Vanguard support package launched

The NHS Five Year Forward View partners have today (31 July 2015) published an initial support package for the new models of care vanguards which were launched in March 2015.

The 29 vanguards, local NHS and care consortiums which are leading on developing new and better ways of providing care to act as blueprints for the NHS in England, were selected following a rigorous process involving patients, clinicians and peer review, and will initially improve the care provided to more than five million people.

Following extensive engagement with the vanguard leaders, including two-day visits to all 29 sites in April and May and follow-up discussions and seminars, a support package has now been developed to enable them to make the changes they want to make effectively and at pace.

Building on the best practice already being displayed, the support package is designed to be led by vanguard leaders alongside national experts, and aims to help the vanguards be as successful as possible in making the changes they are planning.

It is also intended to maximise sharing of learning and practice across the 29 vanguards and, importantly, with the wider NHS and care system – a key element of the vanguards’ work.

The support package, which covers 2015/16, focuses on eight areas:

  • Designing new care models – working with the vanguards to develop their local model of care, maximising the greatest impact and value for patients;
  • Evaluation and metrics – supporting the vanguards to understand – on an ongoing basis – the impact their changes are having on patients, staff and the wider population;
  • Integrated commissioning and provision – assisting the vanguards to break down the barriers which prevent their local health system from developing integrated  commissioning;
  • Empowering patients and communities – working with the vanguards to enhance the way in which they work with patients, local people and communities to develop services;
  • Harnessing technology – supporting the vanguards to rethink how care is delivered, given the potential of digital technology to deliver care in radically different ways.  It will also help organisations to more easily share patient information;
  • Workforce redesign – supporting the vanguards to develop a modern, flexible workforce which is organised around patients and their local populations;
  • Local leadership and delivery – working with the vanguards to develop leadership capability and learn from international experts, and;
  • Communications and engagement – supporting the vanguards to demonstrate best practice in the way they engage with staff, patients and local people.

A number of dedicated workstreams – which will be led by a vanguard leader and national subject matter expert – will work with the vanguards to refine what is being offered so that it is fully tailored to their needs.

In addition to the practical support outlined in the new document, vanguards also have access to the £200m Transformation Fund.  Over the last two weeks, the following funding has been earmarked for 2015/16 for three of the first 29 vanguards:

  • Better Health and Care for Sunderland – £6.5 million;
  • Northumberland Accountable Care Organisation – £8.3 million;
  • South Somerset Symphony Programme – £4.9 million.

A further £41m has been approved in principle for the following vanguards: Better Care Together (Morecambe); Better Local Care (Southern Hampshire); My Life a Full Life (Isle of Wight); Salford Together; and, Wirral Partners.  This will be finalised in August.

Funding for other vanguards will be approved over the coming months.

NHS England Chief Executive, Simon Stevens, said: “Led by doctors, nurses and other staff, as well as patients and community groups, the vanguards are being asked to radically redesign the way they provide care.  The support package has been designed with and for the vanguards.  It provides them with additional tools to move at pace and, importantly, to remove barriers that stop them from delivering the best possible care to patients.”

Samantha Jones, New Care Models Programme Director, said: “A key focus of the support package is how we spread good practice between the vanguards, as well as across the wider NHS and social care community.  In addition, it reverses the ‘top-down’ approach by empowering the vanguards to commission the national NHS bodies to support them.”

Jim Mackey is Chief Executive of Northumbria Healthcare NHS Foundation Trust, a partner in the Northumberland Accountable Care Organisation vanguard. He said: “We have been heavily involved in helping to design the initial support package and look forward to shaping it further as we move forward.  We have a very strong track record of working together in Northumberland and welcome this opportunity to think innovatively about how we can further integrate health and social care to create services which are fit for the changing needs of our aging population and the challenges facing the NHS.”

Dr Nick Harding OBE, GP and partner at Handsworth Wood Medical Centre and part of the Vitality vanguard, said: “We welcome the publication of the support package.  It will help us to transfer more power to patients, to redesign our workforce, and to rethink how care is delivered by harnessing the benefits of digital and other technology.”

Support for more-recently announced vanguards – acute care collaboration (ACC) vanguards and urgent and emergency care (UEC) vanguards – will be published in November 2015.


  1. Tim Oakley says:

    The new models of care are multi-speciality but seem to focus almost exclusively on patients with primary physical health problems: mental health problems seem under-represented, other than where they form a significant co-morbidity in this population. Despite talk of “parity of esteem”, mental health seems again to have been somewhat overlooked. Are there plans to develop new models of care that explicitly address the needs of patients with long term mental health conditions? Are these models being developed, described and piloted or will mental health remain an afterthought?

    • NHS England says:

      Dear Tim,
      Providing improved care for people with long term mental health conditions is a key priority for the new care models programme. This is not something we are addressing separately but across all of our existing and planned new care models. The vanguards will be integral to the new mental health Five Year Forward View for the NHS due to be published later this year. As part of their task to deliver blueprints for the future NHS and social care, they will be designing new care models focussing on both improving the quality of mental health services and considering ways to tackle the prevention of mental health problems.
      Kind regards,
      NHS England

  2. Pearl Baker says:

    The first priority is for ALL GP practices to be ‘singing from the same hymn sheet’ unless their is a mechanism in place for this to occur it will not be successful. It is important to put in place a monitoring system and regular audits, including the participation of the General Public as to what they should expect from the system, and a ‘feedback’ mechanism in place to a central department.

    I refer to LA Care Quality Framework Inspections of Supported unregulated accommodation, this is far from perfect where evidence confirms the LA Contracted Private Management Company complete the CQF report! I am informed that they use the CQC Essential Standards for this purpose, another issue that need addressing, by the CQC.

