This is the report of a discussion on the implications of integrated care developments for NHS policy as implemented in Torbay, Devon. It is one of a series of five events, organised by the Nuffield Trust, which aim to draw on experience in areas where integrated models of care are being developed in order to facilitate closer working between primary and secondary care, and health and social care. Questions to be addressed include: can integrated care be developed while also enabling patients to exercise choice?; do current incentives such as payment by results and practice based commissioning support closer integration of care?; does the current NHS operating framework and performance management regime facilitate or inhibit integration?