Integration at place

From ambition to delivery

A practical toolkit to help place-based partnerships make integrated health and care a reality

Executive Summary

Welcome to Integration at place, a practical toolkit developed by NHS Providers and Newton to support leaders and individuals engaged in the design and delivery of integrated care at a local level, particularly those leading at place.

Delivering better care that works seamlessly for patients is a central ambition for national policy makers and local practitioners alike. While key strategic decisions to promote collaboration among health and care organisations will be taken across integrated care systems, and some improvement work will be delivered at scale through provider collaboratives, much of the operational work of making integration happen on the ground will be led and delivered by place-based partnerships.

The challenge for these partnerships is to ensure delivery of better services, better care for people, and measurably improved outcomes. In a complex operating environment, this is a challenging ask. In the context of extreme workforce pressures and recovery from the pandemic, the challenge is even greater.

This toolkit aims to support leaders as they navigate this process. The content and approaches in the toolkit have been developed by drawing on the experiences of NHS Providers, Newton, and the insights of health and care leaders in different parts of England involved in the design and delivery of integrated care at a local level.

There is not a particular model for integration at place; appropriate models will vary based on local needs and contexts. The toolkit sets out an approach to change focused on pursuing measurable improvements in outcomes and shares some examples of integrated approaches which show success or promise.


Start exploring the content:

About this work

Learn more about this work, its context and how it has been developed.

The approach

Read about the approach which underpins the toolkit.


The Toolkit

Section 1
Starting with outcomes

The toolkit explores some key elements that need to be in place and steps required to:

  • start with outcomes
  • maintain clarity on what is to be achieved
  • keep measurable outcomes at the heart of place-based working.
Section 2
Overcoming common barriers to delivery

Systems involved shared some common barriers they encountered delivering improved services, and working across organisational boundaries to make integration a reality.

These include:

workforce pressures

workforce pressures


competing demands and incentives


navigating governance and moving beyond a focus on structures


lack of joined up data and insight at place


historical ways of working and behaviours.

Section 3
Culture and leadership

Leadership skills and associated culture, behaviours, and norms are critical to the success of integration at place. In creating the toolkit, leaders reflected on the value of their shared commitment and ambition in overcoming common barriers. They emphasised that the culture within organisations and on the frontline can make or break joint working and delivery of improved outcomes.


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