Developing new care models through NHS vanguards

The vanguard programme, one of NHS England’s attempts to better meet patients’ needs and deliver savings by developing new care models to integrate health and social care services, has not delivered the depth and scale of transformed services it aimed for at the beginning of the programme, according to this report by the National Audit Office.

A key objective of the programme was to design new care models that could be quickly replicated across England. NHS England selected 50 sites to act as ‘vanguards’ which might entail, for example, joining up GP, hospital and community and mental health services in an integrated network or single organisation in one area to improve healthcare for patients.

NHS England’s early planning assumption was £2.2 billion of funding for new care models between 2016-17 and 2020-21, but it used much of the funding to reduce deficits faced by hospitals. Actual direct funding of vanguards was £329 million over three years from 2015-16, with another £60 million spent by NHS England on central support for vanguards. Consequently, with less funding for transformation, the original intention to expand the programme was not realised.

Despite not meeting its original intention to expand the models across the country, vanguards have made progress in developing new care models. NHS England forecasts that vanguards will make net savings. As at April 2018, it estimated that vanguards would secure £324 million net savings annually by 2020-21, which is 90% of the £360 million that had been expected.

Full report:  Developing new care models through NHS vanguards

See also: National Audit Office press release


Long-term funding of adult social care

The Housing, Communities and Local Government and Health and Social Care Committees have published Long-term funding of adult social care.

The joint report calls for a sustainable funding solution for adult social care and the introduction of a ‘Social Care Premium’, either as an additional element of National Insurance or with the premium paid into dedicated not-for-profit social insurance fund that people would be confident could only be used for social care.

Watch the interactive report:

social care
Image source:


Innovation in Medicine 2018: Government must double number of medical students

Royal College of Physicians | June 2018 | Innovation in Medicine 2018: Government must double number of medical students

A new policy briefing, Double or quits: calculating how many more medical students we need , from the Royal College of Physicians (RCP)  outlines new calculations for the number of doctors needed, and sets out the key issues facing workforce planning in the UK that affect current supply, future service demand and predicted losses in the workforce. The RCP  has called on the government to double the number of medical school places from 7,500 to 15,000 to meet the needs of tomorrow’s patients (Source: RCP). 

Double or nothing
Image source:

The briefing paper is available to read here 
The new release is accessible from RCP




The NHS at 70

The Health Foundation, Institute for Fiscal Studies, The King’s Fund and the Nuffield Trust have published the next three briefings in their series marking 70 years of the NHS

Reducing reliance on medical locums: a practical guide for medical directors

NHS Improvement | June 2018 | Reducing reliance on medical locums: a practical guide for medical directors

The guide gives six practical steps to addressing over-reliance on medical locums and taking great control of workforce deployment. It also contains case studies from trusts who have been successful in finding alternatives to using medical locums (NHS Improvement).

Image source:

Supporting documents:

Board reporting dashboard template

Use this template to produce monthly reports for your trust board and more regular reports to your executives in charge of reducing medical locum spend

Reporting and tracking template

This spreadsheet provides a guide to some of the information your central booking team should be providing your executives in charge of reducing medical locum spend.

Reducing reliance on medical agency staff: sharing successful strategies

This document reflects some of the strategies being adopted by trusts to reduce reliance on medical agency staff. All the trusts included in this document have a relatively lower medical agency spend in comparison to other trusts in their region as a result of these common strategies and other strategies reflected in this document.


Further details from NHS Improvement 

Leadership of allied health professions in trusts: what exists and what matters

NHS Improvement | June 2018 | Leadership of allied health professions in trusts: what exists and what matters

Allied health professional (AHPs) are the third largest workforce, offering significant contribution to quality, productivity and system sustainability. This report shares the findings from a project we commissioned to evaluate current leadership arrangements for allied health professionals (AHPs). It was developed to provide an evidence-based approach to reviewing and improving AHP leadership in provider organisations.leadership-3331244_1920NHS Improvement have produced this report in response to requests from directors of nursing for guidance about developing AHP leadership in their organisation (Source: NHS Improvement).

The news release is available to read from NHS Improvement 

The report is available here 

Redesigning care delivery

This case study looks at the work of Chesterfield Royal Hospital NHS Foundation Trust in using new models of care to overcome workforce supply challenges.

Image source:

Despite running proactive campaigns to recruit to nursing posts, the trust was unable to make up for the shortfall it was experiencing in the number of registered nurses in its workforce. Using the concept of building a team around the patient, based on identified skills needed to deliver best care, the trust looked at how it could make use of newly introduced band 4 roles, such as the nursing associate and the assistant practitioner.

This case study outlines how Chesterfield Royal engaged its staff to help develop the new team structure, addressed the issues this presented, and has got to a position where other wards are now looking to adopt model.

Full document available at NHS Employers