Supporting the vanguards

The NHS Five Year Forward View partners published an updated national support package for all 50 vanguards in December 2015.

This followed an initial programme of support package published in July 2015 for the first 29 vanguards.

The revised package reflects the needs of the eight urgent and emergency care (UEC) and 13 acute care collaboration (ACC) vanguards selected in July and September 2015. It includes learning to date from the first 29 vanguards.

Extensive engagement with the vanguards was carried out including site visits, workshops and discussions. Based on their feedback there are 9 areas of support:

  1. Designing new care models – working with the vanguards to develop their local model of care, maximising the greatest impact and value for patients;
  2. 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;
  3. Integrated commissioning and provision – assisting the vanguards to break down the barriers which prevent their local health system from developing integrated  commissioning;
  4. Governance, accountability and provider regulation – helping the vanguards develop the right organisational form and governance model, as well as understand the impact on how they are regulated;
  5. 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;
  6. 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;
  7. Workforce redesign – supporting the vanguards to develop a modern, flexible workforce which is organised around patients and their local populations;
  8. Local leadership and delivery – working with the vanguards to develop leadership capability and learn from international experts, and;
  9. Communications and engagement – supporting the vanguards to demonstrate best practice in the way they engage with staff, patients and local people.

The national package has been developed to enable the vanguards to make the changes they want effectively and at pace.  It is also aims to maximise the sharing of learning across the vanguards and spread good practice nationally across the wider NHS and care system.

The vanguards also have access to a transformation fund and jointly received more than £130 million in 2015/16.

In May 2016, NHS England also announced that it would invest around £112 million (2016/17) in the vanguard projects which are leading the way and road testing new models of care in different parts of the country. Specific allocations for 47 of the 50 vanguards were announced. The remaining 3 are within Greater Manchester and form part of the devolution deal.

There are two summary documents on how the support package relates to acute care collaboration and urgent and emergency care vanguards.

The multispecialty community provider (MCP) emerging care model and contract framework

The multispecialty community provider (MCP) care model is a population based new care model which aims to improve the physical, mental and social, health and wellbeing of the local population.  It is centred around the general practice registered list and it aims to provide greater joined up, place-based care for patients within their own communities.

The multispecialty community provider emerging care model and contract framework document, published July 2016, describes what being an MCP means, based on assembling the core features from the 14 MCP vanguards into a common framework.  In addition, the document includes proposals for how the new voluntary contract may work. It proposes the contract will be a multi-year contract with payment operating on the basis of a whole population budget, a new pay-for-performance incentive scheme and risk-and gain-share agreement with the hospital sector. Alongside the document, we will also be publishing further resources. These will be available later this year.

The integrated primary and acute care system framework

The integrated primary and acute care system (PACS) – describing the care model and the business model framework outlines what a PACS is and the steps required to set one up. It describes the key features of the care model as well as the changes to contracting, funding and organisational form that are needed to deliver a PACS.  The document shares the learning from the nine existing PACS vanguards and includes case studies highlighting their progress to date.

Enhanced health in care homes framework

The enhanced health in care homes (EHCH) framework (published 29 September 2016) lays out a clear vision for working with care homes to provide joined up primary, community and secondary, social care to residents of care and nursing homes, via a range of in reach services. The framework sets out how care can be transformed with staff from across health and social care organisations working together as part of multidisciplinary teams – joining up services  for residents.

Updated evaluation strategy to support sharing of best practice and learning

The new care  models programme published the National Evaluation Strategy in May 2016.

The strategy sets out our overall approach to both national and local evaluation of the new care model vanguards.

Evaluation of the vanguards is at the heart of the national new care models programme, providing the robust results and learning that can be rapidly disseminated across the NHS and elsewhere to enable duplication of successful models.

The strategy also outlines a partnership approach to evaluation.  It includes analysis of key outcomes of the new care models, as well as provision of support for local evaluation enabling vanguards to evaluate their progress against the measures that are most important to them.