now taking place within the NHS?
Other documents attributed to Bevan include the 46 page How to build unstoppable change and The power of one, the power of many-bringing social movement thinking to healthcare improvement.
The Health & Social Care Act 2013, The NHS Leadership Academy, Clinical Commissioning Groups, and the Leadership Development Support Framework

Since the Francis report the Government has published new regulations under Section 75 of the Health & Social Care Act 2013 (SI 257 - The National Health Service (Procurement, Patient Choice and Competition) Regulations 2013). These regulations create requirements for virtually all commissioning done by the National Commissioning Board and Clinical Commissioning Groups to be carried out through competitive markets, forcing through privatisation. They contain legal powers for the new NHS regulator, Monitor, to enforce the privatisationspontaneously or at the request of private companies which lost bids. According to the Royal College of Physicians “these regulations go much further towards privatising the NHS than ministers implied when the legislation was going through Parliament.”