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‘It’s the economy, stupid’ was coined by Bill Clinton’s election strategist, James Carville, in 1992 to emphasise the single most important issue to voters. The mantra became established thinking; the economy was thought to trump all other areas of policy. The NHS Long Term Plan shouts out ‘it’s integration, stupid’’ throughout its 133 pages. The, not so new, theory of integration has been posited as the way to develop a ‘future fit’ NHS with the next decade acting as the springboard.
Integration, a more joined up and coordinated NHS at both the service delivery and planning level, will be the panacea for a whole host of issues currently faced. Money will be fed into developing primary medical and community health services, and into a host of clinical priorities (especially mental health). The ultimate aim is increased capacity, more responsive care, reduced upstream pressures (especially on overstretched acute hospitals) and so a rebalanced NHS morphing gradually from cure to prevention.