    The LA are ultimately responsible for the Private Contracted Provider and their clients. It is very clear that you cannot put all the patients in the same ‘pot’ they have different needs, which their ‘Care Plan’ identifies, their level of care and support would vary accordingly, however this is not occurring, hence why we have poor care and support in unregulated accommodation, and why there continues to be an abuse of the system, that in fact is not a ‘system’ of anything.

    The LAs are responsible for contracting to a Private Management Company, failure by this Company to deliver is down to the LA, and it is them alone, that should be Prosecuted, in their failure to follow ‘Safeguarding’ procedures.

    I have identified a huge ‘gap’ in the system where in my opinion the CQC could do more. The LA are responsible for their own CQF Inspections! this is an area where the NEGLECT and ‘safeguarding’ issues are occurring. I would suggest that the CQC should request to see these reports, taking into account complaints by the General Public, and investigate complaints regarding clients placed into unregulated accommodation, and the issues that have been highlighted.

    The Public at large have very little understanding or knowledge of what their rights are, or what the LAW is surrounding Mental Health in particular, it is time their was a Poster Campaign to inform.

    The CQC are not interested in unregulated accommodation, but surely the case i have put above warrant some thought into what i have suggested.

    West Berkshire Council refuse to make their CQF reports open to Public Inspection, against all the principles of ‘transparency.

  3. Irene Stratton says:

    Unfortunate that statisticians and health economists are not explicitly mentioned in the document as part of the workforce to design and implement changes and interventions, nor to evaluate whether the interventions work.

    The document mentions risk stratification at 2% or 5% levels but you need statisticians to work out the risk models in order to do this. Risk models do not currently exist for all conditions and have infrequently been validated in cohorts independent of the development population. This is in part because it’s difficult!

  4. Charlotte Peters Rock says:

    Making CCGs beg for such government funding is humiliating in the extreme.

    Telling them whether they had the opportunity to beg for Vanguard status, only by 6 pm on the evening prior to being expected to be in London to beg by 10 am on the following morning (so a 5 or 6 am start for some, with all plans already made to be in London on time) is just unacceptable.

    I say this as a member of the public who expects to receive far better treatment from our NHS than such cavalier ignoring by Government, of practical need of CCG personnel.. particularly where so much money and 24 hour per day help is being requested.

    Stop making it a lottery. This is our health! We have paid and trusted that such help will be available. We did not enter a lottery. We just trusted..(possibly wrongly?)

  5. Gordon(Gus) Cairns says:

    Hi there I am Gus Cairns Patient Leader for Long Term Conditions at West Cheshire CCG a Vanguard Site MCP . I have read the 31 page new Models of Care Guidance and Forward View Document . On page 18 and two lines on page 19 you lay out the plans for Patient involvement and Empowerment . One Page and two lines that to me is typical of NHS Management when it comes patient involvement ,I thought the NEW Models of Care Board and Team were more Patient Centred than that . I have personally seen how good they usually are as Patient Representative on the two day visit to our Vanguard and on Interview Panels in London for 5 days recruiting Support Staff for Vanguards as one of Several Patient Reps . I also have my doubts about the Local Leadership section pages 24 to 29 . I read that very carefully and Patient Leaders weren’t mentioned anywhere . or incidentally were Patients mentioned in any leadership role anywhere in this section . If all the training is going to Clinical and non clinical paid employees how are volunteer Patient Leads on MCP Boards Locally going to keep up with their fellow Board Members . I know Patient Leaders are only at present in a couple of CCG’s and only one is a vanguard site but you must use this innovation in your thinking when looking at training opportunities . I have nearly completed the Edward Jenner Course at the NHS Leadership Academy I just have my 1000 word submission to do so I am not a foolish patient who knows nothing but a leader of patients who probably know as much about my condition and other Cancers as any lay person and run a Prostate Cancer Support Group and sit on Specialist Urology CRG nationally . .Where is the ordinary patient input on the national New Models of Care Board as well . Patient involvement from top Executives at the top to every individual Patient at the bottom . Not CEO’s of Patient organisations either but ordinary Patient Volunteers who don’t ask for huge salaries just expenses . I have just started a Health and Wellbeing Group in Blacon Chester where health inequalities are rife but you wont care about 14000 people who could die 10 years earlier than people living in more affluent areas of Chester This is what our MCP should be aimed at and if I as a Patient Leader have anything to do with it it will be aimed at inequalities . Thank You Gus Cairns

    • NHS England says:

      Thank you for your comments,

      I am sorry you were disappointed regarding the number of patient involvement references in the support package recently published. One of our key principles and an absolute commitment of the new care models programme is patient involvement. As you have experienced personally, patients and patient representatives have been involved since the programme’s inception, for example, in site visits and recruitment.

      Our commitment has not changed. Patients and communities are fundamental to the success of our vanguards and, as we stated in the publication, the support package will work to support vanguards in transferring power to patients. In the empowering patients and communities section, we outlined a new model of partnership based on six principles from the People and Communities Board. Vanguards will be supported to work on delivering these principles with patients and expert advisors. Training will be part of the package. Patients are represented on the new care models board by Jeremy Taylor from National Voices.

      Kind Regards
      NHS England

  6. Angela Cavill-Burch says:

    Forcing people on NHs CHC to have PHB is not the answer for everyone, especially those where all the budget has to go on care provision. PHB will lead to the further de professionalisation of care work expand the idea that anyone with a pulse can do the job. Commissioners need to recognise some conditions need specialist care provision and that costs money.