NEW CARE MODELS - One East Midlands vanguard... · NEW CARE MODELS: Vanguards –developing a...

NOVEMBER 2015

Vanguards - developing a blueprint forthe future of NHS and care services

NEW CARE MODELS:

www.england.nhs.uk/futureNHS#futureNHS

NEW CARE MODELS: Vanguards – developing a blueprint for the future of NHS and care services

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www.england.nhs.uk/futureNHS#futureNHS

WHAT IS THE NEW CARE MODELS PROGRAMME?In January 2015, the NHS invited individual organisations and partnerships to applyto become ‘vanguard’ sites for the new care models programme, one of the firststeps towards delivering the NHS Five Year Forward View and supportingimprovement and integration of services.

In March, the first group of 29 vanguard sites werechosen. There were three vanguard types – integratedprimary and acute care systems; enhanced health in carehomes; and, multispecialty community providers.

Integrated primary and acute care systems will join up GP,hospital, community and mental health services, whilstmultispecialty community providers will move specialistcare out of hospitals into the community. Enhancedhealth in care homes will offer older people better, joined up health, care and rehabilitation services.

In late July, eight additional vanguards were announced.Urgent and emergency care vanguards will develop newapproaches to improve the coordination of services andreduce pressure on A&E departments.

A further 13 vanguards were announced in September –known as acute care collaborations, they aim to link localhospitals together to improve their clinical and financialviability, reducing variation in care and efficiency.

All 50 vanguards were selected following a rigorousprocess, involving workshops and the engagement ofkey partners and patient representative groups.

Each vanguard site will take a lead on the developmentof new care models which will act as the blueprints forthe NHS moving forward and the inspiration to the restof the health and care system.

#futureNHS

CONTENTSWhat is the new care modelsprogramme?

New care models - vanguard sites

The vanguards: integratedprimary and acute care systems

The vanguards: multispecialtycommunity providers

The vanguards: enhanced health in care homes

The vanguards: urgent andemergency care

The vanguards: acute carecollaborations

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http://www.england.nhs.uk/ourwork/futurenhs/5yfv-ch3/new-care-models/uec/

http://www.england.nhs.uk/ourwork/futurenhs/5yfv-ch3/new-care-models/

http://www.england.nhs.uk/ourwork/futurenhs/


What does it mean for patients?The vanguards are improving the care received by millionspeople across England.

Through the new care models programme, completeredesign of whole health and care systems are beingconsidered. This could mean fewer trips to hospitals withcancer and dementia specialists holding clinics in localsurgeries, having one point of call for family doctors,community nurses, social and mental health services, oraccess to blood tests, dialysis or even chemotherapycloser to home.

It will also join up the often confusing array of A&E, GPout of hours, minor injuries clinics, ambulance servicesand 111 so that patients know where they can geturgent help easily and effectively, seven days a week.

The partnersThe new care model vanguards are a key element withinthe Five Year Forward View which is a partnershipbetween NHS England, the Care Quality Commission,Health Education England, Monitor, the NHS TrustDevelopment Authority, Public Health England and theNational Institute for Health and Care Excellence.

Supporting the vanguardsIn July, the Forward View partners published an initialsupport package for the first 29 vanguards.

The support package was developed following extensiveengagement with the vanguard leaders, including two-day visits to all 29 sites in April and May 2015 andfollow-up discussions and seminars. It aims to enablethem to make the changes they want to make effectivelyand at pace.

Building on the best practice already being displayed, thesupport package is designed to be led by vanguardleaders alongside national experts, and aims to help thevanguards be as successful as possible in making thechanges they are planning.

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

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

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 vanguardsto 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 and provision;

4. 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;

5. Harnessing technology – supporting the vanguardsto 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;


6. Workforce redesign – supporting the vanguards to develop a modern, flexible workforce which is organised around patients and their local populations;

7. Local leadership and delivery – working with the vanguards to develop leadership capability and learn from international experts, and;

8. 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 are beingled by a vanguard leader and national subject matterexpert – are working with the vanguards to refine whatis being offered so that it is fully tailored to their needs.

In addition to the practical support outlined in the newdocument, vanguards also have access to a £200mtransformation fund.

Support for more recently announced vanguards – acutecare collaboration vanguards and urgent and emergencycare vanguards – will be published shortly.

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http://www.england.nhs.uk/ourwork/futurenhs/5yfv-ch3/new-care-models/support/

http://www.england.nhs.uk/ourwork/futurenhs/

Integrated primary and acute care systems - joining up GP, hospital, community and mental health services

New care models - vanguard sites

Wirral PartnersMid Nottinghamshire Better TogetherSouth Somerset Symphony ProgrammeNorthumberland Accountable Care OrganisationSalford TogetherBetter Care Together (Morecambe Bay HealthCommunity)North East Hampshire and Farnham Harrogate and Rural District Clinical Commissioning GroupMy Life a Full Life (Isle of Wight)

Multispecialty community providers - moving specialistcare out of hospitals into the community

Calderdale Health and Social Care Economy Erewash Multispecialty Community ProviderFylde Coast Local Health EconomyVitality (Birmingham and Sandwell)West Wakefield Health and Wellbeing LtdBetter Health and Care for SunderlandDudley Multispecialty Community ProviderWhitstable Medical PracticeStockport TogetherTower Hamlets Integrated Provider PartnershipBetter Local Care (Southern Hampshire) West Cheshire WayLakeside Healthcare (Northamptonshire) Principia Partners in Health (Southern Nottinghamshire)

Enhanced health in care homes - offering older people better,joined up health, care and rehabilitation services

Connecting Care - Wakefield DistrictGateshead Care Home ProjectEast and North Hertfordshire ClinicalCommissioning GroupNottingham City Clinical Commissioning GroupSutton Homes of CareAiredale & Partners

Urgent and emergency care - new approaches to improve thecoordination of services and reduce pressure on A&Edepartments

Greater Nottingham System Resilience GroupCambridgeshire and Peterborough ClinicalCommissioning GroupNorth East Urgent Care NetworkBarking and Dagenham, Havering and RedbridgeSystem Resilience GroupWest Yorkshire Urgent Emergency Care NetworkLeicester, Leicestershire & Rutland SystemResilience GroupSolihull Together for Better LivesSouth Devon and Torbay System Resilience Group

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Acute care collaborations - linking hospitals together toimprove their clinical and financial viability

Salford and Wigan Foundation ChainNorthumbria Foundation GroupRoyal Free LondonFoundation Healthcare Group (Dartford andGravesham)MoorfieldsNational Orthopaedic AllianceThe Neuro Network (The Walton Centre, Liverpool)MERIT (The Mental Health Alliance for Excellence,Resilience, Innovation and Training) (WestMidlands)Cheshire and Merseyside Women’s and Children’s ServicesAccountable Clinical Network for Cancer (ACNC)EMRAD - East Midlands Radiology ConsortiumDeveloping One NHS in DorsetWorking Together Partnership (South Yorkshire,Mid Yorkshire, North Derbyshire)

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1. Wirral PartnersPARTNERSWirral University Teaching Hospital NHS FoundationTrust, Cheshire and Wirral Partnership NHS FoundationTrust, Wirral Community NHS Trust, Wirral ClinicalCommissioning Group, GPs on the Wirral, WirralMetropolitan Borough Council, Cerner UK Ltd andAdvocate Physician Partners (accountable careorganisation) alongside local patient and communitygroups and Wirral Healthwatch.

The organisations jointly serve a population of more than400,000.

AIMThe vanguard aims to use a range of approaches to meetthe different needs of specific sections of their localpopulation.

OUTLINEWirral Partners health and wellbeing model is based onself-care and independence as a foundation towellbeing. Work is underway to enable more timelyaccess to services with a care-navigation approach whichwill guide people to the support they require to behealthier for longer.

There are plans for integration between traditional acuteand primary care roles and the provision of more care incommunity settings.

Expected outcomes include a reduction in emergencyadmissions to hospital, fewer permanent admissions toresidential or nursing care and a rebalancing of healthinequalities such as life expectancy.

Another important element is the vanguard’s plan tocreate health economy-wide patient records, giving real-time access to the best information to support care. Thiswill also enable better care planning and the delivery ofcare pathways across organisational boundaries.

The vanguards: integrated primaryand acute care systems

NEW CARE MODELS: Vanguards – developing a blueprint for the future of NHS and care servicesNEW CARE MODELS: Vanguards – developing a blueprint for the future of NHS and care services

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2. Mid Nottinghamshire Better TogetherPARTNERSCentral Nottinghamshire Clinical Services, Circle HealthLimited, East Midlands Ambulance Service NHS Trust,Nottinghamshire County Council, NottinghamshireHealthcare NHS Trust (including County HealthPartnerships), Nottingham University Hospitals NHS Trust,Sherwood Forest Hospital NHS Foundation Trust and United Lincolnshire Hospitals NHS Trust.

The partners together serve a population of around310,000.

AIMBetter Together aims to ensure that everyone receivesthe best possible care with high quality, sustainableservices. The vanguard is working towards carebecoming much more integrated, with doctors, nursesand social care staff working together more closely tosupport the needs of patients, their families and carers.

OUTLINEBetter Together sets out a bold vision for the way healthand care services will look over the next five years, basedon population needs and public, stakeholder and stafffeedback about current services.

It focuses on several important areas – urgent andproactive care (including care for people with long termconditions like diabetes or asthma, and frail olderpeople) and early and planned care (such as surgery forhips and knees, or cataracts).

