David Cameron has announced major concessions to critics of the government’s earlier plans to reform the NHS in a speech in London on 7 June.

Whereas health secretary Andrew Lansley emphasised competition with commissioners having to buy care from any willing provider (BMJ 2010;341:doi:10.1136/bmj.c3843), the revised plans stress integration as the future of the NHS.

Consultants and nurses will be involved in commissioning care alongside GPs, said the prime minister in his speech at a central London hospital. And the NHS regulator Monitor would have a new duty to promote integration of care “whether that’s between primary and secondary care, mental and physical care, or health and social care.” New “clinical senates” are also to be introduced that will oversee …