In March 2015, the King’s Fund published a report regarding the progress made by five acute hospital providers in England towards developing more integrated models of care. According to the report, becoming more closely integrated with primary care has proved a considerable challenge for these hospitals. This is partly due to the lack of alternatives to building relationships on a practice-by-practice basis. As the report explains, GP provider groups or federations “are still at an early stage of development in many areas of the country, and where they do exist it is not always clear that they are sufficiently cohesive to represent local practices and have leverage over them”. 

However, the report identifies a number of factors which facilitate the coordination between hospitals and primary care. These include strong clinical leadership in general practice; employing people with a primary care background at a senior level within the acute provider; joint educational sessions for GPs and hospital-based consultants; piloting new care models with one or two supportive practices before extending the offer to others.

Furthermore, the report states: “Care should be taken to resist oversimplifying discussions [regarding new models of integrated care] as being a binary choice between ‘primary care-led’ and ‘hospital-led’ integration – this is unlikely to foster the collective forms of system leadership that are needed”.