Feedback from local communities is central to planningand the Better Together team has completed aconsiderable amount of engagement with patients, thepublic and staff. They have used this feedback to shapethe design of future care services and understand whathealth outcomes are important to the local population.


3. South Somerset Symphony ProgrammePARTNERSYeovil Hospital, the Somerset GP Federation, SomersetClinical Commissioning Group and Somerset CountyCouncil.

The population covered by the South SomersetSymphony Programme is 200,000.

AIMThis vanguard aims to develop an integrated care systemin south Somerset which removes organisationalboundaries and allows staff to work together to providethe population with swifter and easier access to servicesand support.

The integrated care organisation will be managed by ajoint venture of health and social care professionals.

OUTLINEThe Symphony project will develop new care pathwayswhich provide early intervention and proactive care,closer to where patients live. Patients – particularly thosewith complex conditions – will be supported to retaintheir independence, stay healthier for longer, and avoidunnecessary admissions to hospital.

GPs, hospital clinicians, therapists, social workers andpatients will develop packages of care together whichrecognise the totality of an individual’s care and lifestyleneeds.

The Symphony project is also exploring new models ofcare which make routine clinical interventions – such ascertain day surgery procedures – more accessible andefficient.

Follow us: @bettermidnotts

Follow us: @symphonyproj


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4. Northumberland Accountable Care OrganisationPARTNERSNorthumbria Healthcare NHS Foundation Trust and NHSNorthumberland Clinical Commissioning Group in NorthEast England are the lead partners. Other partnersinclude Northumberland County Council, local GPs,mental health services, the ambulance service, as well aslocal patients, Healthwatch and the Health andWellbeing Board.

These NHS organisations jointly serve a population ofmore than 320,000 in Northumberland – one of thelargest geographical and most rural areas of England.

AIMThe collective ambition for the NHS in Northumberland isto create a single accountable care organisation (ACO)from 2017. The ACO will: focus on preventing ill healthand empower people to live long and healthy lives athome; improve patient outcomes and experience;provide seamless coordination of care; and, maximiseresources and reduce duplication.

What will this mean for patients?• Better access to care seven days a week – both for serious emergencies and primary care. • Better use of technology to empower people to take control of their own health and wellbeing, live independently and stay healthy. • Care delivered by an aligned, integrated workforce, operating as one team, in one system with joined-up.

• One unified patient record, reducing the need for patients to repeat ‘their story’ to different health professionals and different parts of ‘the system’.

OUTLINEIn June 2015, this vanguard completed its first phase ofwork by opening Northumbria Specialist Emergency CareHospital to provide seven day specialist services in acutecare for all serious emergencies. Urgent care is nowavailable 24/7 for walk-in patients at general hospitalsites.

The next phases of work involves creating centralprimary care ‘hubs’ across Northumberland with GPsworking in networks to improve access to primary careservices during working hours, in the evenings and atweekends to meet patient need.

Work will also take place to identify alternative, flexible,workforce solutions, to allow more care to be deliveredby different types of health care professionals in people’shomes and community settings with a strong focus onprevention.


5. Salford TogetherPARTNERSSalford City Council, NHS Salford Clinical CommissioningGroup, Salford Royal NHS Foundation Trust and GreaterManchester West Mental Health NHS Foundation Trust.

Salford has a population of 230,000.

AIMSalford Together aims to integrate health and social carefor older people in Salford, bringing the contributions ofGPs, district nurses, social workers, mental healthprofessionals, care homes, voluntary organisations andlocal hospitals into a more aligned system and provideolder people with the support they need to manage theirown care.

OUTLINEThis new care model has already been tested and refinedin two areas which account for 40 per cent of olderpeople in Salford. By the end of 2015, it is hoped thewhole city will experience the benefits of this new,integrated way of working.

The vanguard is developing multidisciplinary groups ofclinicians and other staff to provide targeted support topeople who are most at risk. There is also a populationfocus on screening, prevention and signposting tocommunity support.

This includes establishing a contact centre which acts asa central health and social care hub, supportingmultidisciplinary groups. The centre will also help peopleto navigate services, access support and will coordinatethe use of telecare. The vanguard also intends using localcommunity support to help enable people to remainindependent and develop greater confidence to managetheir own care.

Follow us: @SalfordTogether

Follow us: @NorthumbriaNHS @NHSNLandCCG


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6. Better Care Together (Morecambe BayHealth Community)PARTNERSThe Better Care Together vanguard is a partnership of 11organisations based across Morecambe Bay and includesUniversity Hospitals of Morecambe Bay NHS FoundationTrust, Cumbria Partnership NHS Foundation Trust, NorthWest Ambulance Service, Blackpool Teaching HospitalsNHS Foundation Trust, Lancashire Care NHS FoundationTrust, Lancashire County Council, Cumbria CountyCouncil, Lancashire North Clinical Commissioning Group(CCG), Cumbria CCG, North Lancashire Medical Servicesand South Cumbria Primary Care Collaborative.

It serves a population of 365,000 people in an area thatis geographically dispersed, financially challenged andhas areas of deprivation and health inequality.

AIMBetter Care Together aims to improve the sustainabilityof services, enhance the quality, safety and experiencefor patients, and reduce the health system financialdeficit. It aims to do this by working interdependentlywith a much more integrated out-of-hospital sector andmoving to a smaller, more productive group of hospitals.

OUTLINEBetter Care Together will see the development ofmultidisciplinary core teams based within communitiesacross Morecambe Bay. There will be increased generalpractice capacity and capability, with an expansion ofcommunity based specialist services.

Increasingly, hospital clinicians will work within thecommunity based teams fostering a shared approach tostaff development and improving pathways of care.

The vanguard is focusing on ensuring that people whouse local services experience care and support that worksthe way it should and that they are supported to takecontrol of their health and wellbeing. Most of their careand support will be provided within their localcommunity, based around their GP practice, with accessto safe and high quality specialist care as and when it isneeded.

This vanguard programme was developed by over 200healthcare professionals together with input from a widerange of local patients, community groups and thirdsector colleagues.


7. North East Hampshire and Farnham PARTNERSNHS North East Hampshire and Farnham ClinicalCommissioning Group, Frimley Health NHS FoundationTrust, Southern Health NHS Foundation Trust, Surrey andBorders Partnership NHS Foundation Trust, Virgin Care,South East Coast Ambulance NHS Foundation Trust,North Hampshire Urgent Care, and Hampshire andSurrey county councils.

This vanguard serves a population of more than220,000.

AIMThe vanguard aims to keep people happy, healthy and athome by motivating and supporting local people toimprove their own health and ensuring a seamlessservice when they are ill or need support.

OUTLINEThe focus of the vanguard is on the way services arecommissioned and the way organisations are set up.These will be reshaped to best support the new model ofcare.

The programme will focus on preventing ill health andmaximising self-care, helping people to manage theirown health conditions, empowering them to makechoices about their care and ensuring the right servicesare available to all.

It will also develop integrated teams of specialist healthand social care professionals. These teams will comprisecommunity nurses, occupational therapists,physiotherapists, social workers, a psychiatric nurse, alead psychiatrist, a pharmacist, a geriatrician, GPs, thevoluntary sector, and specialists in palliative care anddomiciliary care. They will ensure joined up care forpatients, especially those who are vulnerable or havecomplex needs.

There will also be enhanced community services forpeople in their own homes, in GP surgeries and localcommunity hospitals. There will also be access into andout of specialist inpatient care – in community hospitals(such as in Farnham and Fleet) as well as Frimley ParkHospital.

The vanguard’s work will enable health and social careprofessionals to speed up plans to develop new ways ofproviding and paying for support and services for localpeople. It will also provide better value for money,helping to close the gap between the available resourcesand the costs of providing services to meet need.

Follow us: @BCTMorecambeBay


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8. Harrogate and Rural District Clinical Commissioning GroupPARTNERSHarrogate District NHS Foundation Trust, Harrogate andRural District Clinical Commissioning Group, NorthYorkshire County Council, Tees Esk and Wear ValleyFoundation Trust, Harrogate Borough Council andYorkshire Health Network.

The vanguard covers a population of approximately160,000.

AIMThis vanguard aims to transform the way care is providedlocally with GPs, community services, hospitals, mentalhealth and social care staff working together to supportpeople to remain independent, safe and well at home.The vanguard wants to see care provided by a team thata person knows and feels they can trust. This will be setout in a care plan.

OUTLINEThe vanguard focuses on prevention. Targeted serviceswill be increased including their Stronger CommunitiesProgramme (focused on building communities and self-care), prevention officers (working with people who mayneed care in the future) and falls, bereavement andmental health preventative support services.

This work is built on what local people told the vanguardpartners is important to them. Services will be providedby an integrated care team including GPs, communitynurses, adult social care, occupational therapy,physiotherapy, mental health and the voluntary sector.

Boundaries between primary, community, acute, mentalhealth and social care will be removed and hospital bedswill be used only when they are truly needed.

9. My Life a Full Life (Isle of Wight)PARTNERSIsle of Wight Clinical Commissioning Group, Isle ofWight NHS Trust (a unique provider of ambulance,community, hospital, learning disability and mentalhealth services), Isle of Wight Council, One Wight Health(a GP collaborative) and the voluntary and independentsectors.

Jointly the partners serve a population of 140,000.

