This autumn, every health and care system in England will start to implement Sustainability and Transformation Plans (STPs). Key areas of focus will be on reducing inappropriate acute admissions and delayed transfers of care, which recent NHS figures show are rising. The demand created by older people with complex needs accounts for much of this increase, and better integration of care and providing alternative settings to lengthy hospital stays are widely considered to offer the best opportunities for tackling the problem.

Words like ‘integration’ and ‘transformation’ with their connotations of full system change galvanized by an elusive silver bullet can seem daunting for organisations already feeling stretched to maximum capacity. Yet they don’t need to be.

Yes, integration has value, but many of the opportunities that can effect dramatic change – improving patient outcomes and optimising current resources – don't need to rely on or wait for an official system overhaul. Often people look for new, exciting, innovative solutions, when actually the biggest impact can be felt by making what's there work more effectively.