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Four UK areas have been offered the opportunity to radically overhaul their local health and social care systems as part of an international improvement initiative.

Primary care trusts, NHS trusts, and social services departments in Bradford, north and east Devon, London boroughs of Lambeth and Southwark, and Norfolk and Norwich have been selected by the Department of Health to take part in the Pursuing Perfection project, alongside sites in 13 other countries.

Each of the four British sites will focus on at least two pilot projects to test the feasibility of whole-system change. Likely pilot areas include the systems for the care of patients with chronic diseases, and "flow systems" around tackling delayed discharge and waiting lists.

The four sites will receive £200,000 from government funds, which must be matched locally. They will work over a two-year period to achieve major improvements across health and social care.

Speaking at the launch of the UK sites this week, project director and president of the US Institute for Healthcare Improvement Don Berwick said: "In Britain and the US there's a gap between what the health care system needs to be and what it is. This is a call for change."

Stephen Day, of the Broadland PCT, said the Norfolk and Norwich project would require mobilisation of resources, a change in the way the workforce was built and trained, and a change in the way agencies and professionals worked together.