AIMThe vanguard’s new care model is aimed at improvinghealth and wellbeing. It also works to enhance care andimprove quality outcomes, delivering more care inpeople’s own homes and in the community, and makinghealth and wellbeing more financially sustainable. Careon the island has historically been reliant on statutoryservices and is no longer financially sustainable.Vanguard support is helping accelerate the move to thenew care model.

OUTLINEThe integrated ‘My Life a Full Life’ model is prevention-based, promotes health and wellbeing and is built onexperience-based co-design. It is also founded on theprinciples of self-care and empowered communities.

At the centre of our model is the person, whose careacross the community and system is coordinated andsupported by care navigators. This single point of contactwill triage, reduce perceived system complexity, increaseawareness of services, and maximise efficiency.

Another key element of the model is integrated localityteams which deliver person-centred care and support inthe community, with GP clinical leadership and multi-specialist teams.

Follow us: @MyLifeAFullLife

The vanguards: multispecialtycommunity providers


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10. Calderdale Health and Social Care Economy PARTNERSCalderdale Pennine GP Alliance, Calderdale andHuddersfield Foundation Trust, Calderdale ClinicalCommissioning Group , Calderdale MetropolitanBorough Council, South West Yorkshire PartnershipFoundation Trust, Locala Community Partnerships andVoluntary Action Calderdale.

This vanguard will service a patient population of around 100,000.

AIMThis vanguard will build on ongoing work to integratehealth and social care – the ‘care closer to home’programme – enabling the team to deliver benefit at agreater pace and scale. It aims to offer a measurableshift in the balance of service delivery from avoidableunplanned admissions to hospital, to planned, integratedcare, delivered in primary care and community settings.

OUTLINECalderdale has a shared commitment towards acommon goal – a sustainable people-centred, futureproof system for delivering health and social care locally.

One of the challenges that the vanguard faces is itsvalley geography, which has an impact on access andflow. The team is already trialling pilot schemes toprovide truly integrated services closer to where people live.

The focus of the programme is on three patient cohorts– people with long-term conditions, people at riskthrough frailty, and children with complex health andcare needs.

The vanguard will pilot innovative schemes to help thesegroups, firstly in the more remote west side, the ‘uppervalley,’ but quickly roll-out learning across Calderdale.

The team has also already installed telecare technologyin care homes and is confident about the positive effect that it is having upon the experience of care forresidents, reducing their dependency upon hospital care. Patients with chronic obstructive pulmonary disease(COPD) now have access to telehealth.

Progress is also being made on a ‘staying well’programme for older people, helping to tackle socialisolation and loneliness.

At the other end of the age spectrum, a child healthpilot has been launched in north east Halifax, bringingtogether the local hospital trust, GPs and children’scommunity nurses to run paediatric clinics at a children’scentre in the community.



11. Erewash Multispecialty Community ProviderPARTNERSDerbyshire Community Health Services NHS FoundationTrust, Derbyshire Healthcare NHS Foundation Trust,Erewash GP Provider Company, Derbyshire Health Unitedand NHS Erewash Clinical Commissioning Group.

This vanguard covers a population of 97,000 people.

AIMThis vanguard aims to bring together major communityand mental health services alongside GPs to develop aprevention and support team. The team is made up ofhealth and care staff, including GPs, advanced nursepractitioners, mental health nurses, extended caresupport and therapy support.

OUTLINEThe vanguard focusses on the delivery of services topeople with long-term conditions including diabetes,chronic vascular disease and chronic lung conditions.

There are also plans to extend GP access and improverecords so that the treatment plans of the mostvulnerable people are available for all community andprimary care staff. This will reduce duplication and assistin times of need for out of hours or emergencytreatment.

Health professionals will talk frail and vulnerable peoplethrough their concerns and support them to remain intheir homes. Healthcare ‘hubs’ will bring medical,nursing and mental health professionals together toshare information and knowledge about patients withlong-term conditions and acute medical needs so theyget the best care possible to stay well for longer.

The vanguard will also further develop telehealthtechnology to help people with long-term conditions tomanage their health better – particularly for those withcardiovascular disease, respiratory diseases and diabetes.


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12. Fylde Coast Local Health EconomyPARTNERSNHS Blackpool Clinical Commissioning Group, NHS Fyldeand Wyre Clinical Commissioning Group, BlackpoolTeaching Hospitals NHS Foundation Trust, LancashireCare NHS Foundation Trust, Lancashire County Counciland Blackpool Council.

NHS Blackpool and NHS Fylde and Wyre ClinicalCommissioning Groups have a joint registeredpopulation of 320,000 people living across a mix ofcoastal town and rural villages.

AIMThe vision for the Fylde Coast is to ‘wrap’ healthcarearound the patient, delivering more support in the heartof the community and less in hospital.

OUTLINEThis vanguard is already delivering new extensive careservices where clinical and non-clinical staff worktogether, providing proactive care for elderly and frailpatients with long-term conditions. This dramaticallyreduces the need for unplanned hospital visits. Twoextensive care services went live in June 2015 andanother five will become operational during the next 18 months.

Complementing extensive care, plans for enhancedprimary care will enable even more support to bedelivered closer to patients’ homes. Integratingcommunity services will see GPs working inneighbourhoods alongside community care and socialworkers. Supported by shared electronic care recordsand a single point of contact for all out-of-hospitalservices this will ensure seamless care for all.


Follow us: @DCHStrust @NHS_Erewash_CCG @derbyshcft

Follow us: @blackpoolccg @fyldeandwyreccg @BlackpoolHosp@Bpoolcouncil @lancashirecc@lancashirecare


13. Vitality (Birmingham and Sandwell)PARTNERSBirmingham Children’s Hospital, Birmingham CityCouncil, Birmingham Community Health Care Trust,Birmingham and Solihull Mental Health Trust, Sandwelland West Birmingham Hospital Trust, Sandwell andBirmingham Clinical Commissioning Group, and VitalityPartnership (15 GP practices).

The vanguard covers 200,000 patients withinBirmingham and Sandwell.

AIMThis vanguard aims for a future where patients will telltheir story once. It wants care to be better joined up andfor patients to be at the very heart of care planning andhealth management.

OUTLINEBy working together and centralising some processes forstreamlined, efficient and effective care, health andsocial care staff will release more time for patients. Anew clinical model has already released capacity withpositive feedback from patients and clinicians.

The vanguard will also be looking at improvements intechnology to help make it easier for people to accesshealthcare. In the new model of care, all health and careorganisations will encourage patients to takeresponsibility for their health – making sure they getchecks, attend appointments and live a healthy lifestyle.

The model will be delivered by the full range of healthand care partners who are committed to the long-termvision of transformation for healthcare through the‘Right Care Right Here Partnership’. This includes thebuild of a new hospital (Midland Met) by 2018, movingmore services into local settings and a drive forimproving people’s health by focusing on prevention,access and choice.


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14. West Wakefield Health & Wellbeing LtdPARTNERSWest Wakefield Health & Wellbeing Ltd is a federated network of GP practices in west Yorkshire.Other partners include: NHS Wakefield ClinicalCommissioning Group, Wakefield Council, WakefieldDistrict Housing, South West Yorkshire Partnership NHSFoundation Trust, Healthwatch Wakefield, Mid YorkshireHospitals NHS Foundation Trust, NOVA (voluntarycommunity sector representative body), YorkshireAmbulance Service and Local Care Direct.

It is currently responsible for around 65,000 patients.Under vanguard there are plans to merge with two otherGP practice networks in the area, which will see thenumber rise to 152,000.

AIMAs a multispecialty community provider, West WakefieldHealth & Wellbeing Ltd will be working to provide alarger, more diverse primary care team locally. There arecurrently 73 care navigators working in practices. Themajority of these care navigators are administrative staffwho generally have first contact with patients, trained todirect them to the most appropriate care.

OUTLINEA key element of this vanguard’s programme is improvedphysical access to care. It is working to improve its carenavigation system, directing patients to the help theyneed faster. The extended operating hours service hasbeen running since October 2014, and the plans to workwith two other GP networks under vanguard will expandboth the number of clinicians and patients. Meanwhilethe HealthPod, West Wakefield’s mobile clinic, isimproving engagement with ‘hard to reach’ groups suchas members of the gypsy/traveller community.

The vanguard is also creating more ways for patients todigitally access healthcare. This includes an onlinedirectory of local services, which pulls information from avariety of sources online including social media and alibrary of helpful health apps on its website. Thevanguard is also engaging primary school pupils in healthusing a competition to design health apps. An app isnow being built based on the idea of last year’s winningteam.

Self-service kiosks in practices will help patients to access these and other helpful resources, pointing toappropriate care before a patient enters a clinic room. The vanguard is also looking at the potential for use ofemail/instant messaging and video consultations.


Follow us: @westwakefield

#futureNHS


15. Better Health and Care for SunderlandPARTNERSThis vanguard is led by NHS Sunderland ClinicalCommissioning Group (CCG) and Sunderland CityCouncil, in collaboration with local providers includingSunderland Care and Support Service, South TynesideNHS Foundation Trust (providing community services inSunderland), Sunderland City Hospitals NHS FoundationTrust. It also includes the city’s two GP Federations(Sunderland GP Alliance and Washington CommunityHealthcare), Sunderland Carers Centre, Sunderland AgeUK, and Northumberland and Tyne and Wear NHSFoundation Trust.

This vanguard covers a population of 284,000 people.

AIMThe vanguard has an ambitious vision to transform careout of hospital through increased integration ofcommunity services to provide person-centredcoordinated care.

