Five million patients to benefit from new era of patient care

The NHS has today (Tuesday 10 March) chosen the first 29 ‘vanguard’ geographies that will take the national lead on transforming care for patients in towns, cities and counties across England.

269 groups of nurses, doctors and other health and social care staff from across the country put forward their ideas for how they want to redesign care in their areas, and then helped choose the first 29 of the most innovative plans.

Drawing on a new £200 million transformation fund and tailored national support, from April the vanguards will develop local health and care services to keep people well, and bring home care, mental health and community nursing, GP services and hospitals together for the first time since 1948.

For patients, this will lead to a significant improvement in their experience of health services. It is estimated more than five million patients will benefit, just from this first wave. For example, this could mean: fewer trips to hospitals as cancer and dementia specialists and GPs work in new teams; a single point of access for family doctors, community nurses, social and mental health services; and access to tests, dialysis or chemotherapy much closer to home.

Speaking ahead of NHS Change Day (Wednesday 11 March), Simon Stevens, the Chief Executive of NHS England, said: “The NHS now has its own long term plan, backed by just about everybody, and today we’re firing the starting gun. Instead of the usual top-down administrative tinkering, we’re backing radical care redesign by frontline nurses, doctors and other staff – in partnership with their patients and local communities. From Wakefield to Whitstable, and Yeovil to Harrogate, we’re going to see distinctive solutions to shared challenges, which the whole of the NHS will be able to learn from. ”

David Bennett, Chief Executive of Monitor, said: “The first wave of vanguard sites represents a practical start to transforming the NHS. We will use our expertise in areas such as pricing and system economics, alongside our oversight of foundation trusts, to help local areas develop the new models of care that are essential for the NHS and the people who use it.”

David Flory, Chief Executive of the NHS Trust Development Authority, said: “This is positive news for patients. The Five Year Forward View recognised the challenges that lie ahead for the NHS. There are some genuinely innovative plans to help us meet those challenges and with the support announced today there is an opportunity to develop better health and care services that will be built to thrive long into the future.”

Samantha Jones, Director of the New Care Models Programme at NHS England, said: “This is one of the most exciting opportunities to support change to how health and care services are delivered for patients for a long time. The health and social care systems that have been chosen to be vanguards in this cohort embody the forward-thinking and collaborative approach to improving patient care that the NHS Five Year Forward View called for last year. NHS England and partner national and local bodies will now work with those sites to accelerate the improvements that they are making and ensure this is replicated nationally.”

Sir Sam Everington, National GP Advisor, said: “The New Care Models programme is already highlighting just how much innovative and important work is going on in dozens of local areas already. I am confident that the 29 exceptional systems which have been chosen to be vanguards in this cohort will help revolutionise both the quality of care, and patients’ experience of it, over the coming years – not just for the patients in those areas, but for every patient in England.”

The vanguards will take the national lead on the development of game-changing care models:

  • multispecialty community providers (MCPs) – moving specialist care out of hospitals into the community;
  • integrated primary and acute care systems (PACS) – joining up GP, hospital, community and mental health services, and;
  • models of enhanced health in care homes – offering older people better, joined up health, care and rehabilitation services.

From April 2015, the national NHS will work with local vanguard sites to develop dedicated support packages to enable and accelerate change, and an intensive evaluation programme will seek evidence on what works so that this can be spread to other parts of the country.

Support will be tailored to the needs of each area, but could be a combination of peer learning and expertise in areas such as patient empowerment and community engagement, leadership, clinical workforce redesign, using digital technology to redesign care, devising new legal forms and new contractual models; and joined up procurement.

All areas will benefit from a wider support and learning package which will be rolled out later this year, based on the learning from the vanguard sites. Additionally, as a result of the many examples of excellent models up and down the country, a wider programme of support is being put in place for some of the health and social care systems that applied to be part of the programme. This is being supported by the Kings Fund.

The NHS Five Year Forward View, published in October 2014 by NHS England, Monitor, the NHS Trust Development Authority, the Care Quality Commission, Public Health England and Health Education England, set out the health, quality of care, and funding gaps that will open up if the NHS does not change.


  1. J Rhodes says:

    I wish to add that the NHS should address patient’s root cause of their problems, & once these being sorted/addressed, some of their health/problems would improve. Secondly, care in one’s own homes should be encouraged a lot more than in residential care, & costs less.

    Animal healing therapies/encouraging/supporting people’s hobbies should be encouraged a lot more to stimulate people like me who suffer from dimentia, & this needs to be done under one to one assessements, plus acknowledging that everyone is different having different individual needs & intterests, Currently this is lacking especially in W’ton & the black country, Environment/decent visual amenities needs improving urgently for mental health well being, as this is very much lacking. We need to be a lot closer to nature/wildlife nurturing. We need too a much cleaner environment. Please reply. Janet

    • Anonymous says:

      home is another care setting on a unique patient pathway, albeit the most important part of their journey (it will probably be a care setting represented on all a patient’s care models)

  2. Mrs. Janet Davies says:

    I ,for one , would welcome this new approach to patient care . I am a retired state enrolled nurse , having trained in the 1970’s . I live in Chalfont St. Peter . bucks and worked for eight very happy years in the local Chalfonts and Gerrards Cross Community Hospital ,until the wards were closed due to health and safety issues . Although there is an excellent OPD ,x-ray and physio dept . there , this area is sadly lacking in local inpatient care ,especially for the elderly . When I worked at the hospital which had 29 beds , we prided ourselves on the high standard of care we gave and worked closely with the OTS and social workers plus family members so that when patients were discharged they had the correct care package . We also provided a valuable rehabilitation service for the elderly who were ready to leave the acute hospital wards but not ready to go home or were being assessed for care/nursing home placement . Our nearest hospital is at least 5 miles away and public transport is abysmal , especially in the evenings and at the weekends – no bus service at all on a Sunday . Neither my husband and I , and many other people do not drive .
    We will be very interested to see how your proposed scheme will work and hope it will eventually be rolled out nation wide .
    Yours sincerely
    Mrs. Janet Davies

    • Anonymous says:

      a care homes and nursing homes are care setting, they may be the patients home for the rest of their life and will probably be represented on all care models

  3. John Kelly says:

    This initiative seems to represent a welcome significant further step toward a more truly person centred model of healthcare and hopefully a concomitent further step away from overly standardized factory models of care.

    • Anonymous says:

      Unique care models (based on care model types/templates) and Unique patient pathways (based on pathway types), patient centric modellig

  4. Michael Taylor says:

    It sounds all very positive and hope when rolled out it will be of much benefit to patients

  5. Alan Conochie says:

    An excellent initiative. I wish you all every success.

    Best regards
    Alan Conochie
    Cornard Healthcare Limited – CHL

    • Anonymous says:

      all types of health care providers and suppliers of health care IT need 2 engage

    • Anonymous says:

      all types of health care providers and suppliers of health care IT need 2 engage and there is lots of work to “do”