Intended for healthcare professionals

Feature Briefing

Moving to accountable care in the NHS

BMJ 2018; 360 doi: (Published 31 January 2018) Cite this as: BMJ 2018;360:k442
  1. Tom Moberly, UK editor
  1. The BMJ
  1. tmoberly{at}

What do we know about efforts to integrate health and social care in England, asks Tom Moberly

How will UK accountable care organisations differ from those in the US?

In the US, accountable care organisations (ACOs) were formed under Barack Obama’s health reforms by groups of healthcare providers coming together to serve a given population. These organisations are accountable, to patients and funders, for arranging care that meets set quality standards within a fixed budget. In the English NHS, the plan is that ACOs will evolve from sustainability and transformation partnerships (STPs).1 They will integrate funding for, and be responsible for delivery of, all health and social care within a defined area. The health think tank the King’s Fund points out that it is “the idea of holding providers to account for improving [the totality of] health and outcomes for defined populations” that is the aspect of accountable care being adopted from the US to the UK. “Elements such as who pays for the care or who delivers it are not being adopted,” it points out. …

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