OUTLINEThe vanguard is working to provide an enhancedcitywide recovery at home service to offer rapid responseat home or in community beds to prevent emergencyadmissions to hospital and support patients after theyare discharged from hospital.

Another key area is integration of community nursing,social workers, GPs and voluntary staff in five localityteams, wrapped around GP practices providing plannedand proactive care.

The integrated locality teams will ensure care is bettercoordinated, planned and more proactive, particularly forpatients most at risk of avoidable emergency admissions.Based in one location in each locality but working closelywith clusters of practices, the teams will be supported bythe recovery at home service.

GP practices will be supported to work morecollaboratively through the two federations, with the aim of providing enhanced care to patients with long-term conditions.


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16. Dudley Multispecialty Community ProviderPARTNERSNHS Dudley Clinical Commissioning Group, DudleyMetropolitan Borough Council, Dudley Group NHSFoundation Trust, Black Country Partnership FoundationTrust, local GPs, Dudley and Walsall NHS PartnershipTrust and Dudley Council for Voluntary Service.

Dudley has a population of around 318,000 people.

AIMThis vanguard aims to integrate services in order to wraphealth and social care around patients – putting them atthe centre of their care and in control.

OUTLINEThe vision is for teams to work together, and withpatients, their families and carers to ensure they have thehelp and support to live life as independently as possible.

GPs are at the centre of the model as they have theresponsibility for the patients that choose to register withthem. The vanguard seeks to empower localcommunities to take control and responsibility for theirhealth and happiness, and use their skills and expertiseto build community connections and cohesion.

The model already includes voluntary sector link workersas part of the teams which are contributing to buildingrelationships and networks and reducing social isolation.There are also plans for a single GP record operatingacross the whole system and to develop newtechnologies to improve access, continuity andcoordination of care.

The vanguard aims to streamline and simplify patientpathways, removing complexity and bureaucracy fromthe system and looking holistically at the whole personand not just their illness or issue.

#futureNHS

Follow us: @BhforSunderland


17. Whitstable Medical Practice PARTNERSGP practices across Whitstable, Canterbury andFaversham, NHS Canterbury and Coastal ClinicalCommissioning Group, Kent County Council, PilgrimsHospices, local NHS trusts, mental health services, publichealth and voluntary and community services.

The organisations jointly serve a population ofapproximately 170,000 people.

AIMThe new model of care being developed by Whitstable,Northgate and Saddleton Road Medical Practices is amultispecialty community provider. This is expanding toinclude an additional 13 practices across the Canterburyand Coastal area.

This new model will ensure health and social care isintegrated and based around local needs and patientscan receive more of their treatment in their localcommunities, rather than having to travel to hospital.

OUTLINEThis vanguard is focussed on developing a seven day aweek expanded primary care team approach. This willreduce hospital admissions and length of stay throughexpansion of community health and social care teams.

We want to create a more cost and clinically effectiveservice by treating patients closer to home usingspecialist GPs, allied health professionals and communitybased consultants. There will also be a greater use ofinformation technology, using telecare and telemedicineto enable people to maintain their independencethrough self-care and self-management, and a sharedsingle electronic patient record.

Three health and social care hubs will also be createdand will include community hospital beds, nursing homebeds and extra care facilities.

Additionally, focusing on prevention will ensure that thewhole health and social care system is workingseamlessly to support people to stay well and supportsthem where necessary.

Patients are involved in helping to decide which servicesthe vanguard should include through groups known ascommunity networks.


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18. Stockport TogetherPARTNERSStockport NHS Foundation Trust, NHS Stockport ClinicalCommissioning Group, Pennine Care NHS FoundationTrust and Stockport Metropolitan Borough Council alongwith Stockport’s GP federation, frontline staff, the publicand third party voluntary organisations.

Stockport Together will be serving a GP registeredpopulation of more than 305,000.

AIMStockport Together aims to develop a single strategicplan to improve health and social care services across theborough. It wants to fundamentally reform the wayhealth and social care is delivered in Stockport to ensurethe best possible outcomes for local people. This isagainst a backdrop of growing demand and restrictedfunding

OUTLINEThe model in Stockport is a GP-led neighbourhood-based out-of-hospital service, which includes communityhealth services, mental health, social care and the thirdsector.

Initially, the vanguard will be commissioned to delivercare to the over 65 population of Stockport on aweighted capitation basis. The model covers a range ofmeasures including screening for early detection ofdiseases and supporting people to manage their owncare where appropriate through education.

Where people have complex conditions crisis responsewill be put in place through an anticipatory plan to helpsupport them in the management of exacerbationsthemselves and reduce the stress that this can cause.

A facility will also be developed to allow GPs to callconsultants directly for advice initially across up to eightspecialties using a cascade system. The vanguard willalso utilise the skills of social care and third sectorpartners to build community capacity in eachneighbourhood.


Follow us: @Stockport2gther


19. Tower Hamlets Integrated Provider PartnershipPARTNERSTower Hamlets GP Care Group Community InterestCompany, Barts Health NHS Trust, East London NHSFoundation Trust and London Borough of TowerHamlets.

The vanguard serves around 280,000 people.

AIMThis vanguard aims to establish a new model ofcommunity care which will enable social care, primary,community and acute health services to truly coordinatetheir services around the patient.

OUTLINEThe vanguard is working to ensure that more patientshave their care coordinated around their needs and arenot left to navigate themselves through numerousdifferent services. It will also help more vulnerablepatients receive care in their own homes, limiting timespent in hospital away from their family and friends.

A key part of the vanguard is a greater focus on apositive patient experience. Patients can expect improvedexperience of care across all health and social careservices in the local community.


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20. Better Local Care (Southern Hampshire) PARTNERSBetter Local Care is a growing partnership of around 30GP practices, Southern Health NHS Foundation Trust andlocal commissioners based in Hampshire.

The teams currently support around 220,000 peoplewith more teams following in the coming months.

AIMThis vanguard aims to provide better access, experienceand outcomes for patients closer to their homes. Thismeans fewer people will need to go to hospital, andmore will be supported to take control over their ownhealth and wellbeing.

OUTLINEBetter Local Care is joining services up to form oneextended team of health, social care, third sector and GPcolleagues who support the same local population. Thiswill improve access to the right professional at the righttime, including specialists – with fewer unnecessaryappointments in between.

By working in this way, health and care professionals willhave more time to support people who are most at riskof worsening health and wellbeing.

This vanguard understands that people who use servicesare experts too. A big part of Better Local Care is findingnew ways to collaborate with users and carers so newcare models really work for them and their families.


Follow us: @THIPPVanguard

Follow us: @betterlocalcare


21. West Cheshire WayPARTNERSPrimary Care Cheshire (GP Federation involving all 36 GP practices based in west Cheshire) and the localcommunity services provider supported by West CheshireClinical Commissioning Group, Cheshire and Wirral NHSPartnership Foundation Trust, the Countess of ChesterNHS Foundation Trust, Cheshire West and Chester LocalAuthority and partners from the third sector. Localpatient voluntary and community groups are involvedtoo, including Healthwatch Cheshire West.

These organisations serve a population of around250,000.

AIMWith an emphasis on transforming care from cradle tograve, West Cheshire Way focusses on starting well,living well and ageing well as the drivers for change.

OUTLINEA key theme running throughout the West Cheshire Wayvanguard is that the individual and their family andcarers will be given the tools and confidence to managetheir condition for themselves, so far as is possible. Thiswill involve clinicians and local people working togetherto build an understanding of what self-care means andto co-design it together. Where self-care is not thesolution, West Cheshire Way is committed to involvinglocal patients, families and carers in co-designing caremodels that meet their needs.

Babies, children and young people will look to their localGP and cluster team as their gateway to coordinatedsupport. Adults will be helped to make healthier choicesvia innovative self-care programmes, and people withlong-term conditions will be identified and supported tominimise the impact on their daily lives.

Vulnerable older people will be cared for by GPs andintegrated community teams who will proactivelyidentify and target those most at risk, develop sharedcare plans with a single care coordinator and ensure careis provided by specialist, multidisciplinary teams.


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22. Lakeside Healthcare (Northamptonshire)PARTNERSKettering General Hospital, University Hospital Leicester,Northampton County Council, Corby Borough Council,Celesio, Lloyds Pharmacy, Leonard Cheshire Homes andOlympus Social Care Services.

Lakeside Healthcare is the largest single GP ‘super-practice’ partnership in the NHS with a patient list of over 60,000. It is headquartered in Corby,Northamptonshire with several branch surgeries innearby towns.

Through Lakeside Healthcare this vanguard looks afterover 100,000 patients.

AIMBy April 2016, Lakeside Healthcare aims to be one of thefirst accountable care organisations in the NHS.

OUTLINEThe model is to further develop their home andcommunity based service that puts the patient at thevery centre of everything they do.

The vanguard will offer patients four new models of carewhich complement each other: Lakeside ExtensivistServices; Lakeside Enhanced Primary Care; LakesideAmbulatory Surgery Centres; and, CorbyCare UrgentCare Model.

Lakeside Extensivist Services is a holistic care systemwhich will provide coordinated, comprehensive care tothe most needy and frail patients. It aims to ensurepatients receive highly personal care with better accessand are engaged in the management of their conditions.

Lakeside Enhanced Primary Care is team-based care thatprovides comprehensive and convenient medical care toa specific patient segment. This will also allow patientsto receive whole-person focussed care delivered by theircurrent GP.

Lakeside Ambulatory Surgery Centres are outpatientcentres delivering high efficiency care in a convenientsetting with improved patient scheduling which supportsincreased patient choice.

