NHS England has announced £101 million of new funding to support and spread the work of the new care model vanguards. The vanguards are partnerships of NHS, local government, voluntary, community and other organisations that are implementing plans to improve the healthcare people receive, prevent ill health and save funds. Considerable progress has been made since the vanguards were launched in 2015 and there is emerging evidence that they are making significant improvements at a local level. This includes reducing pressure on busy GP and A&E services. In addition to the funding, the vanguards will continue to receive support from NHS England and other national bodies to implement their plans, including how they harness new technology including apps and shared computer systems. They are also receiving help to develop their workforce so that it is organised around patients and their local populations.
Examples of how each of the different care model vanguards are making a difference and how the latest round of funding will be used include:
- Fylde Coast Local Health Economy vanguard (multispecialty community provider) which has created a new ‘extensive care service’ which brings together under one roof different health professionals who offer dedicated, targeted support for older patients with multiple conditions. National vanguard funding means the care model is being rolled across the entire Fylde Coast with every GP practice able to refer eligible patients. Early indications from their figures show a 13% reduction in A&E attendances, 25% reduction in non-elective admissions and 18% reduction in outpatient appointments. Most notably, there has been the 37% fall in planned visits to hospital among patients receiving support.
- In Mid Nottinghamshire Better Together vanguard (integrated primary and acute care system) eight joined-up community teams are working with patients, their families and carers to provide physical, mental and social care support to ensure people are cared for at home wherever possible. The vanguard has reported acute bed days being reduced and reductions in long term admissions to care homes. They have also reported a 5.4 % reduction in avoidable patient attendances for 18-79 year olds and 20.5% for patients aged 80 years and above (compared to 2015/16).
- East and North Hertfordshire Clinical Commissioning Group vanguard (enhanced health in care home) has employed pharmacists to work with GPs, care home staff and other healthcare professionals to provide in depth medicine reviews for residents. Improved IT also means they can now access patients’ records using laptops in the care home, allowing a more thorough review alongside each resident’s care plan and medicines record. Working with 25 care homes, the vanguard has already reviewed over 901 patients and reviewed the use of 8,183 medicines. 1,015 medicines have been stopped, including 198 which could have increased the risk of falls. The direct cost savings are estimated to be about £161,987 or £181 per patient.
- EMRAD (East Midlands Radiology Consortium) vanguard (acute care collaboration) is a partnership of seven local hospitals. A joint procurement of a new shared radiology record has saved £3m each year and is expected to save £30m over the lifetime of the contract.
Samantha Jones, Director of the New Care Models Programme said: “The vanguards are making great progress and have already made a tangible impact on the lives of patients and the working lives of staff. 2017/18 is a crucial year for the vanguards, in particular how we further spread their work across the wider NHS and care services. This funding, as well as the support we offer to them, will help them to continue to move at pace.”
Dr Amanda Doyle GP, Fylde Coast Local Health Economy vanguard said: “We are very pleased with the changes we have made to the care provided to people living on the Fylde Coast. As well as involving patients and local people more in the way services are provided, we’ve cut the number needing to use local A&E services or be admitted to hospital. We’ve also taken pressure off our GP services.”
The total funding allocated matches that of 2016/17 and will be matched by funds and resources from the vanguards themselves. New models of care, including the work of the vanguards, are key to the delivery of sustainability and transformation plans (STPs) which are being developed across the country. In order to secure their allocated funds, vanguards will need to meet a number of conditions including:
- Spread of their new care models within and across STPs, including production of guidance and materials for others to use;
- Full implementation of the published care model frameworks – what good looks like within their vanguard type;
- Clear quality improvements and costs/savings.
As with 2016-17, local evaluation remains a critical part of the programme and will be funded separately, with details set out at a later date.