Speaking at a BMJ lecture in London tonight Professor Chris Ham, a former DoH advisor, said: 'Many people recognise the value of clear integration of care. But I don't think anyone knows a way of achieving it.
'I hope pilots will be given a waiver and allowed exemption from Payment By Results as one example and be given special freedom. I hope the strategy will be primary care-led.
'You can use that approach to deliver more services out of hospitals and closer to home if you integrate. A hospital would be a more difficult place to start than through a primary care base. It needs to be done through a small network of practices working together in primary care controlling commissioning and provision under these waivers to explore the edges of the envelope.'
Earlier during his talk, Professor Ham said: 'There has to be a revitalisation of practice-based commissioning if it helps us more in the direction of integrated care and commissioning using real budgets and a real incentive to be more entrepreneurial with GPs taking up the challenge.'
Health minister Lord Ara Darzi's review is due to be published in the week beginning 30 June.
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