CorbyCare Urgent Care operates either as a standaloneservice or on a hospital site and has satellite primary-pharmacy spokes.


Follow us: @WestCheshireCCG

The vanguards: enhanced health in care homes


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23. Principia Partners in Health (Southern Nottinghamshire)PARTNERS12 GP practices in Rushcliffe are coming together as a‘partnership of partners’ to form the cornerstone of anew multispecialty community provider organisation. It will combine with general practice, GP out-of-hoursservices, community and local mental health services,social care, third sector, hospital and ambulance trusts.

This vanguard will serve a population of 126,000.

AIMServing Rushcliffe’s whole population, the vanguard aimsto accept contractual responsibility for the quality andcosts of healthcare within a single capitated budget. The vanguard will be defined by integrated working anda culture of mutual accountability for patient experienceand outcomes.

OUTLINEA new model of integrated care will focus on promotinghealth and wellbeing through prevention and providingcare at the right time in the right place. This will enablepeople to live independently at home for as long aspossible and avoid unnecessary hospital admissions bymoving traditional hospital-based services intocommunity settings, such as specialist long-termconditions management, nursing, diagnostics and someconsultant-led care.

This vanguard will see the local health and social caresystem working as one to focus on proactive healthcare,with commitment and pride in bringing benefits topatients and the professionals who serve them. Theresult will be a significant culture change, with thehealth and social care workforce coming together toagree ambitions that are patient-centred and empowerpeople to personalise the care they receive, replacing theone-size-fits-all model currently delivered by individualorganisations.


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24. Connecting Care - Wakefield DistrictPARTNERSNHS Wakefield Clinical Commissioning Group, WakefieldCouncil, seven GP networks and the Provider Alliancewhich includes Nova-Wakefield, Age UK, WakefieldDistrict Housing, South West Yorkshire Partnerships NHSFoundation Trust, Mid Yorkshire Hospitals NHS Trust andYorkshire Ambulance Service.

Wakefield district has a population of around 361,000.

AIMThis vanguard focuses on the wider determinant ofwellbeing – ‘somewhere to live, someone to love,something to do’.

OUTLINEThe vanguard is working to ensure people in care homesare offered proactive, holistic assessment and careplanning. Care needs will be reviewed on admission to acare setting, at scheduled intervals (according to need)and after an unplanned episode e.g. an urgent GP callout.

There will be a joined up support package for people inindependent living schemes, i.e. sheltered housing, tokeep them socially connected within the scheme and inthe wider community.

Evidence from existing pilots indicates this will reducefragmentation in care and give equal access to highquality health care whether in a care home or their ownhome. It will also help keep residents and their families incontrol of their care and reduce accidents and healthdeterioration, resulting in urgent GP calls and hospitalattendance or admission.

This will also reduce the number of people choosing togo from independent living into care settings to escapeloneliness and enable couples to be supported to staytogether in independent living schemes.

The vanguard is also working to ensure every residenthas an end of life plan – allowing people to die in theirplace of choice.


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25. Gateshead Care Home ProjectPARTNERSNHS Newcastle Gateshead Clinical CommissioningGroup and Gateshead Council.

Gateshead has a population of around 206,000.

AIMThis vanguard is a pioneering project to improve thehealth of care home residents in Gateshead.

OUTLINEGateshead Care Home Project sees individual GPpractices each allocated to a specific care home, makingit possible to offer greater continuity of care and moreeffective prevention of illness through regular homevisits.

There will also be changes to the way services arecommissioned and contracts managed with a widerange of providers for this group of patients. It will bringtogether a network of organisations working togetherfor a more coherent health and social care offer topatients.

The vanguard is also reviewing the care pathway and anew model for contracts and payments as well as thedevelopment of co-commissioning for all community bedand home based care. Co-commissioning is the clinicalcommissioning group and Gateshead Council workingtogether to bring a simplified and joint approach toenhanced healthcare, making it easier for patients andprofessionals to navigate, with the potential to take outsome transactional costs.

Personalised care delivery and multidisciplinary workinghas already brought a 14% reduction in avoidablehospital admissions, together with an improvement inthe quality of care delivered.


Follow us: @NHSngccg @GMBCouncil


26. East and North Hertfordshire ClinicalCommissioning GroupPARTNERSEast and North Hertfordshire Clinical CommissioningGroup, Hertfordshire County Council and the CareHome Providers Association.

East and North Hertfordshire Clinical CommissioningGroup covers a population of 580,000.

AIMThis vanguard aims to facilitate all parts of the healthand social care system to work together to do more tolook after vulnerable patients in care homes and preventthem having to make unnecessary trips to hospital.

OUTLINEPatients living in care homes are often some of the area’smost vulnerable patients. Most have more than one longterm medical condition, such as diabetes, breathingproblems or heart disease and often need to take severalmedications. These patients can also become very unwellvery quickly and can sometimes need to be rushed tohospital because their condition has deteriorated.

This vanguard will focus on improving services for thesepatients in a number of ways.

It will enhance the skills of care home staff through apackage of education and training, so that patients withcomplex care needs can be looked after with confidence.It will also create teams of GPs, district and practicenurses, mental health nurses, older people’s specialistsand pharmacists, who will work closely with care homestaff to support residents.

The vanguard aims to bring together ‘rapid response’teams of community nurses, matrons, therapists andhome-carers who can get to care homes within 60minutes, as an alternative to sending elderly patients toA&E, when that is in their best interests.

There will also be an investment in technology to give allGPs access to comprehensive information about eachcare home resident when they visit them.


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27. Nottingham City ClinicalCommissioning Group PARTNERSNottingham City Clinical Commissioning Group inpartnership with the Care Home Steering Group whichincludes Nottingham CityCare Partnership, NottinghamUniversity Hospitals, Nottinghamshire Healthcare Trust,Age UK Nottingham and Nottinghamshire, Care HomeManagers Forum, Nottingham City Council andNottingham University.

The organisations jointly serve a population of more than314,000 people.

AIMNottingham City’s vision is for care home residents to behealthier, have a better quality of life and to be treatedwith dignity and respect. This vanguard will focus on thecapabilities of those living in care home settings ratherthan their dependencies with the aim that all residents,and their families, are able to enjoy a positive experienceof care.

OUTLINECare home residents, commissioners and providers arecommitted to working together to transform the modelof support provided to care homes by developing avalue-based approach. To support the transformation ofservices, providers will be given greater freedom toinnovate in the way they deliver health and care serviceswhilst being held to account for the outcomes and costsof care.

The vanguard wants to remove organisational barriers,implement new technology and ensure that care homestaff have support from specialist health services toidentify, understand, manage and respond to theeveryday impact of providing essential care. Residentswill receive coordinated care from GPs and specialisthealth professionals in partnership with social care andtheir care home staff. These partnerships are essentialand will be built on reliable communication and trustbetween teams and individuals through a sharedambition to transform services for care home residentsand their families.


Follow us: @NHSNottingham


28. Sutton Homes of CarePARTNERSNHS Sutton Clinical Commissioning Group, the LondonBorough of Sutton, Epsom and St Helier Hospitals NHSTrust, St Raphael’s Hospice, Sutton and MertonCommunity Services (the community division of TheRoyal Marsden), Age UK Sutton, South West Londonand St George’s Mental Health Trust, The Alzheimer’sSociety, London Ambulance Service and Sutton Centrefor the Voluntary Sector.

Sutton Clinical Commissioning Group serves apopulation of over 190,000.

AIMThe aim of this vanguard is to work together with localcare home providers and communities to provide highquality care that enhances the health and wellbeing ofcare home residents, as well as proving to be financiallybeneficial to the tax payer.

OUTLINEThe vanguard has introduced a number of interventionsincluding the development of a community team to helpprevent unnecessary admissions to hospital and theestablishment of end of life care nursing teams. Theyhave also set up a joint intelligence group andestablished forums for care home managers and seniornursing staff to share best practice, education andtraining.

These interventions have already demonstrated not onlyan increase in the quality of care provided to residents,but have also shown a reduction in pressures on thehealth system.

Whilst much has already been achieved, the vanguardbelieves that further work could bring even greaterbenefits not only the population of Sutton, but also carehome residents nationally through replication ofsuccessful strategies.


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29. Airedale & PartnersPARTNERSAiredale & Partners vanguard is a partnership of over 15organisations in Yorkshire and Lancashire and includesthree hospitals, GPs, three councils, communityhealthcare, IT partners and a range of independent carehome providers.

The organisations jointly serve a population of more than 750,000 people.

AIMThe vanguard is being led by doctors, nurses, and otherhealth and social care professionals, and its main aim isto improve the quality of life and end of life care ofthousands of nursing and care home residents.

OUTLINEThis vanguard is using technology to improve care locally.Improvements include supporting residents who are sickby providing a secure video link to senior nurses so theycan remain in the care home, where safe to do so.

This means patients have, at the touch of a button, 24/7 access to local care and support.

This helps residents remain active and independent, andreduces hospital admissions and A&E and GP visits,including people with breathing problems, heartconditions and dementia.

The vanguard also aims to help residents improve theirhealth and wellbeing, including older, vulnerable peoplewho are most at risk of getting sick. Using remotetechnology, such as telemedicine, doctors and nurses canmonitor people on screen to stop them from becomingill or provide care earlier.

Technology partners are also helping to support a sharedpatient record, including real time information, which issafer, quicker and avoids duplication.


