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A selection of images of Langdon Down museum. Once a progressive hospital, it's the first museum to people with learning disabilities

NHS Gloucestershire's plan to move many of its responsibilities and duties to a social enterprise come to a head next month The sign fixed to the ugly concrete exterior of Stroud general hospital is quite clear. "Gloucestershire NHS," it reads. "PCT." Inside, amid the waiting area's rows of blue chairs and the calming pale blue walls, nurses stride about with measured efficiency. On a quiet weekday afternoon in late January, all is as it should be at this community hospital. But this is not how it was supposed to be. If the heads of NHS Gloucestershire and their overlords...

Doctors are to lead CCGs under current health reforms but the historic divide between medics and management has yet to heal. Richard Vize explores how the cracks appeared The need for doctors to be working in concert with managers has never been greater, as the NHS tries to secure productivity gains which no healthcare system in the world has achieved. But why are medics so distant from managers, and are attitudes changing? The so-called Nicholson challenge to find £20bn of extra productivity by 2014-15 – equivalent to about 4% a year – is impossible without the commitment and expertise of doctors...

Managing services under the same roof may not be new but budget cuts and an ageing population could mean its time has come Barrhead's Health and Care centre is relatively unusual. It is one of only a few partnerships in Scotland that manages local NHS and local authority social care services under a single structure and – in this case – the same roof. Jointly owned by NHS Greater Glasgow & Clyde and East Renfrewshire council, proposals recently announced by the Scottish government mean Barrhead could soon become the norm. Integrating adult health and social care in Scotland is not a new...

Dr Pritti Mehta explains how patients with hearing difficulties could benefit from better choice at their disposal Local decision makers throughout England have voted for hearing services to lead the implementation of 'any qualified provider' (AQP) policy in the health service, with more than half of primary care trust clusters selecting adult hearing services. Under the policy, people will be able to chose a health care service provider in the area. Many PCT clusters have recognised that hearing loss is a major public health issue which should be given a greater profile in their communities...

As the numbers of older people and those with chronic illnesses increase, Denis Campbell reports on a seminar which discussed the benefits of joined-up care While the task of integrating health and social care has never been more pressing, it has also never enjoyed such strong support. The government has made integration one of the key aims of its radical restructuring of the NHS in England. David Cameron has lamented and pledged to end the "deep divide between health and social care that is causing serious problems for vulnerable, often elderly, people and their families". The Department...

Prevention and early intervention in mental health is a priority say healthcare professionals at a London assembly meeting and must include better co-operation At any one time in London, one in six adults suffers mental health symptoms and suicide is the biggest killer of young men in the capital. The issue was raised at a recent London assembly health and public services committee meeting. The statistics are worrying and, along with the growing financial pressures on the health service, those delivering mental health services are looking at the opportunities in preventative care and early intervention...