Abstract
A Health and Social Care Alliance established in 2012 and selected as a national 'Integration Pioneer' site is exploring how integration can address local system challenges faced in many health economies across the UK. The original programme focused on data gathered from the evaluation of the national Integration Care Organisation pilots - there were three in West Norfolk - about patient experience, aiming to develop stronger early community interventions in a more coordinated way to keep people independent longer. The early programme initiatives have created a firm partnership, innovative services and a good foundation on which to build, which has been a strength as the local health economy now faces a huge financial and clinical sustainability challenge in its current configuration. A transformation programme is therefore being developed to address the challenges and identify solutions through integration and innovation for the sustainability of a small rural locality.