Follow us: @SuttonHoC

Follow us: @AiredaleNHSFT

The vanguards: urgentand emergency care


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30. Greater Nottingham System Resilience GroupPARTNERSNottingham University Hospitals NHS Trust, The SouthNottingham and Erewash clinical commissioning groups,Nottingham City and County Councils, East MidlandsAmbulance Service, Nottingham CityCare Partnerships,County Health Partnership, Nottinghamshire HealthcareNHS Foundation Trust, Derbyshire Health United Ltd(111 provider), Nottingham Emergency Medical Services(GP out of hours), Healthwatch Nottingham andHealthwatch Nottinghamshire.

This vanguard has a population of 685,000.

AIMThe partners which form this vanguard are supportingambitious improvements to urgent and emergency careservices across South Nottinghamshire.

OUTLINEThey are looking at what more they can do, usinginnovative workforce solutions, to ensure that peoplereceive care in a timely way and closer to home - inmany cases avoiding the need for assessment oradmission to hospital.

In particular they will focus on enhancing mental healthservices in the community to ensure that patients get thecare they need, in the right setting and in a timelymanner. This will include rolling out and extending theNational Mental Health 111 pilot to provide faster andbetter care when it is needed.

The vanguard will also be working to improve access toprimary care clinicians at the ‘front door’ of theemergency department as well as clinical assessmentsand treatment to allow patients to be assessed and thenfollowed up closer to home. The team is also enablingmore direct clinician to clinician conversations so that agreater number of patients are directed to the rightservice, first time, every time.

The system will involve patients, carers and widerpartners to lead the way in developing more timely andsafe emergency care.

Follow us: @NHSNottingham


31. Cambridgeshire and Peterborough ClinicalCommissioning GroupPARTNERSCambridgeshire and Peterborough ClinicalCommissioning Group (CCG) has three System ResilienceGroups (SRG) and is part of the East of England Urgentand Emergency Care Network.

This vanguard covers a population of 950,000.

AIMThe clinical commissioning group’s vision is to create anoverarching super system resilience group with strongclinical leaders, as part of the existing network.

As an urgent and emergency care vanguard the CCG willaccelerate improvements and develop a best practicemodel for urgent care services. In particular it aims toaddress variations in access to services and healthinequalities in the region.

OUTLINEThis vanguard’s new super SRG will focus on providinghighly responsive urgent care services outside of hospitaland promoting self-care and management. It will workto help people with urgent care needs get the rightadvice first time, and to access the right service sevendays a week.

In order to meet these needs the vanguard’s plansinclude developing the right workforce including GPFellows; Advanced Nurse Practitioner and advanced AHProles; developed community pharmacist roles; physician’sassistants, and staff equipped to meet mental andphysical health needs.

There will also be a reassessment of service standardsbased on outcomes and a redefinition of paymentmethods to incentivise system redesign.


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32. North East Urgent Care NetworkPARTNERSAcademic Health Science Network, Clinical HealthInformation Network, Health Education North East, NineStrategic Resilience Groups and associated members,North East Ambulance Service NHS Foundation Trust,North East Local Authorities, North of EnglandCommissioning Support, Regional Out of HoursProviders, Royal College of Psychiatry, VoluntaryOrganisations’ Network North East.

This Network covers areas around Northumberland, Tees, Esk and Wear Valley, Newcastle, Northumbria,Gateshead, Tyneside, Sunderland, County Durham,Darlington and Hartlepool – a region with a populationof 2.71 million.

AIMThe North East Urgent Care Network– which consists ofall the key physical, mental health and care stakeholdersand providers – already has a strong history of workingcollaboratively to deliver successful innovative projects.These support the recommendations made in the Urgentand Emergency Care Review as well as, importantly,improving patient outcomes and experience, benefitingthe whole of the North East region.

OUTLINEThis programme will enable the Network to transformthe regional urgent and emergency care system and itsservices to further improve consistency and clinicalstandards, reduce fragmentation and deliver high qualityand responsive health and social care to patients.

It will also enable them to move at pace in terms ofcreating and implementing one urgent and emergencycare model as well as giving strategic oversight to urgentand emergency care services across the region. This willprovide consistent and seamless care, wherever patientspresent, whatever the day or hour with no difference intheir clinical outcomes.


Follow us: @fitforfuturenhs


33. Barking and Dagenham, Havering andRedbridge System Resilience GroupPARTNERSBarking and Dagenham, Havering and Redbridge ClinicalCommissioning Groups, Barking, Havering andRedbridge University Hospitals NHS Trust, North EastLondon NHS Foundation Trust, London Borough ofBarking and Dagenham, London Borough of Havering,London Borough of Redbridge, Together First (Barkingand Dagenham GP Federation), Havering Health(Havering GP Federation), Healthbridge Direct (RedbridgeGP Federation), Partnership of East LondonCooperatives, London Ambulance Service, NHS EnglandArea Team, Healthwatch, Local PharmaceuticalCommittee.

This vanguard has a population of 750,000.

AIMBarking and Dagenham, Havering and Redbridge SystemResilience Group (SRG) aims to create a simplified,streamlined urgent care system delivering intelligent,responsive urgent care for its residents which live in oneof the most challenged health economies in the country.

OUTLINEThe SRG believes there is a need to do things differentlyand that patients are confused by the various urgent andemergency care services available to them – A&E, walk-incentre, urgent care centre, GPs, pharmacists, out ofhours services.

Becoming an urgent and emergency care vanguardsupports the SRG in its ambition to streamline thesepoints of access to just three – supported by a smartdigital platform that will recognise patients andpersonalise the help they get as soon as they get incontact. This involves:

1. ‘Click’ – online support and information – will help people to self-care and book urgent appointments when needed.

2. ‘Call’ – telephone for those who need more advice, reassurance or to book-in.

3. ‘Come in’ – where patients really need emergency care – the front door of the hospital will become new ambulatory care centres.

This ambitious plan is being developed with patients andstaff, and will be implemented by building on existingsuccessful partnership working between NHS and socialcare organisations locally.


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34. West Yorkshire Urgent Emergency Care NetworkPARTNERS10 West Yorkshire Clinical Commissioning Groups;Harrogate and Rural Districts CCG; Five West Yorkshireplus Harrogate system resilience groups includingprimary care and local authority partners; Seven NHSacute and community providers; Three NHS mentalhealth service providers; Three providers of district-wideservices; Yorkshire and Humber Academic HealthScience Network; West Yorkshire HealthWatchorganisations; NHS England Yorkshire and Humber;Yorkshire Ambulance Service.

This vanguard reaches a population of 3 million people.

AIMThis vanguard’s collective local vision is that all children,young people and adults with urgent and emergencyneeds in West Yorkshire will get the right care in theright place, first time, every time.

OUTLINETo achieve this the vanguard will transform servicesprovided by local community and primary care andprovide urgent acute and mental health services out-of-hospital where appropriate. There will also be a focus onself-care with individuals and communities provided withthe support they need to self-care.

The vanguard will also work to ensure that emergencymedical centres have the facilities and expertise neededto provide the highest levels of care and there will beimproved integration of information and services tostreamline the system.

This vanguard is building on the firm foundation ofexisting network activity, shared learning and system-wide leadership to deliver the five principles set out inthe national Keogh Urgent Care Review.


Follow us: @BHRpartnership


35. Leicester, Leicestershire & Rutland SystemResilience GroupPARTNERSLeicester City, East Leicestershire and Rutland and WestLeicestershire Clinical Commissioning Groups; the threeupper tier local authorities (Leicester City, LeicestershireCounty, and Rutland County); Arriva (patient transportservice); University Hospitals of Leicester NHS Trust; EastMidlands Ambulance Service; Leicestershire PartnershipNHS Trust; George Elliott (Leicester Royal InfirmaryUrgent Care Centre); CNCS (GP out of hours/Loughborough Urgent Care Centre); Derbyshire HealthUnited (NHS 111); Soldiers, Sailors Airmen and FamiliesAssociation (acute visiting services).

This vanguard has a population of 1.1 million.

AIMThis vanguard’s vision is for a new urgent and emergencycare model that blurs organisational boundaries, andclearly defined outcomes enabling it to be responsive tothe needs of its diverse city/county population. It alsoaims to develop a model which will be replicablenationally.

This vision forms part of a five-year whole-systemreconfiguration plan signed up to by all localcommissioners and providers.

OUTLINEThe vanguard will create a new alliance-based urgentand emergency care system where all providers work asone network. This will bring together ambulance, NHS111, out-of-hours and single point of access services toensure that patients get the right care, first time.The network will include a same-day response team withGPs, acute home-visiting and crisis response services,community nursing, older peoples’ assessment unit andurgent care centres.

University of Leicester Hospitals NHS Trust runs thelargest single site A&E department outside of London. In2016, the hospital’s urgent and emergency care frontdoor will be re-launched to include an assessment teamwith the ability to refer patients to ambulatory clinics,assessment beds, on-the-spot urgent care centres orprimary or community care.

The vanguard also has plans to work with the nationalteam, IBM and Loughborough University to develop ademand and activity model, using realtime data toinform providers’ and patients’ choices.


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36. Solihull Together for Better LivesPARTNERSHeart of England NHS Foundation Trust (includes acuteand community services); Birmingham and SolihullMental Health NHS Foundation Trust; SolihullMetropolitan Borough Council; NHS Solihull ClinicalCommissioning Group; Voluntary and Community Sectorproviders; Primary Care (including confederation of GPpractices in Solihull); West Midlands Ambulance Service;West Midlands Police; West Midlands Academic HealthSciences Network; Lay members representative of serviceusers, carers and the wider Solihull community.

