There are various forms of commissioner integration. The most common arrangements in the NHS are joint commissioning arrangements between local authorities and NHS commissioners under 'section 75' agreements. This allows commissioners to delegate the exercise of certain commissioning functions to each other and pool funds, so that, for example, social care services can be commissioned in an integrated way, alongside community services or mental health services.
With local authorities now key players in health service commissioning, given their role in commissioning public health services, there is widespread recognition of the need to bring together health and social care provision. Integrated commissioning arrangements are likely to increase significantly over the next five years, and there has recently been a national initiative to drive forward integrated commissioning as part of the Better Care Fund.
NHS England and CCGs have broad powers to delegate the exercise of commissioning functions to each other, as illustrated by the delegation by NHS England of primary medical commissioning functions to some CCGs from April 2015, enabling CCGs to bring together commissioning objectives for primary, community and acute services.