Southcentral Foundation in Alaska is widely regarded as one of the best examples of health system redesign in the United States and internationally. It delivers state-funded health care to a minority population with high levels of need, with funding and responsibility for services resting with local people. Southcentral is a working example of a ‘multispecialty community provider’ offering expanded and integrated primary and community services. The case study, with a foreword by Don Berwick, aims to inspire commissioners and providers in the English NHS embarking on whole-system redesign. It analyses the factors behind Southcentral’s achievements and draws lessons for the NHS, focusing on issues with relevance to our system.