People in some parts of England could be offered blood pressure checks in betting shops under the biggest shake-up of the NHS for a decade.

Some 42 integrated care systems (ICSs) come into force today, bringing together GPs, hospitals, care services, and other local groups.

Clinical commissioning groups, which previously controlled local health budgets, will no longer exist as part of the changes.

Under the plan, a GP practice in Stockport is offering blood pressure checks in betting shops, while a sports club in Coventry and North Warwickshire is offering diabetes and obesity support through GP referrals and gym access.

Some GP practices have brought in mental health staff to help young people.

NHS England said the reforms will also save around £14m a year through reducing the number of NHS chief executives by almost 170.

Amanda Pritchard, NHS chief executive, said integrated care systems “have the power to truly transform the way that we care for people up and down the country”.

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“Through these schemes, we are already making a massive difference to people’s lives.

“The NHS will now build on this success and innovation and deliver care for patients that is fit for the future as well as saving taxpayers millions of pounds each year.”

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Some critics have raised concerns that the integrated care systems, which divide the country into geographical areas of roughly similar-sized populations, are not equal in terms of need and resources.

The Health Foundation, an independent charity, said in June: “The task facing ICSs is not equal.

“Pressures on services and the health of the population vary widely between ICSs – as do the resources available to address them.

“ICSs also look very different in their size, complexity, and other characteristics.

“Variations within the NHS are nothing new, but these differences will shape how ICSs function and their ability to collaborate to improve services.”

The British Medical Association said on its website: “The BMA is supportive of efforts to improve collaboration both within the NHS and across the health and care sector, likewise, we recognise the potential value of greater integration.

“However, we do not support a single model of integration and have been highly critical of the approach national bodies have taken to the development of ICSs and their predecessors, STPs (sustainability and transformation plan).

“The BMA also actively opposed the Health and Care Act during its passage through parliament and campaigned vociferously for it to be heavily amended.

“More specifically, we believe that it is essential for ICSs to embed a strong clinical voice throughout their structures, maintain local decision making, be free from competition and private sector involvement, and be led by the NHS and public accountable bodies.”