The New Care Models Zone is one of four ‘feature zones’ at the Health and Care Innovation Expo, with a range of vanguards sharing their learning in an informal way. Following a main stage presentation alongside Sir Sam Everington – National Advisor, New Care Models Programme and three vanguards, Samantha Jones, reflects on how they are improving care for patients and local people.

I’m delighted that the programme and the vanguards themselves were invited to play such a key role in the Health and Care Innovation Expo this week – because innovation is what we’re all about.

In the vanguards, local people, local communities and local health and care systems are working together to design and deliver new care models, and supported by the national bodies to move the blocks out of the way.

Such radical changes take dedication and the vanguard teams across the country have been working incredibly hard, alongside partners in their local areas, to introduce changes that can be shared and spread across the country, improving care for all.

And events such as this week’s Expo are essential to the success of the programme, giving the vanguards themselves the opportunity to share learning and experiences to inform and encourage others. While 50 vanguards are officially taking part in the programme our ambition reaches much further than that. The aim is for more than 50 per cent of the country to be covered by new care models by 2020/1.

Addressing the challenges

Each have clear plans in place for managing demand more effectively across the local health system and reducing costs, whilst at the same time improving outcomes for patients. This includes reducing avoidable hospital admissions and bed days, releasing back office savings across providers and improving prevention, self-care and the use of technology.

And the vanguards are really thriving, with the ‘green shoots’ of effective change already showing.

For example:

• A hotline between hospital consultants and GPs in Stockport is already speeding up patient treatment and reducing hospital appointments. Stockport Together (@Stockport2gther) vanguard established ‘Consultant Connect’ to connect to a ‘rota’ of consultants. GPs can, during patient appointments, call and get instant treatment advice from a specialist at the local hospital, and check whether a referral is necessary. The results have been impressive – dramatically reducing GP to consultant referral time from 3-4 weeks to near-instant telephone access and preventing hospital referrals in 70 per cent of recorded cases since launching for haematology and endocrinology enquiries in February.

• Around 20% of GP appointments in West Wakefield (@westwakefield) are for people with musculoskeletal problems. Recognising the pressure this places on GPs, the vanguard team agreed that it would make more sense for these patients to be seen by an experienced physiotherapist rather than a GP. So, when a patient calls about a bad back a dedicated ‘care navigator’ offers them an initial assessment with a physiotherapist in the GP practice. The service has proved to be a real success with patients and professionals alike. Between April and June, local practices offered over 400 PhysioFirst assessments. Of these, 82% of patients were given advice on self-care, 75% exercises to do at home and 28% referred to a community physiotherapist. Only 5% needed to see their GP, saving 67 hours of GP time.

• The kitchen at Stanborough Lodge care home in Welwyn Garden City is part of the NHS frontline in the fight to ease the strain on hospitals. Funding for training for staff at more than 20 homes in the area in skills such as nutrition and dementia care, has affected day-to-day activities such as encouraging residents to help prepare healthy food. There is close support from a GP linked to the home, and a pharmacist, who has tackled unnecessary medication. Early results in the East and North Hertfordshire Clinical Commissioning vanguard (ENHertsCCG) are encouraging. In March there were no falls. Before the scheme there were about eight a month. Ambulance calls are down more than 30%.

• MERIT (@MERITvanguardwm) is the short name for Mental Health Alliance for Excellence, Resilience, Innovation and Training. It brings together four trusts across the West Midlands and three main areas the mental health vanguard is looking at; promoting a recovery culture, crisis care and the reduction of risk and everyday working in acute services – where possible using the same systems across the organisations to ensure consistency.

Add these together with the green shoots emerging from all the other vanguards, and pretty soon we’ll have a veritable forest of change and improvement across the whole health and care system.

We have already published the first in a series of common frameworks for those wishing to take up the new ways of working being developed, based on learning from the vanguards so far.

We hope that by working together and sharing our learning and experiences – whether positive, difficult, uplifting, frustrating or simply challenging – we will continue to support the growth and spread of the vanguards’ work effectively, to benefit more patients, sooner.

Sir Sam Everington, GP and National Advisor – New Models Programme (Health and Care Innovation Expo)

How the new care models programme vanguards are improving care for patients and local people (Health and Care Innovation Expo) – Samantha Jones