Commissioners hold the key to unlocking more integrated models of care, the chair of the Health Select Committee said yesterday (10 November 2011).

Speaking to health professionals in London, former health secretary Stephen Dorrell MP (pictured) said integration was a significant part of solving the "genuinely unprecedented challenge" of making 4% efficiency savings by 2015 – the QIPP (Quality, Innovation, Productivity and Prevention) programme.

He said: "Trying to find your way through the system with an elderly relative who needs something called either healthcare, social care, primary care… we have a series of silos that don't talk to each other, don't have IT systems that talk to each other… it's not surprising that turns into expensive, disjointed, poor-quality care."

Dorrell asked: "Who owns the process of achieving this process of change? The very clear answer, in my mind, is that is what commissioning is there for – driving change into the system to deliver that different model that we can quite often imagine but too seldom experience in reality."

Dorrell was speaking at the NHS Reform conference at London's Barbican Centre. He said: "Strengthened, empowered, clinically engaged commissioning holds the monkey of delivering that process of change in order to deliver these objectives.

"If you want integrated services, please explain to me how you deliver [these] if you continue with disinterested, silo-based commissioning."

He told delegates that "intelligent commissioning" can make "intelligent use of resources" to deliver more effective and more integrated services.

Dorrell also said that while the debates for and against the Health and Social Care Bill were nothing new – arguing that the arguments had arisen in different forms over the last 20 years when reforms had been introduced – it is the "compelling challenge" of delivering the "Nicholson challenge" of £20bn savings that is the real and unprecedented issue for the health service.