The population in this area is 210,000.

AIMThe local Solihull vision is to create an integrated healthand care system that optimises wellbeing throughpreventative and out-of-hospital care, with rapid accessto specialist services. The vanguard has the ambition toextend healthy active life and independence with equalfocus on physical and mental health. This will beachieved by encouraging healthy lifestyle choices, careco-ordination and empowerment to self-manage long-term conditions which will reduce pressure on secondarycare services and alter the balance of care provided inhospital and the community.

OUTLINEThis vanguard’s programme is delivering an integratedapproach to urgent and emergency care, whichincorporates a number of elements.

Patients and carers will be supported in their homes andat the ‘Health and Wellbeing Campus’ (on the hospitalsite) through open and accessible information andservices using various portals, building on the localauthority ‘Solihull Connect’ service.

There will also be integrated community teams whichinclude improved access to diagnostics and secondarycare specialists supported by innovative informationtechnologies.

Mental health services will be enhanced - building onrapid assessment interface and discharge, street triage,dementia and delirium team and outreach.

Finally the vanguard plans to build an urgent care centrethat includes GP out-of-hours, walk-in and minor injuriesservices within the hospital site as part of the ‘Healthand Wellbeing Campus’.


Follow us: @UrgentCareLLR

Follow us: @SolihullCouncil @SolihullCCG@heartofengland @bsmhft

The vanguards: acute care collaborations


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#futureNHS

37. South Devon and Torbay System Resilience GroupPARTNERSSouth Devon and Torbay Clinical Commissioning Group;South Devon Healthcare Foundation Trust; Torbay andSouthern Devon Health and Care Trust; Torbay Council;South Western Ambulance Services Foundation Trust;Devon Doctors Ltd; Community pharmacy (via LocalPharmaceutical Committee).

This vanguard has a population of 287, 594.

AIMAs a vanguard this System Resilience Group will be ableto move quickly on the implementation of its urgent carestrategy, transforming the local urgent care system, for asustainable future. This strategy aims to make the bestuse of the resources spent locally on urgent andemergency care - deriving greater quality and value formoney by avoiding duplication of effort, first time.

OUTLINEThe model enables the vanguard to implement two setsof priorities, for 2016 and 2017.

For next year, the priorities will include the rapiddevelopment of urgent care centre (UCC) facilities in atleast two centres, prioritising areas of higher deprivationto reduce inequalities. The vanguard will also shareprimary care records with the out-ofhours provider, andco-locate primary care facilities with A&E/UCC facilities inat least two locations.

The following year’s priorities will include making a fullcomplement of urgent care centres available. There willalso be the co-location of primary care in all A&E/UCCfacilities, as well as the decrease in 999 conveyance toA&E of at least 5%.


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#futureNHS


38. Salford and Wigan Foundation Chain PARTNERSSalford Royal NHS Foundation Trust and Wrightington,Wigan & Leigh NHS Foundation Trust.

This vanguard serves around 2 million patients.

AIMThe aim of the two organisations is to create ahealthcare group that will deliver faster improvements inpatient outcomes and greater productivity.

OUTLINESalford Royal NHS Foundation Trust and Wrightington,Wigan and Leigh NHS Foundation Trust are workingtogether with Devo Manc partners to create a newhealthcare group. This will help them to increase thepace at which they are able to make improvementswhich will result in better outcomes for their patientsand increases in productivity.

They are working in partnership with commissioners andprovider organisations across the region to create anIntegrated or Accountable Care type organisation and asingle service model for elective and specialist services.


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39. Northumbria Foundation GroupPARTNERSNorthumbria Healthcare NHS Foundation Trust supportsa number of organisations in the North East and acrossEngland.

The population served by the Foundation Group willdepend on which partners are identified.

AIMThe Trust aims to create a Foundation Group that drivesefficiency and clinical effectiveness within the NHS anddelivers high quality patient care for the long term.

OUTLINENorthumbria Healthcare NHS Foundation Trust’s plans tocreate a Foundation Group will widen the support andservices it can provide to other organisations.

The Trust is already supporting a number oforganisations within the North East and across England(including North Cumbria University Hospitals NHS Trustfor which it is the appointed acquisition partner andbuddy), and will use the development of the FoundationGroup as a vehicle to better coordinate and furtherdevelop this support.

Through the Foundation Group, the Trust and itspartners could support others more effectively in a rangeof ways, these include: acquiring and/or merging otherhospital trusts; providing corporate services to other NHSorganisations; and creating a standard operating modelbuilt on providing excellent clinical outcomes.

This will benefit patients by helping partnerorganisations to be more efficient and to make sure thatpatients are receiving the best possible care and thathigh quality services are more sustainable for the future.


Follow us: @SalfordRoyalNHS @WWLNHSFollow us: @northumbrianhs


40. Royal Free LondonPARTNERSPotential partners will be identified as the proposal isdeveloped but the trust plans to work with Salford RoyalNHS Foundation Trust and Northumbria Healthcare NHSFoundation Trust to develop proposals on a groupmodel.

The population served by this vanguard is dependent onwhich partners are identified.

AIMThe trust is interested in exploring horizontal growth tofind ways to improve the quality of patient care whilealso reducing the cost to the healthcare economy as awhole.

OUTLINEThe Royal Free London NHS Foundation Trust plans tobecome the heart of a group that other organisationswill want to collaborate with.

The trust is considering options including buddying,merging specific office functions and other innovativemodels such as joint clinical and corporate ventures.

The key benefits of this approach are that it wouldreduce the variation patients can experience in care,increase efficiency and identify ways that high qualityservices can be delivered at reduced cost.


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41. Foundation Healthcare Group (Dartfordand Gravesham)PARTNERSDartford and Gravesham NHS Trust (DGT); Guy's and StThomas' NHS Foundation Trust (GSTT).

AIMDartford and Gravesham NHS Trust is exploring andmoving into one of the first Foundation Group modelswith Guy's and St Thomas' NHS Foundation Trust on amanagement contract basis.

OUTLINEThe Trusts are working together to assess the benefitsfor patients and staff of becoming one of the firstFoundation Groups. These groups will involve differenthospitals working closer together, offering clinicalservices into another site, and sharing corporate servicesvia a management contract.

At present DGT is unsustainable in its current form. Thepartnership’s vision is to create a sustainable care systemfor Dartford and Gravesham, with DGT patientsbenefiting from greater integration locally with primary,community, and mental health partners; secondary carepartners and a more seamless transition to specialist andtertiary care at GSTT when required. The proposal willalso respond to expected population growth in the area(at Ebbsfleet).


Follow us: @darentvalleyhsp


42. Moorfields PARTNERSMoorfields Eye Hospital NHS Foundation Trust.

The potential patient population of this vanguarddepends on which partners are identified..

AIMThe Trust aims to learn from its experience of existingsatellite models to develop future networks and sharegood practice across the wider NHS.

OUTLINEMoorfields Eye Hospital NHS Foundation Trust alreadyruns services in 22 locations in and around London in avariety of healthcare settings, but recognises that thismodel has grown in response to ad hoc requests.Therefore it aims to identify the best approach toestablishing and sustaining a chain of services and toproduce a toolkit which can be used to roll out servicelevel chains regardless of the specialty to benefit patientsin other parts of the NHS.

In addition to analysing the best approach for asuccessful chain of services, the Trust will also explorethe opportunities and risks associated with running anextended network of eye services, based on increasingthe number of Moorfields satellite sites and wideningthe Trust’s geographic reach.


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43. National Orthopaedic Alliance PARTNERSRobert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust in Oswestry; Royal NationalOrthopaedic Hospital NHS Trust in Stanmore and RoyalOrthopaedic Hospital NHS Foundation Trust inBirmingham.

This vanguard has national reach.

AIMThe National Orthopaedic Alliance vanguard aims tocreate a UK-wide franchise or chain of orthopaedicproviders to deliver outstanding and consistent care inmore areas.

OUTLINEThe vanguard partners will explore formal ways ofcollaborating more closely to explore how they couldextend their model more widely across the country. Thiswork builds on their already established base ofcollaboration and will formalise the way organisationswork together on a clinical basis as well as through backoffice functions.

The vanguard will also explore the possibility of enablingexemplar orthopaedic services to be offered on afranchise model across England. Their work will includedeveloping a single common model for NHS franchisingthat can be picked up by any speciality; to implementbest practice; to identify ways of expanding across awider geography; and to ensure that scale brings with itstronger local patient and community involvement.

For patients this could help deliver higher quality caremore consistently across the country and also provide anew model for smaller hospitals and specialist providers.


Follow us: @rjah_NHS @ROHNHSFT @RNOHnhs


44. The Neuro Network (The Walton Centre, Liverpool) PARTNERSThe Walton Centre NHS Foundation Trust; Warringtonand Halton Hospitals NHS Foundation Trust; LiverpoolClinical Commissioning Group; Warrington ClinicalCommissioning Group; NHS England Specialised ServicesCommissioning Team (North).

This vanguard reaches 3 million patients.

AIMThe Neuro Network aims to work with its partners todevelop a high quality and cost effective neuroscienceservice chain.

OUTLINEThe programme will build on partners’ extensiveexperience in developing the network models forneurology and spinal services in Cheshire andMerseyside. It will also strengthen the neurologicalsupport provided by the Walton Centre to local hospitals,GPs and patients, and look to extend the spinal model inpartnership with The Royal Liverpool & BroadgreenUniversity Hospitals and Aintree University Hospital. Thisapproach enables patients to have rapid access, locally,to high quality care from a regional specialist centre.


