The effective working of primary care, secondary care and social care has always been at the heart of good geriatric practice. The need for integrated care pathways is increasingly accepted by clinicians and has been championed by influential think tanks such as The King’s Fund, and the first Future Forum report produced earlier this summer. These argue that integration of care produces better outcomes and therefore more cost effective outcomes. There are, of course, a number of well recognised exemplars of good practice such as Torbay.