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45. MERIT (Mental Health Alliance for Excellence,Resilience, Innovation and Training) (West Midlands) PARTNERSBirmingham and Solihull Mental Health NHS FoundationTrust, Black Country Partnership NHS Foundation Trust,Dudley and Walsall Mental Health Partnership NHS Trustand Coventry and Warwickshire Partnership NHS Trust.

This vanguard has a patient population of 3.4 million.

AIMThis vanguard aims to share best practice and createreplicable models for long-term clinically and financiallysustainable specialist mental health services. They willwork together to solve efficiency, workforce, equalityand policy implementation challenges.

OUTLINEMERIT will focus on three priority areas where thegreatest challenges for urban mental health servicesexist. These are seven day working in acute services;crisis care and reduction of risk; and recovery andrehabilitation. In these areas better integration acrossorganisations will aim to improve quality and increaseefficiency rapidly while reducing variations and spreadingbest practice.

Service users will benefit from faster decision making,such as discharges seven days a week and a co-ordinatedemergency response. They will also have a shared careplan, meaning just one assessment and only having totell their story once.

The vanguards will also be providing more support forrecovery in the community to reduce the chance of arelapse or return to secondary care services; and lessunnecessary time spent in A&E or police cells.


Follow us: @waltoncentreFollow us: @MERITvanguardwm


46. Cheshire and Merseyside Women andChildren’s ServicesPARTNERSAlder Hey Children’s NHS Foundation Trust; Countess ofChester Hospital NHS Foundation Trust; LiverpoolWomen’s NHS Foundation Trust; Mid Cheshire HospitalsNHS Foundation Trust; Southport and Ormskirk HospitalNHS Trust; St Helens and Knowsley Teaching HospitalsNHS Trust; Warrington and Halton Hospitals NHSFoundation Trust; Wirral University Teaching HospitalNHS Foundation Trust; NHS Halton ClinicalCommissioning Group (CCG), NHS Knowsley CCG, NHSLiverpool CCG, NHS St Helens CCG, NHS South SeftonCCG, NHS Southport and Formby CCG, NHS WarringtonCCG, NHS West Lancashire CCG, NHS Wirral CCG, NHSWest Cheshire CCG; Cheshire and Merseyside Maternity,Children and Young Strategic Clinical Network; NorthWest Neonatal Operational Delivery Network; AdultCritical Care Operational Delivery Network.

2.4 million people could benefit from the work of thisvanguard.

AIMThis vanguard aims to develop a clinically managednetwork for women’s and children’s services (includingmaternity, gynaecology, neonatal and paediatric services)across Cheshire and Merseyside in order to furtherimprove quality and ensure services are clinically andfinancially sustainable.

It has the backing of all provider trusts, clinicalcommissioning groups and networks across Cheshireand Merseyside.

OUTLINEThe vanguard will address the challenges facing servicesfor women and children locally by creating a newapproach between commissioners, clinicians andproviders that goes beyond organisational boundaries.

These challenges include a greater demand for servicesand an increase in patients with more complex needs aswell a variation in quality of services. No singleorganisation, commissioner or provider can alone resolvethese issues and this vanguard will also alloworganisations to work together to tackle challengesaround workforce like recruitment, retention, retirementand skills mix, as well as overall financial sustainability.

Working more closely together will also allow thevanguard to better engage with the people who usetheir services and create a more personalised offer forthem.


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47. Accountable Clinical Network for Cancer (ACNC)PARTNERSThe Royal Marsden NHS Foundation Trust, The ChristieNHS Foundation Trust and UCLH (University CollegeLondon Hospitals NHS Foundation Trust).

The partners in this vanguard jointly support apopulation of 10.7 million

AIMIndividual networks led by The Royal Marsden NHSFoundation Trust, The Christie NHS Foundation Trust andUCLH (University College London Hospitals NHSFoundation Trust) will work together to develop plans forimplementing Accountable Clinical Networks for Cancer,capable of being reproduced nationally.

OUTLINEWorking with a range of partners, including Devo Mancpartners in Manchester, this vanguard will supportintegration across the entire cancer patient pathway(including public health, primary care and diagnostics), inorder to secure improvements in delivering patientcentred, quality and more financially sustainable cancercare.

Working together the networks will focus on a numberof areas. These include improving early diagnosis anddetection of cancer by taking advantage of the scale andpace working together will allow. The aim of this will beon driving improvements in clinical outcomes,particularly around patient survival rates through analignment of objectives and focussed leadership acrosscancer services at a local level and less variation in accessand outcomes.

Patients should also see an improvement in theirexperience across the whole pathway from diagnosis toliving with and beyond cancer.


Follow us: @LiverpoolWomens

Follow us: @royalmarsden @uclh@TheChristieNHS


48. EMRAD - East Midlands RadiologyConsortiumPARTNERSChesterfield Royal Hospitals NHS Foundation Trust,Kettering General Hospital NHS Foundation Trust,Northampton General Hospital NHS Trust, NottinghamUniversity Hospitals NHS Trust, Sherwood ForestHospitals NHS Foundation Trust, United LincolnshireHospitals NHS Trust, University Hospitals of Leicester NHSTrust.

The population covered by this vanguard isapproximately 6 million patients in the East Midlands.

AIMEMRAD - East Midlands Radiology Consortium is aconsortium of seven NHS trusts within the East Midlandsworking together, hosted by Nottingham UniversityHospitals NHS Trust. Together they aim to create aclinical network, providing timely and expert radiologycare for patients across the East Midlands regardless oftheir location. Once developed, this Network will be seenas a national benchmark for new models of clinicalcollaboration within NHS radiology services.

OUTLINEIn order to achieve this vision they will deliver a numberof improvements. They have already started work onpurchasing a shared, technical system to allow access topatient radiology images at the point of clinical need. Inorder to maximise the benefits of this technicalinvestment they will develop and implement newregional systems of governance, patient consent,commissioner support and education.

The vanguard also has plans to develop a collaborativenetwork of services, aided by the shared technicalsystems, which support network-wide clinical care forpatients. They hope to develop a mechanism forworking regionally, bringing work back into the NHSwhich is currently being delivered in other sectors,providing expert trusted opinions within the NHS, andsupporting both large and small trusts by creating cross-trust expert radiology networks.


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49. Developing One NHS in Dorset PARTNERSDorset County Hospital NHS Foundation Trust; PooleHospital NHS Foundation Trust; The Royal Bournemouthand Christchurch Hospitals NHS Foundation Trust.

Patient population: 850,000.

AIMThe recent Dorset Clinical Services Review, had a visionof sustainable models of care for in- and out-of-hospitalcare, to meet the needs of local people 24 hours a day,seven days a week. The three district hospital providersin Dorset aim to use a multi-service joint venture todeliver this vision and ensure the future sustainability ofhealth services in Dorset.

OUTLINEPatients will benefit from a reduction in avoidablevariations in care, the implementation of standardisedbest practice and the spread of service innovation. Therewill be a more equitable delivery of services to patientsacross the whole of Dorset, with the clinical network(s)organised to ensure that all patients have faster access toa consistent, high standard of care irrespective of wherethey live.

It is envisaged that there will be movement to a singleshared rota for some agreed clinical services acrossDorset which will ensure the best use of senior clinicians.The creation of job plans that allow for the recruitmentand retention of high calibre clinicians will facilitate thedevelopment of sustainable clinical models.


Follow us: @emradNHS

Follow us: @poole_hospital @DCHFT@RBCH_NHS

50. Working Together Partnership (SouthYorkshire, Mid Yorkshire, North Derbyshire)PARTNERSSheffield Teaching NHS Foundation Trust, SheffieldChildren’s NHS Foundation Trust, Barnsley Hospital NHSFoundation Trust, Doncaster and Bassetlaw NHSFoundation Trust, Rotherham NHS Foundation Trust, MidYorkshire Hospitals NHS Trust, Chesterfield Royal NHSFoundation Trust.

The population covered by this vanguard is 2.3 million.

AIMThe programme aims to develop a clinical strategyinvolving different models highlighted in the DaltonReview.

OUTLINEThe Provider Working Together Partnership is an existingpartnership established in March 2013 between sevenacute trusts in South Yorkshire, Mid Yorkshire and NorthDerbyshire. The partners are focussing on key areas likedelivering a seven day service and improving patientcare. The partners also plan to develop solutions andmodels for joint ventures on shared services and to workacross organisational boundaries.

Models will include greater use of networking, sharing ofclinicians across sites and delivery of specialist anddiagnostic services across a number of differentproviders. The focus will be on making sure that localservices are both clinically and financially viable in thefuture.


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#futureNHS

Follow us: @MidYorkshireNHS @DBH_NHSFT@SheffChildrens @royalhospital@RotherhamNHS_FT @SheffieldHosp@barnshospital @MidYorkshireNHS

#futureNHS

The new care model vanguards are about delivering real change for patients and staff. Working with clinicians and the people who use their services, they are developing a blueprint for the future of NHS and care services across England. They’re being led locally, but with national support to help them move forward at pace and to unlock barriers that get in their way.

Samantha JonesDirector - New Care Models Programme@SamanthaJNHS

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NHS England Publication Gateway Reference: 04386

For more information visit:

www.england.nhs.uk/futureNHS

#futureNHS

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